Sari City Research Articles

Effectiveness of Buspirone in Patients with Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study.

BACKGROUND Functional dyspepsia (FD) is a relatively common disorder whose pathogenesis has yet been poorly understood. There are still debates concerning definitions and the best possible treatments for this disorder. We aimed to assess the effectiveness of buspirone, a 5-hydroxytryptamine (HT)1A agonist, in improving the symptoms and quality of life (QoL) as well as psychological dimensions in patients with FD. METHODS This study was a randomized, double-blinded, placebo-controlled trial performed on 30 patients with FD, residing in the city of Sari, northern Iran, from December 2017 to October 2018. Consecutive patients referring to a tertiary hospital with a clinical diagnosis of FD, according to the Rome IV criteria, were recruited. All patients were ethnically Persian and had normal upper endoscopy and negative histological evaluation results for any gastrointestinal disease or helicobacter pylori (H. pylori) infection while evaluating biopsy samples endoscopically. Exclusion criteria were being diagnosed with major psychiatric disorders, suicidal thoughts, recent treatments with psychoactive drugs, as well as major cognitive impairments. Patients were randomly assigned to receive either buspirone (n=18) or placebo (n=12) for two months. The first group received buspirone 5mg three times a day for the first month and 10mg three times a day for the second month. During the treatment course, the patients were advised to report any adverse reactions. Also, both groups were evaluated by three questionnaires [demographic characteristics form, the 36-Item Short-Form Health Survey (SF-36), The Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) and Hospital Anxiety and Depression Scale(HADS)] at the baseline and at the end of the 8th week by a blinded psychologist. Finally, data were analyzed using SPSS software (version 18). P values <0.05 were considered statistically significant. RESULTS The most common symptoms of the patients were FD followed by heartburn. No significant differences were observed between buspirone and placebo groups regarding QoL (p=0.58), anxiety and depression (p =0.36), and severity and frequency of FD symptoms (p =0.22) before and after the intervention. In both groups, the overall QoL as well as HADS and SF-LDQ scores had significantly improved at the end of the study compared with the baseline. CONCLUSION Our findings indicate no significant effects associated with buspirone on the clinical course of FD, compared with placebo. More studies are needed to introduce effective therapies according to the pathophysiology of FD.

Anxiety and Depression as a Factor of Disability in People with Chronic Low Back Pain Referred to the Orthopedic Clinic of Touba Clinic, Sari in 2018

Introduction: Chronic pain is one of the most common diseases in today's world, which has a serious influence on the quality of life. Low back pain (LBP) is very common in developed and developing countries. This study aimed to investigate anxiety &amp; depression as a disability factor in chronic LBP in patients referred to the Orthopedic Clinic of Touba Clinic in Sari, Iran in 2018.&#x0D; Material and Methods: The Ronald-Morris Disability Questionnaire was used to assess disability, the Beck Anxiety Questionnaire was used to assess anxiety, the Beck Depression Questionnaire was used to assess depression, the SF-36 was used to assess quality of life, and the Visual Analog Scale was used to assess pain. &#x0D; Results: In this study, 100 patients were studied. Seventy were female and 30 were male. The mean age of patients was 45.05 ± 11.45 years. Sixty five patients suffered from depression and 35 patients had normal depression. The mean score for disability was 14.05, and the mean and standard deviation from the pain score of patients was 36.2 ± 2.7.&#x0D; Conclusion: Depression is one of the disability factors in people with chronic LBP in patients referring to the orthopedic clinic of Touba Clinic in Sari city in 2018.

Evaluation of the Drug Hypersensitivity Reactions Prevalence in Hospitalized Children in Sari City from 2014 to 2018: An Original Research

Background: Drug allergy is a subtype of Adverse Drug Reaction (ADR) mediated by the immunologic system. Extreme drug allergy is poorly known in children that contribute to hospitalization in our region. Objectives: This research aimed to study major drug hypersensitivity reactions in the north of Iran among the hospitalized children. Methods: This cross-sectional study was conducted at Bou Ali Sina Hospital in the north of Iran. We analyzed the medical files of 140 children admitted to the hospital with drug allergies from 2014 to 2018. The inclusion criteria were based on the DRESS (drug reaction with eosinophilia and systemic symptoms) scoring system, and those who scored more than four were enrolled. Patients with incomplete medical charts were excluded. The sampling methodology was based on the consecutive census method. Results: In the current study, 62 patients were females (44.29%), and 78 were males (55.71%). Ninety-six cases (68.57%) were children under five, and 44 cases (31.43%) were over five years old. Most ADRs were seen in patients from urban areas (58.57%) than in rural areas (41.43%). In 116 children (82.6%), maculopapular rashes were seen. Phenobarbital and cefalexin had the highest levels of drug reactions, including 85 persons (55.19%) and 18 persons (11.69%), respectively. Pruritus, fever, and scaling were the most common symptoms observed in the patients. The most commonly used treatment was antihistamines. Conclusions: The most causative medication inducing ADR was phenobarbital. The maculopapular rash was the most common skin manifestation, and there were no relationships between sex, age, medication type, and type of hypersensitivity reactions.

Evaluation of Oral Health Literacy among Adults in Sari - Iran

Background and aim: It is generally accepted that oral health literacy is one of the important determinants of oral health. The aim of this study was to evaluated oral health literacy in Sari City -Northern Iran. Methods: This cross-sectional study was carried out on 855 adult citizens of Sari by random sampling. The data was collected using a standard questionnaire including 17 questions regarding oral health literacy in four sections: content comprehension, number comprehension, listening and decision making; three questions about oral health behaviors and some questions about self-assessment of oral health status, age, gender and education. Citizens were divided into three groups in terms of oral health literacy: inadequate (0-9), marginal (10-11), and adequate (12-17). The data was analyzed using descriptive and analytical statistics including chi-square, t-test, ANOVA and correlation coefficient in SPSS ver. 20 software. Results: 43.3% of the Sari city citizens had adequate oral health literacy. The mean score of oral health literacy was 10.02 ± 3.4 out of 17. Oral health literacy was higher among educated and employed people, as well as those with smaller households. Those who reported better oral health behaviors had higher oral health literacy than others (P-value &lt;0.001). Also, those who had poor oral health status in compare with two other groups had lower oral health literacy (P-value &lt;0.001). Conclusion: The oral health literacy of Sari city citizens was marginal. Oral health care providers need to devise the necessary plans to improve the oral health of the community Key words: Health Literacy, Oral Health Literacy, Oral Health.

The Effect of Entrepreneurship Education on the Ability to Recognize Entrepreneurial Opportunities (Case study: Technical and vocational training centres in Sari city)

The lack of entrepreneurial opportunities in many organizations and individuals has caused the unemployment rate to increase in the country and a significant share in different fields; employment decreases day by day. In this regard, opportunity recognition is one of the critical pillars of entrepreneurship education that has been considered in entrepreneurship studies in recent years. This study aimed to investigate the effect of entrepreneurship education on capability. Identify entrepreneurial opportunities of individuals and organizations regarding the Sari brothers centre, Sari Sister Centre, Farahabad dual-purpose centre of Sari city was selected from technical and vocational training centres. The measurement tool of this study is a questionnaire, and SPSS software for analysis Data was used. Data were collected by a researcher-made questionnaire containing 31 questionnaires, and its validity was done through four experts. Entrepreneurship and dynamics were confirmed by calculating Cronbach's alpha with a coefficient of 0/8056. This research is calculated through Krejcie and Morgan formulasby 59 people. A sample size of 70 experts and trainers with several years of experience in technical and vocational training centres in SariCity were calculated and studied. Based on the results of this study, entrepreneurship education is effective in identifying entrepreneurial opportunities and Entrepreneurship education in six factors of active search, awareness, prior knowledge, social capital, environmental factors and cognitive and individual characteristics of diagnosis.

Prevalence of Maxillary Dental Anomalies and Related Factors in Children with Cleft Lip and Palate in Sari, North of Iran

Introduction: Individuals with cleft lip and palate (CLP) experience a number of dental anomalies, which affected on the patient’s facial anatomy and self- esteem. Dental complications are considered as a contributing factor in cleft formation. The purpose of this study was to evaluate the prevalence of various kinds of maxillary dental anomalies in group of children with CLP in city of Sari, Iran.Methods: This cross-sectional study was performed to evaluate the panoramic radiographs of 84 patients (age 7-19 years-old), with CLP who were selected by census method and attended private and public dental and/or orthodontic clinics in Sari during 2020- 2021. The frequency of maxillary dental anomalies including hypodontia, microdontia and macrodontia, ectopic eruption, rotation and supernumerary tooth were examined by orthodontist and radiologist. Standard Pearson chi-squared tests were used for all dental anomalies. Data were analyzed using SPSS software through the Mann-Whitney and chi-squared tests.Results: At least one maxillary dental anomaly was reported in 83.3% of patients with CLP. The unilateral CLP (61.9%) was the most common type of cleft. The tooth agenesis was observed in 63.09% of subjects with more frequently on the left side (35.7%) followed by rotation (35.71%), microdontia (34.5%), supernumerary teeth (11.9%), and macrodontia (5.9%). No difference in gender was observed in the prevalence of these anomalies.Conclusion: According to our resultsthemostprevalent cleft types was UCLP with left side predominance. Hypodontia, rotation and microdontia, were the most prevalent developmental dental anomalies among children with CLP in Sari, Iran.

Family Relational Boundaries Questionnaire (FRBQ): Developing and Standardization

Objective: The present study attempted to develop and validate the Family Relationships Questionnaire (FRQ) Based on Minuchin’s Structural Family Therapy (SFT). Methods: The study sample was comprised of 200 high school students; they were selected by cluster sampling method from Mazandaran, Sari City, Iran. The research instrument included a researcher-developed questionnaire, based on Minuchin’s SFT. Results: The exploratory factor analysis data have led to extracting 3 factors; normal boundary, enmeshment boundary, and disengaged boundary. Additionally, the obtained results suggested that the 3 elicited factors explained 62.28 variances of family relationships boundaries. Confirmatory factor analysis results revealed that elicited factors can also measure family relationships boundaries. Reliability analysis, distinctive, and convergent validity of the components of family relationship boundaries indicated that questions in assessing the components of family relationships boundaries are clear and defined. Reliability testing with Cronbach’s alpha coefficient reported a score of above 0.60 and the structural reliability was measured to be above 0.70. In other words, all 3 components can define the FRQ constructs as well. For validation, we first calculated the scores of family relationships boundaries and categorized those in a frequency table. The results scores of T and Z values revealed that the scores above the mean value indicated that more participants were aware of their family relationship boundaries. Conclusion: The present research results suggested that this questionnaire has proper validity and reliability; thus, it is proper for assessing family relationship boundaries. Therefore, the collected results can help to assess family relationship boundaries and to develop proper strategies for treatment and future researches.

Quantitative and qualitative assessment of waste produced in sari hospitals

Aims: The Iranian city of Sari with a green nature has great environmental importance, especially in ecotourism. Thus, the proper management of medical wastes is necessary to maintain a sustainable environment. This study is aimed to determine the quantitative and qualitative wastes in the hospitals of Sari. Materials and Methods: This was a cross-sectional study using a descriptive-analytical approach to analyze the infectious and noninfectious wastes of four hospitals in Sari. The data collection instrument was a checklist that was completed on visits to hospitals and observation of cases. Data analysis was performed using Excel and R software programs. Results: The average quantity of the total waste produced in hospitals was 218, 482, 19.5, and 17 kg/day for infectious, household, sharp-cutter, and pharmaceutical wastes, respectively. The rate of hospital waste production for various types of infectious, household, sharp-cutter, and pharmaceutical wastes equaled 1.15, 2.13, 0.09, and 0.28 kg/bed, respectively. Conclusion: Due to the high percentage of infectious wastes, despite considerable efforts to separate wastes, there are still problems in the hospitals that require more attention from the authorities, as well as the incorporation of new methods to render waste safe before it leaves the hospital.

The effects of relationship enrichment counseling on marital satisfaction among infertile couples with a history of domestic violence

Context: One method for improving marital satisfaction is to educate relationship enrichment programs to couples.Aim: This study aimed to determine the effects of relationship enrichment counseling on the marital satisfaction among infertile couples with a history of domestic violence.Setting and Design: This study was conducted in Imam Khomeini Hospital of Sari city in 2015.Materials and Methods: This was a semiexperimental study with pre and postintervention measurements. The study was conducted in two intervention and control groups consisting of 44 infertile couples referred to Imam Khomeini Hospital of Sari city in 2015.Statistical Analysis Used: SPSS 20 software was used for data analysis applying descriptive and inferential statistics (repeatedmeasures oneway ANOVA and twoway ANOVA).Results: The means of marital satisfaction scores were obtained as 3.4 ± 0.36, 3.71 ± 0.4, and 3.87 ± 0.28 in intervention and 3.44 ± 0.47, 2.56 ± 0.3, and 2.52 ± 0.33 in control groups at pretest, immediate posttest, and 2 months after the intervention, respectively. There was no statistically significant difference in the mean score of quality of life between the two intervention and control groups at pre and postintervention (P = 0.75). As evidenced by the repeatedmeasures ANOVA test, the relationship enrichment program was effective in boosting marital satisfaction score among infertile couples (P = 0.001).Conclusions: The enrichment program was effective in improving marital satisfaction and its all domains among infertile couples with a history of domestic violence.

Effects of drought stress on some phytochemical characteristics of rice cultivars under different chemical and organic nutritional sources

To study the phytochemical properties of rice cultivars using different nutrients (chemical and organic) under drought stress, a split-plot factorial experiment with randomized complete block design with three replications at Dasht-e-Naz field in Sari city, in the crop years 2016 and 2017 were repeated. The drought stresses were fully performed in three levels; stress on the time of tillering initiation (15 days after transplanting), in remobilization stage (the end of flowering and the beginning of grain filling stage), and no stress (control) as the main factors in terms of elimination of irrigation and re-irrigation after the appearance of hairy cleavage. The type of nutrition system was considered as the sub-factors in the factorial pattern in terms of four levels of vermicomposting and Azolla compost, in the quantities of 6 and 8 tons per hectare respectively, humic acid (4.5 per one thousand), the conventional chemical fertilizers (Nitrogen, Phosphor, and Potassium), and two cultivars (Shirodi and the local Tarom). The highest proline, CAT, POX, APX, and enzymes ABA were also carried out under drought stress conditions in the remobilization stage using conventional fertilizer (Nitrogen, Phosphor, and Potassium) in the local Tarom cultivar. Therefore, according to this experiment’s results, the local Tarom cultivar, due to increased activity of enzymes under stress conditions, is a tolerant cultivar. One can also consider humic acid’s role in increasing drought tolerance of rice cultivars by reducing the oxidative damage caused by active oxygen species created under drought stress and protecting plants’ physiological processes.

The Relationship Between Defense Mechanisms and Nurses’ Occupational Burnout: A Cross-sectional Study

Background: Occupational burnout is a psychological syndrome that occurs in response to chronic stress in the workplace. Nowadays, it is known as one of the most important consequences of occupational stress. Defense mechanisms may also affect occupational burnout. Objectives: Since burnout is an important factor influencing the productivity of nurses, this study was conducted to investigate the relationship between the defense mechanisms and occupational burnout among nurses in the educational hospitals of an urban area in Iran. Methods: This descriptive cross-sectional study was conducted on 318 nurses who had at least one-year of work experience in four educational hospitals in Sari city, Iran, in 2018. Sampling was performed using the proportional stratified sampling method. The data were collected by the Maslach Burnout Inventory (MBI) scale, psychological Defense Styles questionnaire (DSQ-40), and a demographic questionnaire. Data were analyzed using descriptive and inferential statistics via the SPSS software V.20. Results: A total of 318 nurses were studied, 13 (4.1%) of the nurses had a burnout. The mean score of the dimension of emotional exhaustion (EE) was 17.49, in the dimension of depersonalization (DP) it was 5.42, and in the dimension of personal achievement (PA) it was 31.58. They indicated a low level of occupational burnout, and the mean scores of FE, DP, and PA subscales indicated a low level of occupational burnout. The use of more mature defense mechanisms had a significant negative correlation with the increase of the EE score (rho = -0.210, P &lt; 0.001), but no significant relationship was reported with other aspects of burnout. Increased use of immature defense mechanisms had a direct correlation with the increase in the score of DP (rho = 0.255 and P &lt; 0.001), but had a significant inverse relationship with the PA score (rho = -0.238 and P &lt; 0.001) and no significant relationship with EE (P = 0.627). No significant relationship was found between the use of neurotic defense mechanisms and burnout dimensions (PEE = 0.119, PDP = 0.174, and PPA = 0.127). Conclusions: Since there is a significant relationship between defense mechanisms and occupational burnout, using the components of defense mechanisms in job interviews can lead to choosing appropriate nurses to perform different tasks in different settings, in accordance with individual and psychological characteristics. Also, teaching problem-solving skills, stress management, and useful information can improve defense mechanisms, nurses’ job performance, and patient satisfaction.

Sustainable fuzzy multi-trip location-routing problem for medical waste management during the COVID-19 outbreak

The performance of waste management system has been recently interrupted and encountered a very serious situation due to the epidemic outbreak of the novel Coronavirus (COVID-19). To this end, the handling of infectious medical waste has been particularly more vital than ever. Therefore, in this study, a novel mixed-integer linear programming (MILP) model is developed to formulate the sustainable multi-trip location-routing problem with time windows (MTLRP-TW) for medical waste management in the COVID-19 pandemic. The objectives are to concurrently minimize the total traveling time, total violation from time windows/service priorities and total infection/environmental risk imposed on the population around disposal sites. Here, the time windows play a key role to define the priority of services for hospitals with a different range of risks. To deal with the uncertainty, a fuzzy chance-constrained programming approach is applied to the proposed model. A real case study is investigated in Sari city of Iran to test the performance and applicability of the proposed model. Accordingly, the optimal planning of vehicles is determined to be implemented by the municipality, which takes 19.733 h to complete the processes of collection, transportation and disposal. Finally, several sensitivity analyses are performed to examine the behavior of the objective functions against the changes of controllable parameters and evaluate optimal policies and suggest useful managerial insights under different conditions.

Socio-demographic determinants of low sexual desire and hypoactive sexual desire disorder: a population-based study in Iran

BackgroundVarious socio-demographic factors have been introduced as the determinants of Low Sexual Desire (LSD), but whether these variables can also contribute to the Hypoactive Sexual Desire Disorder (HSDD), remains uncertain. In this study, we sought to identify the socio-demographic determinants of LSD and HSDD in Iranian women of reproductive age.MethodsThis was a population-based, cross-sectional study of 1000 married Iranian women of reproductive age (16–49 years) who met the inclusion criteria. The participants were chosen using the systematic random sampling method from all the healthcare centres in the city of Sari, Iran. LSD was defined as a score no higher than 33 on the Sexual Interest and Desire Inventory-Female (SIDI-F). The sexually-related personal distress was considered as a score of at least 11.0 on the Female Sexual Distress Scale-Revised (FSDS-R), and HSDD was determined based on the sum of those scores. Descriptive statistics were used to describe the socio-demographic characteristics and a chi-square test was run for data analysis using grouping variables. Multivariate logistic regression test was also employed to adjust the effect of confounding variables.ResultsThe mean score of sexual interest/desire among women was 30.6 ± 10.5. After adjusting the effect of confounding variables, logistic regression showed that socio-demographic variables including age at first intercourse, length of marriage and the level of satisfaction with income were significantly associated with both LSD and HSDD (P < 0.01). While advancing age (P < 0.001) and body mass index (P < 0.01) were just predictors of LSD.ConclusionSome socio-demographic factors could predict LSD in women, while they were not associated with HSDD. In other words, some factors associated with LSD do not instigate sexually-related personal distress, which is one of the criteria necessary for the diagnosis of HSDD.

The Effect of Spiritual Self-care Training on the Suffering of Mothers of Newborns Admitted to the Intensive Care Unit of Sari Hospitals

Objective: Infant hospitalization in the Intensive Care Unit (ICU) may cause many challenges for the family, especially the mother, and cause psychological problems and shock. Self-care, as a prominent factor in physical and mental health and effective in mothers’ adaptation to their child’s illness. Therefore, this study aimed to investigate the effect of spiritual self-care education on mothers of newborns admitted to the ICU of the hospitals in Sari City. Methods: This experimental study was performed on 64 mothers of newborns hospitalized with informed written consent in the hospitals’ respiratory ICU in Sari City in 2019. Sampling was done by an available method and simple random sampling in two groups: Experimental (n=32) and control (n=32). The experimental group received a spiritual self-care training program in 6 sessions of 60 minutes every day. Data were collected using a demographic questionnaire and a 22-item scale of suffering (CBC) and entered into SPSS V. 25 software, then performed using independent statistical tests, Chi-square, Fisher, and ANCOVA (analysis of covariance). Results: The mean of the pre-intervention care range in the experimental and control groups was 65.46±4.51 and 62.68±7.29, respectively, but the paired t-test did not show a significant difference (P=0.07). According to the paired t-test, the Mean±SD care range after the intervention was 43.47±6.47 and 60.59±6.73, respectively, which led to a significant difference (P&lt;0.01). Conclusion: The results of this study showed that spiritual self-care education reduces maternal care suffering. Therefore, its use is recommended for all caregivers

The role of social capital in identifying a neighborhood from the perspective of the functioning of public spaces,Case study of Sari city

The role of social capital in identifying a neighborhood from the perspective of the functioning of public spaces,Case study of Sari city

Extracting the Meaning Order of Alley [Case Study: Historical Context of Sari City Center

The present study is an attempt to find out conceptual and fondumental aspects of alley meaning in the context of Sari historical city center. In this research the considered environment is the allies of historical center context of Sari city. This research tries to discover the hidden meaning system behind the current behaviors and activities in the alleys of this area. This research is based on Exploratory factor analysis research method which is one of the branches of correlation research method and is calculated by using covariance matrix method of analysis. The results of this study showed that there is a collection of meaning components which are working as a network in the final model. The study identified 17 components that were categorized into four main systems: individual social position, individual internal feelings, cultural relationships, and tradition. This paper concludes that the proposed model carefully shows the meanings regulation of the historical fabric of alleys.

Patients’ Attitude and Knowledge About Epilepsy in the North of Iran in 2016 - 2018

Background: Epilepsy is a severe problem incorporating a high degree of the misconception that influences the quality of life of individuals suffering from the disease. Objectives: The purpose of the present study was to assess the knowledge and attitudes of patients with epilepsy toward the disease. Methods: A cross-sectional study was conducted on 155 individuals with epilepsy aged ≥ 18 years from August 2016 to Jun 2018 in an outpatient clinic of a medical university in Sari City, North of Iran. Thirty-four closed-ended questions were developed, including 14 items about knowledge, 11 items about attitudes, and nine questions about knowledge profile-personal toward epilepsy. Answers to the questions were either “yes,” “no,” or “I do not know.” The chi-square (χ2) test was used to explain the association between variables and demographic information. Results: The mean age of the participants was 31.73 ± 11.06 years. Regarding the cause of epilepsy, 85.8% of the participants reported that epilepsy is a brain disorder. Moreover, in terms of the knowledge score, 54.8% of the participants had a fair knowledge of epilepsy. Accordingly, patients with university education had good knowledge about the disease (P = 0.007). In terms of attitudes toward epilepsy, 82.6% of the patients had a positive attitude toward the disease but had no good awareness of it. These positive attitudes were associated with a high education level (P = 0.001). Conclusions: This study showed that despite the positive attitude toward epilepsy, good knowledge about the disease was still below 50%.

Factors affecting microplastic retention and emission by a wastewater treatment plant on the southern coast of Caspian Sea

Understanding how wastewater treatment plants (WWTPs) process microplastics (MPs) will help informing management practices to reduce MP emissions to the environment. We show that composite 24 h samples taken at three replications from the outflow of the grit chamber, primary settling tank and clarifier of the WWTP of Sari City, on the southern coast of the Caspian Sea, contained 12667 ± 668, 3514 ± 543 and 423 ± 44.9 MP/m3, respectively. Fibers accounted for 94.9%, 89.9% and 77.5% of the total number of MPs, respectively. The MP removal efficiency was 96.7%. MP shape (fiber, particle), size and structure were the most important factors determining their removal in different steps of the wastewater treatment process. The structure of microfibers (polyester, acrylic and nylon) and the consequent higher density than water explained their high removal (72.3%) in the primary settling tank. However, size was more important in microparticle removal with particles ≥500 μm being removed in the primary settling tank and <500 μm in the clarifier unit. The smallest particles (37–300 μm) showed the lowest removal efficiency. The predominant types of fibers and particles were polyester and polyethylene, respectively, which are likely to originate from the washing of synthetic textiles and from microbeads in toothpaste and cosmetics. Despite the efficiency of the Sari WWTP in removing MPs, it remains a major emission source of MPs to the Caspian Sea due to its high daily discharge load.

Ranking of hospitals in the case of COVID-19 outbreak: A new integrated approach using patient satisfaction criteria

ABSTRACT Since December 2019, a new virus, called the Corona Virus Disease-2019 (COVID-19), triggers pneumonia outbreak from Wuhan across China, which now poses major health threats to public health. According to the World Health Organization, the death rate of this virus has been 3.4%. Hospitals are the most important element of the health care system during an outbreak like COVID 19. The main goal of hospitals is to provide high quality care to patients and meet their needs and expectations during an outbreak like COVID 19. The hospital must provide high quality services to meet patients’ needs. Expectations are therefore one of the most important determinants of patients’ or their families’ evaluation of service quality, and accurate understanding of customer expectations is the most important step in defining and delivering high quality services. In this study, using the FAHP-PROMETHEE hybrid approach, we will rate hospitals in Sari city of Iran in terms of patient satisfaction during the outbreak of COVID 19. Therefore, first, patient satisfaction factors are identified under normal conditions and then patient satisfaction factors are identified during the outbreak of COVID 19 and hospitals are ranked under normal conditions and during the outbreak of COVID 19 using FAHP-PROMETHEE approach.

Genetic Counseling for Families with Sporadic Intellectual Disability in North of Iran: A Retrospective Study

Background Intellectual Disability (ID) is a heterogeneous disorder, in which at least 600 genes participate. The present study aimed to identify the effect of genetic counseling and consanguinity marriage in Iranian families with sporadic mental disability. Materials and Methods: In this retrospective cross-sectional study, we examined 151 families with a sporadic mental disability referred for genetic consultation to the Welfare Center of Sari city, North of Iran. Results: About 41.05% (n=62) of the cases were consanguinity marriage. In this study, other diseases were also observed with ID. The following four types of consultations were also reviewed, most of which were Diagnostic Counseling (DC) (60%). According to the inheritance pattern analysis, the share of non-hereditary cases was higher compared to the share of hereditary and unknown cases. The results of the present study showed a significant difference between consanguinity marriages and potential genetic etiology ID (P=0.012). Besides, there was no significant difference between other groups. Conclusion: In this study, we highlighted the importance of genetic counseling and found that consanguinity marriage was a key factor in the development of the disease in our society. Therefore, given the high cost of genetic tests and socio-economic problems, it is wise to include genetic counseling to prevent many diseases such as mental disability before birth.