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Abstract Background The access to anti-cancer medications is influenced by policies formed via the convergence of various stakeholders. The aim of this study is to identify and analyse the stakeholders involved in formulating and implementing policies related to the accessibility of anti-cancer medications in Iran and their interactions that are relevant to the outcomes of these policies for the first time. Methods To achieve the objectives, a novel multistage social network analysis (SNA)-based approach that includes three phases is proposed. First, the actors were identified by a team consisting of multidisciplinary knowledgeable experts through 15 comprehensive interviews. Then, the influence relationships of these actors were comprehensively analysed through in-depth interviews with nine key informants involved in pharmaceutical policies through a structured questionnaire. Finally, a novel network of actors was determined accordingly, and a SNA-based approach proposed to reveal the intrinsic roles and various aspects of the importance of the network’s actors. Results The study identified a total of 45 actors, which were then classified into 4 categories on the basis of their public or private nature and their foreign or domestic origin. This established network helped in creating a comprehensive view of the main actors, and can help policymakers to solve the problems related to access to anti-cancer medications more effectively and prevent the creation of these problems in the future. In this way, the network identified specific actors that can benefit from increased attention and dialogue. The computational results revealed that the Iran Food and Drug Administration (IFDA), Pharmaceutical Importer Companies (PharIc) and Pharmaceutical Manufacturing Companies (PharMC) were highly important actors in terms of their connectivity to other actors. Additionally, law enforcement agencies (LEA) have shown limited effectiveness within this network. Conclusions This study highlights the importance of complex relationships among various actors and proposes a novel SNA-based approach to analyse them. Regarding the main steps of the proposed approach and the findings, it is imperative for pharmaceutical policy plans to involve a diverse group of experts from the beginning, prioritizing the preferences of stakeholders, and providing a patient-centred approach to prevent the worsening of resource shortages.

Background: In order to design better management for anti-diabetic medication, pharmacoepidemiological studies are required to have an update on the drug utilization. Therefore, the present study was performed with the aim of pharmacoepidemiological analysis on utilization of antidiabetic drugs based on PERSIAN cohort data.Methods: In this study, 10138 participants were included by baseline data. Use of anti-diabetic medications based on Anatomical Therapeutic Chemical (ATC) code A10 was provided. Quantitative and qualitative variables were illustrated using mean±standard deviation (SD) and frequency (percent). Logistic regression was employed to define associated factors with categorical outcomes.Results: The descriptive analysis showed that 12.3% (n=1249) of the participants had diabetes, while only 5.3% (n=540) of them had utilized anti-diabetic medications. Totally, 94.7% of the participants did not take any anti-diabetic drug, 3% received monotherapy and 2% reported a combination of anti-diabetic medication therapies. Also, the higher ages showed a more chance for use of anti-diabetic medications (40-59 years: OR=3.72, 95% CI: 2.38-5.81; ≥60, OR=5.61, 95% CI: 3.41-9.22).In addition, married and employed participants were more likely to take anti-diabetic medications. Also, having cardiovascular diseases (CVDs), fatty liver and pregnancy were associated with a higher significant chance of using anti-diabetic medications.Conclusion: Less than half of the patients diagnosed with diabetes received anti-diabetic drugs indicating the importance of medication adherence training programs in this group of patients.

Flaxseed is an important crop that is used extensively for medicine, nutrition, and industry. Then, this research aims to investigate the effect of foliar spraying of bulk and nanoparticle forms of iron and zinc with different particle sizes on yield and its related traits of flaxseed under post-anthesis water deficit. To this end, a split-plot factorial experiment based on randomized complete blocks design in three replications was used at Razi University, Kermanshah, Iran, in two crop years (2019-2021). The experiment comprised two moisture regimes - optimal irrigation and post-anthesis water deficit, applied in the main plots. Different fertilizers (bulk and nanoparticles with varying particle sizes) and fertilizer concentrations (0, 300, and 600 mg l-1) were tested in the subplot. The results showed that under optimal moisture conditions, the highest grain and biomass yield was in the foliar treatments of iron nanoparticles 20-30 nm and 600 mg l-1 and zinc nanoparticles 10-30 nm and 300 mg l-1, with 2448 and 8432 kg ha-1, respectively and the lowest amount was obtained in the control treatment with 2028 and 7599 kg ha-1. Under post-anthesis water deficit environment, zinc nanoparticles 10-30 nm and 300 mg l-1 caused a 35% increase in grain yield compared to the control treatment (997 kg ha-1). Also, the highest oil percentage and yield were obtained in iron nanoparticles 20-30 nm and 600 mg l-1 with 35.25% and 866 kg ha-1, respectively. In general, the efficiency of iron and zinc nanoparticle fertilizers with different particle sizes was significantly higher than that of iron and zinc bulk forms and control treatment (without fertilization). Nanoparticle fertilizers significantly reduced the adverse effects of late-season water deficit on grain, oil, and biomass yield.

Abstract Objectives The objective of this study was to specifically investigate Separation Anxiety Disorder (SAD), as one of the noteworthy disorders within the spectrum of anxiety disorders, among children and adolescents, after overcoming the crises caused by the Coronavirus Disease 2019 (COVID-19) pandemic. Efforts were also made to identify socio-demographic factors that could be associated with changes in SAD level and also to assess the effect of different constituting dimensions of SAD on the severity of this disorder. Methods In this cross-sectional study, face-to-face interviews were conducted with the parents of 317 (7-13-year-old) Iranian students, who were selected through a multi-stage random sampling method in the city of Shiraz. During the interviews, socio-demographic data were collected, and subsequently, SAD symptoms and dimensions were assessed using the Separation Anxiety Assessment Scale (Parent Version) (SAAS-P) questionnaire. Later, employing the Partition Around Medoids (PAM) statistical method, the participants were categorized into two groups with low and high levels of SAD. Also, to understand the interaction between the different dimensions of SAD, the network analysis method was employed. Finally, univariate analysis and logistic regression were utilized, with a significance level of 0.05, to determine potential associating factors with the level of SAD. Results The sample included 128 girls and 189 boys with a mean age of 9.63 ± 2.63 and 9.63 ± 1.95 years respectively. Based on the PAM method, 51.1% of the participants presented a high level of SAD. According to network analysis, it was demonstrated that the “fear of abandonment” dimension plays a central role in high levels of SAD. Based on logistic regression, female gender, age ≥ 10 years, parents’ unacademic educational background, mother’s employment, and child’s history of physical/mental problems were significantly associated with the high level of SAD. Conclusions A considerable number of the participants in this study presented a high level of SAD with the “fear of abandonment” being a key influential dimension of elevated levels of this disorder. Maternal employment, female gender, child’s history of health issues, and low parental education were identified as important contributors to the high SAD level. Considering these factors allows for more effective diagnostic and therapeutic interventions. However, the need for further studies remains crucial.

Abstract Background Following the rapid aging of population, some concerns have emerged regarding increasing demand for health care services and the consequent increase in health costs. Besides, older adult patients with chronic disease are more prone to show cost-related medication non-adherence (CRN) to cope with their medication costs. The objective of this qualitative study was to develop an adopted conceptual framework on the contextual determinants that affect the CRN in older adult patients with chronic diseases. Methods Problem-centered, semi-structured, in-depth, and face-to-face interviews, were conducted with healthcare informants in Iran, from Sep. 2021 to Feb. 2022. Collected data were analyzed using deductive and inductive analytic approaches and content analysis methodology was used to develop the model. This study applies to the COREQ checklist. Results Fifteen informants, including 8 (60%) males, with mean ± SD age of 44.4 ± 9.7 years, entered into the study. Based on the data analysis performed on the information obtained from the interview with 3 subgroups of geriatricians, health policymakers, and pharmacists, six major themes identified as determinants: 1) socio-economic factors, 2) health system-related factors, 3) healthcare provider-related factors, 4) medication-related factors, 5) disease-related factors, and 6) patient-related factors. There were also 23 minor themes which were matched with the aforementioned six major themes. Conclusion The final framework obtained in this qualitative study depicts CRN as an issue that is highly likely affected by six main determinants among older patients with chronic disease. Our findings emphasize that policymakers would focus on certain major themes and allocate resources to programs to improve medication therapy management in older adult patients.

Introduction: Among cereals, durum wheat (Triticum turgidum L. var. durum) is one of the most important protein and energy sources after bread wheat. It has a significant role in human nutrition in most countries. Materials and methods: In this study, in order to identify and localization of QTLs controlling traits related to flag leaf and peduncle, 118 durum wheat recombinant inbred lines obtained from the cross between the local genotype of Iran-249 originated from the west of Iran and the local cultivar of Zardak from Kermanshah were evaluated in three environments under rainfall conditions using randomized complete block design along with parents in three replications. QTL analysis for each trait was performed using the inclusive composite interval mapping method to identify genomic regions that significantly affected the studied traits. Results: Based on the analysis of variance, the effect of genotype (recombinant inbred line) was significant in terms of traits related to flag leaf and peduncle in three environments, which indicates the existence of appropriate levels of genetic diversity in the studied population for measured traits. The results of QTL analysis using the inclusive composite interval mapping method led to the identification of 33 QTL for the measured traits. The common and stable QTLs were located in at least two environments on chromosomes 1A, 1B.1, 2B.1 and 5A for peduncle length and diameter traits and on chromosomes 2A, 5A and 7A for flag leaf length, flag leaf width and flag leaf area. Identification of repeatable QTLs in the different environments can indicate the existence of stable genomic regions related to flag leaf and peduncle. On the other hand, a positive and significant correlation was observed between the traits, probably due to the linkage or pleiotropic effect of their controlling QTLs. Also, based on QTL analysis using the two-locus method, the additive main effect, as well as the interaction effect of the QTL× environment, was significant for all traits except for the middle and bottom peduncle diameter. In total, six gene loci with significant additive× additive epistasis effects were identified for the flag leaf area-related traits and top peduncle diameter. Conclusion: Identification and localization of stable QTLs in different environments for some traits related to flag leaf and peduncle can assist in understanding better the genetic basis of these traits to be used in breeding programs, especially in MAS projects.

The plant Camelina sativa (L.), a member of the Brassicaceae family, is an ancient oilseed crop. Due to its adaptation to vast areas of the world and its unique oil composition and properties, it is useful for the production of biofuels, jet fuel, bio-based products, feed, and food. The present study was performed to investigate the morphological and agro-physiological characteristics of this plant through Factor Analysis (FA). For this purpose, 136 doubled haploid line genotypes were assessed in the form of a randomized complete block design with three replications in the research field of Razi University, Kermanshah, Iran. FA, based on the principal component analysis method and varimax rotation, showed that two important factors make up about 74.97% of the total variety of characters. The Eigen values of these two factors were 9.76 and 3.72, respectively. The first and second factors assigned 53.99 and 20.98 percent, respectively, of the total variation. Factor 1, which was called the biological performance, included the seed yield, number of pods per plant, number of pods per main branch plant, number of pods per lateral branch, biological yield per five plants, plant height with roots, root weight, shoots weight, pod straw weight, number of lateral branches, length of lateral branch and length of the main branch. Factor 2, which was called the seed characteristics, covered seed length, seed perimeter, seed area, the weight of 1000 seeds, and the number of seeds in the pod. Using FA, two sets of traits were identified and named in Camelina. The traits in one category that affected the attributes of the other category were selected to be studied to help Camelina breed more precisely. Entering more traits and performing FA increased the accuracy of the categories.

Abstract Background Inflammatory bowel disease (IBD) is a chronic inflammatory condition involving individuals across all age groups. Recent data suggests the increase in the prevalence of IBD and the surge in applying the biologic drugs in which both change the cost of IBD in recent years. Comprehensive assessment of direct and indirect cost profiles associated with IBD in our area is scarce. This study aimed to determine the economic burden of IBD in Iran from a societal perspective, using cost diaries. Methods Patients available on clinic registry and hospital information system (HIS), who were diagnosed with IBD, were invited to take part in this study. Demographic and clinical data, the healthcare resource utilization or cost items, absenteeism for the patients and their caregivers were obtained. The cost of the used resources were derived from national tariffs. The data regarding premature mortality in IBD patients was extracted from HIS. Productivity loss was estimated based on the human capital method. Then, cost date were calculated as mean annual costs per patient. Results The cost diaries were obtained from 240 subjects (Ulcerative colitis: n = 168, Crohn’s disease, n = 72). The mean annual costs per patient were 1077 US$ (95% CI 900–1253), and 1608 (95% CI 1256, 1960) for the patients with ulcerative colitis and Crohn’s disease, respectively. Of the total costs, 58% and 63% were in terms of the indirect costs for the patients with ulcerative colitis and Crohn’s disease, respectively. The cost of illness for country was found to be 22,331,079 US$ and 15,183,678 US$ for patients with ulcerative colitis and Crohn’s disease, respectively. Highest nationwide economic burden of IBD was found for patients older than 40 years were estimated to be 8,198,519 US$ and 7,120,891 US$, for ulcerative colitis and Crohn’s disease, respectively. Conclusion The medication was found to be the greatest contributor of direct medical costs. Productivity loss in terms of long-term disability and premature mortality were major components of IBD’s economic burden in Iran.

Abstract Objectives This study aimed to assess the financial burden of out-of-pocket (OOP) payments to purchase antidiabetic medicines for type 2 patients in Iran. Method The “budget share” and “capacity to pay” approaches were employed to assess the catastrophic pharmaceutical expenditures of antidiabetic medication therapies. The catastrophic thresholds were adjusted for pharmaceutical sectors. The data was 2019 monthly household expenditures in rural and urban areas, insurance coverages of antidiabetic medicines and patients' out-of-pocket (OOP) payments in 30-day treatment schedules. Results The results show that expenditure on diabetes medication therapies in the form of mono-dual therapy and some cases triple oral therapies were not catastrophic even for rural households. Insulin puts patients at risk of catastrophic pharmaceutical expenditures when added to the treatment schedules, and lack of financial protection intensifies it. In general, the poorer households and those resistant to first-line treatments were at increased risk of catastrophic pharmaceutical expenditures. The number of treatments that put patients at risk of catastrophic pharmaceutical expenditure in "budget share" was higher than the "capacity to pay" approach. Conclusions Assessing medication treatment affordability instead of a single medicine assessment is needed. Assessment could be done by utilizing a macro-level data approach and applying adjusted pharmaceutical sector threshold values. Considering the variation between treatment schedules that put patients at risk of catastrophic pharmaceutical expenditures, targeted pharmaceutical policies and reimbursement decisions are recommended to promote Universal Health Coverage (UHC) and to protect vulnerable populations from hardship.

Background: On 30 January 2020, the WHO declared the outbreak of SARS-CoV-2 as a public health emergency. In the present study, we compared the preventative and therapeutic strategies and the success rates of Iran and Switzerland during the COVID-19 outbreak. Materials and Methods: This study was conducted using electronic databases such as PubMed, Scopus, and Web of Science. In addition, the official documents of developed countries and WHO from 1st February until 15th May 2020 were studied. Relevant documents were reviewed in detail, and vital data were extracted. Results: Both countries have restriction policies to reduce the infection rate in the prevention setting. These policies, such as the recommendation to all citizens to stay home unless necessary, army participation, and non-face-to-face counseling, were surveyed by similar techniques in both countries. Some policies were implemented in both countries with different protocols. These policies, including social distancing practices, smart distancing methods, business activities, border closures, border controls, and restrictions, travel restrictions, testing and screening for infection and fever, and decreased working hours, were performed in both countries. In the treatment setting, the therapeutic strategy used in Iran consisted of hydroxychloroquine or chloroquine phosphate and anti-viral drugs. Switzerland followed the guidelines of the European countries. The infection rate, recovery rate, and death rate were 0.139%, 78.73%, and 5.91% in Iran, while these rates were 0.352%, 88.81%, and 6.15% in Switzerland, respectively. Conclusion: Due to the lack of special treatment for the disease, prevention must be considered the most important factor in policymaking. Importantly, observing social distance is the most effective method among the preventative strategies. The capacity of the health care systems to provide optimal services and facilities is an important factor for patients recovery.

Introduction: Quinoa (Chenopodium quinoa Willd) a member of the Amaranthaceae family is a dicotyledon pseudocereal. Quinoa is a plant that is very resistant to unfavorable environmental conditions and shows high resistance to biotic and abiotic stresses. Quinoa seeds have a higher nutritional value than many cereal grains and contain higher quality protein and large amounts of carbohydrates, fat, vitamins, and minerals, which are used both in human food and for feeding animals. The high adaptability of this product to different weather conditions has increased the yield of its various types in countries outside of South America. The existence of nutritious compounds in quinoa seeds, including the combination of amino acids, minerals, and vitamins, has led to more research on the properties of this plant.Materials and methods: The field experiment was conducted to study the relationship between agronomic traits (including plant height, panicle length, number of seeds per plant, plant yield, thousand seed weight, seed yield, biological yield, and harvest index) and mineral elements of quinoa seeds (including Zn, Fe, Mn, Na, Ca, K, and P). The experiment was conducted in the 2018-2019 growing season at the faculty of agriculture, Razi University, Kermanshah with a randomized complete blocks design as a split-plot factorial with three replications. The experimental treatments included three planting dates (March 15, April 15, and May 15) as the main factor and the combination of planting densities (40 and 60 plants/m2) with genotypes (Q29, Titicaca, and Red Carina) as subplot factor.Results: The results of the experiment showed that the seed yield (2297.5 kg/ha) on the sowing date of April was significantly higher than March and May (1484.5 and 2137.7 kg/ha) sowing dates, respectively. The effect of the studied treatments on the mineral elements of quinoa seed was insignificant. The mean comparison for plant density showed that the density of 60 plants/m2 had a higher seed yield than the density of 40 plants/m2. The results of canonical correlation analysis showed that Wilk's lambda statistic was significant at a 5% probability level in the case of the first function, indicating the existence of a significant correlation between the two groups of the studied traits.Conclusion: The results of this evaluation showed that zinc (Zn) and phosphorus (P) had the highest correlation with the corresponding focal function among the mineral elements. Among the agronomical traits, the highest correlation was between the traits of 1000 seed weight and panicle length with the first focal function. Therefore, the plants with higher values of 1000 seeds weight and panicle length, can be used to select seeds with higher amounts of zinc (Zn) and phosphorus (P).

Background and Aim: Pistachio nut and hull have anti-inflammatory, antimicrobial and antioxidant effects. The aim of this study was to investigate the effects of pistachio hull hydroalcoholic extract ointment on wound healing process. Materials and methods: For wound planimetric assessment, 20 healthy rats were randomly divided into 5 groups of 4, including control group (open wound without any intervention and treatment), positive control group (open wound with basic ointment without extract), and the 3 other groups receiving 1%, 2% and 4% ointments respectively. On the 7th and 14th days, biopsies from wound tissues were taken and after Mason Trichrome staining we evaluated collagen. H&E staining was done for histopathological assessments. Results: The results showed that wound treatment with pistachio hull ointment in the experimental groups showed a significant increase (P

Introduction: Barley is one of the most important crops that is cultivated in many areas and is mainly used in livestock and poultry feed and malt production industry. Some physical and biochemical properties of grain are very effective on the quantity and quality of the grain, malt production, and its nutritional properties.Materials and methods: In this study, seven Iranian and European barley cultivars (Hordeum vulgare subsp. Vulgare) and two wild barley genotypes (Hordeum vulgare subsp. Spontaneum (K. Koch)) were studied for some physicochemical characteristics of the grain.Results: Based on the results, genotypes were significantly different for all studied traits except moisture content and percentage of soluble sugar, and wild genotypes showed a higher mean for most traits. Cluster analysis divided the genotypes into three groups. The lowest and highest values of genetic variation coefficient were obtained for moisture content and iron content, and the lowest and highest values of phenotypic and environmental variation coefficients were recorded for grain thickness and grain iron content, respectively. Broad-sense heritability was estimated to be high for ash percentage, grain length, width and thickness, and thousand kernel weight. Ash percentage and thousand kernel weight had a higher percentage of mean genetic advance. The coefficient of phenotypic variation of all traits was higher than the coefficient of genetic variation. The small difference between the coefficient of phenotypic and genotypic variations for length, width, thickness, and weight of thousand kernel weight indicates the greater influence of genetic factors on the control of these traits. On the other hand, the genetic and phenotypic correlation coefficients of some traits were significant, which indicates the possibility of simultaneous breeding of the two traits.Conclusion: According to the results and the significant differences in physicochemical characteristics, the selection of a wild genotype and a cultivated variety with a suitable genetic distance based on ash percentage, iron and zinc content, grain protein and high thousand kernel weight was found to be suitable for creating a segregating population.

BackgroundDiabetes imposes an enormous burden on patients, families, societies, and healthcare systems. Determining the affordability of medications is an important complicated and vague task, especially in low- and middle-income countries (LMICs). This study aimed to assess the affordability of diabetes medication therapy in Iran’s health system. MethodsThis paper presents a scenario-based assessment of the affordability of all registered anti-diabetes medications in Iran in 2017. To this end, 4 medication therapy scenarios were defined as mono, dual, triple, and insulin therapy in accordance with the existing guidelines and clinicians’ opinions. Then the affordability ratio of each treatment scenario was determined for type 1 and type 2 diabetes drawing on the World Health Organization (WHO)/Health Action International (HAI) Methodology. If the affordability ratio for treatment schedules was more than 1, the patients’ out-of-pocket (OOP) expenses exceeded the lowest-paid unskilled government worker (LPGW)’ wage per day, and the treatment was labelled as non-affordable. ResultsThe results revealed that the mono, dual, and triple (non-insulin) medication therapies in type 2 diabetes were affordable, despite an increase in the dosage or a switch from the monotherapy to the combination therapy of oral medications. However, some treatment scenarios in the triple therapy, including oral plus insulin and some insulin only therapies, were proved to be non-affordable. In type 1 diabetes, only insulin glulisine, detemir, and lispro were non-affordable in monotherapy. Regarding the combination therapy, only isophane insulin with aspart or regular insulin were affordable treatments. ConclusionAlthough oral medication therapies were documented to be affordable, insulin therapy, with current coverage conditions, for patients with lowest paid wages and those receiving even less is unaffordable and a major barrier to treatment; hence, policy-maker should consider targeting and more financial protection policies to improve the affordability of insulin therapies among this group of patients.

The Islamic Republic of Iran provided a national action plan against antimicrobial resistance (NAP/AMR) for 2016-2021. In this study, we have dealt with the background and Iran’s efforts in this way, compare Iran’s NAP/AMR with other international programs, represent efficient policy options, and the evaluation indicators of each purpose of Iran NAP/AMR. The indicators of each group are represented through the consensus of three academic researchers. Finally, our assessment reveals that performing a constant observation is highly required for a prearranged NAP/AMR. The political parties and stakeholders should punctually receive interpretable feedbacks; also, it is very important to conduct periodical assessments with the purpose of perceiving the purpose feasibility and determining the dimensions that require advancements.

Abstract Background High toll of traffic-related injuries, climate change, natural disasters, population aging, as well as chronic diseases have all made considerable demands on receiving physiotherapy services in Iran. Nevertheless, there is an assortment of complications facing utilization of such services, particularly poor insurance coverage. Therefore, the present study investigated and identified gaps in insurance coverage in order to inform future policy reforms and the design of a more comprehensive and universal benefits package for physiotherapy services in Iran. Methods This project was carried out in Iran, using a mix-methods (viz. qualitative-quantitative) approach. Within the first phase, a qualitative study was completed to find policy recommendations. Such recommendations were then prioritized through the Analytical Hierarchy Process (AHP), in the second phase, based on effectiveness, acceptability, cost, fairness, feasibility, and time. Results Within the first phase, a total number of 30 semi-structured interviews with health policy-makers, health insurers, faculty members, rehabilitation experts, and physiotherapists were completed. Several policy recommendations were also proposed by the study participants. Following the second phase, prioritized recommendations were provided to promote stewardship (e.g., informing policy-makers about physiotherapy services), collection of funds (e.g., placing value-added taxes on luxury goods and services), pooling of funds (e.g., moving allocated resources towards insurance (viz. third-party) mechanism), purchasing (e.g., using strategic purchasing), and benefit package (e.g., considering preventive interventions) as the main components of insurance coverage. Conclusion The study findings provided a favorable ground to improve insurance coverage for physiotherapy services in Iran. As well, decision- and policy-makers can place these recommendations on the agenda in the health sector to protect population health status, especially that of groups with disabilities.

Abstract Background Policymaking in the pharmaceutical sector plays a pivotal role in achieving the health systems’ goals. Transparency in the pharmaceutical policy could increase confidence in decision-making processes. This study aims to assess transparency in the public pharmaceutical sector of Iran. Methods This qualitative study with a content analysis approach was conducted in 2017 using the World Health Organization tool to explore pharmaceutical transparency. The perceptions of the various stakeholders of the health system through semi-structured interviews with a maximum variation of stakeholders were obtained in eight functions, including registration, licensing, inspection, promotion, clinical trials, selection, procurement, and distribution of medicines. Results There are some problems in two main categories: (1) General problems, including lack of transparency, conflict of interest, centralization, and monopoly. (2) Ethical problems include illegal payments, gifts, bribes, conflicts of interest, hidden power, hoarding, relationship-oriented behavior, medicine trafficking, and counterfeit medicine. Suggested solutions include evidence-based decision-making, the use of transparent and accountable processes, standardization, needs assessment, declaring a conflict of interest, skilled human resources, and tracking prescription. Conclusion Despite the development of effective pharmaceutical policy in the health care system and government interventions for the control of the market, in some functions, reviewing the pharmaceutical policy is essential. Additionally, declaring a conflict of interest statement must be at the core of policy development to provide greater transparency.

Abstract Introduction Social capital is critical to organizational dynamics, particularly in developing countries. This study explored strategies for enhancing social capital among faculty members at seven medical universities in the south of Iran. Methods This qualitative study was conducted in 2021. We used a purposeful sampling technique to recruit faculty members and conducted individual semi‐structured interviews with them. Thematic analysis was used to analyze and describe the collected data. Results A total of 49 faculty members (34 males; 15 females) participated in this study. The participants expressed satisfaction with their affiliations with medical universities. Social capital was related to the feeling of belonging to the organization, as well as to interpersonal and intra‐organizational relations. Social capital was associated with three components: empowerment, organizational policy change, and organizational identification. Additionally, a dynamic relationship between the individual, interpersonal, and macro‐organizational levels reinforced the organization's social capital. This means that, just as the macro‐organizational level affects the members' identities, the members' activism affects the macro‐organizational level. Conclusion To strengthen the organization's social capital, managers should work on the mentioned components at the individual, interpersonal, and macro‐organizational levels.

Abstract Background In the COVID-19 pandemic, rumors travel far faster than the outbreak itself. The current study aimed to evaluate the factors affecting the attitudes of individuals towards the rumors-producing media in Iran. Methods An online cross-sectional survey was conducted in Iran in March 2020 on the source of information and rumors, along with the perception of individuals regarding the reasons for rumors propagation during the COVID-19 pandemic. Results Results showed that the majority of the participants (59.3%) believed that social media were the main source of rumors. The lack of a reliable and formal news resource was also considered the most common cause of rumoring by the participants (63.6%). An evaluation was carried out to identify the main source of misinformation and rumors. Results showed that Retired participants considered foreign media (P

The aim of the present study was to assess the wound-healing activity of extract of Allium stipitatum. Thirty-six male Wistar rats were used in this study. The rats weighing approximately 160-180 g and seven weeks of age were randomized into three groups of 12 rats each: Control surgery group (Control) including the creation of wounds and no treatment, base formulation groups positive (POS) with the creation of wounds and application of base formulation ointment, treatment group 1 (T1) with 2 g of powder extract of the plant material in the ointment. A wound was induced by an excisional based wound model in male rats. The mature green leaves of Allium stipitatum were collected and authenticated. Extractions of dried leaves were carried out. For wound-healing activity, the extracts were applied topically in the form of ointment and compared to control groups. The healing of the wound was assessed based on the wound area, histomorphometry, and hydroxyproline estimation studies. Reduction in the wound area and hydroxyproline contents indicated that there was a significant difference (p = 0.001) between group T1 and other groups. Quantitative histological studies and mean rank of the qualitative studies demonstrated that there was a significant difference between group T1 and other groups (p = 0.001). The extract of Allium stipitatum leaves enhanced wound-healing activity significantly in both the wound models studied. Enhanced wound contraction, decreased epithelialization time, increased hydroxyproline content, improved histological characteristics studies suggested Allium stipitatum leaves extract might have therapeutic benefits in wound healing.

Abstract Background The government is the main body in charge of controlling epidemics; hence, expectations from the intention and capacities of the government would affect the flexibility and behaviors of citizens. Given the severity of COVID-19 pandemic and the urgent need for cooperation of people in the prevention and combat processes, understanding the public perspectives would be crucial and instructive. This study aimed to explore such perspectives towards the current pandemic among the Iranian. Indeed, we sought to provide a favorable platform for effective policies in the face of the COVID-19 pandemic through recognizing public expectations. Methods This cross-sectional survey used an open-ended online questionnaire to investigate the common perspectives of the Iranian towards the response of government to COVID-19 pandemic. The participants were selected using snowball and convenient sampling techniques across the country. The collected data were analyzed and described using a thematic analysis. Results In general, 2547 participants agreed to participate in this study and completed the online questionnaire. According to the findings, the Iranian exhibited several expectations regarding the response of the government to COVID-19 pandemic. Three main themes were extracted based on these expectations: (1) health-related expectations, (2) policy-related expectations, and (3) Information-related expectations. In this study, a majority of participants highlighted the need to consider and follow-up the patients and their families, providing the financial and hygiene support during the pandemic, applying strict restrictions, and using close monitoring and controlling procedures. Furthermore, they mentioned that authorities and news agencies should observe the principals honesty and transparency. Conclusions Our findings revealed that people expect the government and other responsible institutions to minimize the burden of this pandemic through adopting effective policies. Also, they could help policy-makers become aware of the expectations of people and develop better strategies.

Abstract Background Drug shortage is a significant public health problem, especially for drugs related to life threatening conditions. Almost all countries affected by variety of supply problems and spent a considerable amount of time and resources responding to shortage. The aim of present study is to determine and prioritize strategies to achieve best solutions for these considerable healthcare system challenges and to evaluate this strategies base on practical criteria. Methods To achieve the study objectives, the research was conducted in two phases. Determining of the strategies to control drug shortage, and comprehensive assessments of priority of possible strategies. For each phase, a self-design questionnaire was developed. The five main managerial strategies dimensions including: regulatory, financial, supply chain, information system and policy-making were set out. Forty-five alternatives were elicited from literature, and were evaluated and trimmed to 37 strategies based on experts’ opinion. The Multiple criteria decision-making (MCDM) methods were applied in second phase. Five important criteria including cost, time, labor, compliance with law and culture were weighed by Analytic Hierarchy Process (AHP) technique. Then, 37 alternatives have been rated base on the five criteria on the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) technique. Results “Creating integrated Supply chain information system to manage medicines inventory in the country”, “Creating and using the databases to predict the shortage of medicines”, “Using track and trace system” are alternatives 20th, 24th and 25th, which related to supply chain (SC) and information system (IS) dimensions have higher priority in the experts’ point of view. The results show IS dimension has 100 percentage of priority; following that policy and supply chain have higher priority, respectively. Conclusion Health systems rely on consistent supplying of pharmaceuticals to support patient care. The results show that information system, policy-making and supply chain are in the top-ranking priorities. Warning system needs to be improved to the advance system via better collaboration with stakeholders, publish precise and explicit national guidelines for drug shortage management, enforce the guidelines, and improve Iran FDA’s pharmaceutical market control capability.

Abstract Background and Aims COVID‐19 has adversely impacted the public's mental health. One of the causes of psychopathology during the present pandemic is death anxiety and fear of COVID‐19. The present study aimed to determine the prevalence and risk factors of death anxiety and fear of COVID‐19 in Shiraz city, south of Iran. Methods This cross‐sectional study was conducted among 982 participants in Shiraz from October to November 2021. Data were collected using Templer's Death Anxiety Scale and the Fear of COVID‐19 Scale. Trained interviewers collected data throughout different city districts. A data‐driven approach (latent class analysis) was applied to categorize the participants and determine the risk factors. Results Among the participants, 507 (51.6%) were female, and 475 (48.4%) were male. The participants’ mean age was 38.26 ± 15.16 years. Based on the analysis, 259 (26.4%), 512 (52.1%), and 211 (21.5%) participants had low, moderate, and severe levels of death anxiety. Also, 393 (40.06%) and 588 (59.94%) of the participants had low and high levels of fear, respectively. Higher death anxiety was significantly associated with being female, having an associate degree, being retired, share of medical expenditure from total expenditure of more than 10%, having a history of hospital admission due to COVID‐19, history of COVID‐19 in relatives, and having fear of COVID‐19. Also, being female, expenses equal to income, history of hospital admission due to COVID‐19, death in relatives, and higher death anxiety were linked to higher levels of fear of COVID‐19. Conclusions Death anxiety and fear of COVID‐19 are closely associated with each other and affected by various sociodemographic and economic factors. Given this pandemic's unpredictable nature and chronicity, interventions at the community level to support high‐risk groups are crucial.

Abstract Background The COVID-19 outbreak is a global pandemic, during which the community preventive and protective behaviors play a crucial role in the containment and control of infection. This study was designed to contribute to the existing knowledge on how risk communication (RC) and risk perception (RP) affect protective and preventive behaviors (PPB) during the COVID-19 outbreak. Methods The required data were extracted from a national online survey of Iranian adults aged 15 and older during March 15–19, 2020 (n=3213). Data analysis was performed using structural equation modeling. Results The study findings reveal that RC has direct and indirect positive effects on PB. Furthermore, this study also provides new evidence indicating that RP mediates the relationship between RC and PB and there is a two-way relationship between RC and RP. These interactions may have impact on risk communication strategies which should be adopted during this pandemic. Conclusion The study findings have remarkable implications for informing future communications as well as interventions during this ongoing outbreak and subsequent national risk events.

Abstract Aim The global outbreak of coronavirus in 2020 was considered as a serious risk for healthcare providers, especially nurses. This study aimed to investigate nurses’ perceptions and experiences of COVID‐19 outbreak in Iran. Design This thematic analysis study was conducted in March 2020. Method Semi‐structured interviews were conducted with 24 nurses in Qazvin, Arak, Shiraz and Kashan cities of Iran. Results It was found out that all the participants had faced a mysterious world created by the virus. No one had clear understanding of the new virus and knew how to tackle with such a virus. In this case, the main experiences were related to defected preparedness, the worst perceived risk, family protection, social stigma and sacrificial commitment. Urgent preparedness of facilities in such outbreaks is inevitable. Accordingly, psycho‐social support of nurses and their families and strengthening their sacrificial commitments are proposed in these conditions.

Objective: The purpose of this study was to document the demographic data, to assess the proportion of consumed medicines and the amounts and types of drugs available to households, and to to estimate the probable prevalence of certain diseases in the southern region of Iran. Methods: In this cross-sectional population-based study carried out in Shiraz (the central city in the Southern part of Iran), we documented and evaluated the drug usage details in a random sample of 1000 households during 2018–2020. We analyzed the usage of drug categories based on the anatomical therapeutic chemical classification, which the World Health Organization recommends. Findings: In the studied population, the average age (± standard deviation) was 45.54 ± 15.82, ranged 18–91 years. More than 90% had medical insurance coverage. About 81.8% of the participants had individual family medicine practitioners, and most of them (93.8%) received medications with a physician's prescription. The most frequently used medications were cough and cold preparations (12.9%), nervous system drugs (12.6%), and cardiovascular system drugs (11.6%). Conclusion: Despite the easy access to medications for most participants, few individuals (about 6%) received their medications without a prescription. The most frequently prescribed medicines were the common cold, acetaminophen, and metformin. Common cold, gastrointestinal (GI) disorder, and diabetes were the most commonly used medication classes. Furthermore, we have found a probably higher than average prevalence of cardiovascular, GI, and endocrine disorders. This information could be used by the local policymakers as a basis for the estimation and allotment of health-care resources.

Objective: Despite growing debates about the health systems' nonmedical performance, there has not been any empirical research on nonmedical performance and patients' rights consideration as a driver of human rights in the pharmaceutical sector. This study's main objective was to assess the nonmedical performance of community pharmacies of Shiraz, Iran. Methods: A cross-sectional study was conducted using two self-administrated Likert-based questionnaires based on the World Health Organization (WHO) responsiveness framework and the legal charter communicated by the Ministry of Health and Medical Education of Iran. The population was patients older than 18 years who took a prescription from community pharmacies located in Shiraz and willing to answer the questions voluntarily, from 2018 to 2019. Considering the weights of subdimensions of responsiveness provided by the WHO framework, the total score of responsiveness was calculated ranging from 0 to 100. Findings: The response rate was 80.5%. The mean (standard deviation) overall score of responsiveness was 57.18 (21.61), with a median of 56.71. The mean score of client orientation was lower in respondents with a high education level than those with a diploma and under diploma (P = 0.028). Conclusion: Nonmedical pharmacy performance was considered either medium or high in more than half of the cases based on the participants' views. Regarding client, orientation was seen less often in patients with high education level compared to those with a lower education level.

Abstract Background Corona virus epidemic may be acts as a stressor or trauma that affects both physical health and mental health. People exhibited various reactive behaviors to confront with this stressful situation. In Iran, one of the common motives for alcohol consumption is to scape problems and cope with stresses. It has been shown that personality factors influence alcohol consumption, since they are associated with drinking motives. The main purpose of this study was to investigate the correlation between temperament and character and alcohol abuse. Methods This cross-section study was conducted on 135 alcohol intoxicated patients admitted to emergency room in March 2020 and 255 participants who were randomly selected from public in Shiraz. A questionnaire consisted of TCI (Temperament and character inventory) and several questions about COVID-19 pandemic. It was completed by a trained interviewer using the matched answer technique. Demographic factors were self-reported. Results Among the alcohol intoxicated group, 117 (86.7%) were males and 18(13.3%) were females. The mean age of the participants was 32.43 ± 10.81 years. Among control group, 99 (38.8%) were males and 156 (61.2%) were females. The mean age of control group was 33.12 ± 14.77 years. Alcohol toxicity was mostly observed among the young males (male/female ratio was 6.45). According to temperament and character index, mean scores of novelty seeking, harm avoidant, and self-transcendence were higher in the alcohol toxicity group than normal population (P

Abstract Background The current corona virus pandemic is acting as a stressor or trauma, which not only threats physical health status, but also threats mental health status and well-being of people. Currently, COVID-19 pandemic is a life-threatening unpredictable condition accompanied with a large number of uncertainties. The present study has mainly aimed to assess mental health and the relevant social factors during this pandemic in Fars province. Methods This cross-sectional study was performed on 922 participants in Fars province, Iran, using internet-based data collection technique. All the included participants filled out the General Health Questionnaire (GHQ-28). Moreover, demographic variables and some social factors were evaluated by asking some questions. All the participants were ensured of the confidentiality of the collected data, and willingly completed the questionnaire. Results Among the participants, there were 629 women (68.2%) and 293 men (31.2%). The mean age of the participants was 36.98 ± 11.08 years old. Four hundred twenty-five subjects (46.1%) obtained GHQ-28 scores above the cut-off point, and accordingly, they were suspected of having poor mental health statuses. Women, in comparison to men (OR = 2.034, 95%:1.62–3.28), and individuals aged 50 years old (OR: 4.01 95%:2.15–7.50), have poorer mental health statuses. Trusting on media, health authorities, and cooperation with policy makers, as well as having uncertainty on information about Coronavirus pandemic were also shown to be associated with poor mental health condition (P

Abstract Background The present study aimed to develop an Analytic Network Process (ANP) model to assist policymakers in identifying and prioritizing allocation indicators, which are being used or should be used to distribute drugs in short supply among different provinces. Methods The model encompasses the interactions between various indicators and efficiency, equity, and effectiveness paradigms. Accordingly, a set of clusters and elements, which were associated with the allocation of drugs in short supply in Iran’s pharmaceutical system, were detected to develop the model and were then compared in pairs in terms of a specified factor to show the priorities. Results Equity had the highest priority (0.459) following by Efficiency (0.37), and Effectiveness (0.171). The 4 most important allocation indicator were “number of prescriptions” (0.26) and “total bed occupancy rate” (0.19) related to equity, “total population” (0.21) in efficiency and “the burden of rare and incurable disease” (0.07) in effectiveness paradigm. Conclusions The capability to overcome inefficient resource allocation patterns caused by both oversupply and undersupply derived from historic resource allocation may be highly limited in the absence of the need indicators. The quality of the decision is related to a careful balancing act of the three paradigms which represents roughly the triple aim of public healthcare systems: clinical improvement (effectiveness), population health improvement (equity and access), and reducing cost (economic aspects -efficiency).

Diabetes is one of the most common non-communicable diseases that have far-reaching economic and social consequences and threaten the national production and economy of countries. However, diabetes is a disease of self-control. Therefore, self-care strategies can maintain patients' independence while reducing the burden imposed on health care resources. This study aimed to investigate the factors affecting self-care behaviors in diabetic patients. This study is a systematic review; Google Scholar, SID, Scopus, PubMed, Science Direct, and ISI databases were used; 17,500 articles were found including the keywords "self-care", "diabetes" and "affecting factors" in the search process and all studies after 2010 were included. After reviewing the titles and abstracts, 51 studies were included. The studies' reports on self-care behaviors and their prevalence were very different depending on the tools used . The studies show the relationship between various factors including demographic, socio-economic, and psychological with self-care behaviors in patients with diabetes, which the most important variables included educational status, age, gender, marital status, BMI, occupational status, duration of illness, comorbidities, income, having glucometer, perceived severity of the disease and its complications, perceived barriers, diabetes distress, diabetes knowledge, perceived susceptibility, self-efficacy, social and family support, depression, anxiety. Due to the relationship of demographic, socio-economic, and psychological factors with self-care behaviors in patients with diabetes, it is suggested that a comprehensive program for the management of caring behaviors in diabetic patients should be designed to include all of the above.

Background The argument about funding criteria poses challenges for health decision-makers in all countries. This study aimed to investigate the public and decision-maker preferences for pharmaceutical subsidy decisions in Iran. Methods A discrete choice experiment (DCE) was used for eliciting the preferences of the public and decision-makers. Four attributes including health gain after treatment, the severity of the disease, prevalence of the disease, and monthly out of pocket and relevant levels were designed in the form of hypothetical scenarios. The analysis was done by using conditional logit analysis. Results The results show all of four attributes are important for pharmaceutical subsidy decisions. But a medicine that improves health gain after treatment is more likely to be a choice in subsidy decisions (by relative importance of 28% for public and 42% for decision-makers). Out of pocket, severity, and prevalence of disease subsequently influence the preferences of the public and decision-makers, respectively. The greatest difference is observed in changing the health gain after treatment and out of pocket levels, between public and decision-makers. Conclusion This research reveals that the public is willing and able to provide preferences to inform policymakers for pharmaceutical decision-making; it also sets grounds for further studies.

Aim This study estimated the GDP share of pharmaceuticals in Iran based on the drivers of pharmaceutical expenditure and compared it with that of 31 members of the Organisation for Economic Cooperation and Development (OECD). Subject and methods The factors contributing to pharmaceutical expenditure were identified through literature review and studied by 8 experts to classify the factors. Then, using the panel data method, a model was built to estimate the GDP share of pharmaceutical expenditure based on the extracted factors of the selected countries in Iran’s model. To explain the observed differences, several regression analyses were performed based on cross-sectional data. The analyses were performed using EVIEWS software, version 10. Results The explanatory variables for the selected countries in the panel model (R 2 = 0.98) were specified. Government health expenditure (β = 0.1432), the share of generic drugs (β = − 0.0143), gross domestic product (GDP) per capita (β = − 0.0058) and the rate of disability-adjusted life-years (DALY) (β = 0.0028) contributed most to pharmaceutical expenditure. In comparison, in the Iranian estimation model (R 2 = 0.84), government health expenditure (β = 0.0536) and the share of generic drugs (β = 0.0369) had a significant impact on pharmaceutical expenditure. In the estimation model with more estimators for Iran (R 2 = 0.99), government health expenditure (β = 0.1694), disease prevalence (β = 0.0537), the share of generic drugs (β = 0.0102), the DALY rate (β = 0.0039), GDP per capita (β = − 0.0033), and the drug price index (β = 0.0007) contribute most to pharmaceutical expenditure. Conclusion In the models of the study, factors related to the structure of the healthcare system and the pharmaceutical system contributed most to pharmaceutical expenditure as a share of GDP. Moreover, disease profiles show its predictive role in the second model for Iran.

Objective: Patients' complain regarding pharmaceutical services at community pharmacies is a fundamental issue as it can directly affect people's service utilization. For the first time in Iran, this survey aimed to investigate the experience of people regarding declare a complaint against the pharmacy sectors as a community-based study. Methods: In this cross-sectional study, over 100 samples based on postal codes were randomly selected from the city of Shiraz in 2017–2018. The data collection instrument was designed in two parts (demographic and social profile which record the complaint experiences against pharmacists, pharmacy services, etc.). The data were analyzed by SPSS. Findings: All 1035 eligible participants had a mean age of 45.54 ± 15.82 years (ranged from 14 to 91). Nearly 70% of the participants were female. Around 81.8% had a family physician coverage, whereas 7.4% of them had no medical insurance coverage. The frequency of complaints from the pharmacies was 35.6%. Nearly 55% of the complaints were related to governmental pharmacies. Homemakers were 1.36 times more likely to have experienced complaints in comparison with their employed female counterparts. Health status had an inverse association with complaints. Those participants who had received prescription medication were about two times more likely to have filed a complaint in comparison with those who received medication without a prescription. In addition, females aged 40–59 and above 60 and unemployed participants were more satisfied with respect to complaint follow-up process. Conclusion: Low level of satisfaction with respect to the complaint process is a concerning issue; hence, strategies are warranted to improve the quality of services provided in the pharmacies.

The aim of this paper was examining the combined impacts of CuO nanoparticles (CuO NPs), hyperthermia (H), and irradiation (R) on an increment of MCF-7 cells. The MTT assay was employed to assess the antiproliferative effects of CuO NPs (25, 50, and 100 μg/ml), hyperthermia (41 °C for 1 h), and irradiation (200 cGy). Moreover, the perniciousness was estimated through the survival capability of cells, and apoptosis, ROS production, and levels of caspase-3, -8 and -9 proteins were determined. A significant (p < .01) decrease in proliferation index (0.124 ± 0.021), a significant (p < .01) increase in apoptosis (42% ± 1.54) of MCF7 cells, a significant (p < .03) increase in ROS formation (32.16 ± 1.9) and a significant (p < .01) increase in LDH release (33.28 ± 1.56) were recorded in the adjacency of MCF-7 cells by a combination of CuO NPs (100 µg/ml) and R + H compared to control and other treatments. The activities of caspase-3 (0.33 ± 0.014) and caspase-9 (0.389 ± 0.019) also increased significantly (p < .05). However, caspase-8 showed no significant changes in its activity (p = .065). Based on these observations, a combination of CuO NPs, hyperthermia, and irradiation could suppress the growth of MCF-7 cells and evoke cell apoptosis via mitochondrial membrane potential.

Background: Breast cancer is the most common cancer and the second leading cause of cancer death among women. Regarding that chemotherapy drugs are often associated with adverse effects on the patients. Common medicinal therapies for breast cancer have often short term effects and some of them lead to drug resistance. The target of this study is to determine the effects of aqueous and hydro-alcoholic extract of Aloe Vera on MCF 7 cells. Materials and Methods: After culturing MCF7 cancer cells in the PRMI 1460 medium, both aqueous and hydro-alcoholic extract of Aloe Vera was prepared in concentrations of 20, 40, 60, 80 and 100 μg/mL from bulk solution. Then MCF7 cells were contacted with different concentration of prepared extract. The MTT test and Acridine Orange / Propidium Iodide (AO/PI) stained was used to determine the survival rate of cells. Doxorubicin (0.1 Mm) was used as positive control. The T-Student test was used in order to analyze the data using SPSS 21. p< 0.05 was considered as significant level. Result: The results of MTT assay and viability showed that different concentrations of ethanol extracts of Aloe Vera plant to the concentration of the extract significantly and dose-dependently decreased cell proliferation of MCF7 gets (p < 0.05). Conclusion: It seems should be considered that hydro alcoholic extract can be used as a natural compound in the treatment of breast cancer.

Objective: The present study was aimed at assessment of effect of application of Chitosan/Nano Selenium biofilm on infected wound healing in ratsMethods: Sixty-eight male Wistar rats were randomized into four groups of 17 animals each. In group I (Normal) the wounds were created with no infection. In group II (MRSA), the wounds were infected with methicillin resistant Staphylococcus aureus (MRSA). In group III (MRSA/CHIT), animals with infected wounds were dressed with chitosan biofilm only. In group IV (MRSA/CHIT/NS), animals with infected wounds were dressed with Chitosan/Nano Selenium biofilm.Results: There were significant differences in comparisons of group IV and other groups, particularly in terms of cellular infiltration and neovascularization. During the study period, scores for neovascularization was significantly higher in group IV rats than other groups (P

Objective - The objective of the present study was to assess effect of Propolis in combination with chitosan biofilm on excisional wounds. Design- Experimental Study.Animals- Male healthy Wistar rats.Procedures- Sixty-four rats were randomized into four groups of 16 rats each. Group I: Animals with wounds treated with 0.9% saline solution. Group II: Animals with wounds were dressed with chitosan biofilm. Group III: Animals with wounds were treated topically with Propolis and Group IV: Animals with wounds were treated topically with Propolis and dressed with chitosan biofilm. Wound size was measured on 6, 9, 12, 15, 18 and 21days after surgery. Histological studies were performed on three time points of 7, 14 and 21 days post-wounding. Results- Planimetric studies and quantitative histological studies and mean rank of the qualitative studies demonstrated that there was significant difference (P < 0.05) between group IV and other groups. Conclusion and Clinical Relevance- It was concluded that the Propolis with chitosan biofilm had a reproducible wound healing potential in excisional wounds in rats.

Accountability has been widely considered the leading cause of student achievement and received much attention in recent years. Unlike the researchers in America and European countries, few scholars have addressed learner accountability in Iran to evaluate its effect on different EFL contexts. This mixed-method research design study compared the level of learner accountability between public high school students and English language institute learners. Data were gained from 150 high school students and 150 English language institute learners through a researcher-made learner accountability questionnaire. Moreover, 15 high school students and 15 language institute English learners participated in the qualitative phase of the study to strengthen and expand the study’s conclusions. Both instruments were piloted and validated. Through exploratory factor analysis, seven underlying variables of learner accountability were confirmed. The internal consistency of the questionnaire was high and the reliability of the learner accountability questionnaire was .89. The results of the t-tests revealed a higher statistical level of learner accountability in the context of English language institutes. The findings of this research may contribute to motivating English learners to consider the significance of their roles in active and independent learning.

Abstract Background Recent years have witnessed a strong tendency to apply economic evidence as a guide for making health resource allocation decisions, especially those related to reimbursement policies. One such measure is the use of the cost-effectiveness threshold as a benchmark. This study explored the threshold for use in the health system of Iran by determining society’s preferences. Methods A cross-sectional household survey based on the contingent valuation method was administered to a representative general population of 1002 in Tehran, Iran from April to June 2015. The survey was intended to estimate the respondents’ willingness-to-pay (WTP) preferences for one quality-adjusted life year (QALY) gained. The valuation scenarios featured 12 vignettes on mild to severe diseases that can change people’s quality of life. The mean of WTP for QALY was estimated using different health instruments, and the determinants of such willingness were analyzed using the Heckman selection model. Results WTP for QALY varied depending on the severity of a disease and the instrument used to determine health preferences. Mean low health state value were associated with high valuation. The best estimated WTP values ranged from US$1032 to US$2666 and 0.22–0.56 of Iran’s local gross domestic product (GDP) per capita in 2014. Except for educational level, significant variables differed across different disease scenarios. Generally, a high health state valuation for target diseases, high income, high educational level, and being married were associated with high WTP for QALY. Conclusion From the general public’s perspective, the monetary value of QALY for mild to severe diseases with no risk of death was less than one GDP per capita. Therefore, the obtained valuation range is recommended as reference only for the adoption of interventions designed to improve quality of life. Future studies should estimate the threshold of interventions for life-threatening diseases or formulate transparent policies in such contexts.

Background: Gestational diabetes is one of the common causes of maternal and fetal complications. Due to fetal and maternal complications of diabetes, it is very important to reduce the prevalence of diabetes and its consequences. The relationship between vitamin D deficiency and type 2 diabetes has been reported. There is little information about the relationship between serum vitamin D levels and the risk of gestational diabetes mellitus (GDM). The aim of this study was to determine the relationship between the levels of vitamin D and gestational diabetes. Methods: This case-control study was conducted in health centers of Urmia University of Medical Sciences in May 2015 until March 2016. A total of 100 pregnant women with gestational diabetes and 100 healthy pregnant women were entered into the study by nonrandom and available sampling. The level of vitamin D was measured and levels were divided into three levels. Vitamin D levels were considered less than 20 ng/ml, 20-30 ng/ml and more than 30 ng/ml as deficiency, insufficiency and sufficient, respectively. Exclusion criteria include pre-pregnancy glucose tolerance, history of medical disease, and supplementation with vitamin D. Results: The mean age of women in the study group was 30.31±5 years and in the control group was 28.83±4.95 years (P=0.06). The vitamin D levels in GDM and control groups were 7.25±4.76 ng/ml and 11.93±16.12 ng/ml, which is lower in the gestational diabetes than the control group (P=0.01). The severe deficiency of vitamin D in the gestational diabetes group and in control group were 34% and 27% respectively (P

Objective: Busulfan(Bus) is a chemotherapy drug that is widely used for cancer treatment. The protective effect of CoQ10 evaluated on testis and sperm parameters after busulfan treatment. Design: Experimental StudyAnimals: Thirty tow adult male Wistar rats Procedures: In this experimental study 32 adult male Wistar rats have randomly divided into four groups: Control group received normal saline (0.1 mL, daily, intraperitoneally). Sham group received a single dose of busulfan 10 mg/kg, IP. Positive control group received 0.1 mL CoQ10 (10 mg/kg, IP). The treatment group received busulfan along with CoQ10 (10 mg/kg, IP). All procedures were continued for 35 days. For histomorphometric analyses, the thickness of testicular capsule, the germinal epithelium height and the diameter of the seminiferous tubules were measured. Semen analysis was used for the assessment of sperm parameters. Results: Histomorphometric analyses showed the thickness of testicular capsule was increased in busulfan groups (PConclusion and Clinical Relevance: Administration of CoQ10 in busulfan-treated animals improved histological and sperm quality.

Objective- The studies have been shown that aspirin, an anti-inflammatory agent, could reduce occurrence of different cancers. The aim of the present study was to evaluate pharmacological effective concentrations of aspirin with/without radiotherapy on growth rate of MCF-7 breast cancer cell lineDesign- Experimental StudyAnimals- The MCF-7 breast cancer cell line from ratsProcedures- The MCF-7 breast cancer cell line was prepared commercially and cultured. The cultured cells were then separated to labelled tubes and treated for 24 hours with 1, 2, 3, 4, and 5 mg aspirin plus 0.1 mg doxorubicin. Cells were then exposed to radiation. Cell proliferation and survival were measured by MTT assay, following acridine orange and propidium iodide staining methods using spectrophotometry and fluorescence microscopy.Results- The findings showed that proliferation and survival of the cells treated with 5 mM aspirin followed by radiotherapy were significantly decreased compared to them of the control group (PConclusion and Clinical Relevance- Although anti-proliferative activity of aspirin was lower than that of doxorubicin, it can be considered in combination therapy because of its affordability and cost-effectiveness

Objective- Breast cancer is one of the most serious problems in oncology. Alkaloids pyrrolizidine are widely found in nature and exhibited versatile biological activities. The aim of the present study was to assess anti-tumor activity of methyl 1,3-dioxo-1,1',2',3,5',6',7',7a'-octahydrospiro[indene-2,3'-pyrrolizidine]-2'-carboxylate (6) on 7,12 dimethylbenz(a) anthracene (DMBA)-induced mammary tumors in rat. Design- Experimental study. Animals- Twenty-one female Wistar ats Procedures- 7-Week-old female Wistar rats (180 g body weight) were randomized into three groups of seven animals each. DMBA-induced mammary tumors was achived using DMBA dissolved in 1ml of vehicle (0.5 ml of DMSO plus 0.5 ml of saline) and injected by subcutaneous injection beneath the mammary gland on either side. Tumor yield and size were stabilized after 90 days with the initiation of DMBA. Healthy intact animals (NC) were considered as a normal control feeding on pellets and tap water. In group DMBA, the tumor was induced by DMBA. In group DMBA/7d the animals with tumor received 100 µL 6 dissolved in DMSO (0.25 µM) solution intraperitoneally for one week. Synthesis of 6 was accomplished and the structure of new product was assigned by their 1H/13C NMR, IR, CH-COSY and mass spectral data as well as the elemental analysis. Results- The overall tumor analysis showed that 6 treatment significantly inhibited the breast tumor incidence, tumor multiplicity, and tumor size in the DMBA-initiated rat model. 6 treatment significantly inhibited the total volume of tumors per rat. Conclusion and Clinical Relevance-The findings of the present study showed that the 6 treatment was significantly effective in reduction of tumors versus the cancer controls.

Background & Objective: In the previous studies, the beneficial effects of oral administration of probiotic bacteria in treatment of some gastrointestinal cancer have been documented. The main aim of this study was to evaluate the direct effects of the bacterial cell wall extract Bifidobacterium bifidum on proliferation of human erythromyeloid cancer cell line K562. Material & methods: After culturing the bacteria, and preparing cell wall fractions, dilutions of 1000, 2000, 4000 and 8000 µg/ml bacteria cell walls were prepared in sterile conditions. K562 cells and peripheral blood mononuclear cells (PBMC) were cultured in a conventional manner in the presence of different concentrations of bacteria from cell wall extract with the doxorubicin concentration of 0.1 mM. In order to assess the anticancer property of the abovementioned extract the MTT test was utilized. The T-Student test was used in order to analyze the data using SPSS 21. Results: The minimum effective concentration of bacteria extract on the viability of K562 cells and PBMC was 2000 and 4000 µg/ml, respectively. Conclusion: The selected bacterial extract killed more cancer cells than PBMC cells.

The identification of associations between molecular markers and agronomic traits provides an excellent tool for indirect selection of traits of interest in a population. In this study, a stepwise regression analysis was used to estimate associations between inter-simple sequence repeat (ISSR) and random amplified polymorphic DNA (RAPD) markers with some agronomic traits in barley genotypes. Two-year average values for the measured traits under rain-fed and irrigation conditions were used for association analyzes. Thirty-one random RAPD and 20 ISSR primers were used in the study. The results of the stepwise regression analysis revealed significant associations between the traits and some of the studied loci. For all traits more than one informative marker was detected. A total of 88 informative markers, including 32 ISSR loci and 56 RAPD loci, were identified under both tested conditions. OPC4-1050, E17-400, and E19-1100 markers were associated with grain yield, biomass and spike length, respectively, under both tested conditions. These markers are relatively more reliable than other identified markers. Among the RAPD primers, special attention should be drawn to primer E17, which produced the highest number of fragments associated with traits such as biomass, plant height, spike length and number of seeds per spike, under rain-fed conditions. Moreover, the UBC856 ISSR primer revealed loci associated with grain yield, plant height and number of sterile spikelets per spike under irrigated conditions.

Objective: To assess the effect of combination of pulsed electromagnetic fields (PEMF) with predatory stress on transected sciatic nerve regeneration in rats. Methods: In sham- operated group (SOG) the nerve was manipulated and left intact. The 10-mm rat sciatic nerve gap was created in rats. In transected group (Transected) nerve stumps were sutured to adjacent muscle and in vein graft group (VG) the gap was bridged using an inside-out vein graft. In VG/PEMF group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the whole body was exposed to PEMF. In VG/PS group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the rats underwent predatory stress (PS). In VG/PEMF/PS group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft, the whole body was exposed to PEMF and the rats underwent predatory stress. The regenerated nerve fibers were studied within 12 weeks after surgery.Results: Functional, gastrocnemius muscle mass findings and morphometric indices confirmed faster recovery of regenerated axons in VG/PEMF and VG/PEMF/PS groups compared to those in the other groups (p=0.001). The whole body exposure to PEMF improved functional recovery. Predatory stress did not affect nerve regeneration in the animals undergone predatory stress (p=0.343). Conclusion: Pulsed electromagnetic fields could be considered as an effective, safe and tolerable treatment for peripheral nerve repair in clinical practice.

Kernel size and shape are important parameters determining the wheat profitability, being main determinants of yield and its technological quality. In this study, a segregating population of 118 recombinant inbred lines, derived from a cross between the Iranian durum landrace accession “Iran_249” and the Iranian durum cultivar “Zardak”, was used to investigate durum wheat kernel morphology factors and their relationships with kernel weight, and to map the corresponding QTLs. A high density genetic map, based on wheat 90k iSelect Infinium SNP assay, comprising 6,195 markers, was developed and used to perform the QTL analysis for kernel length and width, traits related to kernel shape and weight, and heading date, using phenotypic data from three environments. Overall, a total of 31 different QTLs and 9 QTL interactions for kernel size, and 21 different QTLs and 5 QTL interactions for kernel shape were identified. The landrace Iran_249 contributed the allele with positive effect for most of the QTLs related to kernel length and kernel weight suggesting that the landrace might have considerable potential toward enhancing the existing gene pool for grain shape and size traits and for further yield improvement in wheat. The correlation among traits and co-localization of corresponding QTLs permitted to define 11 clusters suggesting causal relationships between simplest kernel size trait, like kernel length and width, and more complex secondary trait, like kernel shape and weight related traits. Lastly, the recent release of the T. durum reference genome sequence allowed to define the physical interval of our QTL/clusters and to hypothesize novel candidate genes inspecting the gene content of the genomic regions associated to target traits.

This study describes morphological diversity and relationship of 14 cultivars and 133 wild fig accessions from central Zagros Mountains located in the west of Iran, based on 58 morphological characters. Among all characters, secondary drooping branches, number of bark tubers, shape of central lobe, length of central lobe/length of lamina, little lateral lobes, shape of leaf without lobed, fruit shape, fruit weight, fruit neck length, fruit skin over color and fruit pulp cavity showed higher coefficient of variation (CV) indicating a high level of variation. The existence of high CV in the evaluated characters indicates that there is a high diversity among the studied cultivars and accessions. One of the important wild figs that called 'Ghir-vahshi' was found in 'Baba-Heyran 2' location showing very diverse characters. Cluster analysis divided the 147 genotypes into five main clusters. The results of principal components analysis showed that the first three components explained 33.22% of total variation in data. According to the factor analysis, eighteen factors justified about 75.62% of the total variation found among genotypes. The factor analysis showed that the most of discriminator variables were depend on leaf, fruit size and growth form. The obtained results revealed that central Zagros Mountains in the west of Iran is a rich source of fig genetic diversity which could be used for fig breeding programs.

Introduction and Aims Ruta Graveolens (RG) has been used in various medical preparations for its anti-oxidant, anti-inflammatory, anti-tumour, anti-androgenic and anti-fertility properties. More than 120 natural compounds mainly including acridone alkaloids, coumarines, essential oils, flavonoids, and furoquinolines have been found in the roots and aerial parts of this plant. The aim of this work is to study the anti-fertility propertiese of RG extract. Histochemical studies have been carried out in mouse ovary. Materials and Methods In this study 36 female mice were used in two groups as control and RG. Control group received the saline normal 0.2 ml and the RG group received 300mg/kg of the aqueous extract of RG per day orally for 14 days. Ovaries were studied after staining ALP, PAS and sudan Black. Results It was found that in RG group of first week most follicle were atretic. Results indicate that the staining intensity in ALP, PAS and Sudan Black were sever in RG group when compared with the control group. There was no significant difference between the control and RG group after 2 and 3 weeks treatment. Conclusion RG extract caused metabolic disorder and reduced fertility. This may be due to the increase in the intensity of reaction due to the accumulation of lidids and carbohydrates and damage of intracytoplasmic organels. * Corresponding Author: Faculty of Veterinary Medicine, Urmia University. Email: G.najafi2006@yahoo.com