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Introduction: Intestinal fatty acid-binding protein (I-FABP) is located in the apex of mature enterocytes and released into circulation; once the injury of enterocyte happens, its circulating levels are considered an early and sensitive marker of intestinal ischemia as in necrotizing enterocolitis (NEC); because of its small molecular weight, it can be detected in urine. Aims: The aim was to study the usefulness of both serum and urine I-FABP in early diagnosis of NEC and to correlate the serum and urinary levels. Settings and Design: This study was case–control design. Methods: Simultaneous serum and urine samples obtained at the onset of symptoms, in 40 preterms with suspected NEC, with gestational age ± 27.70 weeks and birth weight ± 1.11 kg, i.e., 20 preterms diagnosed at Stage I, 12 preterms at Stage II, and 8 preterms at Stage III, were compared with age- and weight-matched preterms with no NEC. Statistical Analysis: The collected data were tabulated, coded, and then analyzed using the computer program Statistical Package for the Social Science (SPSS version 22). Results: Serum levels of I-FABP in NEC cases were significantly higher than the control group, with a mean of 6005.77 ± 6384.77 and 1480.79 ± 1276.48 pg/ml, respectively (P < 0.001). Urine levels of I-FABP in NEC cases were significantly higher than the control group, with a mean of 5009.22 ± 3941.64 and 2677.62 ± 2257.29 pg/ml, respectively (P = 0.04). Both serum and urine I-FABP levels not only in Stage II are significantly higher than Stage I but also in Stage III are significantly higher than Stage I and II (P < 0.001, P = 0.03, respectively), which showed significant positive correlation with stages of NEC (r = 0.618; P < 0.001; r = 0.306; P = 0.049, respectively). Both serum and urine I-FABP levels had a highly significant positive correlation with each other (r = 0.406 P < 0.0001). Receiving operating characteristic curve showed an area under the curve of 0.92 and 0.81 for serum and urine I-FABP, respectively. Conclusions: Whether serum or urinary I-FABP is valuable in the diagnosis and prediction of NEC and strongly correlated with the disease severity and with each other.

Abstract Background Reliance solely on traditional approaches in health education is no longer considered sufficient, and electronic/digital education can be a complementary approach. Implementing electronic methods in health education requires identifying the requirements from the perspective of the service providers. Therefore, this study aimed to elucidate the experiences and perspectives of community health workers (Behvarzan) regarding the requirements for providing health education for rural people through electronic/digital means. Methods This descriptive qualitative study was conducted in 2022 at Alborz University of Medical Sciences. Data were collected through semi-structured interviews with 14 Behvarzan from Health Houses (HH) in Karaj City. The data were analyzed using the inductive Elo & Kyngas approach and conventional content analysis facilitated with MAXQDA software. Results After analyzing the results, we extracted 139 open codes, and by merging them for more precise coding and to facilitate the research process, we formed three main themes and ten subthemes. The themes included Technology (technical infrastructure, content production, content delivery methods, and content delivery channels), Facilities and equipment (communication equipment and electronic content repositories), and Stakeholders (training of providers, motivating providers, persuading learners and target groups, and reference groups). Conclusion From the perspective of rural healthcare workers, the implementation of electronic education requires necessary technology, equipment, facilities, processes, and content should be pursued and provided through specialized working groups, extending from the Ministry of Health and Medical Education to local HHs. These resources should be available to the healthcare workers and their target populations. Concurrently, educational programs and incentives should be defined and offered at the university level and within health networks for rural healthcare workers and their populations.

BACKGROUND: Childhood obesity is one of the most serious global public health challenges of the 21st century, affecting every country in the world. Mothers’ beliefs and perceptions about their children’s obesity and overweight are key to obesity prevention. Given the importance of this issue, the present study aimed to determine perceptions and beliefs of mothers’ nutritional behaviors related to overweight preschool children. MATERIALS AND METHODS: This cross-sectional study was conducted on 350 mothers of preschool children with health records who were referred to child health assessment centers. The data collection tool was a researcher-made questionnaire based on the health belief model. SPSS19 was used for data analysis. P < 0.05 was considered significant. RESULTS: The participants (350) included 52% 25–36 years old, and 57.3% live in rural areas. There was a significant difference in the mean perceived susceptibility between mothers with obese children and normal-weight children (P < 0.05). There was a significant positive relationship between severity and perceived benefits and a significant negative relationship with mothers’ knowledge. There was also a significant negative relationship between self-efficacy and perceived barriers (P > 0.05). CONCLUSIONS: The results of this study showed that maternal health beliefs were effective in the formation of obesity prevention behaviors in children. In this regard, educational interventions can play an important role in the proper practice of such behaviors.

Background & aim: Midwives play an essential role in sexual counseling. The present study aimed to measure knowledge, attitude and self-efficacy towards providing sexual counseling among students doing the master of Counseling in Midwifery program in Iran.Methods: This cross-sectional study was conducted on 148 midwifery students doing the master of Counseling in Midwifery, who selected via convenience sampling from universities across the country. Data collection was carried out using a researcher-made questionnaire including demographic characteristics, knowledge of sexual counseling (KSH), attitude towards sexual counseling (ASH), and self-efficacy to do sexual counseling (SESH) in 2021. Data analysis was done using the Student t-test, Pearson correlation test, and ANOVA using SPSS ver. 25.Results: Mean and standard deviation of the total score was 74.67 ±12 for knowledge, 80.8 ±76.98 for attitude, and 81 ± 16 for self-efficacy. Management of victims of sexual assault and counseling models had the lowest score on the knowledge scale. Students had poor self-efficacy when providing sexual counseling to the men and sexual minorities. There was a significant relationship between knowledge and attitude towards sexual counseling (P

Background: Males’ viewpoint about sexual and reproductive health (SRH) and their situation are essential components of men’s and women’s health in the community. Men have been overlooked in reproduction health, especially with reproductive issues such as contraception, sexually transmitted infections (STIs), infertility, and sexual function. This study aimed to investigate the males’ perceptions of their SRH situation in Iran. Methods: A qualitative study was conducted from May 2016 to April 2017 on data retrieved through semi-structured interviews with 19 adult males aged 18 to 59 years. The participants were purposefully recruited from among populations of health centers in Alborz province, Iran. Conventional content analysis in OneNote software version 2016 was used for data analysis. Results: Three main themes and nine categories emerged including 1) Perceived SRH needs, including “need to increase men’s awareness about SRH”, “need to have an accessibility to SRH services”, and “need to have a high-quality sexual relationship”; 2) perceived SRH responsibilities, including “health-seeking behaviors”, “sexual skills”, “childbearing responsibilities”, and “ethical commitment”, and 3) Men’ perception of trends of social and cultural norms, including “changing SRH priorities” and “changing marital prototype”. Conclusion: In this study, men perceived SRH as an important issue due to the changes in social and cultural trends, and many of their SRH needs have not yet been addressed. Hence, along with socio-economic changes, the policymakers of the health system should develop strategies and interventions to meet these needs.

This research was aimed at identifying the antecedents and consequences of digital content marketing using grounded theory model (case study: Instagram bloggers). The statistical population in the qualitative section consisted of experts and knowledgeable people in the field of digital content marketing, especially Instagram bloggers. The sample size in the qualitative section with theoretical saturation (20 people) was estimated using purposeful sampling. The data collection tool in the qualitative part was a semi-structured interview. For validity and reliability of the work the Goba and Lincoln criteria were used, which consist of four more detailed concepts of validity, transferability, verifiability and reliability. MAXQDA software was used for coding. To analyze the data, Strauss and Corbin systematic method was performed with open coding, axial coding and selective coding. After data analysis, the paradigm model or optimal model of digital content marketing was extracted. The results identified 62 core codes, 216 indicators (open coding) and 6 selective coding of which 7 precedents (effective component) including motivation, business intelligence, audience experience, preferences, research and development, creativity, and influencers and 11 consequences (effective component) include competitiveness, communication, audience trust, value creation for the audience, promoting e-learning culture, loyalty and persuasion to buy, brand awareness, brand health, e-marketing effectiveness, word of mouth and engagement embraced. In addition, strategies, contextual factors and barriers to digital content marketing were presented. Therefore, according to the research results, attention to digital content marketing for branding and audience attraction, as well as loyalty to the target audience should be considered by bloggers and people who have online businesses.

Abstract Background The association between renal parenchyma changes on dimercaptosuccinic acid (DMSA) scans and demographic, clinical, and laboratory markers was assessed in pediatric patients with acute pyelonephritis. Methods A retrospective study of 67 Iranian babies and children aged 1-month to 12-year with APN was conducted between 2012 and 2018. The presence of renal parenchymal involvement (RPI) during APN was determined using technetium-99m DMSA during the first 2 weeks of hospitalization. The association of DMSA results with demographic data, clinical features (hospitalization stay, fever temperature and duration), and laboratory parameters such as pathogen type, and hematological factors (ESR, CRP, BUN, Cr, Hb, and WBC) was evaluated. Results 92.5% of children with an average age of 43.76 ± 5.2 months were girls. Twenty-four children (35.8%) did not have renal parenchymal injury (RPI), while 26 (38.8%) and 17 (25.4%) patients showed RPI in one and both kidneys, respectively. There was no significant association between RPI and mean ESR, CRP, BUN, and WBC. However, there were significant associations between RPI and higher mean levels of Cr, Hb, and BMI. Conclusions Low BMI and Hb levels and increased Cr levels might be indicative of the presence of RPI in children with APN.

Abstract Background Kawasaki disease (KD) as an acute, systemic vasculitis is the leading cause of acquired heart disease in children under the age of 5 years. Methods A 10-year cross-sectional retrospective study was designed to assess 190 Iranian children with KD during 2008–2018. Demographic data, clinical and laboratory manifestations from the onset of symptoms to diagnosis, clinical signs and symptoms, and subsequent treatments were evaluated to predict hospitalization stay, complications, and response to treatment. Results Children with KD had a male-to-female ratio of 1.18:1 and an average age of 36 months. There was an insignificantly more incidence of KD in cold seasons. The most frequent symptoms were fever (92.6%), oral mucus membrane changes (75.8%), bilateral bulbar conjunctival injection (73.7%), polymorphous skin rash (73.2%), peripheral extremity changes (63.7%), and cervical lymphadenopathy (60.0%). The rate of gastrointestinal, cardiac, joint, and hepatic complications was determined to be 38.4, 27.9, 6.8, and 4.2%, respectively. 89.5% of patients received intravenous immunoglobulin (IVIG) plus aspirin as the first line of treatment, while, 16.3% of them needed an extra second line of treatment. Significantly low serum sodium levels and high platelet counts were detected in KD patients with cardiac complications. Cardiac complications often were more encountered in patients who did not respond to the first line of treatment. Higher platelet count, lower serum sodium amount, and C-reactive protein (CRP) level were significantly associated with a need for an additive second line of treatment. A significant relationship between hospitalization stay and hemoglobin level was found. Conclusion As most of the clinical manifestations and complications were following other reports released over the past few years, such data can be confidently used to diagnose KD in Iran. Seasonal incidence and a positive history of recent infection in a notable number of patients may provide clues to understand possible etiologies of KD. Laboratory markers can successfully contribute to health practitioners with the clinical judgment of the need for additional treatments, possible complications, and hospitalization duration.

Abstract Background Upper urinary tract infection (UTI) or pyelonephritis may increase the pathogenesis rate and risk of severe complications in children due to kidney atrophy. Objective A set of clinical symptoms, laboratory markers, and ultrasound findings were assessed to achieve the early diagnosis and prognosis of pyelonephritis in hospitalized pediatrics. Methods A cross-sectional study with 104 Iranian children (95 girls and 9 boys) aged 1 month to 12 years with acute pyelonephritis during 2012–2018 was conducted. The ultrasound examination of kidneys and urinary tract during hospitalization, the incidence of clinical symptoms, and laboratory markers in blood and urine were monitored to identify the best predictive factors of early diagnosis of this bacterial infection. Results Three-fourth of the patients had one of the four clinical symptoms of abdominal pain, constipation, dysuria, and vomiting, while others were asymptomatic. A much frequency of pyuria (88.46%), Escherichia coli in urine (92.31%), leukocytosis (81.73%), and high ESR (> 10 mm/h, 92.30%) and CRP (> 10 mg/L, 82.82%) was observed. The kidney and urinary tract ultrasonography only in 32.7% of children revealed findings in favor of pyelonephritis (cystitis, ureteral stones, and hydronephrosis). Conclusion There was a high frequency of clinical signs and laboratory markers associated with pyelonephritis. Ultrasound alone was not an efficient tool to track febrile UTI as most patients presented normal sonography.

Objective: To compare the performance index of private and public sector hospitals of Karachi, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: In a tertiary care hospitals (one private and one public sector) of Karachi, from Nov 2016 to Nov 2017. Methodology: A sample size of 153 were enrolled by purposive sampling technique. Performance index of both hospitals was compared by asking questions from the hospitals staff. Data were collected by the researcher using closed ended questionnaire. Results: Out of 153, 78 (51%) cases were for private hospitals and 75 (49%) cases were for public hospitals. While evaluating the performance index by hospital work area/unit elements, “Enough staff to handle workload" was significantly higher for private hospitals with the p-value of

Objective: To determine the factors potentially influencing patient safety culture in hospital settings an comparison of patient safety factors in public and private hospital. Study Design: Qualitative study. Place and Duration of Study: The study was conducted in two hospitalsin Pakistan; one from public and other from private sector, from Feb 2017 to Jun 2018. Methodology: A multimethod approach was used for data collection including interviews and focused group discussionswith 50 physicians/doctors & staff from different levels of management hierarchy/department and analysis was done by integrating and coding the two sets of data manually. The data was coded and themes were formed. Results: The different themes obtained from the study included: Human factors like leadership, teamwork, communication work-load and professionalism;physical factors like resources, infrastructure and cleanliness; patient factors like severity of illness, availability of attendant and drug allergies; environmental factors like climate, staff and working conditions and safety culture like safe administration of drugs, blood products, sampling, sterilization and prophylactic antibiotics administration. Conclusion: Multiple factors related to human being and environment were identified to influence patient safety in a hospital setting. Participants from the public hospital were more knowledgeable compared to the private hospital.

Objective: The educational regulations are the most important regulation of the University, because they are stimulant for the main activities of the University. As a result, before any action, it is necessary to be familiar with laws and regulations. This study aimed to investigate the knowledge and attitude of students of Alborz University of Medical Sciences of the rules and the training and education they need to be done. Design: The study population was included to all undergraduate students of Alborz University of Medical Sciences who wish had to participate in the study. The population sample was selected in proportion to the number of students in each discipline. The data collection tool was a questionnaire Researcher made which its validity and reliability was measured. The questionnaire after coordination with deputy Schools students from theywere asked to complete it within twenty minutes. Collected information is encoded in software spss version 19 enter the purposes of study, as well as descriptive statistics and inferential statistics were used to analyze the data. Results: Results showed that the average awareness among the students of the three domains of educational regulations is 9/55± 5/48 and The mean attitude towards training regulations and the need to train them is19/24±3/47. Conclusion: According to low average student awareness of educational regulations, as well as being a positive attitude about the necessity and the need to hold training workshops in this regard there.

Objective (s): The level of injury in SCI patients determines the level of functional disability, level of dependency and independency. This can also influence on the quality of life greatly. So this study aimed to examine the relationship between the level of injury and the quality of life in SCI patients. Methods: This was a cross sectional study carried out on 110 patients in Isfahan, Iran, in 2017. Information related to the quality of life was measured using the WHOQOL-BREF and the level of injury was estimated by clinical diagnosis of patients. Results: The findings showed that the level of the injury has meaningful relationship with the patientschr('39') mental, physical, and environmental aspects of quality of life but not social domain. Conclusion: The level of injury in people with SCI has a widespread impact on their quality of life, suggesting that these people need adaptive and compensatory equipment to improve their quality of life.

Background: To date few reports have pointed out the role of circulating miRNAs in discriminating metastatic liver tumors from primary hepatocellular (HCC) tumors. Such discrimination will have significant therapeutic and prognostic implications. The purpose of this study was to evaluate the potential value of a panel of HCC-related circulating miRNAs (miR-142, miR-182, miR-200a, mir-210, miR-211, miR-302b, miR-324, miR-338, miR-340 and miR-1246) as noninvasive biomarkers for discriminating primary HCC from metastatic tumors in the liver. Methods: The expression level of the selected miRNAs was quantified by quantitative real time PCR in 33 patients with HCC, 22 patients with metastatic tumors in the liver, and 30 healthy volunteers as control. Mann-Whitney U test was used to evaluate the difference in miRNAs expression between primary and metastatic liver tumors and to study the associations between their relative expression levels and the clinicopathological factors. Receiver operating characteristic curve was used to evaluate the diagnostic value of the individual miRNAs. Results: Statistical analyses revealed a differential expression in the level of serum miR-210 and miR-1246 between the two groups of patients. The sensitivity and specificity of miR-210, for differentiating HCC from metastatic malignancies in the liver were found to be 73.7% and 64.28%, respectively. Whilst, of miR-1246 were 72.2% and 67.8%, respectively. In addition, the differential expression of the two miRNAs was also found to be associated with clinicopathological parameters in the two studied groups. Conclusions: Serum miR-210 and miR-1246 have some diagnostic value for discriminating patients with metastatic tumors to patients with primary HCC.

Introduction: Medial tibial stress syndrome or shin splints is one of the most common overuse injuries in active people, that its risk factors are unknown. On the other hand, leg stiffness is a modifiable mechanical property that may be related to overuse injury. So, the aim of this study was to investigate the role of the leg stiffness in the prediction of medial tibial stress syndrome in active people. Materials and Methods: 80 students in physical education (50 girls and 30 boys) were selected in a convenience manner. Before the start of training sessions, the stiffness of both legs was measured. During the sessions, injured‏ people were examined, and the type of injury registered by the orthopedic physician. At the end of the training sessions, the subjects were divided into two groups of injured and non-injured. The independent t-test was used to compare the leg stiffness between the two groups. Binary logistic regression was used to investigate the role of leg stiffness in the prediction of the occurrence of this syndrome. Results: There was a significant difference in leg stiffness between the two groups (P = 0.001). Logistic regression analysis revealed that injured subjects had a significantly more leg stiffness‏ before the injury compared to‏ non-injured group. So, leg stiffness was a risk factor this syndrome. Conclusion: This study showed that leg stiffness could predict medial tibial stress syndrome or shin splint. So, high leg stiffness may increase the risk of overuse injuries. This research provides important information to the coaches and team doctors about the management of injury and its treatment.

Background: Knowing the pattern of carbon monoxide (CO) poisoning in each region is vital for enhanced health planning. This study was designed to evaluate the epidemiologic pattern of unintentional acute CO poisoning in major cities of Fars province, southwest of Iran. Methods: This one-year cross-sectional study was carried out on unintentional CO poisoning incidents in Fars province, Iran, during the year 2011. The target population was people living in 7 major cities under supervision of Shiraz University of Medical Sciences including Shiraz, Eghlid, Neyriz, Khorambid, Marvdasht, Darab and Bavanat. Results: During 2011, 111 CO poisoning events occurred in the catchment area. These events involved 420 individuals (50.2% men) who were present during the poisoning event, of which 281 individuals with mean age of 27.8 ± 14.8 years were poisoned (46.5% men). The majority of CO poisoning events (77.3%) occurred in colder months of the year. Most events happened in urban areas (61.3%). The most common source of CO was water heater (27.5%) closely followed by gas stove (24.8%). The majority of poisoned patients were asleep during the event (150/281: 53.3%). The main causes of CO generation were inbound gas return (62.2%) and inappropriate ventilation (28.8%). The fatality rate of CO poisoning was significantly higher in men compared to women both in involved individuals and poisoned patients (P = 0.035, < 0.001; respectively). Moreover, poisoned victims who were asleep during the accident were more likely to die than those who were awake (14.3 vs. 3.7%, P < 0.001). Conclusion: Generally, the incidence and fatality rate of CO poisoning in the current study were comparable to those of the world statistics, but higher than in developed counties. Attention and emphasis on the safety of gas heaters, stoves, and other gas-powered appliances in residential places should be enforced.

El-Fayoum governorate has unique characteristics which induces mosquito proliferation and thus increased the risk arisen from diseases transmission. Present study explores the role of remote sensing and GIS modeling integrated with field survey for mapping mosquito breeding sites and the areas under risk of diseases transmission in El-Fayoum governorate. Entomological surveys were conducted for a total number of 40 accessible breeding sites during the period 12-16 November 2017. A calibrated Landsat OLI image, synchronized with the field trip, was processed to produce Normalized Difference Vegetation Index (NDVI), Normalized Difference Moisture Index (NDMI), and Land Surface Temperature (LST). A cartographic GIS model was generated to predict breeding sites in the whole governorate and to assess the potential risk. The main filarial disease vector (Culex pipiens) was abundant at Atsa district, while Malaria vectors (Anopheles sergentii and Anopheles multicolor) were mainly distributed in El-Fayoum and Youssef El-Seddiq districts. Means levels of NDVI, NDMI and LST at breeding habitats were recorded; 0.18, 0.08 and 21.75° C, respectively. Results of the model showed that the highest predicted risk area was reported at Atsa district (94.4 km2) and Yousef El-Sediq (81.8 km2) while the lowest prediction was observed at Abshawai district (35.9 km2). It can be concluded that Atsa, Yousef El-Sedik and El-Fayoum districts are more vulnerable to Malaria and Filaria diseases outbreaks, thus precaution and pest control methods must be applied to mitigate the possible risks.

An epidemiological study among 203 workers of whom 119 were exposed to cotton dust and 84 controls revealed the occurence of byssinosis among 20.1% of the exposed group. Radiological examination of nasal sinuses was performed and the diagnosis was made without previous knowledge of the state of exposure of the workers or their pulmonary diagnosis. The exposed group showed a significant difference in the occurence of chronic bacterial sinusitis which also increases in prevalence by the increased duration of exposure to cotton dust. Non specific respiratory disease was significantly higher in prevalence among exposed workers (14.3%). No significant difference of allergic sinusitis was observed in the two groups although the whole population examined showed noticeably high rates of sinus diseases. Most of the air-borne cotton dust is composed of large fibers which have a greater probability of retention in the nasal and upper respiratory passages. Chronic irritation from this dust and superadded infection may explain the higher ration of chronic bacterial sinusitis and non specific respiratory disease. There was no association between byssinosis and any form of sinusitis. [ABSTRACT FROM AUTHOR]

Objective: Lower extremity stiffness is associated with variables such as the frequency and length of running steps, the amount of muscle force and power production. Previous studies showed contradictory findings regarding the relationship between lower extremities joints stiffness and start velocity. Sprint start can be highly affected by two key components of lower limb stiffness, namely, force and time. However, no research has yet investigated the effect of start velocity changes on lower–limb stiffness during sprint start. To test the effect of velocity changes on lower-limb stiffness during sprint start. Method: 15 male members of track and field were selected for this study. Leg stiffness was calculated dividing peak ground reaction force by the leg length. Joint stiffness was also estimated dividing the muscle moment of force by joint angular displacement. Subjects performed a start with three different speeds. Results: From low to high start velocity, means of leg stiffness, knee stiffness and ankle stiffness increased by 67.53%, 41.9% and 39.03% respectively. Conclusion: The findings show that lower-limb stiffness could be a key factor in changing runners' acceleration during sprint start.

Chaos management is one of the most necessary efforts on managing business units. Many organizations fail to cope with undesirable circumstances, which may happen without any prior notice and as a result, they may face with significant financial losses. In this paper, we present an empirical study to determine critical success factors, which could help handle any possible chaos in organizations. The proposed study of this paper is implemented for a set of travel agencies located in Tehran, Iran. Chronbach alpha is calculated as 0.821, which is well above the minimum desirable level. In addition, we have also performed factor analysis, which yields a KMO value of 0.576 with the level of significance of 0.000. The results indicate that there are six important factors including effective management strategy, internal environmental factors, creative and innovative attitudes, external environmental factors and top level management thoughts.