فهرست مطالب kourosh etemad

Therapeutic plasma exchange (TPE) is a plasmapheresis procedure whose Safety data for pediatric neuro-immunological disorders (PNID) is confined. The present research documents TPE’s safety and feasibility data in these conditions.

The current study involved six distinct groups of patients with PNID undergoing TPE: neuromyelitis optic spectrum disorder (NMOSD), autoimmune encephalitis (AIE), acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), Guillain-Barre syndrome (GBS), and optic neuritis (ON). This study documented complications related to each TPE process. In addition, TPE’s efficacy was studied in these patients.

The present study recorded adverse effects in 18 patients with PNID that received 121 TPE cycles: five cycles (4.13%) in MS, three (2.48%) in AIE subgroup, one (0.82%) in ADEM, and two (1.65%) in GBS. No severe complications were observed among the patients.

Patients with PNID tolerated therapeutic plasma exchange, which was a safe process.

Neuroimmunological diseases in children encompass a range of disorders that lead to neurological complications in patients due to immune responses and systemic circulating antibodies. Limited research has been conducted on therapeutic plasma exchange’s efficacy and potential side effects in children with neuroimmunological diseases.

This study aimed to investigate this procedure’s effectiveness and potential side effects in children afflicted by these diseases.

This cross-sectional study examined a cohort of 18 children with neuroimmunological diseases who were admitted to the neurology department of Mofid Hospital over one year from March 2021 and underwent therapeutic plasma exchange.

The study included 18 patients, with an equal distribution of 9 females and 9 males. A total of 121 procedures were performed across 6 different disease groups: Multiple Sclerosis (22%, n = 4), Autoimmune Encephalitis (22%, n = 4), Neuromyelitis Optica Spectrum Disorder (22%, n = 4), Guillain-Barré syndrome (22%, n = 4), Acute Disseminated Encephalomyelitis (6%, n = 1), and Optic Neuritis (6%, n = 1). Following the plasma exchange, 17 patients (95%) showed immediate clinical improvement, while one patient diagnosed with optic neuritis did not respond to the treatment. During the follow-up period, 14 patients (78%) demonstrated significant improvement, one patient (6%) showed moderate improvement, and two patients (11%) exhibited mild improvement compared to their pre-plasmapheresis condition. Laboratory examinations revealed that only one patient experienced thrombocytopenia, which resolved without requiring treatment. No complications were observed during the follow-up visits for any of the patients.

Plasma exchange is a safe procedure for children with neuroimmunological diseases and yields favorable clinical responses.

The need to ensure safety and security is one of the most critical priorities for humans. Awareness of the safety status of buildings can prevent many accidents and damages. This study aimed to provide an algorithm for ranking the safety of institutional buildings to implement a tool to predict institutional buildings’ safety status in operation.

In this study a checklist was designed. In the next step, checklist items were weighted using the Fuzzy Analytic Hierarchy Process (FAHP) method. Then, the safety rating algorithm of institutional buildings was developed based on the internal relationships of criteria. In the next stage, the tools provided for the institutional building of Shahid Beheshti University of Medical Sciences were used, and its level of safety was assessed.

A 42-item checklist was designed based on three main criteria. Three main criteria including the "technical-service," "architectural," and "managerial" criteria gained local weights of 0.549, 0.313, and 0.136, respectively. The ranking algorithm of building safety was based on the results of weighting criteria and decision tree. Safety score of building was calibrated in a five points level from very good to very weak level. The results of safety assessment of institutional building of university using the proposed algorithm and formula showed a safety score of 13.27 and in moderate safety level.

The importance and weight of the criteria affecting the safety of the building are not the same. The items related to emergency exits and firefighting had the most impact on the safety score of in operation building. Most of the non-compliances in building safety inspection are seen in technical-service and architectural criteria.

The purpose of phenylketonuria (PKU) screening is to assess the risk of, and prevent, the disease in the newborns likely inflicted with it. The aim of this study was to investigate why and how PKU screening was decided to be included in the national health agenda, initiated and implemented in Iran. This qualitative study was conducted based on the Kingdon’s framework model in 2015. The participants were thirty-eight policy-makers, managers and researchers selected by purposeful sampling.Data were collected using semi-structured interviews and analyzed using framework analysis. The physical and mental disabilities, medical and maintenance costs and the need for rehabilitation services were examples of the problem stream. In addition, sampling based on the National Congenital Hypothyroidism Program and implementation feasibility at the national level were examples of the policy stream. Finally, pressure by the patients' families, the Scientific Children Association and executive managers were examples of the political will stream. When the three streams occurred simultaneously, health policy-makers agreed to implement the program and then was opened the window of opportunity. Successful implementation of the National Phenylketonuria Screening Program in Iran has been the result of interactions among three streams, namely, nature of the problem, political will and optimal use of policy-makers of the window of opportunity opened

Estimating the burden of diseases، injuries and major risk factors is necessary for adopting appropriate health policies in every country، and this paper aims to explain the study protocol of national and sub-national burden of breast cancer in Iran from 1990 to 2013. We will perform a systematic review of the confirmed databases and literature to gather data on breast cancer epidemiology in Iran. The definitions، data sources، organizing the team، methods of data gathering and data generating will be explained in this paper. The methodology of estimating the trend of prevalence، years of life lost due to premature death (YLLs)، years of life lost due to disability (YLDs) and disability-adjusted life years lost (DALYs) of breast cancer by age groups، provinces and probable inequalities will be explained. We will tackle possible data problems due to the lack of data points on provinces and years and also geographical misalignment by using two advanced statistical methods، namely Bayesian autoregressive multilevel and Spatio-temporal models. Trend estimation will be reported using these two models together with uncertainty intervals. This study provides a comprehensive assessment of breast cancer and its specific pattern in Iran. The results will help policy makers to know the trend of prevalence، the distribution، and the inequalities of breast cancer in Iran to allocate resources in a better way.

Non-communicable diseases, as the major public health problem, are caused by different risk factors. The main leading lifestyle risk factors for most diseases burden in Iran are unhealthy diet, physical inactivity, and smoking. The aim of this study is to provide data collection and methodology processes for estimating the trends of exposures to the selected lifestyle risk factors and their attributed burden at national and sub-national levels. Systematic review will be performed through PubMed/MEDLINE, Scopus and ISI/Web of Science as well as Iranian databases such as IranMedex, Irandoc and Scientific Information Database (SID). In addition, hand searching of unpublished data sources will be used to identify relevant population-based studies. The searched studies will be included only if it is reasonably population-based and representative, and exposure data has been reported or could be plausibly obtained from the study. For risk factors with no surveys identified, other sources of potential data will be considered. The target population is healthy Iranian adult population living within Iran from 1990 to 2013. Other data sources include national censuses, national registration systems, and national and sub-national surveys. Spatio-temporal Bayesian hierarchical model and Bayesian multilevel autoregressive model will be used to overcome the problem of data gaps in provinces, and in some age or sex groups or in urban/rural areas. The problem of misaligned areal units will be also addressed in these models. National and sub-national assessment of major lifestyle risk factors such as unhealthy diet, physical inactivity, and smoking is necessary for priority setting and policy making in different regions of Iran.