ایران

Dear Editor, Fertility rate in Iran has declined, and population policies are aimed at increasing it. Drawing on data from the 2017 Marriage Survey conducted by Iran’s Civil Registration Organization, this study finds that 98% of young individuals planning to marry intend to have children, with only 2% expressing no desire for parenthood. Approximately 60% plan to have their first child within the first two years of marriage, and 78% aspire to have two children. Reluctance to have children is slightly higher in Tehran and Rasht (5%) and among those with higher education and socioeconomic status, though these differences are not statistically significant due to the low prevalence. The findings underscore the enduring cultural value of family and childbearing in Iran, indicating that the second demographic transition, unlike in Western countries, is accompanied by minimal inclination toward childless families. The decline in fertility rates in Iran is primarily linked to inadequate economic and social conditions rather than a cultural shift away from desiring children. Population policies should prioritize creating favorable conditions to enable young people to realize their childbearing aspirations. A proposed slogan for Iran’s population policy is encapsulated in three statements:Young people are the vanguard of demographic change; Young Iranians are eager to have children; Support young couples in the early years of marriage and with their first child...

Given the economic and social burden of oral diseases and the inadequate coverage of dental services in many countries, comparing oral health systems across different nations-particularly in member states of the Organization for Economic Co-operation and Development (OECD)-is essential for identifying and implementing effective policies and programs. This study aims to examine and compare oral health systems in 35 OECD member countries and Iran.

This comparative study analyzed key oral health indicators, including life expectancy, the DMFT index at age 12, the prevalence of untreated caries in permanent and primary teeth, per capita dental expenditures, the number of dentists per 10,000 people, and dental care financing methods. Data were collected and analyzed from reliable international sources and official reports from various countries for the period 2018 to 2024.

The DMFT index was highest in the United States (6.3) and lowest in Denmark (0.38), while this index was reported as 1.84 in Iran. The highest prevalence of untreated dental caries in permanent teeth was observed in Chile, and in primary teeth in Hungary; in Iran, these prevalences were reported as 33.6% and 46.7%, respectively. Per capita dental expenditure was highest in Switzerland and lowest in Turkey; it was estimated as 1.42 USD in Iran. The highest density of dentists per 10,000 population was observed in Sweden, whereas the lowest was reported in Turkey; this indicator was 4.27 per 10,000 population in Iran. In Iran, the financing of dental services is provided through public health insurance, private insurance, and supplementary insurance schemes.

Reforming the dental care financing system and expanding insurance coverage play a crucial role in reducing inequalities and improving access to dental services. Moreover, focusing on preventive measures, increasing public awareness, and enhancing oral health infrastructure can be effective strategies for reducing treatment costs and improving public health. In the future, implementing sustainable policies and making strategic investments in oral health-while leveraging successful global experiences-can contribute to enhanced quality of life and better overall health outcomes.

 Social health is one of the key dimensions of human health that plays an important role in the quality of social life. Empowerment, as one of the influential factors, can promote social health. This study aims to present an empowerment model to promote social health and its relationship with life expectancy of Afghan women living in Iran.

 This study uses a qualitative research method of grounded theory drawing on semi-structured in-depth interviews with 20 Afghan women living in Iran in 2016-2021, who were empowered and hopeful for life. The interviews were conducted using coding on the text. All ethical considerations were observed in this study and the authors do not report any conflicts of interest.

 The results revealed 100 general selected codes including causal conditions (healthy communication with society, ability to interact effectively with society, satisfaction with interpersonal relationships, playing a role in society), intervention conditions (lack of support from society, superstitions, secrecy, lack of problem-solving skills), central category (social health as a guarantee of life expectancy), strategies (self-confidence in Afghan women, strengthening adaptation strategies, rational beliefs, mutual understanding, independence in carrying out activities in society, hope) and outcome (life expectancy of Afghan women).

 The findings indicate that promoting the social health of Afghan women in their empowerment model in Iran is dependent on the realization of such factors and components as healthy communication with society, ability to interact effectively with other people and the social environment, satisfaction with interpersonal relationships, playing a role, and acceptance in society. Therefore, sociologists and social workers, experts in the field of women's studies, and social policy makers are advised to take steps towards building society and family by investing in the social health of citizens, especially women.

Considering the changes and challenges posed by the COVID-19 pandemic on communities and families, as well as the loss of family members, promoting spiritual well-being, reducing psychological stress, and achieving post-traumatic growth in older adults from bereaved families is of particular importance. This study aimed to examine the relationship between spiritual well-being and post-traumatic growth in older adults from families of COVID-19 victims in Tehran, Iran.
This descriptive-analytical study was conducted from April to December 2022 with a sample of 230 older adults in Tehran. Eligible participants were recruited using a cluster sampling method. Data were collected electronically using demographic questionnaires, the Paloutzian and Ellison Spiritual Well-Being Questionnaire (1982), and the Post-Traumatic Growth Inventory. Data were analyzed using descriptive statistics and Spearman’s rank correlation coefficient.
Spearman correlation results indicated a moderate positive and statistically significant relationship between total spiritual well-being and post-traumatic growth in older adults (r = 0.61, p < 0.001). Additionally, moderate positive correlations were observed between the religious dimension (r = 0.55, p < 0.001) and the existential dimension (r = 0.58, p < 0.001) of spiritual well-being and post-traumatic growth. Among these dimensions, existential or inner spiritual well-being showed a stronger relationship with post-traumatic growth compared to religious or environmental spiritual well-being. Therefore, higher levels of spiritual well-being in older adults were associated with greater post-traumatic growth.
The findings suggest that therapeutic and supportive programs, along with interventions aimed at enhancing spiritual well-being, can effectively promote post-traumatic growth in older adults facing crises such as the COVID-19 pandemic.

Leishmaniasis is considered one of the major health problems in Iran. Given that epidemiological analyses play an important role in disease control and preventive measures, this study was conducted with the aim of epidemiological analysis of cutaneous leishmaniasis in the North Khorasan Province of Iran.

This descriptive-analytical study was conducted on the data of patients with cutaneous leishmaniasis between years 2014 and 2022. The demographic and epidemiological data recorded in the disease surveillance system of the Health Deputy of North Khorasan Province were extracted and analyzed using SPSS software by the Chi-square test.

The number of patients with cutaneous leishmaniasis during these 8 years was 2243 cases. Considering the population of the region (863,000 people), the overall incidence of the disease during these few years was 32.5 per 100,000 people. Out of the patients, 62.2% were male; 51.1% were rural residents. Most cases were in the age groups of children under 10 years old. In terms of occupation, the highest frequency occurred among the two groups of students and children (P<0.05). The majority of wounds (76.6%) were exudative.

The prevalence of the disease in the North Khorasan Province lies in the middle of the frequency spectrum of endemic diseases of Iran, which is higher than the national average incidence. Considering the high incidence of the disease among the two groups of children and students, the need for necessary education in disease prevention and increasing the level of health literacy is suggested.

Tuberculosis continues to be a significant public health challenge, especially in resource-limited areas such as Iran. The incidence of tuberculosis in Iran, especially in high-risk provinces such as Khorasan Razavi, is higher than the national average, requiring urgent public health interventions. Therefore, this study aimed to investigate some factors affecting the outcomes of tuberculosis treatment in Khorasan Razavi during 2016-2022.

This retrospective cross-sectional study used comprehensive data from the National Tuberculosis Registration System during 2016-2022, and investigated factors affecting the recovery and treatment failure of patients with tuberculosis in this North-Eastern province. Statistical analyses, including chi-square and logistic regression, were used to assess the relationships between demographic variables and treatment success rates.

Among 2186 patients, the treatment failure rate was 2.1%, with no statistically significant associations observed for gender, marital status, nationality, and education level. Logistic regression also revealed no significant predictors of treatment outcomes. However, treatment failure was highest among single individuals (2.8%) and those with higher education levels (3.0%).

This study highlights the need for targeted interventions to address social determinants, including specific support provision for vulnerable groups. Disruptions caused by the COVID-19 pandemic are likely to have contributed to reduced TB case detection and treatment adherence. Strengthening TB prevention and control programs are essential to achieve global goals for eradication of the disease.

The unnecessary use of Computed Tomography (CT) scans in children and adolescents can be associated with significant complications and a financial burden. This study aimed to evaluate the findings, indications, and economic burden of brain CT scans performed in children and adolescents referred to Amirkola Children's Hospital during 2021-2023.

This descriptive-analytical (cross-sectional) study was conducted on patients aged 1 month to 18 years who were referred to Amirkola Children's Hospital, Babol, Iran, who underwent brain CT scans with various complaints, including seizures and headaches, during 2021-2023. Demographic information, imaging indications, and findings (normal/abnormal), and costs were assessed.

Among the 1114 children aged 1 month to 18 years, 663 (59.5%) were boys, and 257 (23.1%) were under 1 year of age. 578 children (51.9%) had normal CT scan results, and 536 (48.1%) had abnormal results. Abnormal results were significantly more common in children under 1 year of age than in older children (p<0.001). The most common indications for brain CT scan included seizures (with or without fever) in 349 cases (53.8%) and brain symptoms due to systemic diseases in 101 cases (15.6%). The results of the study showed that the cost of brain CT scans increased remarkably throughout the study years, and the total financial burden in children and adolescents with normal and abnormal CT scan findings was estimated to be 1,233,976,429 and 1,253,638,823 rials, respectively.

Given that more than 50% of CT scan findings in this study were normal, this could lead to unnecessary financial expenditures.

The "Drug Subsidy" plan, implemented by the Ministry of Health and Medical Education on July 23, 2022, represents a major reform in pharmaceutical policy in Iran. Given the significance of this national initiative for organizing and improving the country’s pharmaceutical system, understanding the emerging implementation issues and challenges is crucial for achieving its intended goals. Therefore, this study aimed to identify the challenges in implementing this plan at Tehran University of Medical Sciences from the stakeholders’ perspective and to offer solutions.

This qualitative study was conducted in 2023. Semi-structured interviews were conducted with 23 managers, key informants from Food and Drug and Treatment deputies, health insurance experts, doctors, pharmacists, and technical managers of pharmacies at Tehran University of Medical Sciences, selected through purposive and snowball sampling. Data analysis was performed using thematic analysis assisted with MAXQDA software (version 2020).

The challenges and solutions were categorized into three main areas: Financing (e.g., the limited allocation to the subsidy plan in the national budget bill), implementation (e.g., delays in the clearance of pharmaceutical raw materials due to increased value-added tax), and monitoring and supervision (e.g., the costs associated with monitoring and evaluation).

Although the Drug Subsidy plan marks a pivotal step in reforming currency policies, attaining its objectives requires overcoming existing hurdles. Based on the conducted assessment, securing sustainable and earmarked financial resources, streamlining executive and customs procedures, and strengthening infrastructure and supervisory mechanisms appear essential for the program's improvement and ultimate success.

Regarding the prevalence of inactivity among women, mainly working women (affected by a vast network of psychosocial causes) and its individual, family, and social risks and complications, the present study was conducted to determine the factors related to physical activity in working women in Isfahan University of Medical Sciences, Isfahan, Iran, using the Health Action Process Approach (HAPA).
This cross-sectional, descriptive-analytical study was conducted on 350 women working in the university. The quota sampling method was used in this research. The data were measured with a questionnaire containing demographic information and structures of the motivational and volitional stages of the HAPA model and the International Physical Activity Questionnaire (shortened version), and analyzed using Pearson/Spearman correlation coefficients and one-way analysis of variance (ANOVA) in SPSS software.
About half of women participating in the study were in the sedentary group. There was a statistically significant correlation between all HAPA model constructs and women's physical activity; the highest correlation was with the action planning construct. Three constructs of action planning (β = 1.379, P < 0.001), risk perception (β = 0.472, P < 0.001), and action self-efficacy (β = 0.544, P < 0.001) were predictors of physical activity behavior. The expectation of the outcome of married women was more than that of single women, and perception of risk and expectation of the outcome of faculty women was more than that of female employees.
To improve the physical activity of working women, it is recommended that the HAPA model be used and more emphasis be placed on the structures of action planning, risk perception, and action self-efficacy in interventions.

Viral hepatitis remains a major global cause of morbidity and mortality. This study aimed to investigate various epidemiological aspects of hepatitis B virus (HBV) and hepatitis C virus (HCV) in Babol County, northern Iran, including incidence trends, demographic characteristics, risk factors, and disease outcomes from 2016 to 2021.
In this cross-sectional study, all registered cases of HBV and HCV in Babol County during 2016-2021 were included. Data were extracted on demographic variables, reasons for referral, clinical features, and disease outcomes. Incidence rates and their annual trends were also calculated. Data were analyzed using SPSS software, with a significance level set at P < 0.05.
A total of 184 patients were identified, comprising 159 (86.4%) with HBV and 25 (13.6%) with HCV. The mean age was 43.03 ± 13.27 years (range: 19-79). The overall incidence rate of viral hepatitis was 8.83 per 100000 population in 2016, decreasing to 4.88 per 100000 in the final year of the study; however, the trend was not statistically significant (P = 0.394). Most patients were men (n = 121, 65.8%), urban residents (n = 118, 64.1%), and married (n = 168, 91.3%). The majority (n = 165, 89.7%) had not received HBV vaccination. A total of 115 individuals (62.5%) were tested due to at least one risk factor, most commonly a history of blood transfusion and contaminated blood products or unknown sources. Regarding outcomes, 130 patients (70.6%) were identified as carriers and 113 (61.5%) had chronic hepatitis.
The findings can support health system managers in developing appropriate interventions to improve the current situation. Moreover, these results may inform the design of educational programs to enhance awareness among at-risk groups regarding the importance of vaccination and screening.

Exclusive breastfeeding is known as the basis of child survival and affects all aspects of women's lives. There is little scientific evidence about the relationship between the quality of life (QOL) of the mother and the type of infant nutrition. This study aimed to determine the relationship between QOL and exclusive breastfeeding among the mothers with infants living in Mashhad City, Iran.
This cross-sectional study was conducted on 247 women, between April and June 2023, in Mashhad City. Sampling was done by stratified method, so that each of the five health centers of Mashhad City were considered as a stratum. The research tool included two sections, demographic characteristics and World Health Organization Quality of Life Scale (WHOQOL-BREF). Using SPSS software, the data were analyzed firstly as descriptive statistics and then based on normality, chi-square, Mann-Whitney, and Kruskal-Wallis tests at a significance level of 0.05.
The current study revealed a significant relationship between the average score of the physical dimension and the social relationship dimension of the QOL between the two groups (P < 0.05). In addition, a significant correlation was observed between the physical dimension of QOL with body mass index (BMI), mother's education, and father's occupation and education (P < 0.05).
Based on the results, the physical health and social relationship dimensions of QOL significantly affect exclusive breastfeeding. It can be inferred that with increasing maternal physical health and social support, exclusive breastfeeding increases. Future health interventions, therefore, should be planned to improve these dimensions of QOL by attracting family support.

Family health is a critical factor in creating a healthy society, playing a significant role in the life of every individual. Consequently, fostering healthy families is considered a fundamental priority in any culture or community. This study aims to examine the components of family health in Nahj al-Balaghah within the context of advancing the second phase of the Islamic Revolution in the Islamic Republic of Iran.

This applied research was conducted in two stages to achieve its objectives. •Stage One: A qualitative descriptive-analytical approach was employed. The three-pronged method (triangulation) was used to extract and compile data, which involved studying the foundational principles derived from Nahj al-Balaghah, as well as drawing upon relevant research and theoretical frameworks. •Stage Two: Content analysis was utilized to assess the frequency and significance coefficients of family health components in Nahj al-Balaghah. The content was analyzed based on the source text (Nahj al-Balaghah ) and seven primary components related to family health.

An examination of family health components from the perspective of Nahj al-Balaghah revealed the following frequencies: affection and compassion (9), parenthood (3), consultation (6), male guardianship (3), reconciliation and kindness (3), family economy (16), stress management (7), life skills education (46), commitment and appreciation (21), marriage (6), purity (9), appropriate attire (3), the prohibition of adultery (2), child-rearing (4), happiness and interaction (10), participation and cooperation (15), moderation in family dealings (1), importance of family authenticity (5), family religiosity (5), respecting family boundaries (9), respecting family members’ rights (3), and maintaining family limits (9).

The highest significance coefficient was attributed to “life skills education” with a frequency of 46, while the lowest significance coefficient was for “moderation in family dealings,” with a frequency of 1.

Variation in host genetic factors may play a role in immune response and severity of influenza. This study investigated the association of host genetic factors with the severity of influenza A H1N1 in an Iranian population.

Nasopharyngeal swab samples from 97 patients were evaluated by PCR(+) test. Single nucleotide polymorphisms in the studied genes were studied with iPLEX platform. The association of host genetic variants with influenza severity was assessed by logistic regression analysis.

Participants with severe influenza had a higher mean age than those with mild influenza, but this was not significant (P=0.3764). In mild influenza group, mean BMI levels were slightly higher (mean difference=3.8 kg/m2), although it was not significant (Pt-test=0.1098). Logistic regression analysis showed that the presence of G/A genotype at rs1800629, rs1800871, rs1801274, rs361525 and rs8070740 increased the risk of severe H1N1 influenza infection compared to G/G genotype. This association was significant only for rs1800629 (P=0.097) and rs1801274 (P=0.062) (at 0.1 level). This association was similar for A/A genotypes with a lower magnitude. The effect of other genotypes on severity of H1N1 influenza infection was not statistically significant.

In a sample of Iranian adult population, an association was observed between different SNPs and susceptibility to severe A/H1N1 influenza infection. The rs8070740 allele affected both susceptibility and severity of A/H1N1 infection in the Iranian population. Influenza pathogenicity is influenced by a multigene set of host and pathogen.

Hydatid cyst disease is one of the most important parasitic infections between humans and animals. The prevention and control of this disease in Iran face several challenges, including the ineffectiveness of the national prevention and control program, limitations in diagnosis and treatment, challenges in animal vaccine production, mismanagement of stray dog population control, suboptimal performance of traditional slaughterhouses in the hygienic disposal of infected organs, and the need to improve the quality and coverage of educational programs. The researchers at the Toxoplasmosis Research Center affiliated with Mazandaran University of Medical Sciences have presented a brief policy brief, based on scientific evidence and operational experiences, divided into two sections: healthcare and veterinary medicine, and recommend developing a comprehensive and integrated program for the management and control of hydatid cyst using a scheduled approach The necessary measures in the health sector of the country include four main components: national planning, implementation strategies and social policies, research and development initiatives, and healthcare delivery. In veterinary medicine, training livestock owners, livestock vaccination, repeated administration of praziquantel, prevention of informal or non-industrial slaughter, monitoring hygienic disposal of infected offal, restriction of dogs’ access to slaughterhouse offal, stray dog population control, periodic monitoring of host contamination, and fostering interdisciplinary collaboration between human and veterinary medicine are very important. This approach, tailored to local conditions and aimed at reducing the burden of hydatid cyst disease, can significantly contribute to public health improvement and health system sustainability in Iran.

The communicable disease surveillance system has evolved over several decades; the basic infrastructure of the surveillance system, including the health network, headquarters structures, reporting systems, and national guidelines, has been established over recent decades, however, evidence suggests that sensitivity, completeness, and timeliness remain suboptimal across several domains. The COVID-19 pandemic further exposed these weaknesses and underscored the need to update surveillance protocols, enhance digitalization, and strengthen syndromic surveillance. The aim of this paper is to review existing evidence and propose policy recommendations to reinforce the national communicable disease surveillance system. This policy brief synthesizes Iranian research evidence, including field assessments; the experiences of managers and experts in district and provincial health centers in Qom; findings from quantitative and qualitative studies conducted in Iran over the past decade; a review of novel outbreak-detection methods; and an assessment of relevant Ministry of Health documents. Key findings were extracted, synthesized, and structured to inform policy options. Across the evidence base, underreporting, reporting delays, limited private-sector engagement, and fragmentation of data between treatment and public-health sectors were consistently observed. National syndromic surveillance guidelines specify a list of 15 priority syndromes and standard precautionary requirements (standard, contact, droplet, and airborne), which provide a framework to support earlier outbreak detection. Nevertheless, existing systems require functional revision and comprehensive digital transformation. The COVID-19 experience highlighted the critical importance of strengthening early-warning systems, expanding genomic surveillance, and localizing respiratory disease surveillance platforms. Improving the communicable disease surveillance system will require a coordinated package of interventions, including guideline revision, integration of electronic systems, training and incentivizing providers, ensuring data confidentiality, and developing automated outbreak-detection algorithms. A phased implementation of these measures is expected to substantially enhance system sensitivity and response speed. Rapid and systematic implementation of this package can significantly improve the timeliness and effectiveness of national disease surveillance.

The experience of vaginal childbirth is a multidimensional concept influenced by both physical and psychological factors during labor and childbirth. It is very necessary to identify the factors affecting women’s experiences of vaginal childbirth in Iran, considering the aim of increasing vaginal childbirth and reducing cesarean sections. The purpose of this study is to explain the factors affecting the vaginal childbirth experience.

This study was conducted based on the PRISMA statement and employed the Noblit and Haar method in six stages. All the qualitative studies conducted on the factors affecting the vaginal childbirth experience in Iran were searched in Persian databases (SID, Google Scholar, Civilica, Irandoc, and Magiran) without year restrictions, using the keywords "birth experience", "vaginal childbirth", and "qualitative study". Additionally, English electronic databases (Web of Science, Science Direct, Scopus, PubMed, Cochrane Library, ProQuest) were searched. The quality of the selected articles was independently assessed by two authors using the COREQ checklist.

In this study, 331 articles were identified; 85 duplicate articles were removed, and 246 articles were screened based on their titles and abstracts. A total of 167 articles were excluded, and the full texts of 79 articles were assessed for analysis. Of these, 63 articles were excluded, and ultimately, 16 articles were included in the study. Based on the results, the factors influencing the experience of vaginal childbirth were categorized into three main themes: empowerment for coping or individual capacity (individual preparedness, acceptance of natural childbirth), paradoxes (advantages and disadvantages of natural childbirth and environmental paradoxes), and standard care (safety, team participation, and support).

Women’s vaginal childbirth experiences can be improved by enhancing individual capacity, enabling participation, and maintaining safety throughout the stages of childbirth with the support of healthcare providers.

In recent decades, the role of research laboratories in knowledge generation, support for clinical and basic research, and the enhancement of healthcare quality has become increasingly prominent. Given the importance of laboratory performance indicators in determining research quality, the present study aimed to analyze the status of research laboratories in Iranian universities of medical sciences based on the 2024 national evaluation program. This descriptive–analytic, cross-sectional study applied a mixed-methods (quantitative–qualitative) approach, with an emphasis on qualitative data analysis. The sample included 68 medical schools and universities of medical sciences across the country, categorized into four classes according to the Ministry of Health’s classification system (Type I, II, III, and non-affiliated universities). Six core domains were evaluated to identify strengths and weaknesses: existence of an active website, income-to-cost ratio, external financial support attainment, human resource capacity building, membership in the national strategic laboratory network, and utilization by faculty members. The findings indicate that although research activities in Iran have grown substantially, the performance of research laboratories has not yet been comprehensively assessed based on practical and measurable performance indicators. Results from the 2024 evaluation show that despite the availability of physical and system infrastructures, challenges persist in performance quality, financial management, and workforce development. Significant financial disparities among universities and heavy reliance on government funding emerged as key barriers to laboratory efficiency. Adopting diversified financial models, strengthening university–industry collaboration, and implementing targeted support policies could substantially improve the quality and financial sustainability of the national research laboratory network.

Prostate cancer is one of the most common cancers among Iranian men and has shown a marked increase in both incidence and mortality over recent decades. This study aimed to analyze temporal trends in prostate cancer incidence and mortality in Iran using an Age–Period–Cohort (APC) analytical framework.
Data were extracted from the Global Burden of Disease Study 2021 for Iranian males aged 45 years and older during 1992–2021. Data were stratified into eight 5-year age groups and six 5-year time periods. APC analysis was conducted using the second-order difference method, and Joinpoint regression was employed to assess temporal trends in risk factors.
In 2021, the age-standardized incidence rate reached 30.05 per 100,000 population, and the mortality rate reached 10.66 per 100,000 representing increases of 105.96% and 14.99%, respectively, compared to 1992. Age effects were positively associated with both incidence and mortality. The period effect peaked during 2002–2006. Cohort analysis revealed that younger birth cohorts exhibited a slower acceleration in incidence rates. Among risk factors, the disease burden attributable to smoking increased by 17.1%, while the protective effects of low calcium intake and low milk consumption diminished over time.
Rising incidence and mortality are shaped by age, period, and cohort effects. The relative decline in younger cohorts underscores the need for targeted prostate cancer screening programs. Strengthening public health education policies and improving access to diagnostic services can reduce the disease burden.

Health Information Networks (HINs) and data-related technologies play a vital role in modern healthcare systems. However, the level of development and maturity of these technologies varies across countries. Iran has made efforts in this area but still faces significant challenges. This article aimed to compare Iran’s health information system with three countries of varying income levels. 

This is a comparative review study. Relevant information was collected and analyzed through a systematic review of selected scientific articles and official documents related to HINs and data technologies in Ethiopia (low income), China (middle income), and the United Kingdom (high income).

The results highlight significant differences in policy-making, infrastructure, adopted technologies, and systemic challenges across the four countries. Iran is developing national infrastructures such as the SEPAS Electronic Health Record system but struggles with issues like incomplete integration and low data quality. Ethiopia faces severe resource limitations, China has made major investments but encounters standardization challenges, and the UK, despite its long-standing experience, still deals with integrating its national systems.

The comparative analysis shows that national income level, policy strategies, and the extent of technological emphasis (such as EHR implementation) influence the development of health information systems. Lessons learned for Iran include the importance of a comprehensive national strategy, investments in infrastructure and human resources, adopting user-centered approaches, and establishing continuous performance evaluation mechanisms.

 Health tourism has emerged as an important strategy for economic diversification and attracting foreign investment, drawing global attention. Although regions such as Azerbaijan in Iran, particularly Maragheh, hold considerable untapped potential, systematic efforts to utilize these capacities remain limited. This study aimed to identify main potentials and barriers for developing health tourism in Maragheh.
 This qualitative study was conducted in 2024 using semi-structured, in-depth interviews. Experts and key stakeholders in health tourism and related organizations in Maragheh County were recruited through purposive and snowball sampling until theoretical saturation. Data collection and analysis were occurred simultaneously. Thematic content analysis was applied, including transcription, initial coding, and theme development through rigorous review and consensus.
 The development of health tourism in Maragheh is influenced by three main domains. The county has significant potential, such as therapeutic natural resources (mineral springs), a favorable geographical location, and specialized health services. However, major obstacles, such as inadequate infrastructure for accommodation and treatment, weak marketing, lack of intersectoral collaboration, and a limited tourist-friendly culture, restrict capacity utilization. Furthermore, hospital-specific operational barriers exist, such as staff shortages, weak communication skills, financial constraints, and lack of integrated planning, clearly reflected in long waiting times due to high non-local patient admissions.
 Despite its potential, Maragheh faces challenges in developing health tourism. Improving tourism and health infrastructure, clarifying treatment costs, fostering intersectoral collaboration, expanding marketing, attracting investors, reducing bureaucratic barriers, and enhancing security are essentials for the growth of this industry.

Suicide is a significant public health issue influenced by various psychological, social, cultural, and biological factors. Religion is recognized as a key factor in individuals’ mental and social well-being. This study was conducted to examine the relationship between religion and the risk of suicide in Iran.
This systematic review included articles published from 2000 to 2025. Relevant studies were identified through comprehensive searches in national and international databases, including SID, Magiran, Irandoc, PubMed, Web of Science, and Scopus. Keywords such as “suicide”, “suicidal ideation”, “suicide attempt”, “religion”, “religiosity”, and “Iran” were used. Inclusion criteria were studies with appropriate methodology focusing on the association between religion and suicide within the Iranian context.
Out of a total of 251 identified records, 15 articles were reviewed, most of which focused on the impact of religiosity and religious beliefs on suicide. The majority of studies suggest that religious beliefs and convictions play a significant protective role in reducing suicidal thoughts and behaviors. However, under certain stressful conditions or within the context of religious conflicts, this protective effect may be diminished or even reversed.
Religion may serve as a protective factor against suicide. The findings highlight the importance of incorporating religious and spiritual aspects in suicide prevention strategies and mental health interventions in Iran. Further research is recommended to examine these associations across different social and cultural groups.

 Bolton ratios—the anterior and overall ratios—are important indicators for assessing the dental proportionality between the maxilla and mandible, playing a crucial role in achieving ideal occlusion and successful orthodontic outcomes. Given individual variations in facial growth patterns and their potential influence on these ratios, the present study aimed to evaluate the relationship between Bolton ratios and vertical skeletal patterns in the population from northern Iran, as well as to investigate the effect of gender on these ratios.

 In this observational-analytical study, 173 Class I orthodontic patients (121 females and 52 males) with a mean age of 16.02 ± 4.51 years were evaluated. Based on the vertical facial pattern using the Jarabak index, the subjects were categorized into three groups: short face (n=52), normal face (n=67), and long face (n=54). The anterior and overall Bolton ratios, and overbite were measured from dental casts. Data were analyzed using Chi-square, ANOVA, t-test, and Pearson’s correlation coefficient in SPSS ver. 26, with a significance level set at 0.05.

 No statistically significant differences were found in the anterior and overall Bolton ratios among the three vertical facial groups (P=0.062 and P=0.36, respectively) or between genders (P=0.53 and P=0.42, respectively). In contrast, the mean overbite significantly differed among the groups (P<0.001). Comparison of the anterior (79.16 ± 3.88%) and overall (90.09 ± 6.89%) Bolton ratios with the original Bolton standards revealed statistically significant differences (P=0.001 and P=0.02, respectively).

 According to the findings, neither the vertical skeletal pattern nor gender had a significant effect on Bolton ratios. Nevertheless, the observed differences between the ratios in this northern Iranian population and the original Bolton standards underscore the importance of using population-specific norms in orthodontic treatment planning.

Toxoplasmosis is one of the most common parasitic infections, which, when transmitted congenitally, can lead to severe complications in neonates. The present study aimed to investigate the presence of anti-Toxoplasma gondii antibodies in the blood samples of newborns in Bushehr, Iran.

This descriptive–analytical cross-sectional study was conducted on 181 newborns delivered in Bushehr hospitals between 2022 and 2023. Blood samples were collected from each neonate, and the levels of anti-Toxoplasma IgG and IgM antibodies were determined using the enzyme-linked immunosorbent assay (ELISA) method. The obtained results, along with questionnaire data, were analyzed using the Chi-square statistical test in SPSS software.

Among the 181 neonates examined, 33 (18.2%) had a positive titer of anti-Toxoplasma IgG antibody, while 148 (81.8%) showed no detectable IgG antibodies in their serum. Of the IgG-positive samples, two neonates also showed the presence of specific anti-Toxoplasma IgM antibodies. The remaining 179 samples (98.9%) were negative for IgM antibodies.

The findings of this study emphasize the necessity of increasing maternal awareness and establishing toxoplasmosis screening programs during pregnancy. Although the prevalence of acute Toxoplasma infection among the examined neonates was low, early diagnosis and follow-up of infants with positive IgM results can greatly reduce potential long-term complications.

The emergency department is an essential part of the health care system in any country, providing 24-hour service to patients requiring urgent medical, surgical, or other care. The main aim of the present study was to determine the epidemiological characteristics of patients referred to the emergency department at the referral center in Arak city.

The present cross-sectional study was conducted on 226,127 patients referred to the emergency department during 2020-2023. The information in this study was based on the registration system of patients referred to the emergency department in Vali-asr Hospital in Arak. Data analysis was done by using descriptive statistics and t-test and Chi-square statistical tests. The significance level of the tests was considered P < 0.05.

The mean (standard deviation) age of patients was 36.3 (20.5) years with an age range of (1-103). 147,088 patients were male (65%). Death occurred in 2,633 (1.2%) patients. More than 50% of patients were referred between 8:00 AM and 4:00 PM. Hospital admission was required for 32.1% of patients. 63% underwent surgical procedures. A statistically significant association was observed between gender, age, year of visit, season, time of visit and surgical procedures with the type of admission and the condition of the patient at the time of discharge (P < 0.05).

Understanding the epidemiology and the demographic and clinical characteristics of patients can facilitate timely planning for staff deployment and resource allocation. This can help prevent overcrowding, improve patient outcomes, and increase patient satisfaction through effective management.