hamid sharifi

The purpose of this research was to identify and analyze the drivers of the smart sustainable circular supply chain. Twelve samples were selected by the snowball method from among industry experts in the edible oil sector. Drivers were finalized with expert opinions and analyzed using the DEMATEL and AISM methods. The results showed that organizational competence and human resource competence are the most effective drivers, while economic sustainability and environmental sustainability drivers have the highest levels of effectiveness compared to other drivers. According to the results of the research, officials in the edible oil industry should pay special attention to organizational competence to advance towards a sustainable and smart circular supply chain, as this driver has the greatest impact compared to others.

Medication non-adherence remains a significant problem in managing the global epidemic of hypertension. This study aimed to explore the factors affecting medication non-adherence from the perspectives of both patients with hypertension and healthcare providers in Mahan health centers, located in Kerman province.

Methods & Materials: 

This qualitative study utilized a conventional content analysis method within healthcare centers in Mahan city in 2022. A total of 29 participants were included in the study, selected through purposive sampling. Data were collected through in-depth semi-structured interviews, with all interviews being recorded, transcribed verbatim, and utilized as the primary data for analysis. The trustworthiness of data was evaluated in accordance with the criteria established by Guba and Lincoln criteria.

Three categories of factors contributing to medication non-adherence among patients with hypertension were identified: ""nature of the disease and treatment," "individual and family factors," and "organizational factors." Factors related to the "nature of the disease and treatment" included the asymptomatic and chronic nature of hypertension as well as fatigue stemming from continuous drug use. "Individual and family factors" encompassed fear and internal doubts, a desire for non-pharmacological treatments, and inadequate family support. "Organizational factors" comprised high treatment costs and access to specialized services, insufficient support from treatment and care teams, and inadequate disease monitoring.

Various factors across a spectrum of influences contribute to medication non-adherence in patients with hypertension. It is crucial for healthcare providers to engage in consistent patient education regarding the nature of the condition and the importance of medication adherence to enhance compliance among patients.

Pandemics affect patients’ access to diagnostic and treatment services. As cancer patients need regular follow-up, any obstacle in accessing services can affect the conditions of these patients. Therefore, this study was conducted to investigate the effects of the COVID-19 pandemic on cancer patients’ access to diagnostic and treatment services. In this qualitative study, 15 people were selected through a targeted sampling method among the patients who were referred to cancer treatment centers in Kerman. The interviews were semi-structured and face-to-face and were conducted in April 2021. The data were analyzed using directed content analysis. Among the people included in this study, 10 (66.7%) were women and more than half of the investigated people were in the 36 to 55 years age group (53.3%). These patients faced challenges including delay in treatment, mental and psychologicalproblems, financial problems, and delay in COVID-19 vaccination. Various challenges and factors play a role in cancer patients’ access to diagnostic and treatment services during the pandemic. Therefore, more physical space should be allocated to them in treatment environments to reassure them and facilitate their timely referral to doctors. In addition, psychiatric consultations to identify the problems of cancer patients and regular follow-up of these patients can reduce their problems during pandemics such as the COVID-19 pandemic.

The increase in population and the need to supply foodstuffs have raised the importance of animal health and veterinary activities more than ever before in the country's food security and development. In this paper, which focuses on veterinary activities in the field of food-producing livestock, the concepts of need, supply, and demand are defined, and the methods of determining and prioritizing health needs in the livestock population of the country are presented. In the context of problems in setting priorities, there are also important points such as livestock population statistics, lack of human resources, rapid management changes, economic factors, management considerations, the traditional structure of animal husbandry, insufficient training of producers, and technical health officials of livestock farms, lack of inter-sectoral cooperation and necessary support. From the country's veterinary organization, the lack of sufficient information about diseases and animal health status in neighboring countries, especially Iraq and Afghanistan, and the weakness of border and interprovincial quarantine systems have been noted. Factors affecting the use of animal health services points such as access to services, feeling of need or demand, assurance of quality, price and cost of services and insurance coverage have been mentioned. On the other hand, in recent decades, issues such as climate change, changes in international laws and regulations related to animal health and environment, transgenic products, bioterrorism, and drought, each of which affects the health and livestock production in some way, the need to pay attention to Proposes futures studies. Futures studies are a science that helps to better see these changes and prepare for them. The emergence of some new fields such as artificial intelligence, remote medicine and veterinary medicine (Telemedicine), personalized medicine and veterinary medicine, the emergence of robots in medicine and veterinary medicine, etc. paid attention. The sum of these issues should make us think about how much preparation there is for the future and these changes. It is suggested to make changes in the important fields of veterinary medicine such as education and research, veterinary structures at the national and international levels, and jobs related to veterinary medicine, in line with foresight and futurology.

Screening tests are a special type of diagnostic tests that are performed in an apparently healthy population. The purpose of performing diagnostic tests is to correctly diagnose patients, distinguish affected animals from healthy animals, distinguish between cases and controls, and distinguish between normal and abnormal cases. Screening tests should be simple, cheap, rapid and valid. Diagnostic and screening tests are mainly used in the monitoring of diseases. Related terms to the evaluation of these tests, including sensitivity, specificity, positive and negative predictive value, accuracy and precision, as well as concepts such as the golden standard, because they are often used interchangeably or misinterpreted, it is especially important to learn them. Also, due to the fact that gold standard tests are often more expensive and time-consuming, incomplete diagnostic tests are used, which can be calculated by calculating the sensitivity and specificity of the actual and apparent prevalence obtained by the diagnostic test. However, if the golden standard test is not available, other methods are used to evaluate the tests, including the Kappa index test. The interpretation results of these tests provide a comprehensive and evidence-based approach to clinicians and experts, which ultimately leads to more accurate, comprehensive, cheaper and faster monitoring. In this review article, with a complete and comprehensive review of the conventional concepts in the evaluation of diagnostic tests, along with the solution of practical examples, we will expand and provide a comprehensive presentation of these concepts. Also, the latest original studies that have been done in the field of evaluation of diagnostic tests will also be reviewed in this article.

COVID-19 has a range of manifestations among different patients. Knowing the various manifestations of COVID-19 could help in better managing the infection. This study aimed to investigate the ocular manifestations of hospitalized COVID-19 patients. In this study, 379 PCR-positive COVID-19 patients hospitalized in Afzalipour hospital, a tertiary care academic medical center in Kerman city, were recruited. Demographic variables (age and sex), history of systemic diseases (diabetes mellitus and arterial hypertension), systemic COVID-19 signs and symptoms (respiratory, gastrointestinal, neurologic, and sensory), and the severity of the disease were evaluated. Patients were asked about ophthalmic symptoms. If a patient had serious ocular complaints, such as ocular pain or vision loss, and needed specialized examination, an ophthalmologist examined the patient. The patients’ mean (standard deviation) age was 54.2 (15.8) years. Overall, 46 patients (12.1%, 95% confidence interval: 9.0–15.8) showed at least one ocular manifestation. The most common signs and symptoms among those with ocular manifestations were redness (n = 37, 80.4%), discharge (n = 35, 76.1%), lacrimation (n = 31, 67.4%), itching (n = 15, 32.6%), and dry eye sensation (n = 15, 32.6%). Ocular manifestations were more prevalent among those ≥ 60 years old, those with hospitalization days > 7 days, those with more severe respiratory system involvement, and diabetic patients. One out of eight COVID-19 inpatients showed at least one ocular manifestation. As tear and ocular secretions are considered a route for coronavirus transmission, it is essential to pay attention to the early detection of ocular manifestations.

This study aimed to determine the prevalence of central auditory processing disorder (CAPD) in elementary school students in Kerman, Iran, during 2018-2019.

This cross-sectional study was conducted on 1369 elementary school students in Kerman. These students were selected by cluster sampling from different areas of Kerman and then screened using the Buffalo Model Questionnaire (BMQ). Based on the data obtained from the questionnaire, normal children were excluded from the study. Then, children with suspected central auditory processing disorder (CAPD) underwent ear exams and were excluded from the study in case of abnormal results in the tympanic membrane examination (raptureeffusion). The remaining subjects underwent peripheral audiometry evaluation, and children with abnormal audiometry were excluded from the study. Finally, the remaining children with suspicious screening results, a normal examination, and normal audiometry underwent a specific test to detect Central auditory processing disorder. Data analysis was carried out using SPSS software.

One thousand three hundred sixty-nine primary school students with a mean age of 9.15 ±2.63 years enrolled in this study. 52%% of students were male. 8.03% of them had CAPD. A statistically significant relationship was found between the prevalence of CAPD and gender (P<0.001), place of residence (P<0.001), history of middle ear inflammation (P<0.001) and history of head injury.

The quality of life of these students with CAPD can be improved via timely recognition of CAPD and the provision of appropriate preventive and therapeutic facilities

The COVID-19 pandemic has had a profound impact on Iran and numerous other nations, resulting in a surge in infections and fatalities. In response to the COVID-19 crisis, a range of policies and initiatives were enacted, including the deployment of telehealth services. This study aims to outline the requirements for establishing an all-encompassing platform capable of delivering telemedicine services in Iran.

This cross-sectional study was carried out using a researcher-made electronic questionnaire during the period of July to August 2022. All experts in the field of medical informatics and health information systems based in three provinces (Kermanshah, Kerman, and West Azerbaijan) were contacted to fill out the questionnaire, 15 participants completed and returned the questionnaire. Data were analyzed by SPSS using descriptive statistics.

The requirements for the design and implementation of the systems could be divided into internal (technical and infrastructural, security-legal, and environmental), and external categories (technical and infrastructural, and security-legal). The majority of internal and external requirements were related to technical and infrastructure aspects, accounting for 83% and 95%, respectively.

Telemedicine development tools are available to enhance healthcare services in Iran, but there is a need to strengthen the infrastructure and technical equipment to enable the utilization of this technology for improving therapeutic and educational objectives within the healthcare system.

In this paper, the effect of impurity injection on the structural, optical and magnetic properties of ZnO nanostructures prepared by sol-gel method was investigated. The Ultraviolet spectroscopy (UV-Vis), X-ray diffractometer (XRD), scanning electron microscopy (SEM) and vibrometer magnetometer (VSM) were used to analyze the samples. The experimental results showed that the addition of impurities caused the displacement of the adsorption peak and the reduction of the band gap. From the XRD spectrum, it appears that all specimens are formed in the Versatite structure. No additional peaks are seen in the spectrum, indicating complete phase formation without creating any secondary phases. The absence of additional peaks indicates the high solubility of iron in oxidation, and the results show that the addition of impurities increased the size of the nanocrystals, while the increase in the percentage of impurities did not affect the size of the nanocrystals. Also, iron impurity has caused ferromagnetic properties in the samples so that with increasing the amount of impurity, the induction field decreases. Ultraviolet spectroscopy (UV-Vis), scanning electron microscopy (SEM) and vibrometer magnetometer (VSM) were used to analyze the samples.

Masks play a crucial role in preventing and controlling viral epidemics transmitted predominantly through the air. This study aimed to develop and validate a tool to measure people’s attitudes and behaviors related to mask usage during highly contagious viral epidemics.

In this psychometric study, the initial questionnaire was developed and face validity and content validity were assessed by 17 experts and three lay experts. Reliability was evaluated through internal consistency using Cronbach’s alpha and test-retest reliability using the Intraclass Correlation Coefficient (ICC). Construct validity was measured using exploratory factor analysis (EFA) with the principal component extraction method and Varimax rotation.

Based on a review of previous studies, an initial 27-item questionnaire was crafted. During the face validity stage, two items were excluded. Through calculating the Content Validity Ratio (CVR) and the Content Validity Index (CVI), three and one items respectively removed. The average scale level content validity index (S-CVI/Ave) was 0.95. Cronbach's alpha coefficient was found to be 0.76 for attitude and 0.66 for practice sections; the ICC was equal to 0.873. EFA revealed two factors explaining 63.98% of the total variance.

This questionnaire demonstrated sound reliability and validity in Persian, providing an effective means to assess attitude and behavior related to mask usage during highly contagious viral epidemics. It stands as a valuable tool for use in Iran and other countries.

The influential role of epidemiologists in improving health outcomes and conducting pertinent research becomes apparent  when they are strategically positioned and available in sufficient numbers within a nation. This study aims to identify potential job positions in epidemiology within both governmental and non-governmental sectors while estimating the necessary workforce of epidemiologists in the country until 2027.

The present study was conducted as a combination in two quantitative and qualitative parts. In the qualitative part, interviews were conducted with experts, policy makers, graduates and students of this field in the field of job opportunities. In the quantitative part, the number of epidemiologists needed was estimated using modeling and parameters obtained from the review of the literature and the opinions of experts in this field. In this study, the current and near future needs up to 1406 have been considered.

Based on the interviewes, job opportunities for epidemiologists in the country encompass diverse domains, including problem management and analysis, conducting applied research, data analysis, dashboard development, teaching, training, and future-oriented work (forecasting). Acounting for lost job opportunities, the estimated number of epidemiologists required in the country until 2027 is 1122 individuals, that most of them contribute to the country's health system if job opportunities are created. The highest demand for epidemiologists was identidied in units of the Ministry of Health, medical universities, research centers, and hospitals.

Estimating the number of epidemiologists needed using modeling in the country and paying attention to the current number of graduates, reveals that the growth of this field and the increase in graduates can only occur if job opportunities are clearly defined, created, and implemented across proposed job levels.

COVID-19 vaccination is one of the most successful ways to control the ongoing pandemic and prevent severe diseases, hospitalization, and death. Current evidence suggests COVID-19 vaccine hesitancy (a delay in accepting or rejecting the vaccine despite the availability of vaccination services) is a barrier to successful vaccination programs worldwide. This study aimed to explore the underlying factors associated with COVID-19 vaccine hesitancy among the Iranian population. This qualitative content analysis study was conducted using in-depth semi-structured interviews. A total of 32 Iranian participants with diverse ethnicity, language, age, and gender were selected through purposive sampling. Interviews were analyzed using Graneheim and Lundman’s qualitative content analysis method. MAXQDA software was used for data analysis. Three themes and eight subthemes emerged from the qualitative interviews. Individual underlying factors included knowledge, beliefs, and the fear of COVID-19 infection. Social factors included social media, the health system, and governance. Institutional factors included vaccine opponents and health experts that fueled COVID-19 vaccine hesitancy and refusal among the participants. Poor knowledge, misbelief, and fear were the most commonly reported causes of vaccine hesitancy and refusal among Iranians. Therefore, targeted interventions are recommended to address misinformation among the Iranian population.

Background :

Estimating the number of people using illicit drugs and alcohol is necessary for informing health policy and programming. However, it is often challenging to reliably estimate the size of these marginalized populations through direct methods. In this study, we estimated the population size of these groups using the indirect Network Scale-Up (NSU) method in Iran from 2015 to 2016.

Methods :

Using a self-administered questionnaire, we asked 15 124 individuals (54% men) about the number of people they know who used different types of drugs at least once in the past 12 months. Prevalence estimates were reported per 100 000 population. The uncertainty level (UL) was calculated using the bootstrap method.

Results :

The average age of the respondents was 33 years old, and 35.1% of them were unmarried. The most common drugs and their prevalence were as follows: opium (2534 [95% UL: 2467-2598]), hashish (849 [95% UL: 811-886]), stimulants (methamphetamine, ecstasy pills, cocaine, and Ritalin) (842 [95% UL: 802-879]), heroin/crack (578 [95% UL: 550-607]), and drug injection (459 [95% UL: 438-484]). Additionally, we estimated the prevalence of alcohol use as 2797 (95% UL: 2731-2861). On average, substance use was 5.23 times more prevalent among men than women. Opium use was more prevalent among individuals aged >50 years old. Moreover, alcohol use was more prevalent among participants between 18 and 30 years old (5164 per 100 000 population).

Conclusion :

Although opium continues to be the most prevalent illicit drug in Iran, the patterns of illicit drug use are heterogeneous among different age groups, genders, and provinces. Age-gender specific and culturally appropriate interventions are warranted to meet the needs of people in different subgroups.

Substance abuse in women has an increasing trend in all socio-economic classes. In addition to the fetal consequences, this problem has many other economic and social consequences as well.This study aimed to determine the prevalence of substance abuse and its related factors in pregnant women.

This descriptive cross-sectional study was performed employing a self-administered valid questionnaire on 587 pregnant women in Kerman, Iran who referred to public health centers and private offices to receive prenatal care. Participants were recruited from January to February 2020 using a multistage sampling method.

The most prevalent substances used during pregnancy (current use) were waterpipe (8.5%), opium (2.6%), and alcohol (1.7%).Substance abuse in first-degree relatives was a very strong correlate of substance abuse in pregnant women (OR = 7.26). The low level of education of pregnant women's husbands was also a strong predictor of substance abuse in pregnant women. (OR = 3.15).

Since substance abuse by family members was the strongest correlate of drug abuse during pregnancy, family-based interventions should be tailored to address early detection of such vulnerable women and necessary counseling services.

Healthcare-associated infections (HAIs) are among the most critical challenges for patients and healthcare providers. To achieve the goals of the surveillance system, it is necessary to identify its barriers and problems. This study aimed to identify the barriers and problems of the surveillance system for HAIs.  

This qualitative study was conducted using the content analysis method to investigate the challenges of this surveillance system from the perspective of 18 infection control nurses from hospitals in different cities of Iran with work experience of 1 to 15 years. Data were collected through semi-structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method.  

In this study, we found 2 categories and 7 subcategories. Two categories were barriers related to human resources and organizational barriers to infection control. The 7 subcategories included weakness of medical staff in adherence to health principles, obstacles related to patients, high workload and insufficient motivation, lack of staff knowledge, lack of human resources, functional and logistical weaknesses, and weaknesses in the surveillance system.  

To reduce problems and improve HAIs reporting, the HAIs surveillance system needs the support of health system officials and managers. This administrative and support focus can establish the framework for removing and lowering other barriers, such as the number of reported cases, physician and staff noncooperation, and the prevalence of HAIs. It can also bring HAIs cases closer to reality.

Children with congenital heart diseases (CHDs) often require cardiac surgery, whose outcome depends on many preoperative, intraoperative, and postoperative factors.

We aimed to investigate the factors associated with in-hospital mortality among patients undergoing pediatric heart surgery for CHDs.

This retrospective cross-sectional study included patients younger than 18 years who underwent cardiac surgery due to CHDs at the Children’s Medical Center of Tehran University of Medical Sciences and were admitted to the open-heart surgery intensive care unit (OH-ICU) between March 2018 and March 2019. Patients with incomplete records were excluded. The collected data included age (months), weight (kg), type of congenital defect, duration of intensive care unit (ICU) stay, cardiopulmonary bypass (CPB) time, aortic cross-clamping (XCT) time, postoperative (day 1) platelet count and neutrophil-to-lymphocyte ratio (NLR), and mortality.

This study included 275 CHD patients who underwent cardiac surgery. The mean age and weight were 32.54 ± 37.4 months and 11.01 ± 8.43 kg, respectively. Those who died were younger (P = 0.05) and had lower weights (P = 0.001). An inverse relationship existed between thrombocytopeniaandmortality. TheNLRwashigher in thosewhosurvived(mean4.08 vs. 2.87), while the deceased patients had an extended duration of hospitalization, longer CPB time, and longer XCT time.

Younger age, lower body weight, lower NLR ratio, lower platelet count, longer intraoperative CPB time, and XCT time were not associated with increased in-hospital mortality following cardiac surgery for CHDs. The Risk Adjustment for Congenital Heart Surgery (RACHS-1) score was not significantly related to mortality. Also, CPB and XCT times were significantly longer in cyanotic than in non-cyanotic patients. Cyanotic patients also had significantly lower platelets than non-cyanotic patients after the operation. Large, multicenter studies are needed to further investigate the predictors of mortality following surgery for CHDs.

Hyperhomocysteinemia and vitamin D deficiency may be involved in the pathogenesis of vitiligo. This study compared the serum levels of vitamin D, homocysteine, vitamin B12, and folic acid between vitiligo-affected children and healthy children.

Using a case-control design, 30 children with vitiligo and 30 age and sex-matched healthy children were enrolled from April 2018 to August 2020. Serum levels of vitamin D, homocysteine, vitamin B12, and folic acid were analyzed in both groups during the same season of the year. Additionally, the association between serum levels of these factors with demographic and clinical features of the children (collected by interview and physical examination) was evaluated. Data were analyzed using the independent T-test, Fisher’s exact test, and chi-squared test.

The vitiligo group had significantly lower vitamin D and folic acid serum levels compared with the control group [95% CI -19.87 to -2.96 and -4.15 to -4.18, respectively]. Among patients, the vitamin D level was negatively correlated with age (r = -0.459, P = 0.011) and disease duration (r = -0.373, P = 0.042). Moreover, there was a significant association between vitiligo activity and serum homocysteine levels (P = 0.027).

Routine measurement of vitamin D and folic acid serum levels might be suggested, especially in children with long-standing disease. Monitoring the homocysteine level may be beneficial, particularly in children with progressive vitiligo.

Despite the fact that over three years have passed since the onset of the Covid-19 pandemic, it still remains a significant public health concern in Iran and around the world. It is important to acknowledge that the current situation does not signify an end to the epidemic, and measures must be taken across various levels of prevention, treatment, and policy to effectively manage this crisis. This paper analyzes Iran's response to the epidemic, evaluating the country's performance in areas such as surveillance and healthcare systems, diagnostic testing, long-term Covid-19 complications, vaccinations, treatment, and monitoring of variants. Recommendations are also provided for decision-makers in the field of health and Covid-19.

The main issue of this research is the optimization of the logistics system of the Islamic Republic of Iran Army, including Nazaja, and paying attention to all the effective aspects of the subsystems. The objective of the research was "Optimization of Amad and Support (Logistics) System of Nazaja based on Green Supply Chain Management" considering three hypotheses. The main question of the research is: How to optimize the Amad and Nezaja support system by applying green supply chain management? The statistical population of the research includes all deputies, substitutes, regional support commanders and managers and heads of departments of Nazaja and Aja, whose number was 180 people. According to Cochran's formula, the sample population was 123 people.Data collection tools include documents, interviews, and questionnaires, and the collected data were analyzed using qualitative and quantitative methods. according to the respondents, the optimization of the Amad system and the support of Nezaja by using the green purchasing system (with the presented indicators) has been approved with an average of 4.22 out of 5 points. That means, according to the respondents, the Amad and support system of Nezaja will be optimized by using the green purchasing system.According to the respondents, the optimization of the Amad system and Nezaja support by the green transportation system has been approved with an average of 3.9 out of 5 points, that is, according to the respondents, the Amad system and Nezaja support will be optimized by using the green transportation system. According to the respondents, the optimization of the Amad system and the support of Nezaja by using the green production system have been approved with an average of 3.89 out of 5 points. This means that according to the respondents, the readiness and support system of Nezaja will be optimized by using the green production system.

Screening for home contact with TB patients is essential to identify new infections. This study aimed to evaluate the tuberculosis status in family members of patients with pulmonary tuberculosis in Bam.

This cross-sectional study was conducted as a census of patients' family members whose records are registered during 2013-2019 in Bam Health Center. Patients' information was collected based on a checklist, and then sputum smear-positive patients were identified using tuberculin and sputum smear tests.

Ninety-seven of the patients had a positive sputum smear test result. Based on the records of these patients, 237 members of their families were examined as contact persons. Most of the patients were female and in the age group of 40-50 years; 76.8% of them had unprotected close contact, and 78.9% had a history of permanent contact with patients. Five (2.1%; 95% confidence intervals: 0.7-4.9) sputum-positive smear pulmonary tuberculosis cases were found in contacts of patients, most of them were over 50 years old and primarily women. 40% of these people had unprotected close contact, and 80% had a house with less than 70 square meters.

in this study, 2.0% of the family members of patients were sputum smear-positive. Identifying patients and following them up is essential to prevent the spread of tuberculosis in those people around them. Therefore, screening the patient's family members can significantly help ease the disease burden in Iran.

To assess the adverse drug reactions (ADR) of tetracaine among patients referred to an eye emergency department in the southeast of Iran.

In this case series study, we assessed 31 eyes of 24 patients who were referred due to adverse effects of ocular anesthetics during 2017–2020. We collected the data, including age, sex, job, how the medicine was obtained, symptoms, examination results, and ADR.

Of 24 patients, 22 (91.7%) were male. The mean (standard deviation) age of the patients was 32.6 (1.9) years. Twenty-two patients obtained the medicines without a prescription and a general practitioner prescribed the medicine to two patients. In the first interview, the most common symptoms were: photophobia, reduced vision, ocular pain, and redness. The main signs of persistent epithelial defect, patchy or diffuse corneal stromal infiltration, ring infiltration, and Descemet’s folds were noticed in the examinations. Finally, 51.6% (n =16) of the eyes had decreased vision, 45.2% (n =14) had corneal opacity, 16.1% (n = 5) had elevated intraocular pressure that needed long-term anti-glaucoma therapy, and 6.5% (n = 2) had corneal pannus. Corneal perforation and phthisis bulbi were the final results in one eye.

ADR related to the use of ophthalmic topical anesthetics could cause sightthreatening severe morbidities. It seems that some general practitioners are not careful regarding the prescription of these kinds of medicine. Moreover, the over-the-counter availability of tetracaine eye drops should be managed.

During the first months of the coronavirus disease 2019 (COVID-19) pandemic, Iran reported high numbers of infections and deaths. In the following months, the burden of this infection decreased significantly, possibly due to the impact of a package of interventions. We modeled the dynamics of COVID-19 infection in Iran to quantify the impacts of these interventions.

We used a modified susceptible–exposed–infected–recovered (SEIR) model to model the COVID-19 epidemic in Iran, from January 21, 2020 to September 21, 2020. We estimated the 95% uncertainty intervals (UIs) using Markov chain Monte Carlo simulation. Under different scenarios, we assessed the effectiveness of non-pharmaceutical interventions (NPIs) including physical distancing measures and self-isolation. We also estimated the time-varying reproduction number (Rt), using our mathematical model and epidemiologic data.

If no NPIs were applied, there could have been a cumulative number of 51 800 000 (95% UI: 1 910 000–77 600 000) COVID-19 infections and 266 000 (95% UI: 119 000–476 000) deaths by September 21, 2020. If physical distancing interventions, such as school/border closures and self-isolation interventions had been introduced a week earlier than they were actually launched, 30.8% and 35.2% reduction in the number of deaths and infections respectively could have been achieved by September 21, 2020. The observed daily number of deaths showed that the Rt was one or more than one almost every day during the analysis period.

Our models suggest that the NPIs implemented in Iran between January 21, 2020 and September 21, 2020 had significant effects on the spread of the COVID-19 epidemic. Our study also showed that the timely implementation of NPIs showed a profound effect on further reductions in the numbers of infections and deaths. This highlights the importance of forecasting and early detection of future waves of infection and of the need for effective preparedness and response capabilities.

This study was conducted to evaluate the status of eye and intraocular pressure (IOP), two-six hours, one day, and one week after cataract surgery and implantation of the intraocular lens.

In a longitudinal study, 159 patients with senile cataracts were evaluated. Phacoemulsification surgery and intraocular lens (IOL) implantation in the capsular bag was done. The examinations including visual acuity measurement, slit-lamp examination, and measurement of IOP were done preoperatively, and three times after the surgery.

The mean±standard deviation (range) age of the patients was 65.8 ± 10.5 (40-90) years. Preoperatively the IOP was 12.8 ± 3.5 mmHg, it increased to 20.8 ± 10.7, 2-6 hours after surgery (P < 0.0001), and then reached 13.7 ± 4.4 mmHg on the first postoperative day (P < 0.0001), then it decreased to 12.4 ± 2.9 mmHg one week after the surgery (P=0.02). The IOP was 28.6 ± 12.2 mmHg in eyes with epithelial edema which was significantly higher than those with stromal edema (17.3 ± 7.5 mmHg), and those without edema (16.5 ± 7.1 mmHg) 2-6 hours after surgery.

Since the IOP spike can damage the structure and function of the eye and cause pain, discomfort, and corneal edema that in turn prolongs recovery of vision, especially in those previously damaged, early postoperative examination on the same day after cataract surgery is strongly advised. IOP spikes can be managed safely by aqueous paracentesis without oral, parenteral, or topical drugs. Elevated IOP is more prevalent in eyes with postoperative epithelial corneal edema and in individuals whose cornea is totally edematous.

People living with HIV (PLHIV) and those at risk of HIV are marginalized worldwide and need to reach services regularly. The COVID-19 pandemic can disrupt the HIV care continuum.  This study aimed to identify the extent to which HIV-related services have been affected by the COVID-19 pandemic and how we can overcome these challenges.  

In this rapid review, we systematically searched PubMed and Scopus databases, the references of studies, international agencies, and studies "cited by" feature in google scholar till May 28, 2021, without restrictions to language.   

Among the total of 1,121 studies, 31 of them were included in the review. The most important HIV-related services affected by the COVID-19 pandemic were; access to anti-retroviral drugs, HIV testing, periodic HIV-related testing in people living with HIV (PLHIV), pre-exposure prophylaxis, post-exposure prophylaxis, harm reduction services, psychological and counseling services. Some factors were introduced to mitigate the effects of these challenges, including increasing the resilience of health, protecting health care workers and their clients against COVID-19 through vaccination, providing HIV-related services through telehealth, and multi-month dispensing (MMD) of medicines.  

The results of this review study showed that PLHIV had difficulty in accessing follow-up, care and treatment services during the COVID-19 pandemic. Programs such as the MMD or telemedicine can be useful in providing services to PLHIV during the pandemic.

Evaluating a pharmacovigilance system helps identify its deficiencies and could facilitate measures to remedy and improve the quantity and quality of adverse drug reaction (ADR) reports and other opportunities for pharmacovigilance systems strengthening. This study aimed to evaluate the status of pharmacovigilance in Iran using the World Health Organization (WHO) pharmacovigilance indicators with the prospect of identifying the gaps and areas for improvement.

This study was conducted in 2 parts. The first part included a secondary analysis of the national data obtained from the Iranian National Pharmacovigilance Center (PVC) using a structured data collection form based on WHO core pharmacovigilance indicators. In the second part, a 3-month prospective study was carried out to investigate 2 outcome indicators, ie, length of stay and costs of medicine-related hospitalization in all patients of 2 main referral hospitals in the southeast and north of Iran.

Iran has a PVC with national policy, trained staff, and a statutory budget. In 2017, the number of ADR reports was 15.0 per 100 000 population, and 262 signals were detected during the preceding 5 years. The average length of stay and costs of medicine-related hospitalization were 5 days and US$817.2 in Afzalipour hospital and 6.6 days and US$306.7 in Razi hospital, respectively. The status of pharmacovigilance in the Iranian public health programs (PHPs) is unknown, and most of the indicators could not be assessed.

A robust pharmacovigilance system is a pivotal part of the overall medicines regulatory system. The Iranian pharmacovigilance system has relatively the proper structural condition. Though the underreporting of ADRs, especially medicine-related deaths, is an important issue, and some indicators’ status was unclear. The Iranian pharmacovigilance program requires a higher prioritization, particularly in the PHPs, a greater allocation of resources, and cross-sectoral cooperation to bolster and achieve the pharmacovigilance objectives.