Social Values in Health Prioritizing: the analysis of national documents of Iran

Background: Health system, as a part of the wider social system, should consider social values in decisions for health prioritizing. This study was aimed at identifying social values considered in the health-related national documents. Methods: This qualitative study was conducted based on the Clark-Weale framework to identify the social values in health related national documents. Identification of health-related basic documents (11 documents) was performed purposefully. Documents included Iran's Constitution Law, the 5-year development plan, national health insurance law, urban family physician program, health sector development map, Health Ministry foundation law and Health Ministry structure and organizational law. Each value was analyzed based on qualitative content analysis. Results: Different approaches toward considering social values were observed. While some documents had explicitly considered social values, some others had implicitly considered them. The health Road Map was the most comprehensive document in terms of considering social values. Equity was the most repeated value in documents and clinical effectiveness was not mentioned in any of the documents. Conclusion: Although, the importance of social values has been increased in national documents during the recent years, it dose not have the same trend in different documents and each of them have emphasized on different social values. It seems that using national documents, as a practical guide, can be effective in achieving health system goals

Good Clinical Practice in Children and Adolescents

Good clinical practice (GCP) is a series of systematically developed ethical and quality standard of designing, registering, running, recording, and reporting of the clinical trials. Good clinical practice is very important regarding the trials usually performed on the vulnerable populations especially children and adolescents. The sensitivity of the issue is even higher in the children with psychiatric disorders. Usually, these children have little legal protection. Hence, the safety of interventions and the ethical considerations are among the most important issues in this field. The purpose of this chapter is to deal with above problems and globally applicable standards for the conduct of clinical trials on the under legal age subjects especially those with psychiatric disorders. Selection of trial subjects, ethical principles, regulatory requirements, protection of trial subjects, monitoring (compliance with the protocol), responsibilities of the investigator, and other requirements to perform a clinically and ethically sound clinical trial in children and adolescents will be discussed in this chapter

Use of lipophilic and hydrophilic polymers in production of sustained release zinc sulfate tablets

Background and aims: Zinc sulfate administered to correct zinc deficiency. Its oral administration has shown serious digestive side effects and sometimes it has led to the lack of use it. The main aim of the present study was to use lipophilic and hydrophilic polymers in production of sustained release zinc sulfate tabletsover an extended period of time. Methods: Sustained release (SR) zinc sulfate tablets were prepared using either lipophilic-based matrix or hydrophilic matrix system or natural polymers by either hot-fusion (HF) granulation or direct compression (DC) method. Physical and chemical features of provided SR tablets including hardness, friability, and weight variation, disintegration time, swelling index, content uniformity and drug release behavior were evaluated. The drug concentration was assayed by an atomic absorption spectrophotometer at 213.8 nm. Results: Most of the prepared formulations showed acceptable physicochemical properties. Among 30 formulations, SR tablets with lipophilic matrix-based showed more predictable release profiles compared to tablets prepared based on hydrophilic or natural matrixes. Tablets containing carnauba wax showed slower release while tablets with hydrogenated castor oil represented faster release profile. A few lipophilic matrix tablets containing zinc sulfate (110 mg), beeswax (or carnauba wax) and Avicel (or Emcompress) were selected as the optimum formulations showing release profiles based on USP criteria for lipophilic-based SR tablets. The mean dissolution time (MDT) and dissolution efficiency (DE8%) of selected formulations were 1.69-1.95 hr and 69.3-71.8%, respectively. Tablet hardness and granule size had no effects on release rate. The drug release kinetic followed Higuchi model. Conclusion: Lipophilic based SR tablets of zinc sulfate is suggested as an alternative for capsule or syrup of the drug whichhave digestive side effects

Seroepidemiological study of Toxoplasma gondii infection in a population of Iranian epileptic patients

Epilepsy is one of the most common neurologic disorders. Underlying cause of epilepsy is unknown in 60 % of the patients. Toxoplasma gondii is an intracellular parasite which is capable of forming tissue cysts in brain of chronically infected hosts including humans. Some epidemiological studies suggested an association between tox- oplasmosis and acquisition of epilepsy. In this study we determined seroprevalence of latent Toxoplasma infection in a population of Iranian epileptic patients. Participants were classified in three groups as Iranian epileptic patients (IEP, n = 414), non-epileptic patients who had other neurologic disorders (NEP, n = 150), and healthy people without any neurologic disorders (HP, n = 63). The presence of anti-Toxoplasma IgG antibodies and IgG titer in the sera were determined by ELISA method. Anti-T. gondii IgG seroprevalence obtained 35.3 %, 34.7 % and 38.1 % in IEP, NEP and HP, respectively. The seroprevalence rate was not significantly different among the three groups (P = 0.88). Anti-T. gondii IgG titer was 55.7 ± 78, 52.4 ± 74 and 69.7 ± 92 IU/ml in IEP, NEP and HP, respectively. There was not any statistically significant difference in the antibody titer between the study groups (P = 0.32). The rate of T. gondii infection in epileptic patients was not higher than non-epileptic patients and healthy people in the Iranian population

Segmenting breast cancerous regions in thermal images using fuzzy active contours

Breast cancer is the main cause of death among young women in developing countries. The human body temperature carries critical medical information related to the overall body status. Abnormal rise in total and regional body temperature is a natural symptom in diagnosing many diseases. Thermal imaging (Thermography) utilizes infrared beams which are fast, non-invasive, and non-contact and the output created images by this technique are flexible and useful to monitor the temperature of the human body. In some clinical studies and biopsy tests, it is necessary for the clinician to know the extent of the cancerous area. In such cases, the thermal image is very useful. In the same line, to detect the cancerous tissue core, thermal imaging is beneficial. This paper presents a fully automated approach to detect the thermal edge and core of the cancerous area in thermography images. In order to evaluate the proposed method, 60 patients with an average age of 44/9 were chosen. These cases were suspected of breast tissue disease. These patients referred to Tehran Imam Khomeini Imaging Center. Clinical examinations such as ultrasound, biopsy, questionnaire, and eventually thermography were done precisely on these individuals. Finally, the proposed model is applied for segmenting the proved abnormal area in thermal images. The proposed model is based on a fuzzy active contour designed by fuzzy logic. The presented method can segment cancerous tissue areas from its borders in thermal images of the breast area. In order to evaluate the proposed algorithm, Hausdorff and mean distance between manual and automatic method were used. Estimation of distance was conducted to accurately separate the thermal core and edge. Hausdorff distance between the proposed and the manual method for thermal core and edge was 0.4719 ± 0.4389, 0.3171± 0.1056 mm respectively, and the average distance between the proposed and the manual method for core and thermal edge was 0.0845± 0.0619, 0.0710 ± 0.0381 mm respectively. Furthermore, the sensitivity in recognizing the thermal pattern in breast tissue masses is 85 % and its accuracy is 91.98 %.A thermal imaging system has been proposed that is able to recognize abnormal breast tissue masses. This system utilizes fuzzy active contours to extract the abnormal regions automatically