sepehr metanat

 Polycystic ovary syndrome (PCOS) is one of the most common causes of infertility in women worldwide. In vitro fertilization (IVF) is a method used to increase the chance of fertilization. This study was conducted with aim to assess the factors associated with IVF success in women with PCOS.

 This retrospective study was performed on women aged 18 to 46 years with PCOS undergoing IVF in the Infertility Research and Clinical Center, Yazd, Iran, from April 2016 to February 2017. The success of IVF was evaluated in two stages with a β-hCG blood test and ultrasound imaging. The variables of age, number of total embryos, quality of embryos, fertilization rate, number of transferred embryos, and endometrial thickness were measured.

 In this study, 600 women were included. Of these, 213 and 144 patients had positive pregnancy by β-hCG blood test and ultrasound imaging, respectively. The number of total embryos (OR=1.88) and A-quality embryos (OR=1.81) were significantly associated with positive β-hCG test. Regarding pregnancy confirmation by ultrasound imaging, A-quality embryo (OR=3.75), and B-quality embryo (OR=2.68) had a significant relationship with fertilization (OR=8.63).

Age, the quality of embryos and fertilization rate can predict IVF success in PCOS patients. However, no significant relationship was found between endometrial thickness and the number of transferred embryos and pregnancy response. Further studies are needed to obtain more understanding in this regard.

A health crisis can disrupt primary health care where telemedicine technology can facilitate the delivery of healthcare services. This study aimed to identify telemedicine applications in primary health care during a crisis.This research was conducted by scoping review method. All studies had been systematically searched through "Web of Science", "Embase", "PubMed", "MEDLINE", "SID", and "Magiran" databases with appropriate keywords in three groups: "telemedicine", "primary health care" and "health crises". Among 2949 screened studies, 76 were included in this research. Finally, the studies were analyzed using the framework analysis method in MAXQDA software. A total of 47 applications were found for telemedicine in primary health care in critical situations, which were classified into 6 areas including teleconsultation, e-learning, remote monitoring, source of medical information, decision support, and patient self-management. The most common medical applications were remote visits, patient consultation, patient education at home, provider screening, self-management of COVID-19 disease, and psychological and social support for patients. Telemedicine technology enables the control and management of crises that arise in health and treatment fields. By improving access, promoting interaction between specialists in urban and rural areas, reducing costs, and reducing mortality and disability, telemedicine provides socioeconomic benefits to patients, providers, and the health care system.

Research depends on talented people with bright ideas more than anything else. Preserving the turnover of skilled and fresh researchers can help a research center move toward its goals more strongly. We have recently organized an innovative event, titled "Proposal School," to address this issue. It was an incubator and accelerator for students and post-graduates interested in orthopedic research. This first-coming two-month program included high-standard theoretical education, practical tutoring to help create an actual proposal, faculty supervision, and blinded faculty reviews. During this program, we hosted 94 junior researchers from 25 universities across the country; 22 hours of educational content were provided to 88 people; and 45 junior researchers developed 18 proposals, of which 11 were accepted and recruited for grants. In this article, we will share our experiences with our colleagues as a source of inspiration for their future plans.

Family medicine is a program in which the family physician and his team members are responsible for providing comprehensive, coordinated, continuous, and individual and family-based health services to promote, restore, or maintain health in a community. Iran's urban family medicine program was initiated in 2011 and conflict of interest (COI) is a challenge to its effective implementation. This research aimed to identify the types and examples of COI in family medicine programs and to present solutions to control it.

This study was carried out using the scoping review method. All articles and documents published in six databases (i.e., Pubmed, Web of Science, Scopus, SID, Magiran, and Noormags) and Google Scholar search engine in the field of COI in family medicine program between January 1980 and July 2022 were searched. Finally, 31 related documents were selected and analyzed using the framework analysis method.

Overall, 18 examples of COI were identified in the family medicine program, which were divided into two categories: direct and indirect COI. Receiving money, gifts, samples, and grants from pharmaceutical and medical equipment companies has been cited more in the literature. Furthermore, 28 solutions for managing conflict of interests were identified and categorized into four levels: Meta (government and the Ministry of Health), macro (medical universities, health insurance companies and pharmaceutical and medical equipment companies), meso (health organizations) and micro (health services provider and receiver). Developing rules and regulations, using performance-based payment methods, monitoring and controlling the performance of family doctors, clarifying the financial relations of family doctors with industries, using an evidence-based educational system, and enhancing family doctors’ knowledge and skills were cited in the literature.

Conflict of interest is a serious challenge in primary health care and family medicine program which may lead to corruption. Conflict of interest strategies should be implemented at the individual, organizational, and national levels to be effective. A system must be created to increase the cost of COI to individuals.

The primary health care system is the first point of contact for individuals, families and society with the health system, where basic and essential health services are provided in a place close to where people live or work. The primary health care system plays a critical role in responding to epidemics and should be strengthened. This study aimed to strategically analyse the Iranian primary health care system in responding to epidemics and to provide solutions to strengthen it.

This research was carried out using scoping review method. All studies related to the strengths, weaknesses, opportunities and threats of Iran’s primary health care system in responding to epidemics, indexed in PubMed, Scopus, Web of Science and ProQuest, SID and Magiran databases and Google Scholar search engine were searched using appropriate keywords and search strategies. Finally, 52 documents were selected and analyzed using framework analysis method.

Overal, 18 strengths, 10 weaknesses, 17 opportunities and 14 threats were identified for Iran’s primary health care system in responding to epidemics. Besides, 62 actions were suggested to strengthen Iran’s primary health care system in responding to the epidemics, which were grouped into six categories: governance and leadership, financing, health workers, equipment and medicine, health information system, and primary health care delivery. Using the military health staff for deprived areas, home quarantine of the infected, training health workers, social and psychological support for workers and using tele-medical services are necessary to strengthen Iran’s primary health care system.

Iran’s primary health care system is facing many challenges in responding to epidemics. Policy makers and senior managers of the health system should strengthen the country’s primary health care system using the suggested strategies.

The use of oral corticosteroids to treat idiopathic granulomatous mastitis (IGM) has been a point of controversy for a long time. In addition, a wide diversity of combinations with other therapies have been reported so far. This study aims to review the usage of oral corticosteroids and their combinations in the published literature.

PubMed and Scopus were searched using the key word “granulomatous mastitis.” Citations were filtered in two stages, considering the titles/abstracts and full texts. Papers reporting the treatment of IGM with corticosteroids with/without other treatments were included.

Fifty-eight citations were included in this study, 31 of which had at least a group of patients treated only with systemic corticosteroids. Combination therapy of systemic steroids with immunosuppressants, surgical interventions, and antibiotics were used in 6, 12, and 13 studies, respectively.

Considering the inconsistency of studies in reporting the severity of the disease, administered treatments, outcome of treatment, side effects, and follow-up, our study failed to provide solid evidence for using corticosteroids as the first step in the management of idiopathic granulomatous mastitis. There is still a need for further studies emphasizing the homogenization of such reports. In this regard, preparing a questionnaire to help homogenize future reports on IGM is highly recommended.

Idiopathic granulomatous mastitis (IGM) is a challenging exclusion diagnosis for breast lesions, manifested as benign, chronic inflammation of the breast tissue. Although some evidence suggest that IGM cases are not uniformly distributed worldwide, few investigations have specifically addressed this topic. This study aims to examine the distribution of IGM cases among countries and races/ethnicities based on reported cases.

A review of studies with a report of at least one IGM patient published from 2011 to 2020 inclusive was conducted. The search was performed in MEDLINE, and citations were filtered in two stages by title/abstract and full text. Those cases with a positive growth of pathogens, male granulomatous mastitis and review articles were excluded.

Among 365 retrieved publications, 218 were finally included based on the inclusion and exclusion criteria, comprising 7161 patients from 34 different countries. Turkey, the United States, and China were the countries where the most publications (including case reports) originated. Considering the number of patients within papers, Turkey, Iran, and China were the pioneers.

Based on the published literature, some populations seem to be more prone to IGM. Further investigations may reveal the genetic and environmental factors associated with this disease in different geographic areas

Several months have passed since the onset of the COVID-19 pandemic. Multiple characteristics have been proposed as prognostic factors so far. This study aims to provide evidence on the association of neutrophil-to-lymphocyte ratio (NLR) at the hospitalization time and three desired outcomes (mortality, prolonged hospitalization, and intensive care unit [ICU] admission). We designed a single-centre retrospective observational study in Baharloo Hospital (Tehran, Iran) from 20 February to 19 April 2020. Patients with confirmed COVID-19 diagnosis via rt-PCR or chest CT imaging were included. Demographic and clinical data were obtained. The sample was divided into three groups, using tertile boundaries of initial NLR. The differences in mortality, comorbidities, hospitalization duration, drug administration, and ICU admission between these three groups were investigated. The identified confounding factors were adjusted to calculate the odds ratio of death, ICU admission, and prolonged hospitalization. Nine hundred sixty-three patients were included. In total, 151 and 212 participants experienced mortality and ICU admission, respectively. In multivariate logistic regression models, the adjusted odds ratio for mortality event in the second and third tertile of initial NLR after full adjustment were 1.89 (95% CI:1.07-3.32) and 2.57 (95% CI:1.48-4.43) and for ICU admission were 1.85 (95% CI:1.14-3.01) and 2.88 (95% CI:1.79-4.61), respectively. The optimal cut-off value of the initial NLR for predicting mortality was 4.27. Initial NLR can predict mortality and ICU admission in COVID-19 patients. Further investigations for curating the calculated cut-off can propose initial NLR as an indicator of poor prognosis for COVID-19 patients.