shahnam arshi

Since the emergence of coronavirus disease 2019 (COVID-19), many people have been vaccinated worldwide. Despite the preventive role of vaccines, their side effects face disease management with challenges. This study aims to investigate the side effects of COVID-19 vaccination among healthcare workers in Tehran, Iran.

This cross-sectional study was conducted from April to October 2022 on 377 healthcare workers in Tehran, Iran. Data collection was carried out through an interview by a researcher using a checklist assessing systemic and local side effects of COVID-19 vaccines.

The mean age of participants was 36.03±10.24 years, and 68.2% were female. Participants experienced significantly more local (26.5% vs. 14.3%, P<0.001) and systemic (52.0% vs. 31.8%, P<0.001) side effects after the first dose than after the second dose. After the first dose, AstraZeneca (45.9%) caused significantly more local reactions than Sputnik V (21.7%) and Sinopharm (14.5%). AstraZeneca (83.7%) caused significantly more systemic side effects than Sputnik V (50.7%) and Sinopharm (14.5%). The prevalence of local and systemic side effects after the first dose was significantly different in terms of vaccine types (P<0.001). After the second dose, AstraZeneca (20.4%) caused significantly more local reactions than Sputnik V (12.8%) and Sinopharm (10.5%) (P<0.001). Additionally, AstraZeneca (38.8%) and Sputnik V (37.4%) caused significantly more systemic side effects than Sinopharm (7.9%) (P<0.001).

Most healthcare workers in Tehran experienced flu-like symptoms and local reactions at the injection site after vaccination against COVID-19, mainly after the first dose. They had more side effects after vaccination with AstraZeneca and Sputnik V, compared to Sinopharm.

Visceral leishmaniasis (VL) is one of the most important neglected tropical diseases. The zoonotic form of VL is endemic in some areas of Iran. We aimed to determine the status of VL identified in humans and canines in different parts of Iran from 2013 to 2022.

A national representative cross-sectional study was conducted in 10 provinces of Iran, including the national leishmaniasis reference lab. We employed the direct agglutination test (DAT) as a reliable serological method to detect anti-Leishmania infantum antibodies in humans and animal reservoir hosts. Additionally, a narrative literature review was conducted to identify relevant studies on VL seroprevalence in Iran from 2013 to 2023.

The results of 21281 human and 5610 canine serum samples from 2013 to 2022 are reported. Altogether, 448 (2.1%, 95%CI: 2.0-2.3) human serum samples showed anti-L. infantum antibody levels of ≥1:3200. Of these samples, 13716 (64.5%) were collected actively, which showed a seroprevalence of 0.6% (95% CI: 0.5-0.8) and 7565 (35.5%) were collected passively, which showed a seroprevalence of 4.8% (95%CI: 4.3-5.3). Overall, 1035 (20.1%, 95%CI: 19.0-21.2) of 5160 domestic dogs (Canis familiaris) samples showed anti-L. infantum antibody levels of ≥1:320. Northwest (2.8%) and northeast (0.96%) regions had the highest human VL seroprevalence, while northwest (21.5%) and south (14.4%) regions had the highest canine VL seroprevalence.

Zoonotic VL, an endemic parasitic disease, is still present in several different distinct areas across Iran. While human VL cases have shown a declining trend over the last decade, the prevalence of canine VL remains significant.

 The objective of this study was to determine the incidence of workplace violence (WPV) against residents of clinical medicine in Shahid Beheshti University of Medical Sciences in 1398 and also to compare it between different clinical specialties.

 This descriptive-analytical study was conducted with the participation of 219 clinical medical residents of Shahid Beheshti University of Medical Sciences in 1398. To collect data, an edited version of the Workplace Violence in the Health Sector Country Case Study questionnaire was completed in one interview session.

 Total of 219 residents were studied, of which 85 (38.8%) had experienced physical WPV at least once in the last 12 months and 207 (94.5%) were subjected to psychological WPV at least once during this period. During the last 12 months, 21 (80.8%) emergency medicine, 11 (64.7%) psychiatry, 31 (47.0%) surgical sciences, and 22 (20.0%) internal medicine residents, had experienced physical WPV. In contrast, of the total 219 residents. Younger (P=0.04) and female (P<0.001) residents were less likely to encounter physical WPV than their colleagues.

 Nearly one-third of the studied residents had been subjected to at least one episode of physical WPV, and roughly all had encountered psychological WPV at least once in the past 12 months. Unfavorable situation of residents in terms of physical and psychological WPV, underscores the urgent need and necessity of developing preventive guidelines appropriate to the culture and society of Iran.

Since the coronavirus disease 2019 (COVID-19) pandemic began, several vaccines have been manufactured to subside it. This study aimed to determine the prevalence of side effects after injecting common COVID-19 vaccines available in Iran.

This cross-sectional study was accomplished on Shahid Beheshti University of Medical Sciences (Tehran, Iran) employees during January and September 2022. Eligible participants were selected based on the simple ran- dom method and interviewed about side effects after injecting COVID-19 vaccine.

The mean age of 656 participants was 38.03 ± 9.53 years, and 453 (69.1%) were female. The prevalence of post-vac- cination side effects was higher after receiving the first dose (53.2%) than the second (35.9%) and third (49.4%) doses. Across all three vaccine doses, the overall proportion of side effects was higher following AstraZeneca than the others. The most common side effect after the first dose of the vaccine was myalgia (41.9%), followed by fever (36.6%), chills (31.6%), local reactions (27.0%), headache (25.5%), and sweating (21.6%). People experienced mainly myalgia (23.3%) and fever (20.3%) after injecting the second dose of the vaccine. Additionally, the participants had myalgia (37.2%), fever (30.8%), chills (29.2%), local reactions (26.0%), and headache (24.4%) after the third dose of the vaccine.

AstraZeneca had a higher proportion of post-vaccination adverse effects than Sputnik V, Pastocovac, and Sin- opharm. The most common side effects were flu-like syndrome and local reactions at the injection site. Furthermore, people rarely experienced life-threatening side effects. Thus, the available COVID-19 vaccines in Iran are safe.

Developmental delay (DD) in children is a crucial issue in pediatric health. The most practical evaluation way for early detection of developmental delay is parent-completed tool by the Ages and Stages Questionnaire (ASQ).

The aim of this study was to estimate the prevalence of developmental delay in 12-month-old infants.

In this cross-sectional study, 5,025 ASQs of 12-month-old children who presented in urban health centers of Shahid Beheshti University of Medical Sciences from 23 August 2018 to 23 August 2019, were evaluated. Total scores in five main domains and six final questions were extracted.

Fifty-one-point-five percent were boys. Also, 243 cases (4.8%) had problem in at least one out of the five domains, 68 cases (1.35%) had DD in two domains, five cases (0.09%) in three domains, four cases (0.07%) in four domains, and two cases (0.03%) had an essential delay in all five domains. Developmental delay was seen more in gross motor (1.6%), followed by communication (1.5%), problem-solving (1%), fine motor (0.4%), and personal-social (0.3%), respectively. There were significant statistical differences in personal-social and problem-solving in boys. Among six questions in ASQ, the most common problem was in question 4 (1.4%), which is related to auditory problems.

Developmental screening is a basic tool for developmental delay detection. Developmental delay diagnosis and early intervention may be possible through cost-effective screening tools.

Cutaneous leishmaniasis is a neglected and parasitic vector borne diseases that is endemic in tropical and subtropical countries, including Iran. The aim of this study was to explain the present status of CL in Iran. This report is based on data that recorded by cutaneous leishmaniasis surveillance system in 2019, and evaluated in Center for Communicable Diseases Management in Ministry of Health in Iran. Iran has been considered an endemic area for cutaneous leishmaniasis in the world. Dependent to activities for cutaneous leishmaniasis control the number of cases decreased from 23202 in 2008 (Incidence rate 32 per 100000) to 13124 in 2019 (Incidence rate 15.8 per 100000), more cases reported from September to December, in 2019, 46% of cases had one lesion and 21% had 2 lesions, 85% of cases diagnosed when the diameter of lesions had 3 centimeters and bellows. Although the Leishmania control program began in 1977, the incidence of the disease has dropped dramatically since 2008 when the new cutaneous leishmaniasis control program have been implemented. Although in some areas the incidence of the disease increased, but the implementation of the new program has reduced the number of cases, in order to continue reducing the disease, permanent support for the control programs is needed.

The importance of using modern electronic and virtual education in medical sciences, which can be used without any time limit, is increasingly increasing.

The current study aimed to provide a framework for distance education based on the Electronic Learning Management System for the staff of the Deputy for Public Health.

This study had three phases. First, the level of preparedness of the staff of the health department (trainers and learners) was assessed through a descriptive-survey using a questionnaire. In the second phase, the analysis of the educational programs that were implemented during the last year was carried out. Finally, in the third phase, to manage the e-learning process based on the selected Instructional design model, considering the newness, a structure was proposed, guaranteeing quality while taking into consideration the deputy’s current facilities and staff.

According to the results, 84.4% of the trainers and 87.4% of the learners were agreed with E-learning. 72.2% of trainers noted that their educational programs could be held electronically, and 84.4% of trainers and 64.4% of learners believed that moving toward E-learning is necessary. 82.6% of the goals of the curriculum were cognitive, and 92.4% were theoretical. The design of the structure of E-learning was carried out in the areas of planning, content creation, course implementation, evaluation, and electronic loading. Besides, the tasks of each area were tailored to the Instructional Design Model of Gagne and were based on the capabilities of the Deputy for Public Health.

The present study showed that trainers and learners are ready to conduct E-learning and that educational programs also can be held electronically, and a structure that incorporates the quality and proper management of this department is designed based on the potential and personnel resources of the department.

Aim: In this study, we investigated the prevalence of PARV4 virus among the healthy population and four other groups of HBV infected, HCV infected, HIV infected and HIV/HCV co-infected individuals in Iran.
Parvovirus 4 (PARV4) was first discovered in 2005, in a hepatitis B virus infected injecting drug user (IDU). To date, the best evidence about PARV4 transmission is parenteral roots which comes from IDU individuals. It seems that the prevalence of the virus in the normal population is very low.
A total of 613 patients, including chronic HCV (n=103), HBV (n=193), HIV (n 180) infected individuals, HIV/HCV (n=34) co-infected patients and 103 healthy controls, were studied by using nested-PCR and also real-time PCR techniques.
Of those 180 samples were positive for HIV RNA, co-infection of PARV4 was detected in 3 cases (1.66%). All these three patients were male with the age of 28, 32 and 36 years (mean: 32). No statistical differences were found between HIV positive group and the healthy individuals. (P>0.05) The result of PARV4 PCR was negative in all other samples and healthy controls as well.
This study is the first to investigate the occurrence of PARV4 among these groups in Iran. The results show that the virus is not significant in Iranian population, even in patients with blood born infections such as HCV, HBV or even HIV patients. Further studies in other areas and various groups are required.

The aim of this study was to assess the knowledge, attitude and practice of health science students of Shahid Beheshti University of Medical Sciences about the outbreak of water and foodborne diseases in 2017.
In this descriptive and analytic study, 335 students from school of Health and school of Health, Safety and Environment (HSE) were randomly assigned to the study. Data collecting tool was a researcher-made questionnaire containing 61 questions. The data were analyzed using SPSS 18 software.
The mean and standard deviation of knowledge, attitude and practice of students were (66.15 ± 61.15), (66.63 ± 14.68) ± 66.33 and (±21.55) ±65.96, respectively. Only 13.7, 6.6 and 24.5% of students had a good knowledge, attitude and good performance regarding the subject. Mean score of knowledge, attitude and practice among students of the School of Health was more than the students of HSE. The results showed a significant relationship between knowledge and attitude (p According to the average level of knowledge, attitude and practice of students, it seems necessary to plan for an effective intervention in order to improve the level of education of students who are studying in the field of health and will be the trustee of public health as people who guide other sectors of society.

Scientific research has shown that parents’ education level positively affects health conditions of the child. This study was performed to determine the relationship between mother's education status and pentavalent vaccine complications.
A descriptive cross sectional survey consisting of 676 children vaccinated with pentavalent was performed in health care centers covered by Shahid Beheshti University of Medical Sciences from June to December, 2015. There were examples of both sexes and 2-6 month age groups. A questionnaire was delivered to parents after completing their child profile and all the side effects observed in children were marked and returned to the vaccination center within a week. Data were analyzed with the use of descriptive statistics in SPSS software. Ethical issues were all considered.
About 2.4% out of total study group (mothers) were illiterate and 36.4 % were higher educated. Fever, pain, restlessness and induration included the most common side effects. Among the side effects studied, only fever, pain and restlessness were associated with maternal education level. These side effects were significantly lower in children having higher educated mothers.
Considering the fact that the symptoms of fever, pain and restlessness were rarely found in children whose mothers had higher levels of education in this research, it can be concluded that these mothers reported the side effects of vaccine more accurately and reliably

We need a defined population for determining prevalence and incidence of diseases, as well as conducting interventional, cohort and longitudinal studies, calculating correct and timely public health indicators, assessing actual health needs of community, performing educational programs and interventions to promote healthy lifestyle, and enhancing quality of primary health services.The objective of this project was to determine a defined population which is representative of Tehran, the Capital of Iran. This article reports the methodology and establishment of the research network of Tehran defined population. This project started by selecting two urban health centers from each of the five district health centers affiliated to Shahid Beheshti University of Medical Sciences in 2012. Inside each selected urban health center, one defined population research station was established. Two new centers have been added during 2013 and 2014. For the time being, the number of the covered population of the network has reached 40000 individuals. The most important criterion for the defined population has been to be representative of the population of Tehran. For this, we selected two urban health centers from 12 of 22 municipality districts and from each of the five different socioeconomic of Greater Tehran. Merely 80000 individuals in neighborhoods of each defined population research station were considered as control group of the project. Totally we selected 12 defined population research stations and their under-covered population developed a defined population which is representative of Tehran population. a population lab is ready now in metropolitan of Tehran.

Solving the problems caused by household solid waste and its management without the continuous cooperation of the citizens as the main producers of household solid waste is impossible. The aims of this study were to define strategic factors of Household Solid Waste Segregation at Source Program and the level of awareness and participation of citizens in the program.
In this cross-sectional study we interviewed 640 citizens of the 3 Municipality District of Tehran. Internal Factor Evaluation and External Factor Evaluation matrices were used to assess the strategic factors of the program.
Of 640 participants, 517 (80.8%) were aware of the program, and 383 (59.9%) participated in the program. Among participants 628 (98.1%) were well-informed about the correlation between implementation of the program and environmental health promotion. People between 35 to 45 years showed the most participation rate.
This study showed that citizens showed acceptable awareness of the program and evaluation of internal and external factors indicated high potential to increase public participation in the program.

Today, the organizations are obligated to take sufficient attention to human resources in order to attain greater efficiency and ultimately achieve their goals. Considering the importance of desirable behavior in organizations and its impact on the attitudes and perceptions of employees, it is necessary to pay special attention to the treatment of staff and their needs. The present study was prepared to investigate the relationship between organizational justice and organizational commitment and job satisfaction among health care employees in north Tehran.
The study was done descriptive-analytical among employees with at least 6 months of experience and with a sample size of 259 patients at the health center. Data collection tools consisted job satisfaction, organizational justice and organizational commitment questionnaires. SPSS software was used for data analysis and Pearson's correlation coefficient and T-test was used for independent groups and regression.
The mean (SD) of Job satisfaction in employees was 50.1 (12.3), perceived organizational justice was 66.4 (1.17) and organizational commitment was 61.3 (5.7), out of 100. The result value of the correlation coefficient indicates positive and significant relationship between organizational justice and organizational commitment with job satisfaction. Also, components of affective commitment and normative commitment has a significant relationship with job satisfaction, and all of the components of organizational justice (distributive justice, procedural justice, interactional justice) have a significant positive correlation with job satisfaction. Regression analysis indicated that organizational justice and organizational commitment are able to predict job satisfaction of the employees. But the components of procedural justice and distributive justice were not able to predict job satisfaction, and job satisfaction can be predicted only through interactional justice. Affective commitment and normative commitment were able to predict job satisfaction as well, and continuous commitment component is not able to predict job satisfaction.
According to the correlation of organizational justice and organizational commitment with job satisfaction, managers can use efficient methods such as effective management, freedom of action, motivation and self-care, in-service training, the division of labor based on merit and ability, etc. to increase commitment, job satisfaction and justice perceptions of the employees, affect their behavior and increase their efficiency and effectiveness in order to further the organizational goals.

The purpose of this study was to investigate injuries resulting from accidents and incidents referred to medical centers and hospitals of Shahid Beheshti University of Medical Sciences.
This study is a cross-sectional study. The data of all injured patients admitted to hospitals of Shahid Beheshti University of Medical Sciences from March 2014 to March 2015 were reviewed. Accidents and injuries were categorized according to the tenth version of international classification of diseases. Data collected by means of forms and software injury register by Hospital emergency department staff to interview and hospital records, were completed.
In total, 131967 cases were reviewed,in which 66% were male and 34 % were female. Traumas, traffic accidents, and falls were major causes of accidents and injuries. Accidents and injuries were more prevalent in 20-29 years old (the younger age groups; 51%). Individuals living in urban areas sustained more injuries compared to individuals from rural areas. A total of 194 deaths were reported due to accidents and injuries.
Our findings indicated that traffic accidents constitute a large proportion of accident and injuries. Productive groups (young male) were the most victims of accidents and injuries. Training of different groups, including before and during recruitment, training mothers, and elderly seems to be beneficial. Further studies to improve the registration tools for a better access to reliable data are needed. Promotion knowledge and training, especially in the younger age group, intervention to resolve the accident prone spots as well as technical defects are recommended to reduce the traffic accidents.

Leadership style or behavior is an effective factor in employee performance. The purpose of the study was to determine head's leadership style and its relationship with job satisfaction and burnout in staff of Shomal health center of Tehran. In this cross-sectional study, 207 subjects, including 16 heads and 191 health care staff of Shomal health center of Tehran participated. Data were collected using three questionnaires (leadership style, job satisfaction and burnout questionnaires). Statistical analysis was conducted using SPSS-18 software. Descriptive and analytic methods such as Pearson's correlation coefficient and t-test were used for analysis. In this study 85.9% of heads of health centers use consideration leadership style. Overall job satisfaction of staff score was 50.1 (from 100), 48.6 in women and 55.1 in men. Managers’ leadership style had direct and significant relationship with job satisfaction of employees (P<0.001).17.3% of staff had average job burnout and 2.6% of them had high job burnout. Average job burnout in men and women were 32.5 and 37.5, respectively. Manager's leadership style had significantly inverse relationship with job burnout in staff (P<0.001). Selecting leadership style according to the working conditions and attention to modern management methods can lead to increased job satisfaction.

Job satisfaction is an important variable in the area of organizational behavior. Without job satisfaction it is not possible to achieve organizational goals. Therefore the purpose of this study was to assess job satisfaction among Shomal health center of Tehran personnel affiliated to Shahid Beheshti University of Medical Sciences. This cross- sectional study was a descriptive-analytical one. Shomal health center of Tehran personnel with at least six months of work experience participated in the study. Data were collected by demographic characteristics and the Minnesota Satisfaction questionnaire. Job satisfaction was categorized into six areas and five levels. Reliability of the questionnaire was confirmed through Chronbach’s alpha calculation. Statistical analysis was conducted using SPSS- 18 software. Two hundreds and Fifty-nine personnel participated in the study. The mean (SD) of overall satisfaction score was 50.1(12.3) from 100. The study showed that job satisfaction of financial facilities and welfare, educational facilities and job promotion, politics and policy management, quality of human relations, Job security and professional social status were 40%, 43.4%, 53.4%, 66.6%, 54.3% and 57.4%, respectively. Statistical analysis showed a significant relationship between gender and occupational field. Improving the physical conditions at workplace, increasing employee participation in decision-making, the relative increase in salary, Encouraging personnel, job promotion and intimate relationships between them can lead to increase job satisfaction among employees.

Healthy eating in adolescent girls has a crucial role in normal growth and reducing the incidence of chronic disease related to nutrition in adulthood. The purpose of this study was to determine high school girl's eating behaviors in north of Tehran. In this cross-sectional study, 722 female students who were selected randomly from public high schools in four districts of Tehran participated. Demographic variables and nutritional status were evaluated using systematic interviews with them by health professionals. Anthropometric parameters were also assessed. Most girls (42.4%) had a normal BMI. The mean (SD) of daily consumption of fruits, vegetables and dairy products were 2 (1.1), 1.8 (1), 1.9 (1.07) servings, respectively. The mean (SD) of weekly intake of red meat, poultry, fish, eggs and beans were 3.08 (2), 3.15 2.9), 0.95 (0.9), 2.6 (2.9) and 2.2 (1.2) times, respectively. The mean (SD) frequency of eating breakfast was 4.9 (2.6) times per week. 16.9% of girls never consumed fast foods. Girls who do not consume salty snacks and fast foods per week, had significantly normal BMI (p<0.05). Low-fat milk consumption, daily consumption breakfast and non consumption of fruits were significantly associated with social status (p<0.05). Do not eating breakfast had significant association with BMI (p<0.05). The consumption of major food groups in this study was lower than the recommended amounts. Further research is needed to determine enabling and reinforcing factors to healthy eating behaviors. Also, improvement attitudes and empowerment of adolescent girls to adopt healthy eating behaviors can be effective.

Burns are a major factor in injury mortality. The aim of this study was to explore the possible causes of fatal burns using Haddon’s Matrix. This is a qualitative study using a phenomenological approach. We collected elicitation interview data using nine corroborators who were the most knowledgeable about the index burn event. Immediately after recording, the data was verbatim. Each event was analyzed using Haddon’s Matrix. Interviewees provided detailed information about 11 burn cases. Overall, 202 burn-related factors were extracted. Using Haddon’s Matrix, 43 risk factors were identified. The most common included the lack of basic knowledge of burn care, the use of unsafe appliances including kerosene heaters and stoves in hazardous environments such kitchens and bathrooms, poor burn care delivery system in hospitals, poor and unsafe living conditions, financial issues, and other factors detailed in the article. Our findings suggest burn related prevention efforts should focus on improving human living conditions, promoting the use of safe heating appliances, providing public burn-safety precautions education, and improving the quality of care in burn centers and hospitals.

Quality is a major concern in the services offered by the health sector. The first basic step، in formulating any quality-improvement program، is recognizing consumers’ perceptions and expectations of the services'' quality. The aim of this study is to determine the gaps in the health services and provide solutions to increase clients'' satisfaction in the clinics of Shomal Health Center of Tehran. This cross-sectional and descriptive study was done in 2013. The sample size was 325، proportionately selected from the recipients of primary health care in each clinic. Data was collected by a questionnaire، based on the five dimensions of service quality gap SERVQUAL instrument; which includes 22 questions. The collected data was statistically analyzed using SPSS software. There was a significant difference between the client''s perception and expectation in each of the five dimensions of service quality. The smallest gap was in the communion (0. 68) and the largest gap in the concrete (0/88) service. The client''s education was significantly associated with the quality gap. None of the service dimensions were beyond the expectations of the respondents. Therefore، there is an ample room for improving the service processes.

The lack of a proper sewage collection & disposal system، the water and sewerage project، in the city of Rasht، became a priority by Guilan province Urban Water and Sewerage Company with the government partnership and World Bank financial support. The objective of this research was to complete the first phase of a two-phase study، to determine the impact of using an urban sewerage system on acute diarrhea in children under five years old، in Rasht city in the Guilan province. The study is a concurrent control before and after field trial which is carried out in two phases: before (phase I) and after (phase II). Sampling for phase I was performed in the middle month of each season، November and February 2009 and May and August 2010. The incidence of acute Diarrhea was measured with the participation of 1560 mothers of children under 5 years old. This was done in two groups: the intervention group (inside the sewerage system project perimeters) and the control group (outside the project perimeters). Data was collected by local female general practitioners and medical students by door-to-door interviews with mothers. Data was analyzed using the SPSS 11. 5 software package. The Pearson Chi-Square was used to compare qualitative variables between groups، whilst the t-test and One-Way ANOVA was used to compare quantitative variables. The average annual incidence of acute diarrhea in children under five years old was 10. 4% (9. 4% in the intervention group and 11. 4% in the control group). The seasonal pattern of acute diarrhea incidence was 10. 5% (9. 3% in the intervention group and 11. 7% in the control group) in May، 12. 5% (11. 5% in the intervention group and 13. 4% in the control group) in August، 9. 3% (8. 1% in the intervention group and 10. 5% in the control group) in November، and 9. 1% (8. 5% in the intervention group and 9. 8% in the control group) in February respectively. The study showed the incidence of acute diarrhea in children under five years old in Rasht city is moderate and it follows a seasonal pattern. The highest rate was seen in summer and the lowest rate in winter. It is expected to decrease with the initiation of the sewerage system program.

Backgroun and The scarce water resources and Poor quality drinking water with the lack of a proper sewage collection and disposal system and increasing management problems due to rapid population growth made Islamic Republic of Iran to pay priority attention to the water and sewerage problems of districts in its five-year development plan. In this regard, water and sewerage project in Bandar Anzali became a priority by Guilan province Urban Water and Sewerage Company with the government partnership and World Bank financial support. The objective of this study is to complete the first phase of a two-phase study to determine the impact of using an urban sewerage system on acute Diarrhoea in children under five years of age in Bandar-Anzali in the Guilan province.Materails and The study is a concurrent control before and after field trial which is carried out in two stages: before (phase I) and after (phase II). Sampling for phase I was performed in the middle month of each season, November and February 2009 and May and August 2010. The incidence of acute Diarrhoea was measured with the participation of 2400 mothers of children under 5 years old in the city of Bandar-Anzali in two groups: the intervention group (inside the sewerage system project perimeters) and the control group (outside the project perimeters). Data were collected by local female general practitioners and medical students in each city, under supervision of the community medicine department and by door-to-door interview with mothers. Data were analyzed using the SPSS 11.5 software package and the Pearson Chi-Square was used to compare qualitative variables between groups, and the t-test and One-Way ANOVA was used to compare quantitative variables. The annual incidence of acute diarrhoea in children under five years old was 11.9%. The seasonal pattern of acut diarrheoa incidence was 12.6% in May, 13.3 in August, 11.5% in November, and 10.3% in February respectively. The highest incidence of acute diarrhoea was seen in children from 2 to 5 years of age. The study showed the incidence of acute diarrhoea on children under five years old in Bandar-Anzali city is moderate and it follows a seasonal pattern. The highest rate was seen in summer and the lowest rate in winter. It is expected to decrease with the initiation of the sewerage system program.

Malaria is one of the most important parasitic diseases in the world and a major health problem in some areas of Iran. In addition to endemic areas in the south and south-eastern part of Iran a new threat of Plasmodium vivax malaria importation emerged from the Parsabad district which is located in Ardabil province in the north western part of the country. Malaria in this area may have originated from Azerbaijan Armenia or southern part of Iran. This study has been carried out to clarify seroparasitological results from Indirect Fluorescence Assay (IFA) stability of antiplasmodial antibodies and its comparison with those of confirmed direct microscopy in Parsabad district during 2003-2005. This seroparasitological study has been carried out on 250 samples from malaria infected patients which was previously confirmed by microscopy and treated with routine antimalarial agents and 250 samples of healthy control with no history of malaria in Parsabad during two years (2003-2005). Sera of collected blood samples were assessed for the presence of anti-plasmodial antibodies using IFA assay. Statistical analysis was applied by using ANOVA and Student’s t-tests with Graph Pad Prism. The results of this study indicated that all blood smears of test group were detected as positive by observation of P. vivax by direct microscopy and no positive smears were found among control group. Moreover no mixed-infection was observed among collected samples. In addition serological results revealed that 47 cases (19%) from test group and 4 cases (1.6%) from control group had antibodies against P. vivax malaria (P

Regarding the recent implementation of new information system in medical universities, it seems quite necessary to perform an evaluation study on its effectiveness as well as on the functioning of health care systems regarding the different parts of this system. The aim of this study was to investigate skills of family health personnel in health centers of Ardabil province on correctly completing two common data forms called family planning form and maternity care data form. This can be a reasonable criterion for how well the new system is working in the field of family health. This is a descriptive-analytical study. All family health care personnel from Ardabil province heal care centers were entered into the study. They were asked to enter data related to 10 case presentations into blank forms. After filling out the forms they were checked and evaluated for correctness and final scores were analyzed by SPSS. From all the data collected from 9 cities of the province, 38.5% lacked an academic education and 52% were graduated in midwifery. Mean personnel skill was 4.38 out of 10 and only 11.7% had acceptable skills in filling out the forms. Those with academic education outperformed the non-academic ones. Discrepancies regarding the correct ways of filling the forms, were observed among different cities’ health care centers. The findings indicated family health personnel were not skillful enough in completing the data forms. This led to their weak and non-dependable statistic which in turn would waste budget and energy. Moreover, the validity of the collected data would be under question. So the form 108 is very complicated and needs revision.

Providing health services for all population subgroups of a community is a major hallmark for health administration. Little is known about health status of Ashayer population in Iran. This study aims at evaluating health status and quality of health service delivery to them.

In a cross-sectional research 320 households (1800 persons), entered the study. Moreover, blood samples from 458 dogs were taken and studied with both Direct Aglutination Test (DAT) and a newly presented dipstick test. All children under 12 were also studied with DAT. In computing the sample size the generalizability for 63 variables with a minimum and maximum probability level of 90% and 97% respectively were taken into account and since the cluster sampling was employed, the Design Effect would be at least 1.56 and for different variables in the first sample it would be at most 4.

Only 30 households(9.7%) used piped water supply inside their houses while most of the other families (41%) obtained their water from mobile water tanks. Residual water chlorine was measured to be zero in 88.7% of the samples taken from drinking water of Ashayer. 89 (27.8%) households had lavatories and 22 (7%) households had bathrooms inside their houses. 90.4% of those using raw vegetables washed them only with plain water. Monthly incidence rate for accidents was 230 per 10000. 18.1% of women in reproductive age had a history of abortion. Unwanted pregnancy rate was 38.9%. 47.1% of women with a labor history in past three years had never been visited by any person legally allowed to do so. Women in reproductive age had a poor knowledge about contraceptive methods. The minimum delay for vaccination was 16.9 (SD= 19.26) days regarding the third dose of OPV and the highest delay in vaccination was 46.44 (SD=60.7) days belonging to the third dose of HBV. From all 503 persons above 12 years old, 77 cases had hypertension. Periodontal easy bleeding was observed in 13.7 % and pyorrhea in 19.3%. 10.2 % had aching neck, 18.7% had backache and arthralgia was shown in 13.5%. The unmet need for physician's visit was 64.8%. The frequency of positive cases of leshmaniasis was 3.4% and 3.06% for boys and girls respectively. 28 male and 6 female dogs were positive in DAT test making an overall positive rate of 7.4%. Sensitivity of dipstick test was higher than 80 percent only when golden standard was considered to be DAT ≥ 1 /640.

Many of the health indices of Ashayer except for vaccination were suitable. This requires further attemps on the part of govermental and health outhorities. Kale-azar disease can spread to the north of the province as well as the neighboring provinces due to the migration of these tribes. It is predicted that Bilesavar and Parsabad cities will be added to the andemic regions of this disease in coming years. Using dipstick test recently offered by WHO is recommended to be used to screen the infected dogs.