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Effect of TQM educational interventions on the management policy standard of health promoting hospitals
No full textThe purpose of this study was to manage total quality management (TQM) to increase the standard of management policy and contribute to achieve the standards for health promotion hospitals (HPHs). This was a quasi-experimental intervention study. A total of 35 managers participated in this study were selected in the census. Based on the TQM components, educational items were provided as lectures, posters and pamphlets. The TQM questionnaire and HPHs checklist used to collect data in three different periods: before the interventions, immediately after the interventions and 3 months after the interventions (follow-up). The data analysis was done by means of SPSS software (version 23). The results showed that the average difference of the components of the qualitative groups (p 0.05). Based on the findings of this study, the educational interventions had a positive effect on quality management and management policy. Therefore, educational interventions should be accompanied by changes in the culture and management policies of the hospital to meet HPH standards. © 2020 The Author(s). Published by Oxford University Press. All rights reserved
How much will be the cost for universal coverage of COVID-19 vaccination and how shall it be financed?
Get PDFEfficacy and safety of Hemoheal cream in patients with hemorrhoids: a randomized double-blind placebo controlled clinical trial
No full textOBJECTIVE: To evaluate the efficacy and safety of Hemoheal cream, an anti-hemorrhoid herbal preparation, (inspired by Persian medicine literatures in a double-blind, randomized placebo-controlled trial. METHODS: Hemoheal cream consists of aqueous extract of Allium ampeloprasum L., Commiphora mukul (Hook. Ex Stocks) Engl and the oil of Sesamum indicum L. Fifty-two patients with symptomatic hemorrhoids were randomized to receive hemoheal cream or placebo for 3 weeks. The patients were evaluated before and after the intervention in terms of the severity of anal irritation, bleeding, anal itching, pain, defecation discomfort and swelling sense, and overall subjective improvement (), as well as any reported adverse events. RESULTS: The results showed that after 3 weeks of treatment, distribution of anal irritation, bleeding, pain as well as swelling sense were significantly different (P 0.05). Furthermore, a significant difference was observed between the overall subjective improvement of Hemoheal cream and placebo groups (P = 0.012). One patient in the treatment group complained of rashes on the application site. CONCLUSION: The present study showed a positive effect of Hemoheal cream in improving clinical signs and symptoms in patients with hemorrhoids
Spatio-seasonal variation, distribution, levels, and risk assessment of airborne asbestos concentration in the most industrial city of Iran: effect of meteorological factors
No full textLike other dangerous pollutants in the air, asbestos has negative and adverse effects on human and animal health. The present study is designed to determine the concentration of asbestos in the air of the most industrial city of Iran (Karaj) in 2018�2019. For this purpose, 4 samples were taken from different areas of the air of Karaj during a year with an SKC pump and flow of 6 L/min for 8 h and in 45 days, and a total of 68 samples of asbestos fibers were collected. Then, the samples were analyzed by phase-contrast microscope (PCM) and scanning electron microscopy (SEM). Eventually, the health effects of asbestos fibers were evaluated by the IRIS EPA method. The average concentration of asbestos fibers was 1.84 f/L PCM and 18.16 f/L SEM. Also, the results of statistical correlation analysis indicated that asbestos fibers are positively correlated with wind speed but negatively correlated with the other three parameters (temperature, relative humidity, and pressure). On the other hand, the average annual risk of asbestos fiber in the ambient air of Karaj for all samples was in the range of 4.32 � 10�6 to 1.81 � 10�4 which in some places had more danger than the recommended risk range. According to the EPA guidelines, carcinogenicity acceptable levels are in the range of 10�4 and 10�6. Values higher than 10�4 have more carcinogenic risk and values lower than 10�6 have a lower carcinogenic risk. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature
Electrospinning for tissue engineering applications
No full textTissue engineering makes use of the principles of medicine, biology and engineering and integrates them into the design of biological substitutes to restore, maintain and improve the functions of tissue. To fabricate a functional tissue, the engineered structures have to be able to mimic the extracellular matrix (ECM), provide the tissue with oxygen and nutrient circulation as well as remove metabolic wastes in the period of tissue regeneration. Continued efforts have been made in order to fabricate advanced functional three-dimensional scaffolds for tissue engineering. Electrospinning has been recognized and served as one of the most useful techniques based on the resemblance between electrospun fibers and the native tissues. Over the past few decades, a bewildering variety of nanofibrous scaffolds have been developed for various biomedical applications, such as tissue regeneration and therapeutic agent delivery. The present review aims to provide with researchers an in-depth understanding of the promising role and the practical region of applicability of electrospinning in tissue engineering and regenerative medicine by highlighting the outcomes of the most recent studies performed in this field. We address the current strategies used for improving the physicochemical interactions between the cells and the nanofibrous surface. We also discuss the progress and challenges associated with the use of electrospinning for tissue engineering and regenerative medicine applications. © 2020 Elsevier Lt
Distinct patterns of hippocampal subfield volume loss in left and right mesial temporal lobe epilepsy
No full textObjective: To investigate the pattern and severity of hippocampal subfield volume loss in patients with left and right mesial temporal lobe epilepsy (mTLE) using quantitative MRI volumetric analysis. Methods: A total of 21 left and 14 right mTLE subjects, as well as 15 healthy controls, were enrolled in this cross-sectional study. A publically available magnetic resonance imaging (MRI) brain volumetry system (volBrain) was used for volumetric analysis of hippocampal subfields. The T1-weighted images were processed with a HIPS pipeline. Results: A distinct pattern of hippocampal subfield atrophy was found between left and right mTLE patients when compared with controls. Patients with left mTLE exhibited ipsilateral hippocampal atrophy and segmental volume depletion of the Cornu Ammonis (CA) 2/CA3, CA4/dentate gyrus (DG), and strata radiatum-lacunosum-moleculare (SR-SL-SM). Those with right mTLE exhibited similar ipsilateral hippocampal atrophy but with additional segmental CA1 volume depletion. More extensive bilateral subfield volume loss was apparent with right mTLE patients. Conclusion: We demonstrate that left and right mTLE patients show a dissimilar pattern of hippocampal subfield atrophy, suggesting the pathophysiology of epileptogenesis in left and right mTLE to be different. © 2020, Fondazione Società Italiana di Neurologia
FDG PET/CT of an Advanced Case of Malignant Nerve Sheath Tumor of Pleura
No full textWe present a rare case of malignant nerve sheath tumor of pleura referred for the evaluation of metastases and local invasion. FDG PET/CT demonstrated a hypermetabolic tumoral lesion extensively involving the right pleura with no involvement of mediastinal structures or pulmonary parenchyma and no clear evidence of distant metastasis. Malignant nerve sheath tumor of pleura is an extremely rare entity, and FDG PET/CT is valuable in demonstrating the extent of disease and can have potential role for postsurgical as well as postchemotherapy assessment of possible residual disease. © Wolters Kluwer Health, Inc. All rights reserved
The role of Tetrahydrocannabinol in inducing disrupted signaling cascades, hippocampal atrophy and memory defects
No full textTetrahydrocannabinol (THC), a major psychoactive constituent of marijuana, can substantially change the function of several brain areas, leading to behavioral impairment including memory and learning dysfunction. Given the importance of hippocampus as one of the chief parts of the brain involved in memory processing, the present study seeks to investigate structural and histological alterations in hippocampus as well as behavioral defects provoked by THC treatment. Besides, using genome-wide sequencing, we adopted a pathway-based approach to discover dysregulated molecular pathways. Our results demonstrated remarkable hippocampal atrophy, and also interrupted memory function and long term potentiation (LTP) under THC exposure. We also detected several dysregulated signaling pathways involved in synaptic plasticity as well as cell-cell interaction in the hippocampus of THC-treated rats. Overall, the results indicate a potential correlation between disrupted signaling cascades, hippocampal atrophy and memory defects caused by THC treatment. © 2021 Elsevier B.V
MneSCs exert a supportive role in establishing a pregnancy-friendly microenvironment by inhibiting TH17 polarization
No full textObjectives: Uncontrolled TH17 differentiation has been suggested to play a role in the pathogenesis of pregnancy loss. We recently showed that menstrual blood stromal/stem cells (MenSCs) alter functional features of natural killer cells. Here, we hypothesized that MenSCs could modulate differentiation of TH17 cells. Method: MenSCs were collected from 18 apparently healthy women and characterized. Bone marrow mesenchymal stem cells (BMSCs) served as a control. TH17 polarization and proliferation of purified T CD4+ cells were assessed by flow cytometry in a well-defined co-culture system containing T CD4+ cells and MenSCs or BMSCs. Indoleamine 2,3-Dioxygenase (IDO) activity was evaluated in MenSC and BMSC culture supernatants by a colorimetric assay. The impact of MenSCs on expression of transcription factors, RORC, T-bet, Gata3, NRP-1 and Helios were studied by qPCR. Results: MenSCs significantly inhibited TH17 differentiation (p = 0.0383) and percentage of the cells co-expressing IL-17 and IFN-γ (p = 0.0023). PGE2 blockade significantly reduced percentage and proliferation of T CD4+IL-17+ (p = 0.003, p = 0.0018), T CD4+ IFN-γ+ (p = 0.002, p = 0.0022) and T CD4+IL-17+ IFN-γ+ (p = 0.004, p = 0.02) cells. MenSCs produced a considerable activity of IDO (p = 0.0002), induced a significant rise in the Treg frequency (p = 0.0091) and a sharp increase in TH17/Tregs ratio (p = 0.0022). MenSCs increased expression of NRP1 (p = 0.001), while downregulated expression of RORC in T cells (p = 0.001). Conclusion: Our results suggest a supportive role for MenSCs in establishing a pregnancy-friendly microenvironment in the uterus and put forth the idea that inherent abnormalities of MenSCs may be a basis for dysregulated endometrial immune network leading to pregnancy loss. © 2020 Elsevier B.V
Outcomes of oversized coronary stenting in patients undergoing elective percutaneous coronary intervention
No full textBackground: The size of the coronary stent has an important role in the efficacy of stenting and its complications. The present study focused on the clinical outcomes of undersized, normal-sized, and oversized stenting. Methods: This historical cohort study, conducted from April 2016 to March 2017 at Rajaie Cardiovascular Medical and Research Center, analyzed the results of elective percutaneous coronary intervention (PCI) and angiography on patients who met the inclusion criteria. Based on the ratio between the stent and the reference vessel, the patients were divided into 3 groups: undersized stenting (stent diameter/reference vessel diameter 1). Data on demographic characteristics, procedural characteristics, underlying diseases, the hospital length of stay, major adverse cardiac events (MACE), post-PCI restenosis, stent thrombosis, and post-PCI cerebrovascular accident were extracted from the patients� files and entered into a checklist. Results: Oversized stenting significantly reduced the incidence of MACE 1 year after PCI compared with undersized and normal-sized stenting. The incidence of rehospitalization for acute coronary syndrome was 7.5 times lower in oversized stenting than in undersized stenting (P=0.002). The incidence of re-PCI on the involved vessel decreased significantly with an increase in the stent size (P=0.017). Additionally, there was no incidence of stent restenosis in oversized stenting (P=0.001). The other outcomes had no significant correlation with the stent size. Conclusions: Based on the results of our study, oversized stenting could improve clinical outcomes. (Iranian Heart Journal 2021; 22(2): 44-50). © 2021, Iranian Heart Association. All rights reserved