Introduction & Objective: Pilonidal disease is a common inflammatory condition, especially in young population. A wide variety of surgical techniques are used to treat pilonidal sinuses, including open and close techniques. An ideal surgical technique would have minimum risk of recurrence, a short hospital stay and improved patient satisfaction.In this paper we are reporting about our experience in Limberg flap technique, assessing our experience in comparison with studies of other relevant centers in the world.Materials & Methods: In this observative, descriptive, cross sectional study. 70 patients were followed prospectively at least one year post operation. Data collection method is Census and all information was evaluated with SPSS14.The relevant information has been obtained from patients files and also has been directly approached with them.Results: Results reveal that surgery of pilonidal sinus by Limberg flap causes the patients to return to their daily activities earlier. It can also be effective in reducing the hospitalization period as well as hematoma (0%), infection (2.6%), flap necrosis (0%) and numbness of the operation site (26.31%). The prominent point in this method is the low rate of recurrence rate.Conclusions: In this method, early and delayed complications are less than in other surgery methods.The problem of recurrence is that it causes complication and also cost and time for patients.Thus method can be a suitable one to reduce patient’s expenses and costs of apart from work for patients as well as society.

2Objective(s): Health tourism is a branch of the tourism industry that is of interest to many countries of the world due to its high demand and good income. Therefore, considering the importance of health tourism and the existing potential in Mazandaran province, this study was conducted with the aim of identifying and analyzing the factors affecting the development of the health tourism industry in Mazandaran province. Methods: The present study was conducted using a qualitative method with a content analysis approach. For this purpose, 17 health tourism industry experts and health tourists were selected using the purposeful sampling method. Semi-structured interviews were used to collect data. The interviews were conducted until we reached a point of theoretical data saturation. Results: The findings showed that the health tourism industry in Mazandaran province is affected by structural, process and contextual factors. The structural factors included issues related to infrastructures, potentials/attractions, institutional factors, and expert human resources for health tourism destination. The process factor included issues related to drivers of health tourism, provision of health services and destination situational factors. The contextual-field factor included issues related to sociocultural contexts, potentials and attractiveness of tourism, and economic capacity. Conclusion: Despite the importance of services related to health tourism and considering the increasing demand of this industry, travelers who travel to Mazandaran province need a variety of services, and the need to pay attention to quality service development in tourism destinations is evident. Therefore, the provision of other essentials for health tourists such as infrastructure, destination attractions, financial capacities, sociocultural conditions, human resources, situational factors are  the requirements for the development of this industry.

Entering university and beginning of student life is the commencement of facing series of up known and, changes which Will follow such as fearing feeling, insecurity to the future, adjusting, behavioral and moral disorders.Since prayer, blessing, worship and chanting are considered as remembrance of God in rich Islam culture and correspond with verses and traditions, remembrance of God as support against problems and misfortunes for human being. Therefore student’s attitudes about prayer effects have examined in this research.It is descriptive - basic study which its sampling is at unrandom. Tools of gathering information are two part questionnaire which completed by 102 nonnative male and female students and their attitudes have examined and analyzed.According to statistical calculations and diagrams, research results showed all samples according to questionnaire questions in nine fold areas, announce positive attitudes about prayer effects. Holy Koran was remembered different notes in different verses about prayer, customs, virtues and its results in more than 120 verses which cause various and positive effects in one who prays.Research results state that research samples announce their attitudes about prayer effects in belief, religious and psychic health domains highly, social cultural and moral domains moderately and educational economical and material domains lowly in comparison with 3 basic areas.

Objective (s): The Iranian population is rapidly aging, and a large volume of services are provided in comprehensive health service centers with the aim of reducing the costs and care burden of the elderly population, therefore, identifying the factors affecting the elderly's not visiting the health service centers is of great importance. This study was conducted to determine and compare the reasons for the elderly's not visiting the comprehensive health service centers from the perspective of elderly residents of Esfarayen. Methods: This investigation is a cross-sectional descriptive-analytical study. Its statistical population was all elderly residents of Esfarayen city. Initially, 290 elderly people who had not visited comprehensive health centers in the past two years were reviewed by census method. Then, they responded to demographic questionnaires concerning the reasons for the elderly’s not visiting comprehensive health centers, which were psychometrically tested by Masumi et al. (2022). The collected data were analyzed using descriptive and analytical statistical tests, including mean, standard deviation, frequency, Spearman, Mann-Whitney, and Kruskal-Wallis in the SPSS-27 statistical software. The significance level in all tests was considered to be 0. 05. Results: In this study, 245 elderly people (59. 6% female, 40. 4% male) with a mean age of 72. 25±9. 37 years participated. According to the results, the most common reason for the elderly participants not to visit comprehensive health service centers was the inadequate physical conditions of comprehensive health service centers, and the least common reason was insufficient awareness and knowledge about the provision of health and medical services. Conclusion: To improve health services and increase older people's access to healthcare, service providers must pay close attention to existing barriers and seek comprehensive and effective solutions to address them. In this regard, paying attention to the opinions and needs of older people and their participation in the process of designing and implementing health services can lead to continuous and sustainable improvements in their access to health care.

Introduction: Quality improvement in education seems essential for the enhancement of educational productivity, learning quality, and learners' capabilities. This study aimed to identify the challenges and solutions for improving the implementation of the internship program for students of health services management. Methods: The study was conducted using a qualitative approach. This study applied a stakeholder perspective along with a review of studies. A total of 35 interviews were conducted with students, university faculty members, hospital administrators, hospital quality improvement experts, instructors or internship administrators, and university staff managers. Finally, for validation purposes, an expert panel was held with the presence of faculty members in the field of health services management, hospital quality improvement experts, and hospital managers. Findings: Students spend their internships in hospitals and headquarter units under the supervision of the head of the unit. The evaluation methods were also completely different through written reports, project completion, direct supervisor evaluation, evaluation by the course instructor, or a combination of the mentioned methods. The challenges for improving the provision of internship units included educational system challenges, professors and trainers-related challenges, challenges related to students, and challenges related to internship objectives. The solutions were also divided into four categories: teacher and course instructor, course syllabus, hospital liaison, and educational field centers. Conclusion: Experienced internship unit supervisors, simultaneous presence of a faculty member and a supervisor from the organization, developing detailed framework for each course, updating the course outlines, especially the practical units, and requiring internship and apprenticeship students to attend committees can be recommended for better implementation of this course.