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Objective:Goiter is endemic in Iran. The iodine deficiency disorders program was begun a few years ago in Iran, and the coverage of iodized salt is sufficient now. But, in a periodic yearly medical examination of primary school girls in Qom, the prevalence of goiter was above 30% in 2002. This survey was designed to study the risk factors of goiter in those students.Design:The study was a randomized (multistage, proportional simple random sampling) case–control study.Subjects and interventions:We selected and performed thyroid examinations in 1050 girl students in primary schools in Qom city of Iran in 2002. We found 284 cases: girls in primary schools had goiter in accordance with the clinical exam of World Health Organization classification. Among students who did not present with goiter in the clinical exam, we randomly selected 288 students as the control group. We used a questionnaire to evaluate them for the risk factors of goiter.Results:The mean±s.d. ages of cases and controls were 8.7±1.3 and 8.9±1.3 years, respectively. There is no significant difference between the two groups regarding history of soya, kale, turnip, fish, daily iodized salt usage, education and job of mothers, monthly family income, nationality, immigration and residential situation. By using multinomial logistic regression, we found that storage of iodized salt in open containers, odds ratio (OR): 2.201 (1.412–3.428); P-value <0.0001, medium socioeconomic situation (SES) of family, OR: 2.099 (1.029–4.282), P-value=0.041, district 2 of Qom city, OR: 2.880 (1.376–6.027), P-value=0.005, and district 3 of Qom city, OR: 2.051(1.032–4.078), P-value=0.041, were the major risk factors for goiter in this population.Conclusions:In this study, the main risk factors for goiter were storage of iodized salt in open containers, medium SES and also living in specific districts of Qom city. As the coverage of iodinized salt is over 95% in Iran, we advise the education of the family about storage of iodized salt in closed containers. We also recommend the study of the other risk factors of goiter in the different geographical areas of Iran, because of differences in the SES and nutritional habits.Sponsorship:This study was supported by issuing permission letters for our activities: (not funding support) Qom Health Network and Medical Services, Qom Medical University, Qom Primary School Education Office, Fathemieh Medical University.European Journal of Clinical Nutrition (2006) 60, 426–433. doi:10.1038/sj.ejcn.1602335; published online 23 November 2005 [ABSTRACT FROM AUTHOR]

Background: Mortality rate in rural areas is a useful measure of the health of the population and the function of the health system, which varies over space and time. The objective of this research is to explore the spatial and temporal variations in the rural mortality rate in Iran at the county level in 2006, 2011, and 2016., Methods: data were gathered from the rural population and mortality statistics published by the Statistical Centre of Iran (SCI) and the National Organization for Civil Registration (NOCR). Global spatial patterns were assessed using the global Moran's I and local clusters through the local Moran's I., Results: Spatial distribution of rural mortality rate shows that during the years under study the number of counties with a lower rate has increased. The counties with rate of less form continuous areas in the southwest, central and east regions. The excess risk map reveals significant variations in both value and extent. Also, the values of Moran's index increased from 0.1848 in 2006 to 0.4041 in 2016, which indicates the strengthening of the cluster spatial pattern of the overall rural mortality rate. Local patterns have undergone substantial changes over space and time., Conclusion: The findings indicate significant spatial and temporal variations in rural mortality rates in Iran. Policy-makers can use this information to plan and enhance healthcare infrastructure in specific counties. The findings serve for evaluating the effectiveness of health policies, enabling policy-makers to make informed decisions, allocate resources efficiently and design targeted interventions for improved public health outcomes., (© 2024 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

To determine the safety and efficacy profile of teenager COVID-19 vaccination. In this retrospective cohort study, contact numbers of parents of teenagers under 18 years of age referred to a teenager vaccination centers in Tehran-Iran to receive the corona vaccine were collected, and the following information was obtained via the phones: demographic information, type of vaccine, and the number of doses received, as well as additional information like complications and required treatments. Eleven thousand forty-two subjects aged 10-18 years, mean age 14.55 ± 1.83 year  including 5374 boys and 5768 girls were investigated. 88.1% received the Sinopharm and 11.9% the Soberana vaccine. General side effects, including fatigue, fever and chills, injection site pain and dizziness, and so forth happened in 2978 cases; 7421 children presented with at least one general or organ-specific side effect following vaccination, including potentially critical side effects, such as vascular injuries, respiratory complication, and so forth. 0.1% of the subject needed hospital admission. The breakthrough infection happened in 200 individuals. Our study shows that Sinopharm and Soberana (PastoCoVac) COVID-19 vaccines are generally safe with no serious side effects in less than 18 years old. COVID-19 infection and reinfection can occur after vaccination, but the incidence is actually tolerable and significantly lower than in the unvaccinated group., (© 2022 Wiley Periodicals LLC.)

Background: Inappropriate admission and hospitalization days are the factors that impose more costs to hospitals. By considering current condition of hospitals, it is vital to have an insight into the data on inappropriate admission and hospitalization days in order to eliminate obstacles to the proper and appropriate hospitalization., Methods: In this study, 198 patients who were admitted to receive surgical or non-surgical treatment in Sina public hospital were selected. An appropriateness Evaluation Protocol (AEP) was used for data collection. The validity of AEP is well established by the preceding studies. In order to achieve the study objectives, binary logistic regression test was used., Results: According to our findings, 39.4% of hospitalization days and 16.2% of admissions are inappropriate. In this study, inappropriate admission was observed among married patients eight times more than among single ones. Inappropriate hospitalization days were 12 times more prevalent among patients from provinces than among those from Tehran. With increasing age of the patient the probability of inappropriate admission decreases slightly, i.e. the probability of inappropriate admission decreases 10% as the age increases one year. The number of hospitalization days was significantly correlated to the following parameters: type of admission, patient's city of residence, type of treatment, and length of stay (P < 0.05)., Conclusion: Regarding the results of this study, a large number of admissions and specially hospitalization days are inappropriate. According to other studies, with suitable programming many inappropriate admissions and hospitalization days are preventable.

Background: E-health encompasses a wide scope and has excellent potential to grow in the future. Growing numbers of experts believe that e-health will fuel the next breakthroughs in health system improvements throughout the world. There is frequent evidence that largely indicates failures or unsustainable e-health implementations in different countries for different reasons. Iran is also a developing country that is presently applying this promising technology for its traditional healthcare delivery., Materials and Methods: Two phases of research have been carried out for this study. In the first phase, a general Internet search was performed in different databases to extract e-health implementation activities in the world, particularly in Iran. MEDLINE and laboratory research were used for this purpose, using the key words "information technology," "e-health," "health IT," "health informatics," "health," and "Iran." In the second phase, a panel of experts from Isfahan, Iran, who specialized in e-health applications, was selected for a qualitative survey., Results: Efficient administration of e-health implementation improves the quality of healthcare, reduces costs and medical errors, and enables transfer of healthcare resources to rural areas, among other benefits. However, there are numerous issues affecting the successful implementation of e-health such as lack of standardized e-health applications, deployment costs, training costs, legal challenges, privacy and security fears, implementation and acceptance time of such applications, technical difficulties, educational issues, resistance to change, and pilot projects or small implementations with limited numbers of patients in healthcare organizations., Conclusions: The implementation of e-health in Iran, particularly Isfahan, is subject to similar challenges as in other countries throughout the world. Hence, e-health implementers need to adhere to the proposed solutions in order to overcome the mentioned challenges in such complex projects.

Introduction: The e-health system must have the capability of patient access to electronic health record. The advantage of access to their record lets them have better understanding of their condition and treatment. It can also raise the reliability of consistency and correctness of data in health care system. Finally it will improve the maintenance quality of medical records and guarantee better results of medication. This study aimed to carry out a comparative study concerning laws, policies and procedures upon patients' access right to EHR in selected countries and to suggest appropriate solutions for Iran., Method: This was a comparative descriptive study. The study population was the laws, policies and procedures of patients' access right to EHR belong to countries like Canada, Australia, New Zealand and Iran. Data were collected by taking notes on index cards. In this study in order to collect data, at first, the researcher studied the websites related to Health Ministry of the countries and existing laws and policies through related links in the websites. In next step, the health information management association websites were studied and the related data were collected. The gathered data were analyzed through content analysis., Results: The findings of research showed that in every four countries there are generally some laws, policies and procedures. Although Canada and New Zealand concerning the number of laws and policies related to the subject subsequently are ranked after Australia, they are ranked prior to Australia regarding benefiting the laws and specified policies., Conclusion: Given the necessity of EHR implementing and codifying the planning of SEPAS in Iran, as there is no specified laws or procedures regarding patients' access right to EHR, the obligation of paying attention to assigning a law or at least obvious policies and procedures and providing the details is absolutely apparent.

Objectives: This pilot trial was conducted to establish whether Boswellia Serrata (BS), a traditional herbal medicine, could improve the outcome of patients who have diffuse axonal injury (DAI)., Methods: In total, 38 patients with pure DAI were enrolled in this 12-week, double-blind, randomized, cross-over study. The patients were randomly assigned to receive either placebo (group A, n = 20) or BS capsules (group B, n = 18) for 6 weeks and then switched to the other intervention for another 6 weeks. The disability rating scale (DRS) was used to assess the outcome at 2-, 6- and 12-weeks post-trauma., Results: A non-significant trend for improvement of DRS total scores was observed after the use of BS. Regarding the DRS sub-scores, however, there was significant improvement in 'cognitive ability to self-care' during the second 6 weeks in group A on BS compared to an insignificant spontaneous recovery in group B during the same period on placebo. Moreover, both groups experienced a close-to-significant increase in the cognitive function-related items of the DRS during the periods they were on BS. The reported adverse events were all of mild quality and had similar frequency between the groups., Conclusion: These results suggest that BS resin does not significantly affect general outcome, but may enhance the cognitive outcome of patients with DAI.

Background: Prescription and nonprescription medications constitute a substantial proportion of the health care costs of countries. National drug policies and attitudes toward medication use may play a role in irrational prescribing and consumption of medicines, leading to drug wastage. The limited resources of developing countries warrant more careful assessments of current national drug policies., Objective: This study quantified the amounts and types of medications that are stored in a sample of urban Iranian households and estimated the extent of drug wastage in these families., Methods: A literature search was conducted using MEDLINE and International Pharmaceutical Abstracts for 1966 to 2004 to identify articles on drug utilization and wastage. Randomly selected households in a large city in Iran were visited to determine the amounts and types of medicines stored in these households. A questionnaire was used to collect information about medication use in these families., Results: A total of 512 households were assessed. The mean (SD) family size of household respondents was 4.3 (1.6) members. Mothers were responsible for managing medications in 58.1% (291/501) of families. Presence of chronic illness, insurance coverage, higher economic status, literacy among fathers, and siblings without medically related jobs were the variables that showed a significant relationship with the amount of medicines found in the households. The mean (SD) numbers of unit doses of medicines and of drug products found in these households were 238.5 (198.6) and 22.99 (20.1), respectively. The most common therapeutic classes of medications kept at home were central nervous system agents, anti-infectives, and gastrointestinal medications. The real and potential medication wastage was estimated to be 38.8% and 53.8%, respectively., Conclusions: Medications were stored in large quantities in these urban Iranian households, and a large percentage was being wasted. Drug-use assessments and a comprehensive evaluation of the current national drug policies are warranted to curtail this problem.