Infectious Disease
Morteza Arab-Zozani; Hosein Ameri
Abstract
Dear Editor, We have witnessed many advances in all fields of science over the years, especially in the field of health. However, various facts can be obtained in times of adversity. Although programs usually work well until a crisis occurs, they do not well continue during the crises. ...
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Dear Editor, We have witnessed many advances in all fields of science over the years, especially in the field of health. However, various facts can be obtained in times of adversity. Although programs usually work well until a crisis occurs, they do not well continue during the crises. In addition, there are some experiences in every crisis although they are insufficiently used in future plans. Accordingly, we frequently experience various problems in face of similar crises. The outbreak of coronavirus is considered as one of these crises. The world has embraced a new unknown virus called the novel coronavirus disease 2019 (COVID-19) since late December 2019.The first outbreak of this virus was reported in Wuhan, China. Further, it has been reported in all countries worldwide as a pandemic. In the information era, conflicting news exists about the origin of the disease and there is still no general agreement in this respect although we do not intend to discuss it clinically in this article. Some helpful lessons on managing the condition are as follows. From this point of view, the virus revealed some interesting facts about governments and health systems around the world. First, this pandemic showed us that we cannot claim that health systems are capable of responding to emergencies. There are several reasons regarding the inability of a system to respond to a crisis. The weaknesses of governance in health systems worldwide are considered among the substantial reasons. Many health systems do not yet have a clear arrangement, and health decisions are outside the purview of health professionals. For example, when it comes to quarantine a city, many factors affect it and different institutions have to consider it no matter whether they have a health professional. Furthermore, the second point is about how we think about health. Various countries still do not view health as a universal phenomenon and have not realized that their decisions at the level of one country and one system can affect all systems worldwide. Whether or not, there is good thinking among health leaders although the absence of systemic thinking is undeniable. For example, some countries are still blaming each other for the statistics and how they manage the disease after several months of illness and are more looking for the culprit than the solution. Moreover, there are rumors that some countries do not publicly announce their achievements in disease management. The third point is the transparency of governments and health systems in presenting the realities of a disease or crisis. Many health systems in different countries of the world either do not have or publish accurate statistics, and this can be related to a variety of economic, private, political, and other reasons. Additionally, the next point is the lack of cross-sectoral cooperation that can be observed at all international, national, and regional levels. The lack of proper collaboration leads to scattered decisions confusing the general population in a society. The most important issue in times of crisis is to keep calm although this calmness must be accompanied by the expression of reality instead of concealment. Crises have been permanently present and will continue to exist from epidemics to disasters, war, and the like. However, the question remains why responding to a crisis and being prepared for it are always considered as a challenge. Many crises occur unnoticeably and unexpectedly, which is true for China. Nonetheless, the question arises whether the rest of the world consider this crisis as an unexpected one. The other question is why countries are not taking advantage of Chinese experiences and delaying reality. It is assumed that policymakers, especially those in the health area, need to address the behavioral causes of this issue and provide sound and rational decision-making models in times of crisis. The era of hopeful closure is over, and the international community requires a holistic approach for decision making. It should be noted that the implementation of any program necessitates a mutual commitment between the government and the community, and even the best advice will not work well without the commitment of people in the community. Accordingly, it is necessary to comprehensively study why the people of society do not pay enough attention to the recommendations of the government and health systems.
Health Promotion
Morteza Arab-zozani; Reza Majdzadeh; Parvin Sarbakhsh; Roshanak Naseri Sis
Abstract
Background and aims: Positive attitudes toward future career lead to job motivation and consequently to career success. Health technology assessment (HTA) students are worried about their future career due to lack of defined vacancies. The aim of this study was to determine the attitudes of HTA ...
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Background and aims: Positive attitudes toward future career lead to job motivation and consequently to career success. Health technology assessment (HTA) students are worried about their future career due to lack of defined vacancies. The aim of this study was to determine the attitudes of HTA students toward the field of study and future career. Methods: This cross-sectional study was conducted in 2015. The samples (n = 40) were selected by census and the questionnaire was sent by email to each participant. The data collection period was 6 months. The questionnaire reliability was evaluated using Cronbach alpha (α = 0.85). Questions were measured by 5-point Likert scale (absolutely agree to absolutely disagree). The data were analyzed by relevant statistical tests using SPSS version 20.0. At the beginning of the study, informed consent forms along with questionnaire were sent to participants and the participants were enrolled if they were volunteered. Results: Response rate was 95%. The mean score of students’ attitudes toward the field of study and future career was 62.48 (11.15) and 62.63 (8.61) respectively. Participants’ attitudes were generally positive. There was a significant positive correlation between the 2 main areas of attitude (r = 0.43, P = 0.006). Conclusion: In general, the results of this study showed that the attitudes of HTA students toward the field of study and future career are positive. Proper planning in the admission process, addressing the needs of students, professor’s paying attention to motivate the students and responding to student questions, and anticipated job categories in the relevant organizations, can lead to job satisfaction and optimism about the future career.
Pharmacology
Morteza Arab Zozani; Mitra Mahdavi-Mazdeh; Sayed Alireza Hosseini; Reza Majdzadeh; Ali Akbari Sari
Volume 4, Issue 1 , Winter 2017, , Pages 84-90
Abstract
Background and aims: Immunosuppressive regimens are a key component for successful kidney transplantation. This systematic review aimed to assess the efficacy and safety of combination therapy of everolimus with tacrolimus in kidney transplantation recipients. Methods: Results were limited to English-language ...
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Background and aims: Immunosuppressive regimens are a key component for successful kidney transplantation. This systematic review aimed to assess the efficacy and safety of combination therapy of everolimus with tacrolimus in kidney transplantation recipients. Methods: Results were limited to English-language articles. Trials where recipients received another regimen were excluded. The Cochrane Central Register of Controlled Trials and MEDLINE were searched via the optimally sensitive strategies for the identification of randomized trials, combined with the following MeSH headings and text words: Everolimus, Certican, Zortress, tacrolimus, prograf, and kidney transplantation. Results: Five relevant studies of everolimus in combination with tacrolimus were identified and results of them were interpreted. Two trials investigated Fix dose of everolimus in combination with low (1.5-3 mg) versus standard dose of tacrolimus (4-7 mg). One trial investigated variable doses of everolimus (1.5 mg/day or 3 mg/day) in combination with fix dose of tacrolimusand two trials compared fix dose of everolimus versus reduction or elimination of tacrolimus. Sample size of RCTs ranged from 20 to 398 and the follow up time ranged from six to 24 months. The quality score on the Jadad score was 3 in all five trials indicating moderate quality. Conclusion: Immune suppressive regimens including everolimus in combination with tacrolimus therapy show better safety and efficacy compared with single-mode but these differences were not significant in overall studies. In general, compared with a regimen without combination of everolimus with tacrolimus, the newer immunosuppressive regimen consistently reduced the incidence of short-term biopsy-proven acute rejection. However, evidence about impact on side-effects, long term graft loss, compliance and overall health-related quality of life is limited.
Epidemiology
Soheil Hassanipour Azgomi; Morteza Arab Zozani; Ahmad Maghsoudi; Ali Mohammad Mokhtari; Reza Ghadiri Rad
Volume 3, Issue 3 , Summer 2016, , Pages 232-238
Abstract
Background and aims: Sexual dysfunction is a common complaint among drug abusers in the treatment with Methadone and Buprenorphine. The aim of this study was to assess sexual dysfunction in patients undergoing Methadone or Buprenorphine for maintenance therapy. Methods: This research was a cross-sectional ...
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Background and aims: Sexual dysfunction is a common complaint among drug abusers in the treatment with Methadone and Buprenorphine. The aim of this study was to assess sexual dysfunction in patients undergoing Methadone or Buprenorphine for maintenance therapy. Methods: This research was a cross-sectional study. A 3-parts questionnaire (demographic questions, international index of erectile function questionnaire (IIEF) and Beck Depression Inventory (BDI-II)) was used for data collection. Results: Overall, 3.5% reported no Erectile Dysfunction (ED), 79.9 % reported mild to moderate ED, and 10% reported severe ED. There were no statistical differences in the components of the IIEF questionnaire between Methadone maintenance treatment (MMT) and Buprenorphine maintenance treatment (BMT) group. Statistical analysis show that depressed subjects has a higher sexual dysfunction (r= -0.435, P<0.001). The results showed no significant relation between drug dose and sexual function (r= 0.031, P= 780). Conclusions: Based on our findings, sexual dysfunction was relatively high among males who received MMT and BMT and the disorder was more prevalent in depressed people. As the results, the problem needs more attention and should be offered the right solution to solve it.