Background: Kind of delivery affect many aspects of individuals, families and health systems situations. The aim of this study was to identify the Role of non-medical factors on choice of delivery (CS/NVD) in hospital...Background: Kind of delivery affect many aspects of individuals, families and health systems situations. The aim of this study was to identify the Role of non-medical factors on choice of delivery (CS/NVD) in hospitals affiliated to Tehran University of Medical Sciences. Materials and Method: This cross-sectional study was performed to identify the factors involved in the choice of delivery (CS/NVD) among women attending hospitals affiliated to Tehran University of Medical Sciences. Data was derived from the medical records of women who gave birth in the hospitals. Results: A significant statistical relationship was found between factors such as age of mother, level of education, occupational status, type of previous delivery, person supervising the pregnancy and dissatisfaction about delivery were more frequent in women who underwent CS than those who gave birth by NVD. Conclusion: The highly increasing rise in the rate of unnecessary CS during throughout the world, and its adverse effect on maternal and child health, the financial burden imposed on families and health systems, has highlighted the importance of studies to identify the non-medical factors that affect decision-making concerning type of delivery as well as to determine the appropriate medical indications of CS.展开更多
Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The obje...Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.展开更多
This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teachi...This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teaching methods as applied to junior medical students at Tehran University of Medical Sciences. Students were randomly assigned to one of two clinical teaching settings;no student experienced both modules. Coursework for the pilot (experimental) group (n = 19) utilized a teaching approach comprising lectures, genetics laboratory, pelvic ultrasound, small group sessions, and opportunities to observe advanced reproductive technologies such as in vitro fertilization, ICSI, and embryo transfer. A control group (n = 34) received reproductive endocrinology instruction by the ‘traditional curriculum’, consisting mainly of lectures. Students were sampled at baseline and again atthe conclusion of their reproductive endocrinology session. Pre- and post-test data were analyzed for both groups;post-test differences between groups were also compared. No significant differences in mean age or gender mix were identified between the two study groups. Overall, the ques- tionnaire did not identify any significant intergroup differences for any parameter investigated. Although student acceptance rate appeared similar for both educational modules, the ratio of students having a “favorable regard” for reproductive medicine declined only among students randomized to the control group (41.2% vs. 32.3%). This report offers the first data on teaching reproductive endocrinology to medical students in Iran. Both traditional and innovative approaches to teaching reproductive endocrinology were well-accepted by students, although negative post-test responses were more common among students in the control group. While periodic quality assessments for existing clinical teaching methods are necessary, introduction of alternative teaching approaches is also important. Additional studies are planned to evaluate the impact this initiative may have on results on standardized tests measuring reproductive endocrinology knowledge, as well as election of further specialization in training.展开更多
AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students usin...AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students using simple random sampling.Objective refraction,ocular alignment,vergence and accommodative performance were measured and assessed in all participants.Data on QOL were collected using the College of Optometrists in Vision Development-Quality of Life(COVD-QOL)Questionnaire.The effect of mentioned parameters on the QOL were evaluated.RESULTS:Totally 726 students with mean age of 21.35±1.88y were evaluated in this study,51.5%of whom were female.Esophoria was caused significantly lower QOL in the domains of somatic symptoms and occupationalphysical symptoms(P<0.05);Besides,esotropia decreased QOL in domains of somatic symptoms P=0.002 and psychological factors(P=0.023).Students with accommodation insufficiency experienced more symptoms in all domains(P<0.05)except for psychological factors(P=0.07).Increasing in the near point of convergence and accommodation and decreases QOL and increasing accommodative facility increases QOL(all P<0.05).Myopia and astigmatism cause decrease in QOL(both P<0.05),but hyperopic students had better QOL in comparison with others(P<0.05).CONCLUSION:Screening programs and treatment of refractive errors and binocular vision anomalies,especially phoria and accommodative insufficiency,positively impact the QOL and academic achievements of university students.展开更多
AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 ...AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 to Jan 2020.Selected subjects were interviewed and subjected to optometric and ophthalmic examinations.RESULTS:The age and sex standardized prevalence of pterygium and pinguecula was 3.64%[95%confidence interval(CI):2.94%–4.49%]and 55.57%(95%CI:52.89%–58.22%),respectively.The prevalence of pterygium was 4.52%(95%CI:3.5%–5.81%)in men and 2.79%(95%CI:1.97%–3.94%)in women and the prevalence of pinguecula was 64.56%(95%CI:60.92%–68.03%)in men and 46.72%(95%CI:43.74%–49.72%)in women.According to the results of multiple logistic regression,pinguecula had a significant correlation with male sex[odds ratio(OR):2.21,95%CI:1.63–2.99]and education level(OR:0.52,95%CI:0.35-0.77)and pterygium had a significant relationship with male sex(OR:2.2,95%CI:1.38–3.52),socioeconomic status(SES,OR:0.5,95%CI:0.26–0.97),education level(OR:0.22,95%CI:0.08–0.61).CONCLUSION:The prevalence of pinguecula and pterygium in this study are lower than other studies.Sex,SES,and education level are the risk factors of the prevalence of pinguecula and pterygium.展开更多
Objective:To investigate antibiotic resistance and carriage class 1 and 2 integrons in clinical isolates of Acinetobacter baumannii(A.baumannii)from Tehran,Iran.Methods:Antimicrobial susceptibility testing was perform...Objective:To investigate antibiotic resistance and carriage class 1 and 2 integrons in clinical isolates of Acinetobacter baumannii(A.baumannii)from Tehran,Iran.Methods:Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute.The presence of integrons was investigated by PCR using specific primers.Results:Among isolated A.baumannii strains,82%were multidrug resistant,27 samples(54%)were resistant to three or more than three antibiotics and 16 samples(32%)showed resistance to two antibiotics.Integrons were detected from 44 of 50 isolates(88%),with classes 1 and 2 being observed in 42%(21/50)and 82%(41/50)of isolates,respectively.Integron-positive A.baumannii isolates showed higher antibiotic resistance than integron-negative isolates and all showed a multidrug-resistant phenotype.Conclusions:Our findings show that classes 1 and 2 integrons,and especially classes 2 integrons are widely disseminated among A.baumannii strains isolated from Tehran and these structures are playing a major role in the acquisition of multidrug resistance in these strains.So monitoring of drug resistance with investigating carriage class 1 and 2 integrons is very important to plan specific infection control measures due to multidrug resistance A.baumannii in Iran hospitals.展开更多
Objective:To identify the frequency of syphilis among Iranian HIV-positive patients.Methods:A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection wa...Objective:To identify the frequency of syphilis among Iranian HIV-positive patients.Methods:A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital,Tehran,Iran.The lab tests including CD4 cell count,cerebrospinal fluid,veneral disease research laboratory(VDRL),fluorescent treponema antibody-absorption(FTA-Abs)and viral load were performed for all the patients.Data regarding medical history and their demographics were also collected.Results:Of all 450 HIV-positive patients,24(5.3%)had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45%of them had a definite co-infection of syphilis.65.3%of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%.We did not find any patient with neurosyphilis.Conclusions:Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations,the diagnosis of syphilis should be timely established using screening tests among such patients.展开更多
OBJECTIVE: To examine the influence of cupping on the quality of life of healthy people who referred to traditional Persian medicine clinics in Tehran.METHODS: All participants were examined by Traditional Persian Med...OBJECTIVE: To examine the influence of cupping on the quality of life of healthy people who referred to traditional Persian medicine clinics in Tehran.METHODS: All participants were examined by Traditional Persian Medicine specialists and their temperaments were determined. The area between the shoulders was cleaned, and cupping was performed with a disposable cupping glass for a few minutes. The questionnaire used in this project was the Persian version of the SF-36 questionnaire which assesses people's understanding of their health status. Before cupping and then one monthafter cupping, all participants were called and the questionnaires were completed again. Finally, all given data was analyzed.RESULTS: From a total of 290 questionnaires completed in the first phase of the project, 112 patients were excluded. Ultimately, the data of 178 participants was analyzed. After one month, the quality of life score of 155 participants(88%) increased, remained unchanged for 21 participants(11.7%), and decreased for 2 participants(1.1%). Asked about possible complications from cupping, 160 participants reported no side effects(89.9%).CONCLUSION: Our findings suggest that cupping therapy can improve the scores of quality of life in the participants in Tehran.展开更多
AIM:To compare the subjective refraction data with non-cycloplegic auto-refraction findings in the geriatric population above 60 years of age according to the different crystalline lens conditions.METHODS:This report ...AIM:To compare the subjective refraction data with non-cycloplegic auto-refraction findings in the geriatric population above 60 years of age according to the different crystalline lens conditions.METHODS:This report is a part of the Tehran Geriatric Eye Study(TGES)that was conducted from January 2019 to January 2020 on elderly population 60 years of age and above in Tehran.The samples were selected by multistage stratified random cluster sampling.Of 3791 individual invitees,3310(response rate:87.3%)participated in this study.All study participants underwent non-cycloplegic autorefraction(auto-refractometer/keratometer Nidek ARK-510)and subjective refraction.RESULTS:Regarding the sphere,eyes with mixed cataract had the worst limits of agreement(LoA:-1.24 to 0.87)and the best agreement was related to the pseudophakic eyes(LoA:-0.83 to 0.54).The highest(0.27±0.31 D)and lowest(0.21±0.27 D)differences between the two methods regarding the cylinder power were observed in eyes with cortical cataract and normal eyes,respectively.The worst LoA between the two methods in measuring the cylinder power was related to the eyes with mixed cataract(LoA:-0.44 to 0.96).Regarding the J0(horizontal/vertical components of astigmatism),the mean values of J0 obtained by auto-refraction were tended more toward against the rule direction in all crystalline lens conditions,and the two methods had the greatest difference in cortical cataract cases(0.05±0.17 D).Regarding the J45(oblique components of astigmatism),the lowest(0±0.11 D)and highest(-0.01±0.12 D)differences were observed in normal eyes and eyes with cortical cataract,respectively.CONCLUSION:The auto-refractometer/keratometer Nidek ARK-510 results in the elderly with different phakic and pseudophakic conditions do not correspond well with subjective refraction findings.This discrepancy in spherical findings is more pronounced in individuals with mixed cataract than in other cases.展开更多
Natural resources and its condition have always had a key role in economic and social developments of different societies around the world and these resources are considered as natural capital and bankroll of economic...Natural resources and its condition have always had a key role in economic and social developments of different societies around the world and these resources are considered as natural capital and bankroll of economic growth and development for every country. In the present study, we have evaluated the outdoor recreational value of Lavizan Jungle Park of Tehran and its visitors’ willingness to pay per visit (WTP) by using Contingent Valuation method (CV) and two-dimensional choice questionnaires. We used 125 questionnaires and logit model in order to evaluate the WTP. The purpose of this study is to measure individuals’ willingness to pay for visiting and preserving the environment of Lavizan Park as well as indicating the relationship between influential factors on their WTP. Estimating the value of natural resources is very important in making environmental preservation policies because preserving these natural attractions, as a part of ecotourism, is highly important. JEL Classification: Q29, Q51, C25.展开更多
Objective:To determine the prevalence of HIV infection among homeless men and women and the related risk behaviors in Tehran,Iran.Methods:In 2007-2008,Tehran municipality stacked up 10657 homeless men and women for as...Objective:To determine the prevalence of HIV infection among homeless men and women and the related risk behaviors in Tehran,Iran.Methods:In 2007-2008,Tehran municipality stacked up 10657 homeless men and women for assessment of HIV and began collaboration with Iranian Research Center for HIV/AIDS(IRCHA)departments to conduct HIV infection prevalence surveys in homeless populations.The results were analyzed for associations with demographic information,family support,status of drug abuse and relation with family and friends.Results:Overall HIV prevalence was 1.7%(95%confidence interval 1.4-1.9).Factors independently associated with HIV infection included history of using drugs[AOR 8.15(4.86-13.67)].older age[AOR1.80(1.08-2.99)for 40-55 yr],occupation[AOR 1.64(1.19-2.24)for unemployed],and no relation with family[AOR 1.82(l.30-2.54)|.Conclusions:This study supports the idea that injection drug use is contributing to the increased spread of HIV among Iranian homeless.Harm reduction programs should be expanded,particularly among homeless injection drug users.展开更多
Background: Standards of Joint Commission International emphasize on the organizational performance level in basic functional domains including patient right, patient care, medical safety and infection control. These ...Background: Standards of Joint Commission International emphasize on the organizational performance level in basic functional domains including patient right, patient care, medical safety and infection control. These standards are focused on two principles: expectations of the actual organizational performance and assessment of organizational capabilities to provide high quality and safe health care services. The aim of this study is to evaluate the possibility of improvement in Access to Care and Continuity of Care for patients (ACC) in teaching hospitals of Tehran University of Medical Sciences. Methods: This cross-sectional study was conducted in hospitals affiliated to Tehran University of Medical Sciences during 2012. Data collection was performed using author-designed questionnaire of “Access to Care and Continuity of Care patients” based on JCI standards (2013). A total of 171 questionnaires were sent to 26 hospitals and 154 (90%) questionnaires were successfully completed and used for data analysis. The questionnaire was reviewed by experts and the Cronbach’s alpha was calculated to be 0.967. The effects of the two variables of hospital type (general, specialty) and the number of beds on mean scores of ACC standards and each of its domains were analyzed using T-test or Mann-Whitney test depending on the distribution due to Kolmogorov-Smirnov test result. Results: In general, the mean of ACC standards was found comprehendible and applicable by 82.3 (SD = 11) of the respondents. The highest and lowest mean scores of ACC questions belonged to hospitals H21 (90 ± 6) and H14 (67 ± 12), respectively. There were not any significant effects of hospital type and the number of beds on the ACC scores. Conclusion: There was not any important effect of hospital type and bed numbers on ACC, although there was a 9%-15% possibility of improvement in accreditation scores of ACC standards in hospitals of Tehran University of Medical Sciences. A complete accreditation score in this domain didn’t seem achievable in these hospitals. However, it is proposed that future managerial planning of the studied hospitals lead to a complete accreditation score.展开更多
Objective:To identify the biodiversity of Nocardia species isolated from the environments of Tehran hospitals via phenotypic and PCR molecular methods.Methods:A total of 236 samples were collected from the transplanta...Objective:To identify the biodiversity of Nocardia species isolated from the environments of Tehran hospitals via phenotypic and PCR molecular methods.Methods:A total of 236 samples were collected from the transplantation and cancer centers of five Tehran hospitals,and the presence of Nocardia was identified by using standard protocols.Conventional tests were used for preliminary identification,and PCR amplification of the 598 bp amplicon of the 16S rRNA and sequence analysis of 16S rRNA were performed for genus and species identification.Results:From the 236 soil samples,16 samples were identified as positive based on the culture tests,while 8 samples showed positive results based on the molecular method.The phylogenetic tree showed that the most frequent genus of Nocardia was related to Nocardia cyriacigeorgica.Conclusion:The hospital environment is a potential reservoir of a diverse range of Nocardia species.Due to the strong capability of survival,these bacteria bring a threat to the health of patients.Its identification can help physicians to implement treatments and is important for healthcare centers.展开更多
The rate of maternal mortality due to complications of pregnancy and delivery is one of the most significant indicators showing the development state of countries. The purpose of the present study is to assess importa...The rate of maternal mortality due to complications of pregnancy and delivery is one of the most significant indicators showing the development state of countries. The purpose of the present study is to assess important indicators of maternal health and predisposing factors of maternal mortality in Tehran province from 2008 to 2011. The present study is a case-control one. All mothers who had lost their life (n = 113) were selected through census and survived mothers (n = 327) through randomized stratified sampling. Statistical analysis was performed using SPSS V.22, X2 test, Fishers exact test and Logistic regression. The rate of maternal mortality was the highest (29.2%) in 2009 and the lowest (20.4%) in 2011. Variables type of maternity hospital (P-value = 0.036), maternal education (P-value < 0.001), husband’s education (P-value < 0.001) had a significant relation to maternal mortality. Logistic regression analysis showed that there is a relationship between the education level of the husband and maternal mortality. Considering the factors affecting maternal mortality, promoting hospital services, improving skills and knowledge of doctors, midwives and nurses and strengthening educational programs for the illiterate are the most effective measures to reduce maternal mortality.展开更多
Coagulase is considered as a major determinant factor for the identification of Staphylococcus aureus strains.The 3-end coding region of the coagulase(coa)gene contains a series of 81-bp tandem repeats,which differ in...Coagulase is considered as a major determinant factor for the identification of Staphylococcus aureus strains.The 3-end coding region of the coagulase(coa)gene contains a series of 81-bp tandem repeats,which differ in the number and location of enzymatic restriction sites among different isolates.coa PCR-RFLP has been used widely to type S.aureus isolates in epidemiological studies.The current study was conducted to investigate the coagulase gene polymorphisms in S.aureus isolated from various food samples using an in house PCR-RFLP method.A total of 100 strains of S.aureus were isolated from food samples.Isolates were typed by PCR-RFLP analysis using NdeI restriction digestion of the coagulase gene PCR products.Results showed that amplification of coagulase genes from S.aureus produced different PCR products.The isolates were grouped into 18 genotypes using RFLP analysis results of the genes.In this study,the S.aureus isolates have been shown to include more than one coagulase genotype,but only had a few coa genotypes predominated.展开更多
Dear Editor,The first cases of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)in Iran were identified in Qom on February 19,2020,which soon spread throughout the country(Yavarian et al.2020).As of May 12,...Dear Editor,The first cases of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)in Iran were identified in Qom on February 19,2020,which soon spread throughout the country(Yavarian et al.2020).As of May 12,2021,2,691,352 confirmed cases of COVID-19(the disease caused by SARS-Co V-2)and 75,568 associated deaths have been reported in the country by Iran Ministry of Health.展开更多
Background and Objective: Asthma is a major health problem and a high-burden disease in the world. Unfortunately the prevalence of asthma in adult populations in Iran is not determined precisely. The aim of this study...Background and Objective: Asthma is a major health problem and a high-burden disease in the world. Unfortunately the prevalence of asthma in adult populations in Iran is not determined precisely. The aim of this study was to assess the prevalence of asthma symptoms and it’s relation with ages, gender and smoking behaviour in city of Tehran. Methods: A telephone interview survey was conducted among 7150 randomly selected telephone numbers in city of Tehran. A questionnaire adapted from The European Community Respiratory Health Survey (ECRHS) with additional two questions about smoking behaviour and hookah. Results: From 7150 eligible telephone numbers dialled there were 5500 responses (76.92%). The study populations included 3412 female (62%), 2088 men (38%) and the mean age of responder were 31.15 ± 7.33. Their smoking behaviour were;71.6% non smoker, 11.9% active smoker, 16.5% passive smoker and 7.8% used hookah. The prevalence of “wheezing in the last 12 months”, “dyspnea with wheezing” and “wheezing and two nocturnal symptoms” were 24%, 10.8% and 5% respectively. Prevalence of asthma symptoms was significantly greater in smokers than non-smokers groups. Conclusion: In this study by using symptom based questionnaire (ECRHS), we concluded the prevalence of asthma in Tehran adult population was between 5% to 10%. Also this study may made cross-national comparison of our findings with other ECRHS studies possible;rates of “wheezing in the last 12 months”, “dyspnea with wheezing” and “nocturnal dyspnea” were higher than the European Community Respiratory Health Survey median. Role of air pollution, smoking and other risk factors for asthma should be considered.展开更多
Objective: This study aimed to assess training and internship programs (courses) of basic and clinical sciences in hospitals based on surveying the students of Tehran University of Medical Sciences. Material and Metho...Objective: This study aimed to assess training and internship programs (courses) of basic and clinical sciences in hospitals based on surveying the students of Tehran University of Medical Sciences. Material and Methods: The present study was a cross-sectional one with survey descriptive designs. The data collection tool was a questionnaire with 14 five-point likert style items. The Research and Development Center of Tehran University of Medical Sciences surveyed all 185 students of training and internship programs, using a questionnaire with the Cronbach’s alpha coefficient of 81%, for the purpose of adjusting the education to the society’s needs and improving its quality. Result: The mean scores of the assessment of training and internship programs were 3.32%, 2.98%, 3.38% and 3.29%, respectively for theoretical classroom training related to practical training, mental, communicational and practical skills courses. The students’ satisfaction rate regarding the quality of educational courses of training and internship programs was 50.2%. Conclusion: Educational authorities have made necessary attempts to implement these programs and use potential resources for realizing the objectives and achieving the educational quality;however, they should make further attempts in this regard.展开更多
AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster...AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster sampling.After selecting subjects aged 60 and over,optometric,and ophthalmic examinations were done.For retinal examination,a 90 D lens was used and indirect ophthalmoscopy was performed after instilling tropicamide drops.Biometry was done using the IOL Master for all participants.RESULTS:Of 3791 people that were invited through cluster sampling,3310 participated in the study(response rate=82%).The prevalence of retinal pigmented epithelium(RPE)change,drusen,geographic atrophy(GA),hypertensive retinopathy(HTR),nonproliferative diabetic retinopathy(NPDR),proliferative diabetic retinopathy(PDR),choroidal neovascularization(CNV),central retinal artery occlusion(CRAO),myopic retinopathy(MR),branch retinal vein occlusion(BRVO),and central retinal vein occlusion(CRVO)was 27.42%,11.08%,4.52%,3.03%,4.05%,0.54%,0.82%,0.39%,0.20%,0.49%,and 0.19%,respectively.After removing the effect of age,the odds of NPDR were 1.68 times higher in women compared to men(P=0.014).After removing the effect of sex,the odds of drusen,RPE change,GA,CNV,BRVO,and CRVO increased with age.CONCLUSION:There is a higher prevalence of RPE change,drusen,GA,CNV and a lower prevalence of MR and CRAO in the elderly population of Tehran aged over 60y compared to global average values.Considering the correlation of most of the diseases with age and their effects on vision,attention should be paid to these diseases and the related screening programs to prevent vision impairment.展开更多
文摘Background: Kind of delivery affect many aspects of individuals, families and health systems situations. The aim of this study was to identify the Role of non-medical factors on choice of delivery (CS/NVD) in hospitals affiliated to Tehran University of Medical Sciences. Materials and Method: This cross-sectional study was performed to identify the factors involved in the choice of delivery (CS/NVD) among women attending hospitals affiliated to Tehran University of Medical Sciences. Data was derived from the medical records of women who gave birth in the hospitals. Results: A significant statistical relationship was found between factors such as age of mother, level of education, occupational status, type of previous delivery, person supervising the pregnancy and dissatisfaction about delivery were more frequent in women who underwent CS than those who gave birth by NVD. Conclusion: The highly increasing rise in the rate of unnecessary CS during throughout the world, and its adverse effect on maternal and child health, the financial burden imposed on families and health systems, has highlighted the importance of studies to identify the non-medical factors that affect decision-making concerning type of delivery as well as to determine the appropriate medical indications of CS.
文摘Introduction: Self evaluation is a process that defines and collects required data to judge about decision making issues at educational system on whether the educational department is fit to educate students? The objective of this study was determining the quality of the structural elements of the department of Communicable Diseases & determining the strengths, weaknesses, opportunities and threats to improve the quality of activities in the department under research. Materials and Methods: The employed method was Mixed methods (qualitative & quantitative research), on the basis of 10 procedural steps and within 8 sections dealing with evaluated factors;such as 1) organizational and management structure 2) scientific board members 3) students 4) Manpower 5) Space of educational research and health care 6) Equipment 7) curriculum 8) satisfaction of graduates, which were studied using 61 criteria and 172 indicators. Five-point Likert Scale was used for the responses in the questionnaire (1 - 1.75 = undesirable, to 4.2 - 5 completely desirable). Finally the data were analyzed using descriptive statistics indices and the assessment software of the Educational Development Center of TUMS. The instruments used in this method included assessment software, interview, observation and self-prepared questionnaire which consisted of 7 questionnaires and 2 check lists. Finding: The results of the research showed that general average of 8 investigating sections was 56.9% as a rather desirable research work. Conclusions: Therefore, it was concluded that function of the educational management in that group was directly in line with evaluation process, but continuing the process of evaluation seems necessary.
文摘This pilot study evaluated effectiveness and acceptance of a new hospital-based reproductive endocrinology curriculum among Iranian medical students. A voluntary, anonymous questionnaire was used to compare two teaching methods as applied to junior medical students at Tehran University of Medical Sciences. Students were randomly assigned to one of two clinical teaching settings;no student experienced both modules. Coursework for the pilot (experimental) group (n = 19) utilized a teaching approach comprising lectures, genetics laboratory, pelvic ultrasound, small group sessions, and opportunities to observe advanced reproductive technologies such as in vitro fertilization, ICSI, and embryo transfer. A control group (n = 34) received reproductive endocrinology instruction by the ‘traditional curriculum’, consisting mainly of lectures. Students were sampled at baseline and again atthe conclusion of their reproductive endocrinology session. Pre- and post-test data were analyzed for both groups;post-test differences between groups were also compared. No significant differences in mean age or gender mix were identified between the two study groups. Overall, the ques- tionnaire did not identify any significant intergroup differences for any parameter investigated. Although student acceptance rate appeared similar for both educational modules, the ratio of students having a “favorable regard” for reproductive medicine declined only among students randomized to the control group (41.2% vs. 32.3%). This report offers the first data on teaching reproductive endocrinology to medical students in Iran. Both traditional and innovative approaches to teaching reproductive endocrinology were well-accepted by students, although negative post-test responses were more common among students in the control group. While periodic quality assessments for existing clinical teaching methods are necessary, introduction of alternative teaching approaches is also important. Additional studies are planned to evaluate the impact this initiative may have on results on standardized tests measuring reproductive endocrinology knowledge, as well as election of further specialization in training.
文摘AIM:To evaluate the effects of refractive errors and binocular vision anomalies on the quality of life(QOL)of university students.METHODS:This cross-sectional analytical study was conducted on university students using simple random sampling.Objective refraction,ocular alignment,vergence and accommodative performance were measured and assessed in all participants.Data on QOL were collected using the College of Optometrists in Vision Development-Quality of Life(COVD-QOL)Questionnaire.The effect of mentioned parameters on the QOL were evaluated.RESULTS:Totally 726 students with mean age of 21.35±1.88y were evaluated in this study,51.5%of whom were female.Esophoria was caused significantly lower QOL in the domains of somatic symptoms and occupationalphysical symptoms(P<0.05);Besides,esotropia decreased QOL in domains of somatic symptoms P=0.002 and psychological factors(P=0.023).Students with accommodation insufficiency experienced more symptoms in all domains(P<0.05)except for psychological factors(P=0.07).Increasing in the near point of convergence and accommodation and decreases QOL and increasing accommodative facility increases QOL(all P<0.05).Myopia and astigmatism cause decrease in QOL(both P<0.05),but hyperopic students had better QOL in comparison with others(P<0.05).CONCLUSION:Screening programs and treatment of refractive errors and binocular vision anomalies,especially phoria and accommodative insufficiency,positively impact the QOL and academic achievements of university students.
基金Supported by National Institute for Medical Research Development(NIMAD)affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To explore the prevalence of pterygium and pinguecula and their risk factors.METHODS:This population-based cross-sectional study was conducted on geriatric population aged 60 and over in Tehran,Iran from Jan 2019 to Jan 2020.Selected subjects were interviewed and subjected to optometric and ophthalmic examinations.RESULTS:The age and sex standardized prevalence of pterygium and pinguecula was 3.64%[95%confidence interval(CI):2.94%–4.49%]and 55.57%(95%CI:52.89%–58.22%),respectively.The prevalence of pterygium was 4.52%(95%CI:3.5%–5.81%)in men and 2.79%(95%CI:1.97%–3.94%)in women and the prevalence of pinguecula was 64.56%(95%CI:60.92%–68.03%)in men and 46.72%(95%CI:43.74%–49.72%)in women.According to the results of multiple logistic regression,pinguecula had a significant correlation with male sex[odds ratio(OR):2.21,95%CI:1.63–2.99]and education level(OR:0.52,95%CI:0.35-0.77)and pterygium had a significant relationship with male sex(OR:2.2,95%CI:1.38–3.52),socioeconomic status(SES,OR:0.5,95%CI:0.26–0.97),education level(OR:0.22,95%CI:0.08–0.61).CONCLUSION:The prevalence of pinguecula and pterygium in this study are lower than other studies.Sex,SES,and education level are the risk factors of the prevalence of pinguecula and pterygium.
基金supported by Cell and Molecular Biology Research Center and Microbiology group of Tehran Medicine University,with grant number TUMS/CMBRC-89-007
文摘Objective:To investigate antibiotic resistance and carriage class 1 and 2 integrons in clinical isolates of Acinetobacter baumannii(A.baumannii)from Tehran,Iran.Methods:Antimicrobial susceptibility testing was performed according to the Clinical and Laboratory Standards Institute.The presence of integrons was investigated by PCR using specific primers.Results:Among isolated A.baumannii strains,82%were multidrug resistant,27 samples(54%)were resistant to three or more than three antibiotics and 16 samples(32%)showed resistance to two antibiotics.Integrons were detected from 44 of 50 isolates(88%),with classes 1 and 2 being observed in 42%(21/50)and 82%(41/50)of isolates,respectively.Integron-positive A.baumannii isolates showed higher antibiotic resistance than integron-negative isolates and all showed a multidrug-resistant phenotype.Conclusions:Our findings show that classes 1 and 2 integrons,and especially classes 2 integrons are widely disseminated among A.baumannii strains isolated from Tehran and these structures are playing a major role in the acquisition of multidrug resistance in these strains.So monitoring of drug resistance with investigating carriage class 1 and 2 integrons is very important to plan specific infection control measures due to multidrug resistance A.baumannii in Iran hospitals.
基金Supported by Tehran University of Medical Sciences(Grant No.801/86/7056)
文摘Objective:To identify the frequency of syphilis among Iranian HIV-positive patients.Methods:A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital,Tehran,Iran.The lab tests including CD4 cell count,cerebrospinal fluid,veneral disease research laboratory(VDRL),fluorescent treponema antibody-absorption(FTA-Abs)and viral load were performed for all the patients.Data regarding medical history and their demographics were also collected.Results:Of all 450 HIV-positive patients,24(5.3%)had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45%of them had a definite co-infection of syphilis.65.3%of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%.We did not find any patient with neurosyphilis.Conclusions:Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations,the diagnosis of syphilis should be timely established using screening tests among such patients.
文摘OBJECTIVE: To examine the influence of cupping on the quality of life of healthy people who referred to traditional Persian medicine clinics in Tehran.METHODS: All participants were examined by Traditional Persian Medicine specialists and their temperaments were determined. The area between the shoulders was cleaned, and cupping was performed with a disposable cupping glass for a few minutes. The questionnaire used in this project was the Persian version of the SF-36 questionnaire which assesses people's understanding of their health status. Before cupping and then one monthafter cupping, all participants were called and the questionnaires were completed again. Finally, all given data was analyzed.RESULTS: From a total of 290 questionnaires completed in the first phase of the project, 112 patients were excluded. Ultimately, the data of 178 participants was analyzed. After one month, the quality of life score of 155 participants(88%) increased, remained unchanged for 21 participants(11.7%), and decreased for 2 participants(1.1%). Asked about possible complications from cupping, 160 participants reported no side effects(89.9%).CONCLUSION: Our findings suggest that cupping therapy can improve the scores of quality of life in the participants in Tehran.
基金Supported by National Institute for Medical Research Development(NIMAD)affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To compare the subjective refraction data with non-cycloplegic auto-refraction findings in the geriatric population above 60 years of age according to the different crystalline lens conditions.METHODS:This report is a part of the Tehran Geriatric Eye Study(TGES)that was conducted from January 2019 to January 2020 on elderly population 60 years of age and above in Tehran.The samples were selected by multistage stratified random cluster sampling.Of 3791 individual invitees,3310(response rate:87.3%)participated in this study.All study participants underwent non-cycloplegic autorefraction(auto-refractometer/keratometer Nidek ARK-510)and subjective refraction.RESULTS:Regarding the sphere,eyes with mixed cataract had the worst limits of agreement(LoA:-1.24 to 0.87)and the best agreement was related to the pseudophakic eyes(LoA:-0.83 to 0.54).The highest(0.27±0.31 D)and lowest(0.21±0.27 D)differences between the two methods regarding the cylinder power were observed in eyes with cortical cataract and normal eyes,respectively.The worst LoA between the two methods in measuring the cylinder power was related to the eyes with mixed cataract(LoA:-0.44 to 0.96).Regarding the J0(horizontal/vertical components of astigmatism),the mean values of J0 obtained by auto-refraction were tended more toward against the rule direction in all crystalline lens conditions,and the two methods had the greatest difference in cortical cataract cases(0.05±0.17 D).Regarding the J45(oblique components of astigmatism),the lowest(0±0.11 D)and highest(-0.01±0.12 D)differences were observed in normal eyes and eyes with cortical cataract,respectively.CONCLUSION:The auto-refractometer/keratometer Nidek ARK-510 results in the elderly with different phakic and pseudophakic conditions do not correspond well with subjective refraction findings.This discrepancy in spherical findings is more pronounced in individuals with mixed cataract than in other cases.
文摘Natural resources and its condition have always had a key role in economic and social developments of different societies around the world and these resources are considered as natural capital and bankroll of economic growth and development for every country. In the present study, we have evaluated the outdoor recreational value of Lavizan Jungle Park of Tehran and its visitors’ willingness to pay per visit (WTP) by using Contingent Valuation method (CV) and two-dimensional choice questionnaires. We used 125 questionnaires and logit model in order to evaluate the WTP. The purpose of this study is to measure individuals’ willingness to pay for visiting and preserving the environment of Lavizan Park as well as indicating the relationship between influential factors on their WTP. Estimating the value of natural resources is very important in making environmental preservation policies because preserving these natural attractions, as a part of ecotourism, is highly important. JEL Classification: Q29, Q51, C25.
基金Supported by Tehran University of Medical Sciences(Grant No.89/120102)
文摘Objective:To determine the prevalence of HIV infection among homeless men and women and the related risk behaviors in Tehran,Iran.Methods:In 2007-2008,Tehran municipality stacked up 10657 homeless men and women for assessment of HIV and began collaboration with Iranian Research Center for HIV/AIDS(IRCHA)departments to conduct HIV infection prevalence surveys in homeless populations.The results were analyzed for associations with demographic information,family support,status of drug abuse and relation with family and friends.Results:Overall HIV prevalence was 1.7%(95%confidence interval 1.4-1.9).Factors independently associated with HIV infection included history of using drugs[AOR 8.15(4.86-13.67)].older age[AOR1.80(1.08-2.99)for 40-55 yr],occupation[AOR 1.64(1.19-2.24)for unemployed],and no relation with family[AOR 1.82(l.30-2.54)|.Conclusions:This study supports the idea that injection drug use is contributing to the increased spread of HIV among Iranian homeless.Harm reduction programs should be expanded,particularly among homeless injection drug users.
文摘Background: Standards of Joint Commission International emphasize on the organizational performance level in basic functional domains including patient right, patient care, medical safety and infection control. These standards are focused on two principles: expectations of the actual organizational performance and assessment of organizational capabilities to provide high quality and safe health care services. The aim of this study is to evaluate the possibility of improvement in Access to Care and Continuity of Care for patients (ACC) in teaching hospitals of Tehran University of Medical Sciences. Methods: This cross-sectional study was conducted in hospitals affiliated to Tehran University of Medical Sciences during 2012. Data collection was performed using author-designed questionnaire of “Access to Care and Continuity of Care patients” based on JCI standards (2013). A total of 171 questionnaires were sent to 26 hospitals and 154 (90%) questionnaires were successfully completed and used for data analysis. The questionnaire was reviewed by experts and the Cronbach’s alpha was calculated to be 0.967. The effects of the two variables of hospital type (general, specialty) and the number of beds on mean scores of ACC standards and each of its domains were analyzed using T-test or Mann-Whitney test depending on the distribution due to Kolmogorov-Smirnov test result. Results: In general, the mean of ACC standards was found comprehendible and applicable by 82.3 (SD = 11) of the respondents. The highest and lowest mean scores of ACC questions belonged to hospitals H21 (90 ± 6) and H14 (67 ± 12), respectively. There were not any significant effects of hospital type and the number of beds on the ACC scores. Conclusion: There was not any important effect of hospital type and bed numbers on ACC, although there was a 9%-15% possibility of improvement in accreditation scores of ACC standards in hospitals of Tehran University of Medical Sciences. A complete accreditation score in this domain didn’t seem achievable in these hospitals. However, it is proposed that future managerial planning of the studied hospitals lead to a complete accreditation score.
基金This study was part of a PhD thesis supported by Tehran University of Medical Science(Grant No:34468270396).
文摘Objective:To identify the biodiversity of Nocardia species isolated from the environments of Tehran hospitals via phenotypic and PCR molecular methods.Methods:A total of 236 samples were collected from the transplantation and cancer centers of five Tehran hospitals,and the presence of Nocardia was identified by using standard protocols.Conventional tests were used for preliminary identification,and PCR amplification of the 598 bp amplicon of the 16S rRNA and sequence analysis of 16S rRNA were performed for genus and species identification.Results:From the 236 soil samples,16 samples were identified as positive based on the culture tests,while 8 samples showed positive results based on the molecular method.The phylogenetic tree showed that the most frequent genus of Nocardia was related to Nocardia cyriacigeorgica.Conclusion:The hospital environment is a potential reservoir of a diverse range of Nocardia species.Due to the strong capability of survival,these bacteria bring a threat to the health of patients.Its identification can help physicians to implement treatments and is important for healthcare centers.
文摘The rate of maternal mortality due to complications of pregnancy and delivery is one of the most significant indicators showing the development state of countries. The purpose of the present study is to assess important indicators of maternal health and predisposing factors of maternal mortality in Tehran province from 2008 to 2011. The present study is a case-control one. All mothers who had lost their life (n = 113) were selected through census and survived mothers (n = 327) through randomized stratified sampling. Statistical analysis was performed using SPSS V.22, X2 test, Fishers exact test and Logistic regression. The rate of maternal mortality was the highest (29.2%) in 2009 and the lowest (20.4%) in 2011. Variables type of maternity hospital (P-value = 0.036), maternal education (P-value < 0.001), husband’s education (P-value < 0.001) had a significant relation to maternal mortality. Logistic regression analysis showed that there is a relationship between the education level of the husband and maternal mortality. Considering the factors affecting maternal mortality, promoting hospital services, improving skills and knowledge of doctors, midwives and nurses and strengthening educational programs for the illiterate are the most effective measures to reduce maternal mortality.
文摘Coagulase is considered as a major determinant factor for the identification of Staphylococcus aureus strains.The 3-end coding region of the coagulase(coa)gene contains a series of 81-bp tandem repeats,which differ in the number and location of enzymatic restriction sites among different isolates.coa PCR-RFLP has been used widely to type S.aureus isolates in epidemiological studies.The current study was conducted to investigate the coagulase gene polymorphisms in S.aureus isolated from various food samples using an in house PCR-RFLP method.A total of 100 strains of S.aureus were isolated from food samples.Isolates were typed by PCR-RFLP analysis using NdeI restriction digestion of the coagulase gene PCR products.Results showed that amplification of coagulase genes from S.aureus produced different PCR products.The isolates were grouped into 18 genotypes using RFLP analysis results of the genes.In this study,the S.aureus isolates have been shown to include more than one coagulase genotype,but only had a few coa genotypes predominated.
文摘Dear Editor,The first cases of severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)in Iran were identified in Qom on February 19,2020,which soon spread throughout the country(Yavarian et al.2020).As of May 12,2021,2,691,352 confirmed cases of COVID-19(the disease caused by SARS-Co V-2)and 75,568 associated deaths have been reported in the country by Iran Ministry of Health.
文摘Background and Objective: Asthma is a major health problem and a high-burden disease in the world. Unfortunately the prevalence of asthma in adult populations in Iran is not determined precisely. The aim of this study was to assess the prevalence of asthma symptoms and it’s relation with ages, gender and smoking behaviour in city of Tehran. Methods: A telephone interview survey was conducted among 7150 randomly selected telephone numbers in city of Tehran. A questionnaire adapted from The European Community Respiratory Health Survey (ECRHS) with additional two questions about smoking behaviour and hookah. Results: From 7150 eligible telephone numbers dialled there were 5500 responses (76.92%). The study populations included 3412 female (62%), 2088 men (38%) and the mean age of responder were 31.15 ± 7.33. Their smoking behaviour were;71.6% non smoker, 11.9% active smoker, 16.5% passive smoker and 7.8% used hookah. The prevalence of “wheezing in the last 12 months”, “dyspnea with wheezing” and “wheezing and two nocturnal symptoms” were 24%, 10.8% and 5% respectively. Prevalence of asthma symptoms was significantly greater in smokers than non-smokers groups. Conclusion: In this study by using symptom based questionnaire (ECRHS), we concluded the prevalence of asthma in Tehran adult population was between 5% to 10%. Also this study may made cross-national comparison of our findings with other ECRHS studies possible;rates of “wheezing in the last 12 months”, “dyspnea with wheezing” and “nocturnal dyspnea” were higher than the European Community Respiratory Health Survey median. Role of air pollution, smoking and other risk factors for asthma should be considered.
文摘Objective: This study aimed to assess training and internship programs (courses) of basic and clinical sciences in hospitals based on surveying the students of Tehran University of Medical Sciences. Material and Methods: The present study was a cross-sectional one with survey descriptive designs. The data collection tool was a questionnaire with 14 five-point likert style items. The Research and Development Center of Tehran University of Medical Sciences surveyed all 185 students of training and internship programs, using a questionnaire with the Cronbach’s alpha coefficient of 81%, for the purpose of adjusting the education to the society’s needs and improving its quality. Result: The mean scores of the assessment of training and internship programs were 3.32%, 2.98%, 3.38% and 3.29%, respectively for theoretical classroom training related to practical training, mental, communicational and practical skills courses. The students’ satisfaction rate regarding the quality of educational courses of training and internship programs was 50.2%. Conclusion: Educational authorities have made necessary attempts to implement these programs and use potential resources for realizing the objectives and achieving the educational quality;however, they should make further attempts in this regard.
基金Supported by National Institute for Medical Research Development(NIMAD)Affiliated with the Iranian Ministry of Health and Medical Education(No.963660).
文摘AIM:To determine the prevalence of some retinal pathologies in people over 60y and their association with demographic and ocular factors.METHODS:A cross-sectional study was conducted in Tehran using multistage cluster sampling.After selecting subjects aged 60 and over,optometric,and ophthalmic examinations were done.For retinal examination,a 90 D lens was used and indirect ophthalmoscopy was performed after instilling tropicamide drops.Biometry was done using the IOL Master for all participants.RESULTS:Of 3791 people that were invited through cluster sampling,3310 participated in the study(response rate=82%).The prevalence of retinal pigmented epithelium(RPE)change,drusen,geographic atrophy(GA),hypertensive retinopathy(HTR),nonproliferative diabetic retinopathy(NPDR),proliferative diabetic retinopathy(PDR),choroidal neovascularization(CNV),central retinal artery occlusion(CRAO),myopic retinopathy(MR),branch retinal vein occlusion(BRVO),and central retinal vein occlusion(CRVO)was 27.42%,11.08%,4.52%,3.03%,4.05%,0.54%,0.82%,0.39%,0.20%,0.49%,and 0.19%,respectively.After removing the effect of age,the odds of NPDR were 1.68 times higher in women compared to men(P=0.014).After removing the effect of sex,the odds of drusen,RPE change,GA,CNV,BRVO,and CRVO increased with age.CONCLUSION:There is a higher prevalence of RPE change,drusen,GA,CNV and a lower prevalence of MR and CRAO in the elderly population of Tehran aged over 60y compared to global average values.Considering the correlation of most of the diseases with age and their effects on vision,attention should be paid to these diseases and the related screening programs to prevent vision impairment.
