Journal of Medical Council of Iran
Year:2020 | Volume:38 | Issue:1|Papers Count:7

The discipline of sleep medicine was first established in Iran more than 10 years ago. From 2011 universities in Iran began to offer fellowship and technician training programs in sleep medicine. It is estimated that within the next 10 years, the number of experts in this field will reach up to 100. Unfortunately, prevention and treatment of sleep disorders is not fully covered by insurance companies; however, this policy is changing towards increasing the insurance coverage. Despite the rise in the number of patients with sleep disorders, patient referral has not increased due to lack of physicians’ knowledge of this condition. However, because of increasing awareness in this field, physicians’ awareness of sleep disorder is gradually rising. At present due to absence of a suitable structured guideline for treatment and prevention of this disorder as well as lack of sufficient insurance coverage in Iran, proper treatment is not provided and most cases are treated by non-standard methods. As there are not many reputable companies offering medical equipment for sleep disorder in Iran, equipping a sleep laboratory with the essential tools is very expensive and costly.

Background: The prevalence of COVID-19 disease has led to an international health emergency and hazard The disease has not been previously diagnosed in humans. Therefore, governments have made serious decisions to control and manage this crisis so that less harm is done to any society Methods: This research is a review article based on library studies and internet searches in valid databases of Scopus, Web of Science, PubMed, Science Direct and Google Scholar. The number of 227 articles on how to manage the new coronavirus disease crisis in Iran and the world has been studied so far, which was finally 118 used. The articles on the World Health Organization and CDC website were also reviewed. Results: Iran and other countries around the world have designed policies based on countering COVID-19 before and after its entry. Managing this crisis requires professional efforts and inter-sectoral cooperation and government agencies. Conclusion: The pandemic of COVID-19 disease is worrying. It is important to formulate appropriate policies and implement them properly. Iran and other countries in the world are working in this direction. Now more than ever, more coherent and practical measures are needed to control the spread of the disease.

Background: Mental disorders, as the most important global health challenge these days, have created many concerns for health systems, health professionals and policy makers and are a major contributor to the growth of health complications and disabilities worldwide. The present study was designed and conducted to describe the status of the illness burden of mental disorders in the Middle Eastern countries during the period 2000 to 2017. Methods: This descriptive cross-sectional study was conducted based on the latest published and available data (up to 2017) by Global Burden Disease (GBD) database for mental disorders in 2018. The population of the study was Middle Eastern countries. In the present study, mental disorders including: schizophrenia, depression, bipolar disorder, anxiety disorder, eating disorder, autism, ADHD, behavioral disorder and mental disability disorder were evaluated. Disability-Adjusted Life Years Index (DALY) was used as a measure of total disease burden. The information contained in the GBD database is based on data obtained by the countries concerned and due to economic constraints and health development, some countries have performed poorly in research evidence-based data recording. Results: Mental disorders accounted for 4. 9% from DALY recorded for burden of diseases in the world, ranking sixth in the world; for the Middle East region, 6. 2% (rank seventh). Depression disorder (35%) and anxiety disorder (25%) had the highest burden disease of mental disorders. According to data from the GBD database, mental disorders in Iran, Bahrain and Qatar have the highest rank and in Egypt, Iraq and Yemen had the least burden of disease. Also, the burden disease of depression and anxiety disorder, was significantly higher among women than men in all countries. The age group of 15-49 years had the highest DALY level of mental disorders. Conclusion: The results of the present study show that mental disorders in the Middle East region have high burden disease compared to the global level. Also, in the Middle Eastern countries, women were more at risk of mental disorders than men because of cultural barriers and other restrictions. It is suggested that policymakers in the studied countries, including Iran, prioritize action on mental health in their policy priorities to control and reduce the prevalence of mental disorders.

Background: The fast outbreak of COVID-19 in early 2020 in the world, has put great physical and psychological pressure on medical staff of hospitals occupied in treating the COVID-19. It would cause the development of Post-Traumatic Stress Disorder (PTSD) among them. Thus, the current study aimed to determine the incidence of PTSD in hospital staff who were involved in treatment of COVID-19 patients. Methods: The research method was descriptive. 311 nurse and clinical assistants in Masih Daneshvari Hospital were included in the study. The demographic information questionnaire and Mississippi PTSD scale were applied for providing data. Descriptive and inferential statistical methods were used for data analyzing. Results: 69. 3% of the sample groups were nurse and 30. 7% of them were clinical assistant. 13. 3% of themselves or their immediate family members, had been infected by COVID-19. The mean score of PTSD in all participants was critical. There was a significant difference between various age groups in terms of depression, and also between people with various marital status in re-experience, alexithymia and PTSD scores (P<0. 05). Conclusion: The existence of PTSD among medical staff should be a major concern for Ministry of Health in order to protect the mental health of population. If not so, the pandemic of COVID-19 would result in serious psychological problems, especially in the frontline healthcare staff.

Background: Coronary Artery Disease (CAD) refers to the reduction or blockage of all or part of the coronary arteries due to the process of atherosclerosis or the presence of a clot. The aim of this study was to investigate the association of serum miR-197 as a diagnostic index in patients with coronary artery disease. Methods: In this study, 100 patients with CAD were selected. Extraction of microRNAs from peripheral blood plasma was performed using an exclusive microRNA extraction kit. Then the cDNA synthesis and the expression level of miR-197 were performed using the Real Time RT-PCR technique and the SYBER Green method, using U6 snRNA as an internal control. T-test was used to analyze microRNA expression and significance and to determine the relationship between microRNA expression levels, Pearson correlation coefficient test was used. Results: The results showed a positive correlation between miR-197 expression and CAD. The average expression of 0. 78 in the control sample was increased to 2. 76 according to severity of involvement in the patient. That is, the relative expression of miR-197 in the patients + group was significantly increased compared to control (P <0. 004). Conclusion: It appears that miR-197 can be considered as an indicator of coronary endothelial cell function. It is possible to use it as a bio marker for prognosis, and control of treatment for CAD.

Background: After natural disasters the likelihood of outbreak of infectious diseases especially water and foodborne diseases, increases due to population displacement, increasing risk factors, environmental changes, changing living conditions and increasing vulnerability to pathogens. This research was conducted with the aim of designing a model for controlling the outbreak of water and foodborne diseases after natural disasters in Iran. Methods: This study is an applied research that was done in mixed methods and seven stages. The first stage was conducted as a descriptive cross-sectional study. Confirmatory factor analysis was used to validate the initial model. Data were analyzed by SPSS23 and LISREL9. 1 software. The relations of variables were extracted by using structural equation modeling (SEM) and the validity of the model was confirmed. Results: Generally, 6 factors have been identified that affect the control of the outbreak of water and foodborne diseases after natural disasters, including: human resources, syndromic surveillance system, management, public education, logistics and equipment, and national program. Conclusion: Developing policies and guidelines at a national level, planning and determining the resources and local management structure, increasing knowledge and improving attitudes and skills at individual level, situational analysis, providing resources and equipment based on type of risk, continuous education and exercises, reinforcement syndromic surveillance system order to manage and control the outbreak of water and foodborne diseases after natural disasters, can be considered as proposed strategy.

Background: The Connective Tissue Growth Factor (CTGF) gene encoding an extracellular matrix (ECM)-associated protein and as a member of the CCN family of proteins plays a major role in fibrosis, inflammation and connective tissue remodeling in a variety of diseases including cancer. The CCN proteins are multifunctional and are involved in cell proliferation, adhesion and cell development during pathogenesis. The purpose of our study was to determine the expression level of CTGF mRNA in patients with colorectal cancer (CRC). Methods: paraffin embedded tissues from 122 patients with colorectal cancer and their matched normal colon tissues and 20 paraffin embedded normal tissues blocks from normal individual were collected from Taleghani and Shohada hospital in Tehran. The fold change of CTGF expression was analyzed by quantitative real time PCR method, using REST and Prism softwares. Also, LinReg PCR software was also used for the efficiency of primers. Results: We found that expression of CTGF gene in tumor tissue was significantly higher than in adjacent normal tissue (P<0. 0001, RQ>2). A Significant increase was also observed in the expression of this gene in right-sided colon cancer than left side. Conclusion: The findings indicated that the expression pattern of CTGF gene is significantly altered in the development of cancer from normal tissue. Thus, according to major role of CTGF gene in fibrosis, inflammation and connective tissue remodeling, it may be effective in various diseases process including cancer.