bluuebunny/crossref_metadata_2025 huggingface dataset:
Willingness to use HIV self-test kits in Winneba, Ghana
Authors: Mensah Joe
Published: December 2023

Over the years, many successive governments of Ghana have been making efforts to minimise the transmission of HIV in the country through its agencies such as the Ghana health service and the Ghana AIDS Commission. In an attempt to continue to bring the transmission of HIV under control, the government of Ghana in July 2023, launched the HIV self-test (HIVST) kits for use. However, like new health products such as COVID-19 vaccines, there is a tendency of hesitancy to their use in the country. Using the case study design in connection with the purposive sampling technique, the study sampled 12 participants in Winneba, Ghana and data was analysed using thematic analysis. The study found that majority of the people were aware of the HIVST kits in the country with another indicating that the HIVST kits are yet to be made available in communities. Women were found to be more willing to use the HIVST kits than other population groups. Accessing the HIVST kits on the other hand was met with scarcity and participants identified the pharmacy to be the best place to access the HIVST kits. It is recommended that the municipal health directorate and the Ghana AIDS commission should collaborate to intensify education and publicity on the availability and use of the HIVST kits. Additionally, in order to prevent unforeseen shocks, there is a need for the pharmaceutical society of Ghana to train and equip its members to offer counselling services to users of the HIVST kits.
The physiology of orgasmic headache
Authors: Victor Emojevwe , Korede Gbemi Olasunkanmi , Obidike Naiho Alexander , Obukohwo Oyovwi Mega , Abioye Oyeleke Abiodun
Published: December 2023

Orgasmic headache is a headache caused by sexual activity that emerges as sexual excitement increases (progressive at onset) or as an immediate and powerful headache following orgasm (thunderclap at onset) or combines these two characteristics. The idea that orgasmic headache (OGH) is caused by physiologically inappropriate responses is extremely simplistic. As a result, a complete analysis of the physiological mechanisms is provided here in order to comprehend the complex situation of OGH. The physiology of OGH was studied in humans utilizing peer-reviewed papers from Pubmed, Science direct, EBSCO, Scopus, Cochrane library, Sage Journals, and Google Scholar. Author, year of publication published between 2003 and 2020. OGH can regulate psychophysiological reactions, but it can also cause a rise in blood pressure, persistent pain, intracranial hemorrhage, and cerebral infarction. This review explains two physiological systems: the release of calcitonin gene-related peptide (CGRP), which induces the creation of less serotonin, resulting in an inflammatory response and discomfort. The release of epinephrine and nor-epinephrine can cause cerebral ischemia, which can lead to headaches in headache-prone patients. Fear of an orgasmic headache can lead to lower libido, leading to lower sex pleasure. As a result, the condition may deprive sex of its pleasure and turn it into a ‘headache’. We conduct a literature review to study the physiological processes of OGH in connection to its physiological maladaptive responses. A greater understanding of the physiological mechanisms underlying Orgasmic headache will allow practitioners to properly identify and counsel patients without attributing physiological maladaptive reactions to OGH.
Teplizumab: an FDA- approved drug, marks milestone in treatment of type 1 diabetes
Authors: Mukhtar Sameen , Haris Muhammad
Published: December 2023

Diabetes type-1 is a chronic disease characterized by immune-mediated destruction of insulin-producing beta cells in the pancreas. It progresses through distinct stages at varying rates, with stage 1 being β-cell autoimmunity with normal blood sugar, stage 2 being β-cell autoimmunity with dysglycemia, and stage 3 being symptomatic disease onset.
Pap test: significance in early diagnosis of cervical cancer
Authors: Haider Sawera , Masood Fareeha , Javed Eman
Published: December 2023

Cervical cancer refers to a malignancy of the lower part of uterus i.e. cervix. It is the fourth most prevalent among women worldwide and tallies for about 30% of cancer cases in the developing world and 5% in the developed world.
Androgenetic alopecia: evaluation of hormonal profile and its systemic implications
Authors: Pathak Prateek , Adil Mohammad , Sarshar Fariz , Singh Jyoti
Published: December 2023

Background: Androgenetic Alopecia is a hereditary androgen-dependent disorder characterized by a gradual conversion of terminal hair into miniaturized hair with typical bitemporal recession and balding vertex and is considered the most common type of baldness characterized by progressive hair loss. This study evaluated the hormonal profile in males with androgenetic alopecia. This study evaluated the hormonal profile of early androgenetic alopecia in males.
Methods: This prospective study included 84 patients attending the outpatient Department of Dermatology. Forty-four cases and 40 controls were included in the study. The study had 44 male patients presenting with complaints of grade ≥ 3 androgenetic alopecia in the age group 19-35 years, whereas 40 age and sex-matched patients attending Dermatology OPD for unrelated complaints with no history of hair loss or clinical examination suggestive of androgenetic alopecia were included in the control group. After a detailed history, and examination, testosterone, LH, FSH, Prolactin, and SHBG were estimated.
Results: The mean age of onset was found to be 24.29±3.28 years. Positive family history was seen in 65.90% of patients. The mean testosterone, LH, FSH, prolactin, SHBG and free androgen index in cases versus controls was 6.44±2.58 versus 3.32±1.53 ng/ml, 8.01±2.64 IU/l versus 3.01±1.16 IU/l, 3.82±1.33 IU/l versus 5.07±1.27 IU/l, 15.50±5.11 ng/ml versus 9.84±3.91 ng/ml, 12.72±2.63 nmol/l versus 29.18±4.90 nmol/l and 51.03±21.78 versus 11.40±4.66 respectively. LH/FSH ratio was 2.17±0.54 versus 0.63±0.27. These parameters had p values <0.05 and were statistically significant.
Conclusions: Our study concluded that serum testosterone, prolactin, LH, LH/FSH, and FAI are increased whereas serum FSH and SHBG are decreased in cases of androgenetic alopecia compared to controls.
Association of vitiligo and metabolic syndrome: a case control study
Authors: Thakur Priyanka , Mehta Karaninder S. , Chauhan Pushpinder S. , Singh Ravinder , Sharma Anju L. , Sharma Anuj , Sharma Reena , Kumar Prabal , Vashist Sanket , Manvi Sujaya , Kukreja Amisha , Negi Rohit
Published: December 2023

Background: Vitiligo is an acquired disorder of depigmentation which involves skin and mucous membranes characterized by development of well-defined white macules on skin, mucosa and overlying hair of the skin can be involved. Systemic nature of the vitiligo might lead to insulin resistance metabolic profile abnormalities. Objective was to study the association between vitiligo and metabolic syndrome.
Methods: The study was done in department of dermatology, venereology and leprosy of Dr. R. P. Government Medical College Kangra (Tanda), Himachal Pradesh. The study included 150 cases and 150 controls. Cases: age above 18 years with a diagnosis of vitiligo were included in the study. Pregnant and lactating women were excluded. Patients who had used medications that could affect the metabolic status (like systemic steroid therapy or cyclosporine or on hormonal replacement therapy). Patients already on lipid lowering agents and antidiabetic drugs. The case group was further subdivided into three subgroups according to VIDA score (group A: 1-0, group B: 1-2 and group C: 3-4). Controls: those visiting outdoor patient department and admitted for minor day care procedures Clinical details of patients were recorded regarding age, sex, smoking/alcohol consumption. General physical examination includes height, weight, body mass index, waist circumference, blood pressure. All the patients and controls were subjected to following tests: fasting blood sugar (FBS), cholesterol (CHOL), triglyceride (TAG), low density lipoprotein (LDL), high density lipoprotein (HDL), very low-density lipoprotein (VLDL), fasting serum insulin level (FSIL). Venous samples were taken after 12 hours of fasting. The participants were screened for metabolic syndrome as per national cholesterol education program adult treatment panel III (NCEP ATP III). Metabolic syndrome rates were compared between case and control groups.
Results: The mean age was 35.82±12.9 years among cases and 36.97±11.76 years among controls. The M/F ratio of cases being (1:1.6) and controls (1:1). The mean duration of vitiligo was 117.8±105.5 months. Metabolic syndrome was significantly prevalent amid vitiligo cases 74 (49.3%) as compared to controls 23 (15.3%) with OR (95% CI) =5.37 (3.1-9.3). Metabolic syndrome was more frequent in VIDA subgroup 3{71 (47.3%)} and was statistically significant (p≤0.001).
Conclusions: The study found association of metabolic syndrome among vitiligo patients. In addition, the study also found that in non-segmental vitiligo, frequency of metabolic syndrome was higher as compared to another pattern. Furthermore, frequency of metabolic syndrome increased as activity of vitiligo increased in the study.
Halo scalp ring: an undiagnosed neonatal scalp alopecia
Authors: Kulhari Monika , Pathak Prateek , Singh P. K.
Published: December 2023

Halo scalp ring is a rare less frequently diagnosed non scarring alopecia seen in neonatal period. Although a few cases can land up in scarring alopecia if necrosis and deep inflammation due to Caput Succedeneum supervenes. It is imperative to diagnose the condition as various forms of alopecias in infants can lead to psychological disturbance among parents. Herein we report a case of Halo Scalp Ring alopecia so as to keep in mind this condition so that unnecessary investigations of the child can be avoided and in case scarring occurs the child can be referred on time to a plastic surgeon for hair restoration surgeries.
Steroid-sparing effect of emollients in atopic dermatitis and psoriasis
Authors: Waghmare Dipesh M. , Purkait Indranil , Pareek Anil
Published: December 2023

The aim of the present article is to analyze the role of emollients in the topical management of atopic dermatitis and psoriasis and also to review the clinical studies available on the beneficial effect of co-therapy of emollients and topical corticosteroids. Understanding the stratum corneum's key involvement in the pathophysiology of atopic dermatitis and psoriasis has led to the development of new therapeutic approaches for treating not just inflammation but also restoring a healthy skin barrier. While topical corticosteroids are the cornerstones of treatment for atopic dermatitis and psoriasis, the potential risks of overuse (including atrophy, striae, dyspigmentation, and loss in epidermal barrier homeostasis) must be weighed against the benefits. These risks futher increase the necessity of finding non-steroidal treatments. Emollients aid the epidermal barrier function as they improve the oil and lipid levels and restore its protective function. Used regularly, emollients may reduce flare-ups and may also have a direct anti-inflammatory effect and may reduce the need to use topical corticosteroids, i.e. they have a ‘steroid sparing effect’.
Maternal directed interventions of preterm newborn on strengthening mother- newborn interaction in NICU: A systematic review
Authors: Lobo Renilda Shanthi , Mendonca Theresa Leonilda , Chavan Seema S
Published: December 2023

The main factor contributing to neonatal fatalities globally is preterm birth Maternal participation in the care of preemies in the NICU can be challenging for mothers to strengthen the bond between them. The objective of the literature review was to appraise the effectiveness of maternal-directed interventions of preterm newborns on strengthening mother-newborn interaction in NICU, identify which tools are most frequently used, and report on outcomes of strengthening mother-newborn interaction in NICU.

We conducted a PRISMA-compliant Meticulous search for articles indexed in the databasesPubMed, Psyc INFO, Web of Science, and CINAHL using disparate combinations of keywords comprising “maternal directed interventions’’ AND “preterm newborn’’ OR “strengthening’’ AND “mother- newborn interaction” were used to review in the databases.

Five empirical studies were identified, massage including Auditory, Tactile, Visual, and Vestibular was linked to a faster symptom reduction of depression, ATVV have significant implications for mom and their premature babies, especially during the initial six months of life. At day 14 (=45.66, p<0.01), there were noticeable differences between groups as the suction pressure rose linearly over time. The mean weight, height, and head circumference of preterm babies who received the 2-week massage intervention were higher (F=41.151, 6.621, and 24.158, respectively; p<0.001). Breastfeeding habits among mothers of preterm infants are improved by the kangaroo mother's nursing on the infant's growth, neurological development, and reduction of morbidities related to preterm infants.

Maternal interventions support infants from birth through early life to improve infant health, develop newly acquired abilities, reduce developmental issues, promote adaptive parenting and strengthen the mother-newborn bond.
Perception and attitude of nursing faculties regarding innovative teaching strategies in nursing education: A descriptive study
Authors: Choudhury Krishna , Helenpuii
Published: December 2023

Nursing is a field which requiring clinical knowledge & skills to care for the patients & his family as we deal and handle with real life situations. Innovations depends on the teacher that how they utilizes the instructional strategies while delivering lectures or teaching in clinical.

A Non experimental cross sectional descriptive research design was adopted with 73 nursing faculties from entire India. Sampling technique was Non probability convenience sampling. A self-structured socio-demographic tool consisting of 10 questions, a self-structured rating scale on consisting of 14 items and a Self- Structured Likert scale on consisting of 10 items was developed to collect the data. Data was collected by creating Google form in an online mode.

Data was analyzed by using both descriptive and inferential statistics. 64.4% had highly satisfactory perception and 35.6% had satisfactory perception. 82.2% had a positive attitude. The calculated Karl Pearson’s Correlation value of r=0.235 shows a positive correlation. It was observed that exposure to any training program on simulation had statistically significant association with level of perception. Also qualification of the teacher and teaching methods whatever they have been using and place of residence had statistically significant association with level of perception.

With effective knowledge regarding online teaching and learning strategies, future nurses can be trained regarding the innovative methods which will be fruitful and beneficial for the development and widespread in the field of nursing education.
Overlap of histological features of pigmented purpuric dermatosis and kaposi sarcoma – pseudo kaposi sarcoma
Authors: Shreya K , Yadav Shakti Kumar , Asati Dinesh P , Sahni Mukesh
Published: December 2023

Pseudokaposi sarcoma can be congenital or acquired. Due to prolonged venous stasis, leads to peripheral tissue hypoxemia, which results in neovascularisation and fibroblast proliferation. Treatment includes rectification of the underlying pathology such as graded compression stockings or compression pumps for venous stasis and ulcer management with regular wound care. Medical management includes oral antibiotics, along with compression therapy with good results. Our patient presented mild lower limb pitting edema unilaterally with erythematous barely elevated plaque over the anterior aspect of the lower limb.
Paediatric ovarian torsion–A painful twist
Authors: Raveendran Sajeetha Kumari , Mohanapu Swarnalatha
Published: December 2023

Ovarian torsion is a common gynecologic cause of acute abdomen in the reproductive females but it is not commonly encountered in paediatric age group. Safeguarding the ovary is especially important in young girls where the future fertility issue has to be considered. The main challenge in paediatric age group is a prompt diagnosis which aids in the salvagability of the ovary. Herein we are reporting a rare case of ovarian torsion in a 9 year old which was successfully managed by salvaging the ovary.
Azithromycin for COVID-19: Pharmacological Mechanisms, Challenges, and Prospects
Authors: Saberi-Hasanabadi Parisa , Farmad Milad Esmaeilzadeh , Aboulfazli Sajad , Kheirandish Ali , Ataie Amin , Boshtam Somayyeh , Ataee Ramin
Published: December 2023

The coronavirus disease (COVID)-19 pandemic led to a new challenge in the field of effective treatment methods for this disease. Antiviral and immunomodulatory agents were suggested as potential therapeutic methods in this field. Since the most severe clinical symptoms associated with COVID-19 disease appear to be acute respiratory syndrome, azithromycin has been proposed as a potentially effective drug in this context. We have updated the evidence and selected all relevant items to understand the mechanism of role of azithromycin, clinical efficacy, and their side effects in coronavirus disease-19 treatment on July 20th and updated on March 20th, 2020. A literature search of electronic databases including the Web of Science, PubMed, and Google Scholar was conducted by searching keywords such as "Azithromycin", "COVID-19", and "Combination therapy". The ultimate goal of this review was identifying eligible studies about the pharmacological activities, safety, and effectiveness of azithromycin in treating COVID-19 patients. Immunomodulatory properties of azithromycin include the ability to reduce cytokine production, maintain epithelial cell integrity, or prevent lung fibrosis. The use of azithromycin in some studies was associated with a decrease in mortality and need for ventilation in patients. These properties can be useful during the period of COVID-19 infection, especially in patients with underlying diseases. However, the evidence for the use of azithromycin is still scarce and the quality of the studies is low. In some retrospective studies, azithromycin was mainly evaluated in combination with hydroxychloroquine, which showed no particular advantage. The results of this review showed that azithromycin has appropriate and well-known safety characteristics in the treatment of patients with COVID-19. However, the most appropriate dosage in different stages of the disease and the effect of its combination with other drugs are important questions that should be considered in future clinical trials.
Evaluation of Thyromental Height Test for Predicting Difficult Laryngoscopy in Morbid Obese Patients Candidate for Bariatric Surgery: An Observational Study
Authors: Etezadi Farhad , Sabouri Mohsen , Pourfakhr Pejman , Moharari Reza Shariat , Mahmoudabadi Hossein Zabihi , Khajavi Mohammadreza
Published: December 2023

Upper airway management in morbid obese patients undergoing bariatric surgery is a major challenge during induction of anesthesia. Bed side Thyromental Height Test (TMHT) is an easy and valid predictor for prediction of difficult airway in non‑obese patients, but its precision in morbid obese patients haven’t been evaluated yet. The purpose of present study is to find the accuracy of TMHT for the prediction of difficult laryngoscopy in morbid obese patients undergoing bariatric surgery. The present prospective observational study was performed on 95 morbid obese patients at Sina hospital during 2020. Preoperative exams of patients include the assessment of Mallampati classification, thyromental height, thyromental, sternomental and interincisor distances. After induction of anesthesia, the laryngoscopy view was evaluated using the Cormack Lehane classification, and the relationship between these tests to prediction of difficult laryngoscopy view based on the Cormack Lehane degrees (grades 3,4) were evaluated. A total of 95 morbid obese patients with a mean BMI of 44.7±5.6 kg/m2.were included in the study. 67.3% of them were women. The incidence of difficult laryngoscopy (C & L III, IV) was 16.8%. TMHT less than 56.5 mm, with 98% positive predictive value and 93% accuracy was the best predictor of difficult intubation in these patients. The accuracy of thyromental, sternomental and interincisor distance, with cut off value less than 51.5 mm, 89.5 mm, 41.5 mm respectively was less than TMHT in prediction of difficult laryngoscopy in morbid obese patients. In morbid obese patients with a BMI greater than 40, thyromental height less than 56.5 mm with 98% positive predictive value and 93% accuracy is the best predictor for difficult laryngoscopy view.
Chordoma: Excellent Response to Radiotherapy in Combination With Hyperthermia
Authors: Barzegartahamtan Mohammad Reza , Basi Ali , Khalafi Leila , Falahatpour Zahra , Mohamad Ali , Mahdavi Seied Rabi
Published: December 2023

Chordoma is a bone tumor that is resistant to radiotherapy, and few studies have been published on the concomitant use of radiotherapy in combination with hyperthermia in its treatment. We reported a chordoma patient treated with both radiotherapy and hyperthermia. The patient was a 74-year-old man with chordoma who underwent radiotherapy combined with hyperthermia due to his unwillingness to undergo surgery and responded very well clinically and imaging-wise without increasing in complications. Radiotherapy combined with hyperthermia improves the response to treatment (both clinically and in imaging) and does not increase the complications.
Management of Spinal Hemangioblastoma in Von Hippel-Lindau Disease: A Case Report
Authors: Saberi Hooshang , Iranmehr Arad , Derakhshanrad Nazi , Payinmahalli Abolfazl , Soleimani Vahid
Published: December 2023

Vertebral body location of hemangioblastomas (HB) is extremely rare. The authors report a case of spinal mass involving lower thoracic region with cord compression, approved to be spinal HB. A 57-year-old man presented to our center with eight months history of progressive intractable back pain and paraparesis. Admission computed tomography and magnetic resonance imaging (MRI) of the thoracolumbar spine demonstrated a lytic and expansile spinal mass with pedicle expansion and vivid contrast enhancement involving T11 and T12 vertebral bodies on the right side. He was a known case of von Hippel-Lindau (VHL) and he had history of 4th ventricular asymptomatic hemangioblastoma near Obex, multiple pancreatic cystic adenomas, multiple liver cysts, and right non-chromaffin adrenal mass. The patient underwent a T11-T12 partial transpedicular corpectomy with T5 to L3 posterior spinal fixation to bridge the invaded segment. The pathological and immunohistochemical findings were consistent with vertebral HB. Spinal HB although extremely rare, may be managed with subtotal tumor resection and fixation of normal adjacent vertebrae by cemented screws.
Is there a relationship between assisted reproductive technology and maternal outcomes? A systematic review of cohort studies
Authors: Heshmatnia Fatemeh , Jafari Maryam , Bozorgian Leila , Yadollahi Parvin , Khalajinia Zohre , Azizi Marzieh
Published: December 2023

Background: Pregnancy with assisted reproductive technology (ART) is accompanied by fetal and maternal outcomes.
Objective: This systematic review aimed to assess the relationship between ART and maternal outcomes.
Materials and Methods: In this systematic review, the electronic databases, including PubMed, MEDLINE, Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, Magiran, Irandoc, and Scientific Information Database were searched for maternal outcomes reported from 2010-2021. The Newcastle-Ottawa Scale for cohort studies was used to assess the methodological quality of studies.
Results: A total of 3362 studies were identified by searching the databases. After screening abstracts and full-text reviews, 19 studies assessing the singleton pregnancy-related complications of in vitro fertilization/intracytoplasmic sperm injection were included in the study. The results demonstrated that singleton pregnancies conceived through ART had higher risks of pregnancy-related complications and adverse maternal outcomes, such as vaginal bleeding, cesarean section, hypertension induced by pregnancy, pre-eclampsia, placenta previa, and premature membrane rupture than those conceived naturally.
Conclusion: In conclusion, an increased risk of adverse obstetric outcomes was observed in singleton pregnancies conceived by ART. Therefore, obstetricians should consider these pregnancies as high-risk cases and should pay special attention to their pregnancy process.
Key words: Assisted reproductive techniques, Maternal health, Pregnancy complications, In vitro fertilization.
Is there a difference between the effects of phytoestrogens and non-phytoestrogens medicinal plants on sexual health? A systematic review and meta-analysis
Authors: Sayahi Masoumeh , Keramat Afsaneh , Nourimand Firoozeh , Mohammadzadeh Hakimeh
Published: December 2023

Background: The quality of life of a person and her sexual partner is impacted by sexual function. Sexual function disorders have a significant prevalence in society. There are different treatments for sexual disorders, including herbal therapies.
Objective: This study aimed to do a comparison of phytoestrogens and non-phytoestrogens medicinal plant’s effects on sexual health in pre- and postmenopausal women.
Materials and Methods: This systematic review and meta-analysis was performed to identify relevant articles in electronic databases such as Web of Science, Scopus, PubMed, Cochrane Library, Google Scholar, and SID for English- and Persian-language articles published up to December 2021. The Cochrane collaboration tool was used to assess the risk of bias. Heterogeneity was assessed using I2 statistics.
Results: Of 5428 records retrieved by searching the databases, after removing duplicate and irrelevant articles, 39 articles were included based on the inclusion criteria in the study. Finally, 18 articles with 1299 participants were included in the meta-analysis. 18 randomized clinical trial studies of phytoestrogens (n = 13) and non-phytoestrogens (n = 5) plants that used the female sexual function index questionnaire and reported the mean difference (MD) and standard deviation were included in the meta-analysis. The effects of phytoestrogens and non-phytoestrogens plants on the sexual health of postmenopausal women appear to differ significantly from one another, according to the meta-analysis (MD = 7.59; 95% CI = 4.56-10.60 and MD = 3.19; 95% CI = 1.25-5.13, respectively) but this difference was not observed in premenopausal women.
Conclusion: The effect of phytoestrogens plants is more in menopausal women, and they can be advised to use these herbs.
Key words: Medicinal, Plants, Sexual health, Women, Meta-analysis.
What Can We Do to Improve the Health Policy-Making Cycle in the Islamic Republic of Iran with a Good Governance Approach? Recommendations for the Secretariat of the Supreme Council for Health and Food Security
Authors: Azadiyan Marziyeh , Vosoogh Moghaddam Abbas , Farhadi Mahalli Ali
Published: December 2023

Background: The primary purpose of the health system is to promote equitable health in society. The aim of this study is to offer some recommendations for improving the Iranian health policy-making cycle with a good governance approach.
Methods: The systematic review approach was employed to undertake this research. To track down articles published electronically between 2010 and 2021, a comprehensive search in the National Library's English databases, in December 2021, was conducted using the keywords such as public policy, policy, policy-making, health policy, good governance, health, and healthcare. In addition, the Persian equivalents of the aforementioned keywords were searched separately or in combination with Boolean operators (OR, AND) in databases such as Scopus, Ovid, Science Direct, Web of Knowledge, PubMed, IranMedex, Magiran, and SID to further pinpoint the desired articles. To evaluate and validate the quality of the selected articles, critical tools appropriate for the type of study were utilized (e.g., the SRQR tool for qualitative studies and the MMAT tool for mixed-methods studies), and finally, the research team conducted content analysis and categorized the findings.
Results: Findings revealed that the health policy-making cycle is an extensive and intra-sectoral concern. Good governance in the health system results in specialized and individualized opportunities for better health and reduces inequality. To accomplish this purpose, it is necessary to emphasize cross-sectoral participation, social responsiveness, and transparent processes, and incorporate the viewpoints of experts and implementers of the health policy-making system. Furthermore, the health system's sovereignty and progress toward good governance should be evaluated, which results in effective policies and health justice.
Conclusion: Considering the legal mission of the Supreme Council of Health and Food Security (the highest policy-making authority in the Ministry of Health), it is recommended that the council implement the practical recommendations of this research in actualizing and incorporating the good governance approach into the health policy-making cycle.
Designing Organizational Evolution Model in Hospitals Affiliated with Bushehr University of Medical Sciences
Authors: Tashtzar Atefeh , Beheshtifar Malike , Nikpour Amin , Zare Reza
Published: December 2023

Background: The desire to survive is inherent in any organization; in the private sector, profit, and in the public sector, people's satisfaction is the guarantee of survival. Taking into account the ever-increasing changes and developments, achieving this goal, requires the adoption of a suitable strategy such as the evolution of an organization that, along with patient-centeredness and service quality, encourages government employees to gain the satisfaction of citizens. The main goal of this research is to design organizational evolution in hospitals affiliated with Bushehr University of Medical Sciences.
Methods:. This research was carried out qualitatively using grounded theory. To collect data, semi-structured interviews were used and data analysis was done using Strauss and Corbin method and the paradigm model. Purposive sampling was carried out based on which14 interviews conducted with professors of the scientific board of universities and experts working in government hospitals.
Results: The results of the data obtained from the interviews during the process of open, central ,and selective coding led to the creation of grounded theory in the field of organizational evolution in hospitals affiliated with Bushehr University of Medical Sciences. The model designed in this research included 43 sub-categories in the form of 6 main categories of causal, contextual, interventional, central phenomenon, consequences, and strategies.
Conclusion: This research can be a complete road map for hospital managers to move towards an evolutionary organization by providing causal, contextual, and intervening conditions, strategies, and consequences of the central phenomenon of organizational evolutionism. Furthermore, this research will help to better understand this phenomenon.
Designing and Validation of the Leadership Competency Scale in Medicine
Authors: Soleimani Nasrin , Talebi Behnam , Yari Jahangir
Published: December 2023

Background: Leadership competencies in medicine are the key factors in improving the performance of physicians and the health system. The aim of the present study was to design and validate the leadership competencies scale in medicine.
Methods: This research was conducted with a qualitative-quantitative approach. The research sample consisted of 12 physician managers in the qualitative stage and 15 people in the content validity evaluation stage using purposive sampling method. In the preliminary implementation stage of the questionnaire, 35 people were selected by convenience sampling and the main implementation stage of the questionnaire 306 students, faculty members, and medical graduate managers were selected using relative stratified random method. Qualitative data were collected by semi-structured interview and quantitative data by questionnaire. To analyze the qualitative data, the Esterberg analysis method was used, and to evaluate the construct validity, confirmatory factor analysis with Smart-PLS3 software was used. To evaluate the validity of quantitative data, content validity index, content validity ratio, Cronbach's alpha coefficient, convergent validity, and structural equation model fit indices were used. The criteria of credibility, transferability, dependability, and conformability were used using triangulation to evaluate the validity of the qualitative research data.
Results: Competencies and parameters of the questionnaire were extracted into 17 competences and 123 concepts through the coding of interview texts and converted into a questionnaire in 101 items. The content validity of 100 items was valid. The results of factor analysis showed that the factor load of 99 items was valid and 17 components explained the structure of leadership competencies. Based on the fit indices of the model, the measurement scale of leadership competencies in medicine was valid in 17 components and 99 items. These components include perception and impression management, professional ethics, conflict management, problem solving, discipline, informal organization, public communication skills, interpersonal relationship skills, listening, cultural management, professional culture, innovation and creativity, motivation, emotional intelligence, change management, feeling management, participative management.
Conclusion: Attention to the curriculum of leadership competencies in medical education and the application of this scale can improve the quality of leadership in the health system.
Analysis of Exposure of Households to Catastrophic Expenditures of Oral and Dental Health Care in Ahvaz City
Authors: Feizi Ali , Hafezi Bahar , Faradonbeh Saeed Bagheri , Tofighi Shahram
Published: December 2023

Background: The treatment of oral and dental diseases is expensive all over the world and these diseases are considered the fourth most expensive diseases. The aim of the present study is analysis of exposure of households to catastrophic expenditures of oral and dental health care in Ahvaz city.
Methods: The present cross-sectional descriptive-analytical study was conducted on 715 households living in Ahvaz city in 2022using multistage sampling. Collecting the data was done through a questionnaire, and logistic model and Stata 17  software were used to analyze the data and estimate the elasticity of influencing factors.
Results: According to the results of the study, the ratio of oral and dental health expenditures to household payment capacity was 59.03 %, and 52.16 % of households faced catastrophic expenditures. Also, supplementary insurances with Odd Ratio(OR) = 1.39, living in the southern region with OR= 1.08, and being in the 2nd income quintile with OR = 1.1 had a strengthening role in facing catastrophic expenditures.
Conclusion: According to the results of this study, in order to reduce the negative effects of oral and dental health expenditures, it seems necessary to modify the financing policies of these services and move towards equity in financing through increasing insurance coverage.
Topical Application of Chamomile Oil in Combination with Dry Cupping for Dysmenorrhea: A Quasi-Experimental Study
Authors: Dadmehr Majid , Hashem-Dabaghian Fataneh , Akhtari Elham
Published: December 2023

Dysmenorrhea has a negative impact on women's daily activities and quality of life. The purpose of this study was to investigate the effect of topically applied chamomile oil along with dry cupping on dysmenorrhea. A total of 12 patients with dysmenorrhea were included in this quasi-experimental study and treated for three consecutive cycle periods. One mL of chamomile oil was gently massaged on the skin of the suprapubic area for 10 minutes once every night. After the massage, dry cupping was done. During the study, patients were visited on the third day of menstruation for three consecutive cycles, and mean pain was evaluated and recorded based on the visual analog scale (VAS). The mean ± SD of pain intensity in three cycles before the study was 7.5 ± 0.43 and in three cycles after the interventions was 1.44 ± 0.33 (P= 0.002). Indeed, the pain score was decreased as 86.72±1.12% due to the interventions. All the patients discontinued using the analgesic during the study. Topical application of chamomile oil and dry cupping significantly reduced the severity of pain during menstruation and it could be considered as a low-cost modality without side effects for dysmenorrhea. Further studies with larger sample size and longer follow-up are recommended.
Effect of Saffron (Crocus sativus L.), as a Bioenhancer, on Pharmacokinetic of Acetaminophen: An Animal Study
Authors: Lamardi Seyede Nargess Sadati , Ardekani Mohammad Reza Shams , Mireskandari Katayoon , Sharifzadeh Mohammad , Yachchali Maryam , Sadrai Sima
Published: December 2023

In Traditional Persian Medicine (TPM) saffron is used as an accompaniment agent “Mobadreq” in polyherbal formulations. According to TPM texts, “Mobadreq” is a substance (or drug) which facilitates access of drugs or food to the whole body or specific organs. This study investigated the effect of oral co-administration of Crocus sativus L. (saffron) on the absorption and some pharmacokinetic parameters of acetaminophen in rats. Two groups of rats (n=6) were treated by 1: acetaminophen 10 mg/kg along with Crocus sativus 4 mg/kg (test group) and 2: 10 mg/kg acetaminophen (control). The plasma concentrations of acetaminophen after oral administration (at 0, 5, 10, 15, 20, 40, 60, 90, and 120 min) were monitored by an HPLC-UV method. Results indicated that the plasma concentration of acetaminophen in the test group was reached to the maximum concentration (Cmax) faster than control group. As a result, at 5 to 40 minutes after drug gavage, the concentration of acetaminophen in both groups was significantly different.  It was also found that co-administration of acetaminophen and saffron significantly increased acetaminophen’s area under concentration curve (AUC0-60) in comparison to the acetaminophen alone (p<0.025). These results suggest that saffron could increase the absorption rate of acetaminophen. Consequently, saffron can be considered and introduced as an enhancer of absorption rate and efficacy of acetaminophen and other drugs at least by oral route although the drug interactions with this herb should be considered.
Contraceptive Efficacy of Aqueous Extract of Xylopia aethiopica (Dunal) A.Rich. Fruit in Female Sprague Dawley Rats
Authors: Ajayi Babatunde Ebenezer , Odueke Yetunde Adesola , Ibrahim Favour Marian , Ighodaro Macdonald , Bamgbose Janet Titilayo
Published: December 2023

Globally, herbal contraceptives remain a viable option for women in rural settlements with unmet contraceptive needs. Pharmacological reports of the male contraceptive potential of Xylopia aethiopica (Dunal) A.Rich. fruit exist in literature, but there is a paucity of information on its female contraceptive potential. This study evaluated the efficacy of aqueous extract of X. aethiopica fruit (AEXAF) as a reversible contraceptive remedy in female Sprague Dawley rats against a combined oral contraceptive drug containing ethinyl estradiol and levonorgestrel (COC-EEL). AEXAF was obtained by boiling air-dried pulverized fruit samples in water for 15 minutes. Phytochemical screening of AEXAF was carried out.  Mature female rats (30) were assigned into six groups, five per group, with ±20 g weight difference within each group. Group A received water; Groups B, C, D and E received 50, 100, 200, and 300 mg/kg/B.W. doses of AEXAF, respectively; Group F received 3.6 µg/kg/B.W. dose of COC-EEL. COC-EEL and AEXAF were administered orally, once daily, for 21 days. After 14 days of treatment, mature male rats were introduced to the females, two males per group, for 7 days. Litter size was recorded after delivery. Rats that did not produce pups were immediately re-introduced to male rats for 7 days and sacrificed after another 7 days; the number of fetuses in their uteri was determined. The data obtained was analyzed using Unpaired-t test. Phytochemical screening of AEXAF revealed the presence of alkaloids, flavonoids and saponins. High contraceptive efficacy (80%) with 100% reversibility was observed at 50 and 300 mg/kg/B.W. doses of AEXAF; whereas COC-EEL showed 60% efficacy and 100% reversibility. The 100 and 200 mg/kg/B.W. doses of AEXAF did not protect against conception. X. aethiopica possesses contraceptive potential worthy of further scientific consideration.
Complementary and Alternative Medicine Use and Its Determinant Factors in Iranian Asthma and Chronic Obstructive Pulmonary Disease Patients
Authors: Kheirypour Armin , Jazani Arezoo Moini , Hashempur Mohammad Hashem , Ghobadi-Marallu Hassan , Azgomi Ramin Nasimi Doost
Published: December 2023

Asthma and chronic obstructive pulmonary disease (COPD) are the most common chronic diseases with a high global burden of disease. Today, the use of complementary and alternative medicine (CAM) has become more popular. In general, in developing countries, easy access and low cost of traditional medicine, and in developed countries, more access to health information, the prevalence of old age and the increase in chronic diseases are the reasons for this increasing use of traditional medicine. This study aimed to determine the rate and pattern of CAM used and their relationships with demographic characteristics among asthmatic and COPD patients. This research was a cross-sectional study performed on asthma and COPD patients (n=357) referring to the Pulmonary Diseases affiliated with Ardabil University of Medical Sciences, Ardabil, Iran from 2019 to 2020. Data were collected by using semi-structured questionnaires including open and closed questions and face-to-face interviews. Three hundred and thirty-nine patients (95%) used at least one type of CAM in the last year of study. About half of the patients (49.9%) used more than two types of CAM during the last 12 months. Three hundred and four patients (85.2%) used medicinal plants. Few patients reported with the use of CAM to their physician or health care providers (16.1%, 12.5%, and 16.7% of the users of medicinal plants, bloodletting, and dry cupping respectively). Relatives and friends (77.9%) were with the most common sources of recommendation of CAM to the patients. The present study showed the high prevalence of using different types of CAM, especially herbal medicines in Iranian asthmatic and COPD patients. The main incentive for using CAM was for friends and family members, not health care providers. The use of CAM is associated with age patients age, family size, habitat, education, and occupation.
Three-Dimensional Kinematic Analysis of the Lower Extremity in Ruesi Dat Ton Postures Performed by Healthy Volunteers
Authors: Jongjiamdee Ketmanee , Chaowpeerapong Thanaphak , Kerdsomnuek Pichitpol , Booranasubkajorn Suksalin , Vanadurongwan Bavornrat , Limroongreungrat Weerawat , Akarasereenont Pravit , Asavamongkolkul Apichat
Published: December 2023

This study was conducted to investigate the three-dimensional (3D) joint angles and muscle activities of the lower extremities when performing the Ruesi Dat Ton: a form of traditional Thai medicine involving stretching and strengthening postures. Thirty healthy volunteers were recruited in order to let them perform five Ruesi Dat Ton postures, namely Tha Kae Khao Kae Kha, Tha Kae Lom Nai Ook Nai Eo, Tha Kae Klon Pattakhat, Tha Kae Siat Ook, and Tha Kae Lom Pat-Khat Kae Lom Nai Eo, by a random sequence of postures. The 3D joint angles and muscle activities during the performance of the Ruesi Dat Ton were analyzed at the 3D-motion analysis laboratory. Descriptive statistics were used for the analysis. All the Ruesi Dat Ton postures were in the normal range of motion of the back, hips, knees, and ankles. However, when compared to the joint angle values from the 3D motion analysis, a higher joint angle was found in the hip rotation of Tha Kae Khao Kae Kha (27.99±16.72 degrees), Tha Kae Lom Nai Ook Nai Eo (25.99±14.76 degrees), and Tha Kae Klon Pattakhat (20.99±12.59 degrees), knee flexion of Tha Kae Siat Ook (140.05±8.98 degrees), and trunk flexion of Tha Kae Lom Pat-Khat Kae Lom Nai Eo (52.10±14.83 degrees). All the postures produced more than 1% maximum voluntary isometric contraction of the muscle (MVIC). The muscle activities of Tha Kae Siat Ook were the most contracted, whereas Tha Kae Lom Pat-Khat Kae Lom Nai Eo were the least. Moreover, the study found that the rectus femoris muscle was the most active muscle in all postures. In conclusion, this research can help to select the most appropriate Ruesi Dat Ton posture to maximize the benefits for practitioners and to ensure safety while performing the postures.
Massage with Herbal Oils as a Novel Therapeutic Approach for Cerebral Palsy: A Medical Hypothesis
Authors: Hajihoseini Mohsen , Tahermohammadi Hanieh , Daneshfard Babak , Safari Mohammad Saleh , Rouzbahani Arian Karimi
Published: December 2023

Cerebral palsy (CP) is a condition resulting from injury to the developing brain. Treatment modalities vary based on symptomatology and may range from physiotherapy to pharmacologic intervention and surgical intervention. Despite the current therapeutic strategies, outcomes remain suboptimal. In light of limited data regarding the therapeutic effects of oil-based massages on neonates with CP, this study aimed to investigate the potential neurological benefits of incorporating herbal oils into massage treatments for these infants. In this investigation, we conducted a thorough exploration of the medicinal herbs described in the paralysis section of medical and pharmaceutical sources in Persian medicine. Subsequently, we conducted an extensive literature review on the neurological effects of oils or essential oils derived from these herbs. Our search was conducted up to 2023 using pertinent keywords such as Pimpinella anisum L., anise, aniseed, Foeniculum vulgare Miller, fennel, Carum carvi L., caraway, Piper nigrum L., pepper, Cinnamomum zeylanicum, cinnamon, Nigella sativa L., black seed, Vitis vinifera L., grape seed, Olea europaea L., olive, Rosa x damascena Herrm., and rose flower. We specifically focused on studies related to neuroprotection, neurology, massage, and cerebral palsy, and obtained relevant information from data sources such as PubMed, Scopus, and Google Scholar. Our investigation revealed that massage therapy has an impact on CP and that herbal oils possess neurological properties, such as anticonvulsant and neuroprotective effects, as well as enhancements in behavior, memory, learning, and cerebral function. Based on the advantageous mechanisms of action of herbal oils, we postulate that massage therapy utilizing herbal oils may offer a promising complementary approach in the management of newborns with CP. We recommend further experimental and clinical studies to establish their effectiveness.