Isfahan University Research Articles

A new teaching model with artificial teeth containing simulated pulpal tissue

This study aimed to evaluate the use of artificial teeth for endodontic training for dental students. The following aspects of the artificial teeth were approved by the endodontists in Isfahan University of Medical Science: internal and external anatomy; coronal pulp chambers regarding their size, shape, and canal path; the root canals regarding their size, shape, and position; filling the pulp chamber and root canals by considering the texture, quantity, color, and ease of handling; and resin hardness and visualization of the radiographic image. The results showed favorable opinions regarding the internal and external anatomy, coronal pulp chamber, root canal (s), handling, and radiographic imaging. The contents of the pulp space and hardness of the teeth were satisfactory. The artificial teeth tested have the potential to replace the natural teeth in preclinical training.

The Effect of Peer Support on Foot Care in Patients with Type 2 Diabetes.

Background:Diabetes mellitus is one of the prevalent diseases in the world with several complications including diabetic foot ulcers. The aim of this study was to investigate the effect of peer support on foot care in patients with type 2 diabetes.Materials and Methods:This clinical trial study was performed at selected centers of Isfahan University of Medical Sciences in 2017. Fifty patients with type 2 diabetes were randomly assigned into intervention and control groups. Five 30-min. supportive training sessions were held for the intervention group by the peers and during 35 days. Foot Care Confidence/Foot-Care Behavior Scale For Diabetes (FCCS-FCB) was completed by both groups before, immediately after and 1 month after the intervention. Collected data were analyzed using Chi-square, Mann–Whitney, repeated measures ANOVA and t-test.Results: Mean (SD) age of subjects was 56.46 (7.36) years old Mean (SD) score of self-efficacy (F2, 26 = 54.71, p < 0.001), preventive behaviors (F2, 26 = 28.46, p < 0.001), and potentially damaging (F2, 26 = 27.89, p < 0.001) had significant differences between the two groups immediately and 1 month after the peer support.Conclusions:Peer support can enhance foot care behaviors in diabetic patients. Therefore, using people who are successful in the education and support of patients has a significant role, and nurses can use them as a support in the field of care and follow-up. However, health agencies are responsible for providing the patients with the best guidelines, and these results can be useful as an evidence for them.

Clinical informationist participation in grand round sessions of gastroenterology department: An action research study.

BACKGROUND:Nowadays, providing access to the required information by clinical informationist (CI) is vital for clinical teams to make the best decision. This study was carried out to identifying how CIs should participate in grand round (GR).MATERIALS AND METHODS:The current study is an action research study. It was conducted in the GR sessions of the Gastroenterology department of Al-Zahra Hospital affiliated with Isfahan University of Medical Sciences in 2017. Participants included attending physicians, fellowship students of the Gastroenterology departments, a CI, and two supervising medical librarians. Data were collected through observation and discussion. Qualitative content analysis and concept mapping were used for data analysis.RESULTS:The findings indicated that existing problems were related to the CI, medical team, and infrastructural ones. The participation of the CI in medical team was arranged based on the following steps: planning, action, evaluation, and suggestions. It started from an initial diagnosis of patients and ended in GR meetings. During evaluation step, suggestions were made to remove the existing problems and in the fifth step, results were summarized and a framework for the participation of the CI in GR sessions was suggested.CONCLUSIONS:Medical team members were satisfied with the participation of the CI, but it is necessary to remove the existing structural and personal barriers (related to the CI and medical team members), in order to improve the efficiency of this participation.

Investigating the relationship between the dimensions of mindfulness and maternal attachment to the fetus during pregnancy.

BACKGROUND:Maternal attachment to the fetus is a term used to describe the emotional relationship between mother and fetus. This emotional connection increases during pregnancy and is reflected in her feelings, perceptions, and behaviors. Mindfulness is important as one of the factors affecting the mental health of people during pregnancy. Therefore, the present study was conducted to determine the relationship between the dimensions of mindfulness and maternal attachment to the fetus during pregnancy.MATERIALS AND METHODS:The present study was performed on 500 pregnant mothers referred to health centers affiliated to Isfahan University of Medical Sciences. The samples were entered into the study by available sampling method and if they had inclusion criteria and no exclusion criteria. The research instruments were the Fetal Attachment Questionnaire and the Bauer Mindfulness Questionnaire. The collected data were analyzed by SPSS software version 22.RESULTS:The results of the data showed that there was no significant relationship between the overall score of mindfulness and the overall score of maternal attachment to the fetus (P = 0.62). While from the dimensions of mindfulness such as “action with awareness” there was a significant negative relationship (P = 0.03) with maternal attachment to the fetus and a significant positive relationship “observation” with maternal attachment to the fetus (P = 0.03).CONCLUSION:According to the results of this study, there is a relationship between maternal attachment to the fetus during pregnancy and a number of dimensions of mindfulness. For this purpose, since mindfulness can increase the mother's interactions with the fetus, and this interaction begins during pregnancy and with the mother's attachment to the fetus, it is important to pay attention to this.

Complications after dental rehabilitation under general anesthesia in Isfahan during February to May 2016

Children undergoing dental rehabilitations by general anesthesia (GA) commonly experience postoperative symptoms such as pain, fever, sore throat, and sleepiness. The aim of the present study was to investigate the specific complications of pediatric dental GA procedure. In this observational study sample included 72 children attending GA for dental treatment at the School of Dentistry, Isfahan University of Medical Sciences. Children with American Society of Anesthesiologists physical status I and without any communication or mental health problems were included. GA protocol was standardized. A number of complications were recorded by parents via filling a questionnaire for 2 days postoperatively. Data were analyzed using SPSS statistical software by Wilcoxon and Chi-squared test. P < 0.05 considered as significant level. The most postoperative nonpsychological complications were dental pain (59.7 and 47.2% on days 1 and 2, respectively), followed by inability to eat normal (55.6 and 41.7% on days 1 and 2, respectively). All the patients' nonpsychological complaints had significantly decreased from day one to day two (P < 0.05). The most postoperative psychological complications were Attachments to parents (70.8 and 65.2% on days 1 and 2, respectively) followed by excessive crying (56.9 and 45.8% on days 1 and 2, respectively). All psychological complaints reduced by day two nonsignificantly except excessive crying which decreased significantly after 48 h (P = 0.004). The most postoperative complications after dental rehabilitation under GA were attachments to parents, dental pain, and inability to eat normal and excessive crying, respectively.

Strategies to reduce cheating on online exams

Assessment of learners, due to its nature and complexity, is one of the most widespread and controversial educational topics. One of the threats in this process is cheating;cheating is a major concern for professors and institutions, especially when universities conduct exams online due to the Covid-19 pandemic. It means to consider the academic work of others in its place. Cheating can have a devastating effect on the performance, reputation, and longevity of an institution. When academic institutions do not have control over cheating, the result will be employers' dissatisfaction with the graduates' job performance. The first line of defense to prevent cheating is the adoption of ethical codes. In this regard, it is necessary to hold empowerment courses for teachers to train them to design appropriate questions. Other factors include setting a time limit for each question, designing questions with different arrangements, random distribution of questions, holding several midterm exams and reducing the volume of end-of-semester test resources, changing the scoring system to qualitative, matching the taught content with the exams, facilitate vague and complex lessons, project assessments, and reduce exams. The use of web-based cameras (webcams) as a technology-based solution to prevent cheating has also been suggested. Artificial intelligence and image processing, including special software, can also be used to monitor the student's body and face movements, and report suspicious behavior to the teacher. The use of Lockdown Browser also restricts the student's ability to search for resources during the test. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.

Designing, implementation, and evaluation of internship comprehensive system for assessment and monitoring.

BACKGROUND:During the past decade, the benefits of using portfolios, especially electronic portfolios, were recognized. Due to the lack of using portfolios and especially electronic portfolio in the clinical evaluations of internship training in medical schools of Iran, this study has designed, implemented, and evaluated a comprehensive system for monitoring and evaluating the activities of interns.MATERIALS AND METHODS:This study was a software development study in the three phases of design, implementation, and evaluation. All stages of the project were carried out in the Isfahan University of Medical Sciences during 2019–2020. The software design phase was performed using the Rapid Application Development Methodology (RAD model). In the implementation phase, it was used as a pilot study in the internal department of the medical school. System evaluation was performed using a combination of quantitative and qualitative methods. Data were analyzed using the content analysis for qualitative data and descriptive statistical analysis using the SPSS software for quantitative data.RESULTS:In the educational standards survey, in 10 items, the percentage of choosing “perfectly fit” and “fit” was above 90% (high quality). In the technical standards questionnaire, out of 35 items related to software technical quality, eight items were of acceptable quality and 27 of them were partially acceptable. In the Student Satisfaction Questionnaire, in 9 items, interns’ satisfaction with the system was high or very high, and in either case, there was little or no dissatisfaction or satisfaction.CONCLUSIONS:Positive educational effects can be used in all clinical settings if modification and improvement of the software continues, with slight modifications.

Health-care reform implementation challenges at suburban areas in Isfahan province: A qualitative study.

BACKGROUND:Health system reform plan in public health sector in Iran in the first phase focused on improving primary health care in suburban areas in and around big cities. The present study was conducted to assess the implementation process challenges of the reform plan in comprehensive health service centers at suburban areas of Isfahan in 2019.MATERIALS AND METHODS:This qualitative study with conventional content analysis approach was conducted in 2019. Participants were purposefully selected and interviewed at provincial levels from Isfahan University of Medical Sciences health department and health-care providers of comprehensive health services centers. The saturation point was reached after 21 face-to-face semi-structured interviews. Thematic analysis was employed to analyze transcribed documents assisted by MAXQDA version 10.RESULTS:The results revealed four main themes; the human resource management, the executive management, the electronic infrastructure, and the resource management. The major challenges in the implementation planning process included: the referral system, monitoring and supervision, electronic services infrastructure in the design and development of the EHR called the SIB system, lack of instructions guide, salaries and benefits, inconsistent financial and human resources and inappropriate allocation of theses resources.CONCLUSION:Despite the achievements in the development of the Iran health system reform plan, there were many challenges in the implementation planning process. It is recommended that theses challenges be reviewed and amended by health system managers and policymakers.

The Serum Level of Midkine in Patients With Multiple Sclerosis and Neuromyelitis Optica.

Introduction:Midkine (MK), a heparin-binding growth factor, is involved in neurological diseases by mediating the inflammatory responses through enhancing the leukocyte migration. The present study assesses the serum concentration of this growth factor among newly developed Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO) patients.Methods:The present research, as a cross-sectional study, was performed at Isfahan University of Medical Sciences, Isfahan City, Iran. All samples were selected from patients who visited Kashani and Alzahra hospitals for two years (2014 to 2016). The MK level was assessed in 80 new MS cases, 80 NMO patients, and 80 healthy subjects. After collecting blood sera samples, MK serum level was measured using the ELISA. The obtained data were analyzed in SPSS.Results:The Mean±SD MK level was 1038.58±44.73 pg/mL in the MS group, which was significantly higher than the Mean±SD MK level in the NMO (872.62±55.42 pg/mL) and control groups (605.02±9.42 pg/mL).Conclusion:Overall, these results demonstrated that MK plays a prominent role in inflammatory reactions and neuroautoimmune diseases, especially in MS. So, the MK level may be used for earlier diagnosis and also prevention of disease progression by using a special inhibitor.

The Relationship between Nursing Students' Quality of Life with their Academic Achievement Motivation in Isfahan University of Medical Sciences, Iran.

Background:Quality of Life (QoL) and academic achievement motivation are important aspects of students' living and studying. There is a lack of studies to address the QoL of nursing students and its relationship with their academic achievement motivation in Iran. Therefore, the present study was conducted to investigate this relationship.Materials and Methods:This was a correlational study conducted with baccalaureate nursing students of Isfahan University of Medical Sciences, Iran, from December 2019 to February 2020. Data collection tools consisted of three parts: a demographic questionnaire, the World Health Organization QoL-Brief Questionnaire (WHOQOL-BREF), and the Hermans Achievement Motivation Questionnaire. Pearson correlation coefficient and standard multiple regression were used to evaluate the correlation between QoL mean domain scores and academic achievement motivation score.Results:The QoL mean (SD) domain scores of physical, psychological, social, environmental, and academic achievement motivation score were 14.95 (2.43), 13.42 (2.74), 13.96 (3.39), 13.62 (2.54), and 84.40 (7.73), respectively. Pearson correlations between physical, psychological, social, and environmental QoL mean domain scores with academic achievement motivation score was 0.30, 0.35, 0.12, and 0.22 (p < 0.05), respectively. Using standard multiple regression, psychological mean domain score (ß = 0.31) was the only statistically significant predictor of academic achievement motivation.Conclusions:Relationships exist between academic achievement motivation and QoL domains of nursing students, particularly in the psychological domain. This information provides policymakers to plan multi-faceted arrangements to improve nursing students' academic achievement motivation and QoL particularly in most neglected areas as the psychological aspect.

Comparison of Design Fluency Test Results among Patients with Parkinson's Disease, Frontotemporal Dementia, and the Control Group.

Background:Design Fluency Test (DFT) is a nonverbal frame-free, nonstructured assessment of executive function (EF). Since previous studies evaluating EF in Parkinson's disease (PD) have mainly used verbal assessments for EF, this study aims to evaluate the pattern of executive domains in PD using DFT and to compare it with behavioral variant frontotemporal dementia (FTD) as a prototype for executive dysfunction and also with normal controls (NCs).Materials and Methods:Twenty-eight patients with PD, 27 with FTD, and 27 NCs were included in the study in Ayatollah Kashani Neuropsychiatry Clinic affiliated to Isfahan University of Medical Sciences from September 2019 to February 2020. All participants were assessed via semi-structured neuropsychiatric interview, questionnaire for demographic profile (age, handedness, gender, education, and marital status), duration of illness, comorbid medical condition, comorbid psychiatric illnesses and medications, DFT, Short Parkinson's Evaluation Scale, Frontal Assessment Battery, Judgment of Line Orientation, and Neuropsychiatry Unit Cognitive Assessment Tool.Results:Fixed condition novelty score was significantly different between FTD and PD (P < 0.001), FTD and control (P < 0.001), and also between PD and control (P = 0.001). When free and fixed condition novelty scores were considered to predict diagnostic attribution, multinomial logistic regression revealed that odds ratio for free condition novelty score was 0.705 (P = 0.005, 95% confidence interval [CI] = 0.553–0.899) and 0.494 (P = 0.001, 95% CI = 0.328–0.744) in PD and FTD, respectively. The odds ratio for fixed condition novelty score was 0.772 (P = 0.011, 95% CI = 0.632–0.942) and 0.449 (P = 0.00, 95% CI = 0.292–0.691).Conclusion:DFT subscores can be helpful in diagnosis and differentiation between FTD and PD.

Investigation of Urinary Beta-2 Microglobulin Level in Neonates with Asphyxia Admitted in Alzahra Hospitals in Isfahan, 1396-1397

Background: Despite advances in perinatal care, perinatal asphyxia (PA) remains one of the most important causes of mortality and morbidity at birth. Asphyxia is associated with the dysfunction of different organs of the body. Therefore, this study aimed to investigate the urinary biomarker of beta-2 microglobulin in neonates with asphyxia. Methods: This case-control study was performed on neonates admitted to the Neonatal Intensive Care Unit of AL Zahra and Shahid Beheshti hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, during 2017-18. On the second day of birth, beta-2 microglobulin was measured in urine samples using the enzyme-linked immunosorbent assay technique. Results: The mean level of beta-2 microglobulin in the group with asphyxia (9.91±6.16) was significantly higher than that in the control group (3.83±4.03) (P=0.001). Moreover, analysis of beta-2 microglobulin level in the group with asphyxia showed that the mean serum level of neonates with acute renal failure (13.14±6.27) was significantly higher than that in newborns without acute renal failure (6.68±4.24) (P=0.02). Conclusion: The results of our study suggest that the beta-2 microglobulin level can be evaluated as a marker of neonatal asphyxia. Furthermore, its level was significantly associated with acute kidney injury. It is suggested that further studies be conducted with a larger sample size.

Metabolic Acidosis in Multi Drug Poisoning with Antidepressants and Antipsychotics.

Objective:In this study, we evaluated the predictive factors for the occurrence of metabolic acidosis in patients with multi-drug poisoning, including antidepressants (Ad)/antipsychotics (Ap).Methods:This cross-sectional study was carried out in the referral poisoning center, Khorshid University Hospital, affiliated with Isfahan University of Medical Sciences. All patients with multi-drug ingestion, including Ad/Ap, were included in the study. Patients were divided into two groups with and without metabolic acidosis. Demographic factors, time from ingestion to admission, clinical manifestations, length of hospital stay, and outcome were compared in two groups. Binary logistic regression was used to identify factors associated with the risk of metabolic acidosis occurrence.Findings:Among the 206 evaluated patients, 45 patients (21.8%) had metabolic acidosis whom the majority were female (73.3%) with intentional purposes (77.8%). 31.1% of the patients with metabolic acidosis had tachycardia on admission (P = 0.03). Among all variables, time from ingestion to admission (P = 0.02) and lengths of hospital stay (P = 0.002) were significantly different between patients with and without metabolic acidosis. Tachycardia on admission (adjusted odds ratio [OR], 2.24; 95% confidence interval [CI]: 1.05–4.76; P = 0.036) and time from ingestion to admission (adjusted OR, 1.06; 95% CI: 1.00–1.13; P = 0.04) were also the predictive factors in occurrence of metabolic acidosis. Most of the patients survived without any complications (94.6%), of whom 72.3% had no previous underlying somatic diseases (P = 0.05).Conclusion:Admission tachycardia and the time elapsed from ingestion to admission may be considered important factors for predicting metabolic acidosis in multi-drug poisoning, including Ad/Ap.

Information Sharing and Information Quality in the Drugs and Medical Consumables Supply Chain Management (SCM)

Information management is considered as one of the keys to the supply chain management (SCM) success. This study intends to explore the factors affecting the knowledge sharing and knowledge quality in the SCM of the drugs and medical consumables. This applied study was conducted using analytical-survey research method. The research population consisted of 78 people involved in the supply chain of the drug and medical consumables in the teaching hospitals of Isfahan University of Medical Sciences (IUMS). Data were collected by a questionnaire whose face and content validity were both confirmed by pooling the ideas of some professors of Health Information Technology and Health-care Services Management faculties of IUMS. The reliability of the questionnaire was validated by estimating Cornbrash’s alpha coefficient (α=0.93). Data were analyzed using multiple regression analysis method and SPSS software version.23. Based on the results, the environmental uncertainty and intra-organizational facilitators had no impact on information sharing and information quality but inter-organizational relationships influenced the information sharing (p = 0.01) and information quality (p = 0.001). To achieve high-quality information sharing, establishing appropriate relationships with the other chain partners is of critical importance. Based on the results of the study, although there was no statistically significant relationship between the intra-organizational facilitators and environmental uncertainty and the information sharing and information quality, top management support, information technology (IT), appropriate selection of supplier and attention to the drug needs of the patients, should not be neglected.

Effect of a self-help educational program with peer group on anxiety of mothers of children with cancer: A clinical trial study.

BACKGROUND:The mental health of the mothers of the children with cancer is strongly influenced by the child's illness and treatment process. This study aimed to investigate the effect of a self-help educational program with peer group on anxiety of the mothers of the children with cancer.MATERIALS AND METHODS:This clinical trial study was conducted on 44 mothers of the children with cancer in an educational Hospital of Isfahan University of Medical Sciences, Iran. Convenience sampling method was performed on the eligible mothers, and using random allocation, they were divided into two groups of the intervention (n = 22) and the control (n = 22). Both groups completed the Hamilton Anxiety Questionnaire before and after the intervention. The intervention of the study was a self-help educational program with peer group that was performed in collaboration with the mothers of the children with cancer, a psychiatrist, and cancer nurses in the hospital within 3 months.RESULTS:The results showed that 55% of the mothers of the intervention group had severe and very severe anxiety before the intervention, but the intensity of their anxiety was reported to be moderate after the intervention. The analysis of covariance with adjusted anxiety score in the two groups showed that the mean score of anxiety in the intervention group decreased from 22.3 to 12.3 after the intervention, showing a significant difference (P < 0.05).CONCLUSION:The program, designed to support the mothers and guide the specialists and psychiatrists to counsel the mothers, can enhance their self-help and reduce their anxiety level.

The mental health condition of 12-17-year-old girl students in Aran-Bidgol City, Iran, during COVID-19 Pandemic

Background: Fear and stress caused by COVID-19 increases the feeling of insecurity in children and adolescents, and if not taken timely action, will cause serious mental health problems in them. The aim of this study was to determine the mental health status of girls aged 12-17 years in Aran-Bidgol City, Iran, during the COVID-19 pandemic. Methods: This descriptive cross-sectional study was performed on 390 girl students of Aran-Bidgol in 2020-21. Data collection tools were demographic/family information checklist and of child health questionnaire (CHQ), spiritual health, social support, and measuring the long-term effects of the accident on children's mental health, which were completed electronically. Data were analyzed using SPSS software with independent t, ANOVA, Pearson correlation, and multiple linear regression tests with a significance level of 0.05. Finding: 65.10% of girls received a score of 25-50 from the Mental Health Questionnaire, which indicated a mild mental health problem. 34.40% got a score of 50-75 and none of them got a score above 75. The regression model showed that two patterns of family communication (dialogue and compliance) and girls' existential health predicted the girls' mental health score (P < 0.05). Conclusion: The results showed that the patterns of family communication and existential health in adolescents had effect on adolescents' mental health;so it is suggested to identify the best regulatory model and family function with an emphasis on existential health, to improve their mental health by gaining the ability to positive valuation. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.

Content analysis of the official curriculum of undergraduate degree in Iran's medical sciences universities from the perspective of social health: A qualitative study.

BACKGROUND:Social health is considered as an important part of good health both individually and socially. The purpose of this study was to examine the content of the official medical sciences curriculum in undergraduate degrees from a social health perspective.MATERIALS AND METHODS:This qualitative content analysis study was conducted in 2019 at the Isfahan University of Medical Sciences using a deductive approach based on Hsieh and Shannon's directed content analysis. For this purpose, official curricula in the fields of Public Health, Occupational Health, Environmental Health, Nursing, Midwifery, Nutrition Sciences, and Health Services Management were analyzed using MAXQDA 12.RESULTS:The results showed that a total of 136 codes related to the components of social health were identified in the topics of undergraduate medical sciences majors. Most to least relevant topics belonged to the fields of Public Health (61 codes), Midwifery (22 codes), Nursing (16 codes), Occupational Health (12 codes), Environmental Health and Nutrition Sciences (each 10 codes), and Health Services Management (5 codes), respectively. Among the components of social health, only the component related to access to insurance and health services was mentioned in all seven disciplines. However, the components of poverty and inequality were only included in three disciplines (Public Health, Nursing, Midwifery).CONCLUSION:Regarding insufficient focus on social health in curricula, revision of educational curricula is suggested from the perspective of social health, particularly in areas such as poverty and inequality, unemployment, population, violence, and gender discrimination.

The components of diabetes educator's competence in diabetes self-management education in Iran: A qualitative study.

BACKGROUND:Limited research has been conducted in the field of diabetes educator's competency. However, no comprehensive and integrated explanations of educator's competence requirements in treatment centers exist in Iran. The aim of this study is to explain the components of diabetes educator's competence in diabetes self-management education in Iran.MATERIALS AND METHODS:This was a qualitative descriptive-exploratory study. The data were collected through semi-structured and in-depth interviews and using purposeful sampling method in Isfahan University of medical science from April to October 2018. Sampling continued until data saturation. Participants included 20 people who were selected by purposive and snowball sampling method. The interviews were analyzed using content analysis method of Graneheim, Lundman.RESULTS:Data analysis resulted in the emergence of three main categories including (1) Patient and family centered education, (2) process-based education, and (3) continuous progress in profession and also seven subcategories (patient and family activation, empower), facilitating educational process, comprehensive education assessment, development, implementation and evaluation of educational plans, developing educators’ educational knowledge and skills, development of creativity and innovation, promote inter-professional cooperation in education.CONCLUSION:The evaluation of facilitation factors for participation and empowerment patient and family along with creativity and interprofessional collaboration for comprehensive evaluation of patients in designing, implementation of educational programs were mentioned as important competencies of diabetes educators, which can have a significant impact on patients’ recovery, treatment, and the promotion of society's health.

Predictors of disease severity and death in patients admitted with COVID-19 in infectious diseases center, Qazvin University of Medical Sciences, Iran: A cross-sectional study

Background: The aim of this study was to determine the predictors of disease severity and death in patients hospitalized with coronavirus disease 2019 (COVID-19) in the Infectious Diseases Center of Qazvin University of Medical Sciences, Qazvin, Iran. Methods: A total of 228 patients with COVID-19 were included in this cross-sectional study. Of these, 114 patients were alive and 114 patients were dead, who were selected using the available sampling method. The logistic regression analysis method (Inter model) was used to predict the effective factors of severity of disease and mortality of patients and control of confounders. Findings: Multivariate logistic regression analysis showed that increase in C-reactive protein (CRP), blood urea nitrogen (BUN), and potassium (K), and decrease in the mean time from onset of symptoms to hospitalization could be predictors of death in patients with COVID-19. Moreover, the deceased patients were older than the surviving group. There was also a significant difference between the two groups of deceased and survivors in terms of the presence of underlying diseases of hypothyroidism and chronic kidney insufficiency (P < 0.001). Conclusion: According to the results of this study, measuring electrolytes at the beginning of hospitalization, and then serially, is recommended to take corrective measures in the field of disease control. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.

The hospital performance indices after implementing the Universal Health Coverage in the Iran

Background: The health sector evolution plan (HSEP) was implemented in 2014 in Iran. The aim of present study was to evaluate the hospital performances indices after implementing the second phase of universal health coverage (UHC) comparing to before. Methods: In a cross-sectional study in 2019, the data of 58 hospitals were gathered from database in Statistics’ office in clinical deputy of Isfahan University of Medical Sciences (MUI), from 3 years before HSEP implementing to 3 years after that, between 2011 and 2017. Sampling was performed as census method. The data including the inpatient bed count in different type of hospitals (public hospitals affiliated to MUI, not for profit hospitals affiliated to the Social Security Organization (SSO), hospitals affiliated to military organizations, private and charity hospitals), the Bed occupancy rate (BOR), number of inpatients annually and the average length of stay (ALOS) in hospital, were collected and analyzed. Results: By comparing to before carrying out the HSEP, the available beds, particularly in private hospitals was increased significantly (83.22%) after implementing the HSEP. Moreover, the number of hospitalized patients was raised after HSEP, in a way that, the highest percentages have been seen in charity hospitals and private hospitals with the growth rates of 140% and 69.44% respectively. Also, the longest ALOS was seen in public hospitals as likely as 3.4 days. Conclusion: Following the implementing the HSEP, although the available beds and hospitalization rate have been increased significantly, however, the BOR and the ALOS have not been raised markedly.