Evaluation of Consumer Health Information Websites Based on International Guidelines

Background and Aim: Since health information websites in the Internet is almost the first and the most used source of information for public. It is therefore necessary to comprehensively evaluate websites which provide health information for the public. Objective: The research aimed to investigate the quality of Farsi health information websites comparing the international pairs provided with recognized quality standards including those from the Medical Library Association of America (MLA). Materials and Methods: Checklists of the British Medical Association (BMA), MLA, Health On the Net Foundation Code (HONcode) principles, and Web Content Accessibility Guidelines (W3C) were use as the research tools. The sample of websites included the 10 top health websites in English rated by MLA and nine Iranian health information websites in Persian (Farsi). Results: Iranian websites did not obtain desirable scores against the quality standards of health information websites (BMA, HONcode, W3C, and MLA) in terms of scope, accuracy, and quality, authorship and authority, attribution and justifiability, bias -free observation, good design, code of conduct/standards. An analytical comparison of health information websites based on their ownership showed that the private sector organisation websites were better than the governmental Iranian websites in terms of observing the standards as well as comprehensiveness. Strengths of the Iranian websites included information privacy, transparency, consumer involvement, and ease of understanding. No considerable differences were observed between the private sector organisation and governmental websites on other criteria. Conclusions: Results of this research highlighted the need to determine standards and improve the quality control of public health information websites in Iran, by an organization or institute such as the Iranian Medical Library Association. These findings will create the basis of recommendations for developing a comprehensive, consistent, reliable, up-to-date, and high-quality website, which can account for the needs of health consumers. Provision of such a website will contribute to improvements in understanding of diseases, effective self-care and self-management and appropriate lifestyle advice. In turn, this may help to reduce unnecessary referrals to health centers, hospitalization and unnecessary taking of medicine, leading to better health outcomes for the population

Goodenough-Harris Drawing a Man Test (GHDAMT) as a Substitute of Ages

Abstract Objective: Evaluation of concurrent validity of GHDAMT with the problem solving subscale of ASQ2 among 5 years old children was the objective of present research.Materials &Methods: In a cross sectional study 136 boy and 105 girl were selected randomly from childcares and tested with GHDAMT and ASQ2 to compare the concurrent validity of these tests in evaluation of cognition.Data was analyzed using SPSS.16/win.Results: The IQ mean difference in girls was 128±18.18 and in boys 118±18.50, which was statistically significant. There was no statistical significant correlation between GHDAMT and ASQ2. It was significant between IQ and mental age among children who had -2SD score in problem solving subscale, but  there was no correlation between children who had -1SD score.These findings revealed that the GHDAMT does not have acceptable validity and concurrent validity of the test was less than 0.3.Conclusions: In the current research, there is no statistical significant correlation between problem solving subscale of ASQ2 and mental age and IQ. So GHDAMT    can̕ t be used as a substitute of ASQ questionnaire; however, correlation of two tests in children with intellectual disability was meaningful. After further studies, it is possible to use GHDAMT as a proper tool for cognition evaluation of these children.Keywords: concurrent validity, The Goodenough-Harris drawing a man test, ASQ

P53 gene codon 72 polymorphism in patients with oral squamous cell carcinoma in the population of northern Iran

Objectives: Squamous cell carcinoma is the most common cancer of the oral cavity, and several etiologic factors are involved in its development. Single nucleotide polymorphism (SNP) of the P 53 gene codon 72 ( P 53c72) changes the structure of the protein and affects its activity. The prevalence of P 53c72 different genotypes, which seems to vary with race and geographic location, has shown a strong correlation with many types of human cancers. The aim of this study was to investigate the correlation between P 53c72 polymorphism and risk of oral squamous cell carcinoma (OSCC) in the heavily populated Gilan Province in northern Iran. Design of S tudy: This case-control study was done on 55 paraffin-embedded samples from OSCC patients and 100 samples of non-dysplastic oral cavity lesions. The P 53c72 genotypes were determined using the ARMS-PCR method. SPSS-15 software was used for statistical analysis. Results: There were no significant statistical differences found between the prevalence of different P 53c72 genotypes in the OSCC group vs. the control. However, the Pro/Pro genotype in OSCC samples showed a strong correlation with age, as 70% of such patients were below 50 years old. Interestingly, a large portion (40%) of the patients with the Pro/Pro genotype had the tumor in the lip area. Conclusions: Although P 53c72 polymorphism does not appear to be a predisposing factor for OSCC in the population of Northern Iran, the Pro/Pro genotype could be considered as a risk factor for OSCC in adults below 50 years old and the anatomical location of the tumor

Problems of English for Specific Purpose course for medical students in Iran

Introduction

The Effect of Teaching Practical Physical Modalities on the Ordering Skills of Physical Medicine and Rehabilitation Residents

Introduction: Physical modalities are performed by physiotherapists based on physiatrists’ orders, so the residents pay less attention to the need and importance of learning the practical modalities. The aim of this study was to determine the effect of teaching the practical aspects of modalities to residents of Physical Medicine and Rehabilitation in order to improve their skills and attitudes toward ordering and doing physical modalities. Methods: In an interventional, before after study, all residents of physical medicine and rehabilitation, took the medical history of the patients willingly participatedand performed physical examinationand ordered physical modalities. They were also assessed by performing the modalities on the patient. Following the primary assessment, an experienced physiotherapist taught the residents how to do physical modalities. After the practical education, residents were assessed by ordering the modalities and performing them on simulated patients. Their satisfaction of the educational program was evaluated after the intervention. Results: The mean scores of using modalities before and after the education were 23.08± 5.50 and 52±10.18 respectively (p=0.0001). The mean scores of ordering the modalities before and after the education were 1 and 1.66 (p=0.038). The mean score of satisfaction was 91.66±8.74 out of 100. Conclusion: Since physical medicine and rehabilitation residents and specialists who order physical modalities for patients do not perform it on their own patients, teaching the practical physical modalities can improve their skills. The satisfaction rate of residents with the course was very high

The Effect of Different Mixing Methods on the Properties of Calcium-enriched Mixture Cement: A Systematic Review of in Vitro Studies

Introduction: It has been shown that the mechanical and physical properties of Calcium Enriched Mixture (CEM) cement are influenced by the mixing methods. Despite several studies conducted on different mixing methods of CEM cement, there is no systematic review to summarize the results. This systematic review was conducted to investigate the effect of different mixing techniques on mechanical and physical characteristics of CEM cement. Methods and Materials: A professional librarian with skills in informatics conducted a systematic search by searching electronic databases PubMed/MEDLINE and Scopus and Ovid for English language peer-reviewed articles published between 1992 and April 2019. Results: Initial searches from all sources identified 1175 references. Two of the authors examined the titles, abstracts of these articles and the full reports of 20 studies were obtained, and data extraction was performed. Seven studies satisfied the eligibility criteria for the review. The effect of different mixing methods was investigated on bacterial microleakage, push-out bond strength, flow rate, compressive strength, solubility, pH, film thickness, dimensional changes, working time, setting time and quality of the apical plug. Conclusion: Based on the results of this systematic review, some of the important properties of CEM cement were affected by different mixing methods. Although none of these mixing methods could improve all the properties, mechanical and manual methods were more effective compared to ultrasonic method.  Keywords: Calcium-enriched Mixture Cement; Systematic Review; Ultrasoni

The effects of interprofessional education on teamwork, communication skills and quality of health care in advanced and developing countries: A systematic review and meta-analysis study

Background: Inter-professional education is a new approach in education in which professionals in various fields of health systems learn from each other based on educational events in a real environment, actively and interactively. This systematic review and metaanalysis aims to investigate inter-professional education in advanced and developing countries. Methods: Persian and English keywords were used to search these databases: ISI Web of Science, Scopus, ProQuest, PubMed/Medline, Embase, Google Scholar, ERIC, Magiran, Irandoc, and Barakat with an English language restriction and for the years 2000 to 2019, using these terms: Embase, Meshand and free. Two evaluators assessed the extracted articles using the Critical Appraisal Skills Program (CASP) checklist. CMA 3.1 software was used for the analysis with a fixed-effects model. Results: A total of 1425 articles formed the basis of this study. In all, nine articles were extracted that examined the effect of inter-professional education from the viewpoints of professors and students (three for professors and six for students). Heterogeneity among the nine studies was not significant. Teamwork scores, communication skills, and healing of the participants in the study increased by 0.339, 0.283, and 0.275 points after the intervention, respectively. Conclusion: Inter-professional education is one method of educational integration. Students become aware of how their role overlaps with other medical professions as well as the limitations of their role in treating patients. However, inter-professional education implementation requires infrastructure, such as training professors and preparing them and students to accept inter-professional education

Tacrolimus and mycophenolate mofetil as second-line treatment in autoimmune hepatitis:Is the evidence of sufficient quality to develop recommendations?

BACKGROUND The standard management of autoimmune hepatitis (AIH) is based on corticosteroids, alone or in combination with azathioprine. Second-line treatments are needed for patients who have refractory disease. However, high-quality data on the alternative management of AIH are scarce. AIM To evaluate the efficacy and safety of tacrolimus and mycophenolate mofetil (MMF) and the quality of evidence by using the Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). METHODS A systematic review and meta-analysis of the available data were performed. We calculated pooled event rates for three outcome measures: Biochemical remission, adverse events, and mortality, with their corresponding 95% confidence intervals (CI). RESULTS The pooled biochemical remission rate was 68.9% (95%CI: 60.4-76.2) for tacrolimus, and 59.6% (95%CI: 54.8-64.2) for MMF, and rates of adverse events were 25.5% (95%CI: 12.4-45.3) for tacrolimus and 24.1% (95%CI: 15.4-35.7) for MMF. The pooled mortality rate was estimated at 11.5% (95%CI: 7.1-18.1) for tacrolimus and 9.01% (95%CI: 6.2-12.8) for MMF. Pooled biochemical remission rates for tacrolimus and MMF in patients with intolerance to standard therapy were 56.6% (CI: 43.4-56.6) vs 73.5% (CI: 58.1-84.7), and among non-responders were 59.1% (CI: 48.7-68.8) vs 40.8% (CI: 32.3-50.0), respectively. Moreover, the overall quality assessments using GRADE proved to be very low for all our outcomes in both treatment groups. CONCLUSION Tacrolimus and MMF are in practice considered effective for patients with AIH who are non-responders or intolerant to first-line treatment, but we found no high-quality evidence to support this statement