Iran’s healthcare system challenges at a glance

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Analysis of the concept of family-centered care in chronic diseases: Rodgers’s evolutionary approach

BACKGROUND: Considering the fact that hospitalization of a family member in the intensive care unit (ICU) can have a great impact on different aspects of the life of the patient’s family, the purpose of this study was to clarify the concept of family-centered care with chronic diseases admitted to ICU.METHODS: In this study, Rodgers’ evolutionary concept approach was used to analyze the concept of family-centered care for chronic patients. Criteria for entering articles, books and scientific information in English and Persian from 1980 to 2016 on family-based care and chronic diseases were selected using scientific databases.RESULTS: Family-based care in chronic diseases is a concept that process nature with care management, education and interaction. Also, three types of forerunners here include family-related predictions (family efficiency), self-confidence (system-related), adequate resources, social factors and cultural factors (related to care providers), participation (in this case).CONCLUSION: The concept of family-centered care has evolved over the past few years in relation to chronic diseases. Nurses have significantly improved their knowledge of family care mainly focusing on improving the families of patients. Therefore, the nurses in the care groups have been significantly influenced and have been able to assume the responsibility of family-based care groups

Role of magnetic nanoparticles in targeted drug delivery for central nervous system

Introduction: The treatment of neurological disease, such as brain cancer or neurodegenerative diseases, is one of the most difficult challenges in medicine. The major limitation in this therapy is caused by asthenia of some drugs injected to the blood vessel to reach the main tissue of brain. There are three substrate obstacles that adjust molecular exchange in junction between blood and neurotic tissue or its steep spaces: the brain endothelium which makes blood-brain barrier (BBB), the arachnoids epithelium which makes intermediate substrate of meninges and the choroid plexus epithelium, which secretes cerebrospinal fluid (CSF). Methods: In recent years, some significant researches showed that magnetic nanoparticles (through conjugation of iron oxide NPs with hydrophilic polymer coatings of dextran) can be administered for impressive systemic and territorial transfer of therapeutics to the CNS. Nanoparticles also have the potential to revolutionize conventional imaging techniques. Conventional epitomize condition lack the association of high delicacy and high spatial precision required for molecular imaging. Results: Magnetic Resonance Imaging (MRI) has high resolution, but lacks sensitivity to molecular signals, while high sensitivity nuclear medicine modalities such as Individual photon ejaculation calculated tomography and position emission tomography (PET) provide superb sensitivity, at the cost of reduced spatial resolution. Using nanoparticles in some conditions such as MRI can amazingly enhance delicacy, presenting the potential for high resolution molecular imaging. MRI has high spatial resolution, is non-invasive in nature and offers multiplanar tomographic capabilities. Nanoparticles can be managed to have magnetized specifications that can be acquired by MRI at low condensations and at the same time include lingads which target specific molecules. Iron oxide nanoparticles have been widely researched for MRI, as there are several types, namely magnetite (Fe3O4) and hematite (α-Fe2O3), among which magnetite is very promising, because of its proven biocompatibility. For molecular imaging purposes, superparamagnetic iron oxide nanoparticles (SPIONs) need to bind to a range of drugs, proteins, enzymes, antibodies, or other molecular targets. In conclusion, using magnetized nanoparticles as a drug delivering system is still determined by its biocompatibility and optional aiming to the favorable cell or tissue under the guidance of external magnetic field (MRI scanner). Conclusion: Advances in current technologies and the expansion of magnetized nanoparticles as medicine transfer device to transfer medicine to tumor hypoxic zones have fast tracked in the past decade and led to the development of various magnetic nanoformulations such as liposomes, metallic, and polymeric nanoparticles. This technology will not only minimize invasive methods, nut also decrease side effects to intact fiber which are two primary concerns in conventional cancer therapies. The field of magnetic drug delivery is still at infancy, and combination of better magnetized medicine transfer device and association of multifunctional ligands are being continuously investigated so as to carry it from the bench-top to the clinic. Until Then the worries about the omission and long term toxicity remain barriers to clinical entry

LncRNAs: A new trend in molecular biology of diseases; A review

BACKGROUND: Non-coding ribonucleotide sequences, including short and long-term ribonucleic acid (RNA) molecules, are a major part of the gene expression products, which have recently been identified on a large genomic scale. The long non-coding RNAs (lncRNAs) have a length of greater than 200 nucleotides. Only a small fraction of the function of lncRNA molecules is known to date.METHODS: PubMed, Scopus, Embase, and Google Scholar were searched from January 2000 to May 2018. Based on the study inclusion and exclusion criteria and specific keywords, 92 original, relevant, experimental studies with moderate bias were selected. LncRNAs were evaluated as a new trend in molecular biology of diseases.RESULTS: Our analysis showed that the presently available evidence confirmed that lncRNAs can be a tool for the diagnosis and prognosis of many diseases and alternative therapies.CONCLUSION: LncRNAs are an emerging field of investigation as they are suggested to regulate key biological processes, including cellular proliferation and differentiation, and their aberrant expression is associated with many diseases. An improved understanding of the role of lncRNAs in disease would provide valuable information about key biological-promoting pathways and might be highly useful for diagnostic, prognostic, and alternative therapies assessments. This knowledge might also lead to advancement in the management of disease through the development of novel, personalized lncRNAs-based therapies

Undetected leprosy in an endemic area: A case report

Leprosy is an infectious disease causing irreversible disability if unnoticed. A 69-year-old man with undetected leprosy from 30 years ago referred to us with claw hand and Madrosis (Milphosis). The patient complained of non-healing and painless ulcers on the extremities as well as numbness in the right leg. He told the medical team that he could not feel his feet in his shoes. The patient had blurred vision and lacrimation two weeks before admission. He had a history of recurrent foot ulcers from 25 years ago although he referred to medical staff about 5 years ago with infected wound on the hands and multiple scars of pervious ulcers. The disabilities were mainly in consequence of late visit to healthcare centers, misdiagnosis, difficult access to medical centers and patient's unawareness. The case showed the significance of medical education and public awareness for signs and symptoms of leprosy to be recognized and treated on time. In conclusion detecting leprosy should not be delayed just because of a decrease in the number of cases especially in an endemic area like Kurdistan, Iran

A study on nurses’ viewpoint about methods of free visit in intensive care units in Besat hospital affiliated to Kurdistan University of Medical Sciences, Iran, 2015-2016

BACKGROUND: In spite of the evidence of advantages of visitation, the ban on visit in Iran's intensive care units (ICUs) is still underway, and this issue is always a challenging topic that encounters different behaviors in dealing with the phenomenon of visiting. The purpose of this study was to investigate the barriers and strategies for establishing a free visit system in ICUs from the viewpoints of health care providers.METHODS: In this descriptive study, 100 nurses working in ICU were evaluated. The data were collected using a demographic information registration form and a questionnaire on attitudes and views about visit in special units which were analyzed by SPSS software using t-test and chi-square test.RESULTS: 33.3% of cases were men and 66.7% of them were women. Most of the cases (67.9%) were married. The shortest work experience in the ICU was 5 months and the longest was 132 months. The average work experience of the cases in the ICU was 60 months.CONCLUSION: The majority of nurses believe that free visit can interfere with nursing cares. This interference involves direct intervention, more time spent explaining to the patient's family, and creating a busy environment that is the cause of the errors. The time of the visit is largely regulated by healthcare providers, their attitudes towards the topic, as well as their concerns about this issue

The effect of training on the self-efficacy rate among patients with diabetes mellitus

BACKGROUND: Self-efficacy is referred to as a person's belief in his/her ability to succeed in a particular situation. Training can be effective to enhance self-efficacy among the patients with diabetes mellitus (DM). Therefore, the present study was carried out with the aim to determine the effect of training on the self-efficacy rate among the patients with DM.METHODS: The present study is a quasi-experimental study of interventional-control type. The data collection tool was a demographic questionnaire (demographic characteristics, educational needs assessment, and self-efficacy). 60 patients were selected by objective sampling method and were divided into the intervention and control groups (n = 30 in each group). Then, the replication-based study was performed on the subjects. Data were analyzed using independent t-test, chi-square, and Mann-Whitney tests in SPSS software.RESULTS: The difference in mean of educational needs assessment in self-efficacy in the pre-test stage was not significant (P = 0.950), however, there was a significant difference between the two groups in the post-test stage in terms of the educational needs assessment (P = 0.030). From the viewpoint of self-efficacy level, there was a difference between the two groups in the post-test phase. However, this difference was not statistically significant (P = 519).CONCLUSION: Considering the dependence of patients with DM on receiving care services, recognition of patient and self-care needs based on nursing theories and care planning will help the patient to adapt and increase self-efficacy

Idiopathic generalized epilepsies and efficiency of advanced magnetic resonance imaging techniques in present era; perspectives in future

Epilepsy is a common disorder worldwide, with a prevalence of 4.5/1000 (0.45%) for youngsters and youths, and 1.54/1000 (0.15%) for the adult Chinese population in Hong Kong. up to 15% of epileptic patients can still leak the screening process of any structural lesion. In addition, the structural lesions detected on structural MR images may not reveal the correct degree and practical position of the abnormalities, especially with respect to malformations of cortical development. These include magnetic resonance spectroscopy (MRS) and perfusion weighted imaging (PWI). The widespread application of most of these techniques in clinical practice depends on the availability of high-performance MR imagers with the ability to accomplish fast echo-planar pulse sequences (echo-planar imaging), as well as substantial data processing capabilities. Using and PWI in study of microcirculation of tissues and vascular of lesional area on mechanisms by which selective drugs work and will provide new treatment targets for drug development. Finally, there is coupling of cerebral blood flow and metabolism, MR perfusion can act as a surrogate marker of metabolism as measured by MRS

Wolfram syndrome: A case report

Wolfram syndrome (WFS) is a rare disease inherited as an autosomal dominant trait. Type I diabetes mellitus and optic atrophy are the main symptoms of the disease. It is also known as DIDMOAD syndrome due to the association of diabetes insipidus, diabetes mellitus, optic atrophy, and deafness. WFS may be associated with other disorders such as kidney failure, gonadal atrophy, and mental and behavioral disorders. This report is about a 14-year-old teenager who had suffered from vision loss and cataracts when he was 4 years old. At the age of 7 he has been diagnosed with type I diabetes mellitus due to polyuria and polydipsia. At the age of 12 he developed diabetes insipidus, neural hearing loss, urinary incontinence and bilateral hydronephrosis, neurogenic bladder, and increased blood pressure. Physicians should think of this disease and recommend genetic counselling before marriage.

The overhang rate in posterior teeth restorations among a sample of patients from Sari City, Iran, in year 2017

BACKGROUND: Overhang is the extension of restoration material from the prepared cavity. Restoration overhangs have an important role in plaque accumulation, caries, severe gingival inflammation, and periodontal diseases. Therefore, the aim of this study was to determine the frequency of restoration overhanging, and the managements in order to reduce its prevalence and subsequent complications.METHODS: This descriptive cross-sectional study was conducted on 277 patients, who had at least one restoration in the proximal surface of posterior teeth. At first, all the patients were examined using a mirror, and dental floss under the light of the dental chair. In cases in which the existence of the overhang was suspected, Bitewing radiography was operated on respective regions. Data were analyzed using SPSS software.RESULTS: 120 teeth had overhangs (19.60%) and 492 (80.39%) exhibited no overhangs. From 120 restorations with overhang, 76 (63.33%) were amalgam restorations, and 44 (36.66%) were composite restorations. In total, 55.83% of them (67 restorations) were in maxilla and 44.16% (53 restorations) were in mandible. The prevalence of overhang in mandible was as 37.73% in mesial regions, 54.71% in distal regions, and 7.54% in mesial-occlusal-distal (MOD) regions; in addition, the prevalence rate in maxilla was as 38.80% in mesial regions, 58.20% in distal regions, and 2.98% in MOD.CONCLUSION: The overall frequency of restoration overhang was 19.60%, most of which was in amalgam restorations in comparison to composite restorations; and it is mostly seen in distal surfaces of maxillary teeth