مجله دانشگاه علوم پزشکی قم
سال چهاردهم شماره 7 (پیاپی 102، مهر 1399)

Obesity and vitamin D deficiency have been recognized as important risk factors for chronic kidney disease. The use of safe and low-risk non-pharmacological interventions is recommended to reduce and or prevent chronic diseases. The current study aimed to assess the effect of Pilates training and vitamin D on renal function parameters in overweight men.

This quasi-experimental study was conducted on 50 overweight men within the age range of 45-55 years. The participants were selected using convenience sampling and assigned to the groups of Pilates training, Pilates training+ vitamin D supplementation, vitamin D supplementation, and control groups. The Pilates training and Pilates training+ vitamin D supplementation groups performed Pilates programs for 8 weeks (with the intensity of 50-75% of reserve heart rate, 3sessions/week). vitamin D and Pilates training+ vitamin D groups also received 50000 units of oral vitamin D weekly. Blood urea, uric acid, creatinine, and glomerular filtration rate (GFR) were measured before and after the interventions. The data were analyzed using the paired t-test, one way ANOVA, and Kruskal Wallis tests (p˂0.05).

As evidenced by the obtained results, 8 weeks of Pilates training, vitamin D intake, and the combined intervention were associated with a significant increase in GFR and a decrease in the urea, uric acid, and creatinine levels(P<0.05). Furthermore, the combined intervention brought more improvement to these variables, compared to the two other interventions (P˂0.05).

It seems that both vitamin D supplementation and Pilates training interventions may lead to an improvement in the renal function of overweight individuals with abnormal vitamin D status by increasing GFR and decreasing urea, uric acid, and creatinine levels. Nonetheless, the combined intervention is associated with stronger effects.

The presence of bifid mandibular canals are among the anatomical variations in the inferior mandibular canals. Lack of attention to these canals can lead to complications, such as anesthesia and bleeding during dental treatments. This study aimed to investigate the prevalence of bifid canals and its relationship with the position and width of the main canal in the population-based panoramic radiographs in Qom, Iran.

This analytical-descriptive, cross-sectional, and retrospective study investigated 2415 panoramic radiographs of 1320 females and 1095 males (age range: 18-86 years) who refereed to Dentistry School and Salamat Clinic in Qom, Iran, during 2019. The radiographs were evaluated regarding the presence of bifid mandibular canals on the right and left as well as canal width and distance using Scanora software. The data were analyzed in SPSS software through descriptive statistics (i.e., frequency, mean±SD) and analytical statistics (i.e., Chi-square, independent t-test, and Mann-Whitney test). A p-value less than 0.05 was considered statistically significant.

According to the results, the prevalence of the bifid mandibular canal was observed in 64 (2.6%) cases. Moreover, three (0.1%) individuals had bilateral bifid mandibular canals; therefore, the total number of the bifid mandibular canals was estimated at 67 cases. Furthermore, type 2 bifid mandibular canals were the most common type. In addition, the presence of bifid mandibular canals had no significant relationship with age, gender, width, and distance to the inferior border of the mandible.

The presence of bifid mandibular canal in panoramic images had no significant relationship with age, gender, width, and distance to the inferior border.

Strategic purchasing of health care services is one of the major issues contributing to the enhancement of the performance and reform of healthcare systems across the globe. Traditional (passive) purchasing suffers from serious weaknesses, such as low efficiency in the health care system, lack of targeted resources, Resource inefficiency, and unfair access to services. To solve these problems, the World Health Organization has introduced strategic purchasing as the main activity to improve the performance of healthcare systems. In light of the aforementioned issues, the present study aimed to investigate the challenges and problems of strategic purchasing in the health sector.

For the purpose of the current qualitative study, the upstream laws and policies in the field of strategic shopping in Iran were initially investigated to gather the needed information. In the next step, 25 health policymakers were interviewed about the challenges of strategic purchasing and the implemented measures. The data were analyzed in MAXQDA software (version10) using content analysis 

Assessing the current situation, strategic purchasing was classified into 5 dimensions, 21 them, and 57 sub-thems. The most important issues among the findings included governance with the highest frequency of 62% and the health information system with a frequency of 47%. Analyzing the research findings, 52 challenges were identified and examined.

Despite all the benefits of strategic purchasing, its effectiveness depends on the successful implementation and effective cooperation of all stakeholders. In addition, strategic purchasing might need to be tailored to the circumstances of each country and the needs of that community. Therefore, the establishment of the needed infrastructure and tackling the presented challenges are indispensable for the optimal implementation of strategic purchasing in our country.

Today, hypertension is one of the most common cardiovascular disorders being prevalent in developing countries. This study was conducted to determine the role of interpersonal dependence and social support with the mediation of hope affecting the resilience of patients with high blood pressure.

The statistical population of the study included all patients with hypertension referring to medical centers in Tehran with the final sample group of 250 cases. Participation in this study was voluntary and the sampling process was performed by purposeful sampling method. The data collection tools were as follows: Connor-Davidson Resilience Scale, Perceived Social Support designed by Vaux, Adult State Hope Scale developed by Snyder, and Interpersonal Dependency Inventory designed by Hirschfield. Data analysis was carried out using the path analysis method.

Based on the results of the study, social support, interpersonal dependency, and hope had a positive correlation with the resilience of hypertensive patients. It was also revealed that resilience was effected indirectly by social support. The variables of interpersonal dependence and social support and the variables of resilience have significant direct effects. In addition, both interpersonal dependence and social support variables have an indirect effect on resilience, of which only the indirect effect of social support on resilience is significant. 

It was revealed that hope can play the role of mediator between social support and resilience in patients with hypertension. Furthermore, this variable is effective in increasing resilience in such patients.

Health plays a key role in today's society and is considered the core of human development. It goes without saying that health is a matter of concern to all of us, and achieving and maintaining health requires the cooperation of all organs, including the mass media. With this background in mind, the current study aimed to assess the attitude of families residing in Qom towards health-oriented TV/radio programs and how it affects their health practice.

This cross-sectional descriptive study was conducted on families residing in Qom in 2018. Using multi-stage sampling and sample size formula, 310 families were randomly selected. Data collection tools included a researcher-made questionnaire on the use of health-oriented TV/radio programs, attitudes towards health-oriented TV/radio programs, and health practice. Data were analyzed in SPSS software (version 20) using independent t-test, Pearson correlation coefficient, Chi-square, ANOVA, as well as Tukey and Fisher's Least Significant Difference (LSD) post hoc tests.

Based on the results of the present study, 134 (43.2%) cases never used health-oriented TV/radio programs, and 90 (29%) subjects used them for less than one hour throughout the day and night. Furthermore, a significant relationship was observed between the use of health-oriented TV/radio programs with attitudes (P=0.023) and health practice (P<0.001). The study findings also pointed to a positive and significant correlation between attitudes toward the use of health-oriented TV/radio programs and their health practice (P <0.001, r=0.298).

As evidenced by the obtained results, there is a significant relationship between the use of health-oriented TV/radio programs with attitudes and health practice. It is recommended that national media officials and television programmers, based on needs analysis, produce programs with up-to-date methods in an effort to promote the use of health-oriented TV/radio programs.

Preventive behaviors are indispensable to the reduction of the prevalence and severity of the complications of Covid-19 disease. Knowledge, attitudes, and perceptions of the individual are the explanatory variables contributing to the adoption of these health behaviors. The present study aimed to assess the knowledge, perception, attitude, and some factors associated with the preventive behaviors of Covid-19 in Qom.

This descriptive cross-sectional study was conducted on 2423 cases who were selected by cluster sampling method in Qom in 2020. Data were collected using an online researcher-made questionnaire. This 44-item questionnaire encompassed the domains of COVID-19 related knowledge (20 items), COVID-19 perceived threat (5 items), attitude (6 items), and preventive measures (13 items).

The mean scores of knowledge, attitude, perceived threat, and preventive behaviors were obtained at 94.5%, 93.05%, 76.92%, and 88.42%, respectively. Preventive behaviors were significantly correlated with knowledge and attitude, and attitude was the strongest predictor of behavior (B= 0.362; P<0.001).

The obtained results pointed to the high level of COVID-19-related knowledge, perception, and preventive behaviors among the residents of Qom.

In Iran, cardiovascular disease is the leading cause of mortality. The economic burden of these diseases imposed on families makes the situation even worse. Health system policymakers need to be aware of the costs of these diseases to make wise decisions regarding the allocation of resources. The present study aimed to estimate the economic burden of cardiovascular disease in selected hospitals in Yazd.

This cross-sectional study was conducted based on a descriptive-analytical design. The economic burden of cardiovascular disease was estimated using the cost-of-illness method and based on the human capital method. Based on the content and purpose of the current study, the prevalence-based approach was used. A researcher-made questionnaire was used for data collection. The statistical population included patients with cardiovascular disease who referred to the hospitals under study in Yazd. They were selected by random sampling (n=200). The data were analyzed in SPSS and EXCEL software.

41.5% of patients were male and 58.5% were female. The total direct medical cost was 2,6184,130 Rials and the total non-medical direct medical cost was 11,521,250 Rials for each patient. The economic burden of cardiovascular disease was 16,721,997,317,485 Rials  at a discount rate of 3% ,and a discount rate of 5%, it was reported as 11,819,209,806,581 Rials.

Cardiovascular diseases impose a huge cost on society. The best way to manage these diseases and reduce costs is to change and modify risky behaviors that make the patient invulnerable.

One of the most important ways that coronavirus disease 2019 (COVID-19) is transmitted is through respiratory droplets and contact of person to person. Angiotensin-converting enzyme 2 is one of the receptors of this virus, which is abundant in the oral cavity, especially on the epithelial cells of the tongue. By joining to its receptor in the mouth, the virus can infect an individual and transmit the disease to other individuals. Mouthwashes are among the techniques used for the improvement of oral hygiene and reduction of gingivitis and periodontitis. Moreover, some of them have antiviral and antibacterial properties. The purpose of this study was to review the articles related to effective mouthwashes against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (as the causative agent of COVID-19) and its family viruses.

This study was a quick review based on the PRISMA guidelines. The databases, such as PubMed, Scopus, Web of Science, and Google Scholar, were searched using relevant keywords. There were no search restrictions on the date, publication type, and language. Totally, 47 articles were identified in this regard, and finally considering the inclusion criteria 9 articles were extracted and examined based on the study objectives.

Out of nine articles, six and two studies were performed in vitro and in vivo, respectively. The results of in vitro studies showed a positive effect of betadine mouthwash in reducing the load of coronaviruses; however, chlorhexidine had no significant effect in this regard. In two in vivo articles, researchers evaluated the effects of these two mouthwashes on SARS-CoV-2. Based on their findings, both mouthwashes had positive effects on decreasing the load of this virus.

The use of betadine and chlorhexidine mouthwashes results in reducing the load of SARS-CoV-2. In addition, the two mouthwashes can play a role in the prevention of this disease by the inhibition of its transmission through saliva and oral cavity.