Development and implementation of health technology assessment: a policy study

To provide an overview of the development of health technology assessment [HTA] in Iran since 2007, and to facilitate further development of HTA and its integration into policy making. Data of this study were collected through key documents [e.g. literature, laws, and other official documentation] and analyzed by experts of opinion in form of qualitative methods. Health technology assessment entered to the political agenda in Iran only in 2007 with a strong impetus of an evidence-based medicine movement with the bellow objectives: Institutionalization of evidence-based decision making in Ministry of Health, Creating an localization for structural HTA in Health system of Iran, Setting up training courses in order to educate capable manpower to full up the capacity of the universities, Establishment of a new field in HTA subject in medical universities for MSc and PhD degree, International communication about HTA through national website and possible participation in international Congress. HTA has been established in the healthcare system of Iran but what is needed is a clear political will to push forward the objectives of HTA in Iran. Similar to other countries, advance the regulation on the adoption of new health technologies to improve not only technical or allocate efficiency, but also health equity

Health technology assessment on insulin analogues: the rapid review of second type studies

analogues insulin is similar to human insulin but have differences in cell structure that leading to differences in characteristics of pharmacodynamics and pharmacokinetics. A systematic review of published studies between 2009 until June 2010 in Cochrane Library [CENTRAL and Cochrane Systematic Reviews], DARE, NHS EEDs, and CRD databases were searched. Only nine articles were identified to be included in this review. Most of these studies demonstrated that there were no more or less risks caused by rapid acting insulin compared with human insulin in terms of safety. The risk of sever hypoglycemia significantly, reduced by using long acting insulin analogue. Although it has been shown that insulin analogues are not cost effective, some of these studies pointed out that that insulin Aspart 30 compared with other analogues has more cost effectiveness. Although this type of insulin seems very effective for patients with diabetes, due to the less cost effectiveness in comparison to human insulin, it is recommended that government's resources for this technology will be allocated just to the children and elderly people

Classification of health structural indicators using scalogram model in golestan province, Northern Iran

One of the main and basic pillars of health system promotion is the equitable distribution of health facilities in order to ensure fair access of people in the community to the health services. The goal of this study was to classify the health structural indicators in Golestan Province using Scalogram analysis model. A descriptive study was conducted in 2010. Data related to indicators in 3 categories of institutional, human resources and rural health and their indicators were collected using statistical yearbook. Data analysis was done using SPSS software and scalogram analysis model. There is large gap between health structural indicators in cities of Golestan Province. Aq Qala City with 97 score and Azad Shahr City with 41 score were the most and lowest scores respectively from enjoyment of health structural indicators. Generally, 18% of cities were in less developed level and only 27% of cities were developed level. To achieve a fair and balanced healthcare status in different provinces based on their state of development, plans should be arranged in order to reduce the gap in the access to healthcare facilities

[Extraction and molecular determination of major outer membrane proteins of Brucella abortus S99]

Background: brucellosis is one of the five common bacterial zoonosis caused by a gram negative, non-spore forming, and facultative intracellular bacterial organism belonging to the genus Brucella. Although brucellosis is considered as a health problem for both men and domestic animals in many countries, any licensed human vaccine has not been designed and produced for it yet. To overcome the problem, currently, antigenic determinants of Brucella cell wall e.g. outer membrane proteins [OMPs] and lipopolysaccharide [LPS] are considered as potential candidates to develop subunit vaccines

Materials and Methods: brucella abortus S99 used in the present study is obtained from the standard bacterial collection of Institute Pasteur of Iran. OMPs were extracted by deoxy cholate extraction technique and further purification performed by sequential centrifugation and ultracentrifugation. Protein concentration was determined using the Nano drop ND-10000 spectrophotometer. SDS-polyacrylamide gel electrophoresis [SDS- PAGE] was performed to determine the electrophoretic pattern and the molecular weight of the extracted OMP samples

Results: OMPs concentration of B.abortus S99 has been measured and reported as 6.27 mg/ml. SDS-PAGE analysis indicated one protein band in the range of 36-38 kDa which would be classified as the porins of B.abortus S99

Conclusion: extraction of B.abortus S99 OMPs with the applied method in the present study produced a satisfactory yield of OMPs. These proteins belonging to the second group of OMPs, called porins

[Effects of foot orthoses on knee pain and function of female athletes with patellofemoral pain syndrome]

Foot orthoses are a common intervention for patients with patellofemoral pain syndrome but, limited information is available in the effects of foot orthoses on knee pain and function of athletes with patellofemoral pain syndrome. The aim of our study was to determinate the effects of foot orthoses on reducing pain and increasing function of athletes with patellofemoral pain syndrome who demonstrated excessive foot pronation. 418 female athletes between 15. 35 years old in running, soccer, volleyball, fencing and mountain climbing were examinated. Among these athletes 25 subjects with patellofemoral pain syndrome had excessive foot pronation. The severity of pain was measured by VAS [visual analog scale] and their function were measured by KOOS [knee injury and osteoarthritis outcome score]. Full length firm foot orthoses were given to athletes which at least 8 hours during the day was used. After 2 weeks: pain by VAS and function by KOOS were evaluated. After 6 weeks these variables were measured again. The results of analysis of variance in repeated measures indicated a statistically significant improvement in pain by VAS after 2 weeks [p value=0.001] and after 6 weeks [p value=0.001]. Improvement of function on KOOS were statistically significant at 5 subscales: reduction of symptoms after 2 weeks was not prominent but after 6 weeks was significant [p value=0.001] and reduction of pain after 2 weeks [p value=0.001], reduction of pain after 6 weeks [p value=0.001] and improvement of ADL after 2 weeks [p value=0.004] and after 6 weeks [p value = 0.001] and improvement of sport activities after 2 weeks [p value=0.012] and after 6 weeks [p value=0.001] and improvement in QOL after 6 weeks [p value=0.001]. Our results confirmed a significant improvement in reducing pain and increasing function of female athletes with patellofemoral pain syndrome and excessive foot pronation after foot orthoses

[Patellofemoral pain syndrome in Iranian female athletes]

Background: patellofemoral pain syndrome [PFPS] is the most common overuse syndrome in athletes. it is one of the causes of anterior knee pain in athletic population who come to the sports medicine clinic. patellofemoral is more common among female athletes especially adolescents and young adults. Symptoms include: persistent pain behind the patella or peri patella. pain increases on ascending and descending stairs and squatting and prolonged sitting. the aim of this study was to evaluate the prevalence of PFPS in Iranian female athletes

Methods: 418 female athletes aged 15 - 35 years were examined in five sports: Soccer [190], volleyball [103], running [42], fencing [45] and mountain climbing [38]. The numbers of athletes who had anterior knee pain that increased in descending and ascending stairs and squatting, having no other causes of anterior knee pain such as ligament instability, bursitis, meniscal injury, tendonitis and arthritis was determined

Results: 26/190 [13.68 %] soccer players, 21/103 [20.38 %] volleyball players, 7/42 [16.66 %] runners, 6/45 [13.33 %] fencers and 10/38 [26.31 %] mountain climbers had patellofemoral pain

Conclusion: among the 418 female athletes who were evaluated 70 had PFPS. mountain climbers were the most common athletes with PFPS followed by volleyball players and runners