Good Digestion is a Key Element for Healthy Hearts: An Appealing Concept from Avicenna’s Viewpoint

Traditional Persian Medicine (TPM) has a holistic approach towards the human body. Avicenna, an outstanding TPM scholar, has provided appealing concepts such as the association between the heart and gastrointestinal system. Thus, efficient functioning of the gastrointestinal tract (digestion) could influence the proper functioning of the heart and result in a healthy life. Within TPM principles, through proper processes of digestion healthy food produces a suitable amount of the humors. These are necessary for all organs, including the heart, and if this does not occur then an environment for cardiac diseases will develop. It seems wise to provide healthy food and promote good digestion via simple lifestyle considerations rooted in TPM principles to attain a healthy heart

Regression of nonalcoholic fatty liver disease detected by sonography: Results of a four years prospective adult population-based study

Background: Today, nonalcoholic fatty liver disease (NAFLD) has become a major health problem owing to its high prevalence. Literature evidence about regression of NAFLD are not as high as its development or progression. Objectives: This cohort study was conducted to reveal the factors influencing the regression of the NAFLD. Methods: A population-based study conducted in Shiraz, Iran. Adults older than 18 years were recruited by multistage randomized sampling in 2012, and then in 2017. Demographic, anthropometric, nutritional, and medical characteristics of each interviewee were entered into a valid and reliable questionnaire. Interviewees were categorized into three groups according to the changing of their NAFLD status between two stages of this study; no change, regressed and progressed. Results: Of the 537 participants, 163 (30.3%) showed regression of their NAFLD compared to 93 (17.3%) that their NAFLD was progressed. Multinomial regression showed that each unit of decrease in BMI (∆ BMI=-1 kg/m2 ) augmented the relative risk (RR) of improvement of NAFLD by 13.3% (RR: 0.867; 95% CI: 0.776-0.969; P = 0.012) and reduced the relative risk of NAFLD deterioration by 14.3% (RR: 1.143; 95% CI: 1.009-1.294; P = 0.035). Conclusions: A significant portion of patients showed regression of their NAFLD by decreasing their BMI. Therefore, BMI as a modifiable variable should be regarded in the management of NAFLD patients Keywords: Non-Alcoholic Fatty Liver, Regression, Progression, Cohort Stud

A Qualitative Study on the Importance and Value of Doctor-Patient Relationship in Iran: Physicians' Views

BACKGROUND: Doctor-patient relationship [DPR] refers to verbal and non-verbal communication between doctor and patient, which is of great importance in consultation sessions. AIM: Therefore, the present study attempts to explore the importance and value of DPR in Iran. MATERIAL AND METHODS: The method used in the study was conventional content analysis. The data were collected from 21 faculty members (FMs) of Shiraz University of Medical Sciences (SUMS), Shiraz, Iran, who participated in three focus group discussions (FGDs). Transcribed data were analysed using Conventional Content Analysis (CCA) which identified condensed meaning units, subthemes, and themes. RESULTS: Four themes were extracted from 198 meaning units, 87 condensed meaning units, and 17 subthemes. These included gateway [the role of DPR]; nonlinearity [the nature of DPR]; distortion (quality of DPR in the context); and dysfunctional system (weakness in health system). Generally, results showed DPR to be the gateway to consultations based on non-verbal communication and doctor empathy. The study showed distorted DPR which was due to the dysfunctionality of the health care system. CONCLUSION: As indicated DPR plays an important role in medical contexts, but if distorted it leads to an unsuccessful outcome. Therefore, to promote DPR, it is necessary to reinforce its structure. Thus, the infrastructure has to be modified and developed at all levels

Implications of COVID-19 Induced Anxiety of Pregnant Women on Neonatal Health

Background: Anxiety disorders during pregnancy can lead to adverse neonatal outcomes in different ways. This research aimed to investigate the association between anxiety levels in pregnant women and neonatal health outcomes during COVID-19 pandemic.Methods: This was a prospective cohort study in which pregnant women were recruited via a prenatal teaching clinic between March and July 2020, at Hafez Hospital in Shiraz, Iran. Neonate health outcomes were recorded, including the living status, gestational age, route of delivery, the APGAR at the 1st and the 5th minutes of life, anomalies, head circumference, weight, and height. To compare the effect of stress and anxiety of mothers during the first trimester of pregnancy on neonate health outcomes, we used the short form of the Depression Anxiety Stress Scales (DASS-21) score available from the previous phase of the study.Results: In the present work, 146 pregnant women were recruited. There was no significant difference in terms of living status, APGAR scores, and congenital anomalies of neonates born to mothers without anxiety (n=121) compared to those with an abnormal level of COVID-19-related anxiety (n=25) during their pregnancy (P>0.05 for all). Furthermore, our results revealed no association between COVID-19-related anxiety during pregnancy and poor neonatal outcomes, such as low birth weight, NICU admission, macrocephaly, or microcephaly (P=0.85).Conclusions: The obtained findings revealed that COVID-19-induced anxiety did not affect neonatal clinical outcomes. However, the concern still exists regarding the potential effect of COVID-19-induced anxiety on pregnancy and neonatal outcomes. Further investigation could be thus recommended using laboratory assessments

Integrating rehabilitation services into primary health care:policy options for Iran

BACKGROUND: Providing rehabilitation services in primary health care (PHC) is associated with numerous health, social, and economic benefits. Therefore, low and middle-income countries, such as Iran, should benefit from the advantages of integrating rehabilitation services into PHC. We conducted a qualitative study to determine policy solutions that could facilitate the integration of rehabilitation services into Iran’s PHC network. METHODS: Semi-structured interviews were conducted with 38 participants, including health policymakers, rehabilitation managers, faculty members, and rehabilitation practitioners. Purposive and snowball sampling strategies were adopted to recruit participants. The WHO Health System building blocks framework analysis was applied to analyze the collected data. RESULTS: Participants’ perspectives and experiences outlined potential policy options including: (1) stewardship: increasing political support, strengthening the leadership of the rehabilitation sector, and promoting inter-sectoral collaborations; (2) service delivery: increasing the knowledge of healthcare professionals, using local volunteers, deploying mobile rehabilitation teams, using telerehabilitation, and improving referral pathways; (3) financing: increasing government funding, preparing a package of rehabilitation services, and using appropriate payment mechanisms; (4) human resources: expanding rehabilitation workforce, training rehabilitation assistants, and enhancing employment and social opportunities; (5) information systems: establishing a comprehensive information system and an effective surveillance system; and (6) technologies: facilitating access to a range of rehabilitation equipment and raw materials, especially for prosthetics and orthotics services. CONCLUSION: Based on the WHO six building blocks framework, this study identified several policy options for integrating rehabilitation services into the Iranian PHC Network. Some of the policy options include increasing political support, promoting inter-sectoral collaborations, increasing the skills and knowledge of healthcare workers, establishing effective referral pathways, strengthening team-working, and increasing government funding