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Abstract Background In the present study, we aimed to determine the frequency of the csgA, fimH, mrkD, foc, papaGI, papGII and papGIII genes, to provide and to design fimbrial adhesin gene (FAG) patterns and profiles for the isolated uropathogenic Escherichia coli (UPEC) strains. Methods The enrollment of 108 positive urine samples was performed during seven months, between January 2022 and July 2022. The UPEC strains were confirmed through the standard microbiological and biochemical tests. The antimicrobial susceptibility test was performed through the Kirby–Bauer disc diffusion method. Molecular screening of FAGs was done through the polymerase chain reaction technology. The statistical analyses including chi square and Fisher’s exact tests were performed to interpret the obtained results in the present study. Results As the main results, the antimicrobial resistance (AMR) patterns, multi- (MDR) and extensively drug-resistance (XDR) patterns and FAG patterns were designed and provided. fimH (93.3%), csgA (90.4%) and papG (37.5%) (papGII (30.8%)) genes were recognized as the top three FAGs, respectively. Moreover, the frequency of csgA-fimH gene profile was identified as the top FAG pattern (46.2%) among the others. The isolates bearing csgA-fimH gene profile were armed with a versatile of phenotypic AMR patterns. In the current study, 27.8%, 69.4% and 1.9% of the UPEC isolates were detected as extended-spectrum ß-lactamases (ESBLs) producers, MDR and XDR strains, respectively. Conclusions In conclusion, detection, providing and designing of patterns and profiles in association with FAGs, AMR feature in UPEC strains give us an effective option to have a successful and influential prevention for both of UTIs initiation and AMR feature.

Background and purpose: Tympanostomy surgery and ventilation tube (VT) placement are reliable methods to reduce the complications of eustachian tube dysfunction and inadequate middle ear ventilation. However, tympanostomy is associated with some complications. This study aimed to investigate the frequency distribution of tympanostomy surgery, success rate, its complications and the demographic characteristics of patients during 2011-2017 in Sari, Iran. Materials and methods: This retrospective descriptive study was performed using data from the records of 512 patients who underwent VT surgery in Sari during 2011-2017. A checklist was used to collect the data and SPSS V24 was used for data analysis. Results: The most common complaint at the time of referral was hearing loss (38.3%). In 79%, bilateral VT was performed and 6.5% had complications after the operation. The most common complication was purulent otorrhea (4.1%). Postoperative success rate of VT was found to be 93%. Conclusion: Given the high success rate of VT surgery, this procedure could be a good method in treatment of hearing loss, acute recurrent middle ear infections, and the adverse effects of tonsillitis and allergy on middle ear.

Abstract Background Healthcare policy- and decision-makers make efforts to build and maintain high-performing and effective health systems, implementing effectiveness programs and health reforms. In May 2014, the Iranian Ministry of Health and Medical Education has launched a series of ambitious reforms, known as the Health Transformation Plan (HTP). This study aimed to determine the effect of the HTP on hospitalization rate in Iranian public hospitals affiliated to the Ministry of Health and Medical Education. Methods This study was designed as a quasi-experimental, counterfactual study utilizing the interrupted time series analysis (ITSA), comparing the trend of hospitalization rate before and after the HTP implementation in 16 hospitals in the Lorestan province. Data was collected from March 2012 to February 2019. Results In the first month of the HTP implementation, an increase of 2.627 [95% CI: 1.62–3.63] was noted (P

Background and aims: Hemodialysis (HD) is considered as the main method of renal replacement therapy (RRT) for end-stage renal disease (ESRD) patients in many countries including Iran. Given the limited number of epidemiological studies in this regard at the provincial level across the country, the present study aimed to describe the demographic and clinical characteristics of ESRD patients and determine the most important causes of ESRD in Hamadan Province. Methods: This cross-sectional study was conducted on 508 HD patients in Hamadan province in January 2017. The checklist used to gather information comprised of the patient’s demographic and clinical information. The analysis was carried out using descriptive analysis including frequency tables and charts and the chi-square statistic test was used to compare the groups using Stata software, version 12. Results: The prevalence rate of HD treatment was 288.9 per million population (PMP). Further, most under HD patients were married, illiterate, and urban residents. The mean age of patients at the diagnosis was 47.64 ± 15.17 years. Hypertension (37.4%), diabetes (28.74%), and glomerulonephritis (10.63%) were the common causes of ESRD. Eventually, there was a significant difference between ESRD causes according to gender and residency (P

Background: Hospitals are the most important element of the health system. Hospitals play a key role in providing health services and have a major impact on the health system's performance. The success of organizations depends on their managers’ performance. Organizations with qualified and experienced managers will be more successful in achieving their goals and can reach optimal efficiency. Methods: This is a phenomenological qualitative study in which content analysis was used to achieve study objectives. The study population included the hospitals managers and senior experts of the vice chancellor for treatment of a provincial department of the Ministry of Health and Medical Education in Iran. Participants were selected by purposive and heterogeneous methods and data collection continued until data saturation was achieved. Data were collected by semi-structured face-to-face interviews. Results: From our data, seven main themes were drawn, consisting of monitoring and control, planning, organizing, leadership and motivational factors, management of resources and information, communication and interdepartmental coordination and patient orientation Conclusion: Hospital managers play a key role in improving hospital function. Assessing hospital managers' performance, determining their strengths and weaknesses and taking corrective actions are beneficial to the improvement of hospitals’ performance.

BACKGROUND: Obesity is considered as a major health problem of children and adolescents. The present meta-analysis was conducted by extensive search of studies on the prevalence of obesity among school-aged children and youth aged 6-18 years in Iran. METHODS: All conducted cross-sectional studies on the prevalence of obesity in Iranian students in all grades were extracted, without applying any restriction on time in national and international databases including Magiran, Iranmedex, SID, Scopus, Google Scholar, and PubMed. Statistical software Stata 12 was used to analyze the data and to obtain the prevalence of obesity among Iranian students. The heterogeneity between the results was determined using statistical test I2. RESULTS: In this meta-analysis, 51 papers met our inclusion criteria and were therefore considered for the analysis. The prevalence of obesity was equal to 5.82% [95% confidence interval (CI): 5-6.66] in Iranian students. The prevalence of obesity was higher in boys than in girls (6.85% compared to 5.13%) (P = 0.300). The highest prevalence of obesity was related to students living in the North and Northwest areas with 7.07% (95% CI: 4.35-9.78). CONCLUSION: The prevalence of obesity among Iranian students is not high when compared to Western countries. However, due to lifestyle changes in recent years, it is necessary to plan intervention programs within families and schools to improve dietary patterns and physical activity of this age group.

Objective (s): Obesity is a major public health problem worldwide. This review was carried out to assess obesity among Iranian primary school students. Methods: All cross-sectional studies that conducted on prevalence of obesity in adolescents in Iran without any restrictions was examined. The search engines included national and international databases including: Magiran, SID, Iranmedex, Scopus and PubMed in August 2015. Stata software version 12 was used for analysis of data and to obtain a summary measure. Results: In all 25 papers had the inclusion criteria for the study. Studies showed that the prevalence of obesity in Iranian primary school students was 7.18 percent (95% CI: 5.63-8.73). The prevalence of obesity was higher in boys than girls (8.02% vs. 6.07 %). Conclusion: This information might help to implement interventions to prevent obesity among Iranian primary school students. It seems that implementing interventions that aim to improve lifestyle and dietary patterns of this age group range are essential.

Background: Clinical Governance is a Framework in which health care provider will be responsible for continuous quality improvement. This study aimed to identify implementation challenges of Clinical Governance in the area of risk management. Methods: This is a descriptive-qualitative study. We used Content Analysis method for data analysis. Study environment contained 7 teaching hospitals, and the study population included the hospitals staff engaged in Clinical Governance implementation. Using purposive non-randomised sampling, 18 participants were selected. A semi-structured face-to-face interview was used for data collection. Content Analysis method was used to conceptualize, interpret and analyze the texts and maxQDA software for data analysis. Results: Our research findings presented two main themes as cultural factors and lack of resources. Conclusion: Promoting management as well as empowering health care providers could act as a key factor in addressing problems related to the implementation of risk management in health care environments.

Background and Objectives: Obesity is a common nutritional disorder worldwide. Considering extensive studies with different results on the prevalence of obesity in adolescents in the country, the present meta-analysis study were performed to achieve an accurate and valid rate for planners. Methods: All cross-sectional studies conducted on the prevalence of obesity in adolescents were collected without any restrictions from national and international databases, including Scopus, Iranmedex, SID, Magiran, and PubMed in August 2015. Random effect model at 95% confidence level was used for data analysis and obtaining a brief measure. The heterogeneity between the results was determined using I2 statistical test. Results: In this investigation, 24 articles met the inclusion criteria to enter the study. According to the studies, the prevalence of obesity in Iranian adolescents has been reported 4.7% (CI= 95%: 1.4-5.8), and the prevalence of obesity was higher in boys than girls (5.56% compared to 4.32 %). Conclusion: According to changes in lifestyle and also spread of poor dietary patterns in modern societies, the need for planning and implementation of interventional programs is essential in this regard for these age range at family, school, and society levels.

Introduction: This study aimed to identify the challenges of risk management in the context of clinical governance in selected hospitals of Tehran University of Medical Sciences. Materials and Methods:This study was implemented in two phases: qualitative step and quantitative step (survey). The first step was conducted using in-depth interviews and the second was carried out through a survey by questionnaire. Data were collected in hospitals through in-depth interviews with hospitals managers and the experts involved in clinical governance who had been introduced by the hospital manager. All professionals affiliated with clinical governance in Baharloo, Firoozgar, Farabi, Shahid Rajai, Ziaeian, Motahari and Sina hospitals were selected. Results: 35 experts involved in clinical governance were interviewed. According to these experts, the main obstacles in hospital risk management were: Lack of an error reporting culture, exaggerated fear of the consequences, and physicians' lack of interest in this domain. High workloads in this area have led to a reduction in employees' contributions. Conclusion: Establishing clinical governance in health care organizations has had many benefits, such as improving patient care, increased level of patients' satisfaction, establishment of a risk management system, improvement in staff and health-care personnel cooperation, and achieving a more successful organizational management. Appropriate changes in the organizational culture are necessities for the successful establishment of risk management. Human and cultural obstacles that hinder the implementation of risk management in hospitals are evident; thus, major actions are necessary to implement risk management properly in a disciplined manner.