Shiraz E-Medical Journal Shiraz E-Medical Journal Shiraz E-Med J http://www.emedicalj.portal.tools 1735-1391 10.5812/semj. en jalali 2019 6 19 gregorian 2019 6 19 17 1
en 10.17795/semj35258 Newly Defined Role of Pharmacoeconomics in Iran National Medicine Policy Newly Defined Role of Pharmacoeconomics in Iran National Medicine Policy editorial editorial Pharmacoeconomics;Iran Medicine List;Prioritization Pharmacoeconomics;Iran Medicine List;Prioritization http://www.emedicalj.portal.tools/index.php?page=article&article_id=35258 Abdol Majid Cheraghali Abdol Majid Cheraghali Faculty of Pharmacy, Pharmaceutical Management and Economics Research Center (PMERC), Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Faculty of Pharmacy, Pharmaceutical Management and Economics Research Center (PMERC), Baqiyatallah University of Medical Sciences, Tehran, IR Iran Faculty of Pharmacy, Pharmaceutical Management and Economics Research Center (PMERC), Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Faculty of Pharmacy, Pharmaceutical Management and Economics Research Center (PMERC), Baqiyatallah University of Medical Sciences, Tehran, IR Iran
en 10.17795/semj33606 Cost-Utility of Screening Program for Neonatal Hypothyroidism in Iran Cost-Utility of Screening Program for Neonatal Hypothyroidism in Iran research-article research-article Conclusions

The economic evaluation (cost-utility analysis) resulted from the comparison of the above choices revealed that implementing the screening plan can actually be better and more cost-effective.

Results

The incremental cost-effectiveness ratios (ICER) of hypothyroidism, calculated through dividing the cost difference (∆C) by utility difference (∆QALY), indicated that screening saved a total of 13413 US. $.

Background

Hypothyroidism, a preventable cause of mental retardation, is one of the most common diseases of the endocrine gland in children. The disorder can be corrected if it is identified and treated within the first few days of birth. In Iran, hypothyroidism is estimated to affect one out of 400 to 900 neonates, which is much higher than the global average.

Objectives

This article is conducted to investigate the most cost–utility option i.e. whether to implement the neonatal screening of genetic hypothyroidism or to merely treat such patients in the absence of the screening process.

Patients and Methods

The present research is a cross-sectional, descriptive and analytical study. The provider perspective was employed to calculate the direct costs imposed on Shiraz University of Medical Sciences, insurance organizations, charities and patients concerning the implementation of screening program and the treatment of detected cases along with the direct costs related to patients treated in the absence of the screening process; costs related to death were excluded. The statistical population of the study consisted of all 81837 newborns referred to university laboratory in Shiraz in 2010. In order to measure the utility, time-trade-off method was employed to determine the life quality of patients.

Conclusions

The economic evaluation (cost-utility analysis) resulted from the comparison of the above choices revealed that implementing the screening plan can actually be better and more cost-effective.

Results

The incremental cost-effectiveness ratios (ICER) of hypothyroidism, calculated through dividing the cost difference (∆C) by utility difference (∆QALY), indicated that screening saved a total of 13413 US. $.

Background

Hypothyroidism, a preventable cause of mental retardation, is one of the most common diseases of the endocrine gland in children. The disorder can be corrected if it is identified and treated within the first few days of birth. In Iran, hypothyroidism is estimated to affect one out of 400 to 900 neonates, which is much higher than the global average.

Objectives

This article is conducted to investigate the most cost–utility option i.e. whether to implement the neonatal screening of genetic hypothyroidism or to merely treat such patients in the absence of the screening process.

Patients and Methods

The present research is a cross-sectional, descriptive and analytical study. The provider perspective was employed to calculate the direct costs imposed on Shiraz University of Medical Sciences, insurance organizations, charities and patients concerning the implementation of screening program and the treatment of detected cases along with the direct costs related to patients treated in the absence of the screening process; costs related to death were excluded. The statistical population of the study consisted of all 81837 newborns referred to university laboratory in Shiraz in 2010. In order to measure the utility, time-trade-off method was employed to determine the life quality of patients.

Cost-utility Analysis;Congenital Hypothyroidism;Neonatal Screening Cost-utility Analysis;Congenital Hypothyroidism;Neonatal Screening http://www.emedicalj.portal.tools/index.php?page=article&article_id=33606 Nahid Hatam Nahid Hatam Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Mehrdad Askarian Mehrdad Askarian Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran Peivand Bastani Peivand Bastani Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Kimia Pourmohammadi Kimia Pourmohammadi Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-9177079194 Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-9177079194 Samad Shirvani Samad Shirvani Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Health Service Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.17795/semj35479 The Millennium Development Goals; A Global Assignment The Millennium Development Goals; A Global Assignment review-article review-article Conclusions

All countries reported improvements in MDG indicators, while SDGs has opened new doors of opportunity for countries to promote their socio-economic status.

Context

The millennium development goals (MDG) are global committed efforts to provide anti-poverty and disparity document. During the past 15 years and based on MDGs, nearly all countries have made efforts to achieve its related goals. Therefore, the current narrative review aimed to analyze the MDGs’ challenge and achievements with the focus on Islamic Republic of Iran.

Evidence Acquisition

This study was a non-systematic narrative review conducted through studies and reports published from 2000 to 2015, about MDGs’ progress worldwide, compared to the Islamic Republic of Iran.

Results

According to the review, almost all countries have had remarkable improvement in all MDGs. Among them Iran’s achievements are significant in five goals out of eight, but to reach the goals number 6 and 7 related to HIV/AIDS control and environmental sustainability, Iran has a rough way to go. The challenges that countries are facing to reach MDGs are slow growth outlook, limited resources, institutional reforms deficiency, insufficient development capacity, unequal income distribution, global economic situation especially during the past five years, absence of political commitment to the MDGs, lack of supportive environment to attract private sector for investment and development and the last but not least un-inclusive growth.

Conclusions

All countries reported improvements in MDG indicators, while SDGs has opened new doors of opportunity for countries to promote their socio-economic status.

Context

The millennium development goals (MDG) are global committed efforts to provide anti-poverty and disparity document. During the past 15 years and based on MDGs, nearly all countries have made efforts to achieve its related goals. Therefore, the current narrative review aimed to analyze the MDGs’ challenge and achievements with the focus on Islamic Republic of Iran.

Evidence Acquisition

This study was a non-systematic narrative review conducted through studies and reports published from 2000 to 2015, about MDGs’ progress worldwide, compared to the Islamic Republic of Iran.

Results

According to the review, almost all countries have had remarkable improvement in all MDGs. Among them Iran’s achievements are significant in five goals out of eight, but to reach the goals number 6 and 7 related to HIV/AIDS control and environmental sustainability, Iran has a rough way to go. The challenges that countries are facing to reach MDGs are slow growth outlook, limited resources, institutional reforms deficiency, insufficient development capacity, unequal income distribution, global economic situation especially during the past five years, absence of political commitment to the MDGs, lack of supportive environment to attract private sector for investment and development and the last but not least un-inclusive growth.

Millennium Development Goals;Mortality;Health;Iran Millennium Development Goals;Mortality;Health;Iran http://www.emedicalj.portal.tools/index.php?page=article&article_id=35479 Hassan Joulaei Hassan Joulaei HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Najmeh Maharlouei Najmeh Maharlouei Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Najmeh Maharlouei, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Najmeh Maharlouei, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Reza Tabrizi Reza Tabrizi Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Kamran B. Lankarani Kamran B. Lankarani Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.17795/semj29200 The Effect of Complex Decongestive Therapy on Post-Breast Surgery Quality of Life in Breast Cancer Patients With Unilateral Lymphedema and Its Predictive Factors The Effect of Complex Decongestive Therapy on Post-Breast Surgery Quality of Life in Breast Cancer Patients With Unilateral Lymphedema and Its Predictive Factors research-article research-article Conclusions

Although this study showed that some factors can improve patients’ feeling and HRQOL after treatment in our population, in many aspects no changes were observed. It is recommended to improve patients’ HRQOL through more social and physiological support in our setting. Also, more follow-up duration after the intervention is recommended in future studies.

Patients and Methods

The present study was a quasi-experimental study on health-related HRQOL. A general data gathering form was used in 120 patients who developed lymphedema following breast cancer surgery and referred for treatment to Shiraz Motahari clinic in 2014. All patients’ arm size was measured by “direct voltmeter” before the intervention to determine the grade of lymphedema. SF-36 questionnaire was used pre- and one month post-intervention to collect HRQOL data. Complete decongestive therapy (CDT) with or without Pump was used as the intervention.

Results

Patients had higher scores after treatment in all subscales of quality of life (except for “role limitation due to physical problems”), but a statistically significant difference (P = 0.023) was observed only in the “mental health” subscale. The results showed significant changes in bodily pain after the intervention in patients less than 40 years old (P = 0.03), “general health” and “vitality” in single patients (P values equal to 0.013 and 0.02, respectively) and “mental health” in those with education “less than high school” (P = 0.018). In the case of household patients, only PF changed significantly after treatment (P = 0.027). Moreover, “role limitation due to physical problems” and “mental health” subscales changed significantly after treatment with CDT + Pump (P values equal to 0.004 and 0.003). Other groups represented no significant changes in other subscales. Besides, duration of lymph edema had no effect on improvement of HRQOL after treatment.

Background

Complex decongestive therapy (CDT) is one of the most common treatments used in lymphedema. Effects of lymphedema treatment and its predictive factors were studied previously but its impact on quality of life (HRQOL) is still unknown.

Objectives

This study, in addition to investigating CDT effects on HRQOL, examined factors that can influence it, to estimate the effect of treatment according to patient’s condition in our setting.

Conclusions

Although this study showed that some factors can improve patients’ feeling and HRQOL after treatment in our population, in many aspects no changes were observed. It is recommended to improve patients’ HRQOL through more social and physiological support in our setting. Also, more follow-up duration after the intervention is recommended in future studies.

Patients and Methods

The present study was a quasi-experimental study on health-related HRQOL. A general data gathering form was used in 120 patients who developed lymphedema following breast cancer surgery and referred for treatment to Shiraz Motahari clinic in 2014. All patients’ arm size was measured by “direct voltmeter” before the intervention to determine the grade of lymphedema. SF-36 questionnaire was used pre- and one month post-intervention to collect HRQOL data. Complete decongestive therapy (CDT) with or without Pump was used as the intervention.

Results

Patients had higher scores after treatment in all subscales of quality of life (except for “role limitation due to physical problems”), but a statistically significant difference (P = 0.023) was observed only in the “mental health” subscale. The results showed significant changes in bodily pain after the intervention in patients less than 40 years old (P = 0.03), “general health” and “vitality” in single patients (P values equal to 0.013 and 0.02, respectively) and “mental health” in those with education “less than high school” (P = 0.018). In the case of household patients, only PF changed significantly after treatment (P = 0.027). Moreover, “role limitation due to physical problems” and “mental health” subscales changed significantly after treatment with CDT + Pump (P values equal to 0.004 and 0.003). Other groups represented no significant changes in other subscales. Besides, duration of lymph edema had no effect on improvement of HRQOL after treatment.

Background

Complex decongestive therapy (CDT) is one of the most common treatments used in lymphedema. Effects of lymphedema treatment and its predictive factors were studied previously but its impact on quality of life (HRQOL) is still unknown.

Objectives

This study, in addition to investigating CDT effects on HRQOL, examined factors that can influence it, to estimate the effect of treatment according to patient’s condition in our setting.

Breast Cancer;Lymphedema;Complex Decongestive Therapy;Quality of Life Breast Cancer;Lymphedema;Complex Decongestive Therapy;Quality of Life http://www.emedicalj.portal.tools/index.php?page=article&article_id=29200 Hourvash Akbari Haghighinejad Hourvash Akbari Haghighinejad Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Negin Hadi Negin Hadi Department of Community Medicine, Health Policy Research Center, Neurosciences Research Center, Research Center for Psychiatry and Behavioral Science, Shiraz University of Medical Sciences, Shiraz, IR Iran; Negin Hadi, Department of Community Medicine, Health Policy Research Center, Neurosciences Research Center, Research Center for Psychiatry and Behavioral Science, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7132354431 Department of Community Medicine, Health Policy Research Center, Neurosciences Research Center, Research Center for Psychiatry and Behavioral Science, Shiraz University of Medical Sciences, Shiraz, IR Iran; Negin Hadi, Department of Community Medicine, Health Policy Research Center, Neurosciences Research Center, Research Center for Psychiatry and Behavioral Science, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7132354431 Sheida Banihashemi Sheida Banihashemi Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Maryam Abdinejad Maryam Abdinejad Health Policy Research Center, Shohadae Neiriz Hospital, Emergency Ward, Shiraz University of Medical Sciences, Shiraz, IR Iran Health Policy Research Center, Shohadae Neiriz Hospital, Emergency Ward, Shiraz University of Medical Sciences, Shiraz, IR Iran Sedigheh Tahmasebi Sedigheh Tahmasebi Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Zinab Zakeri Zinab Zakeri Department of General Surgery, Lymphedema Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of General Surgery, Lymphedema Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Abdolrasoul Talei Abdolrasoul Talei Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of General Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Ali Montazeri Ali Montazeri Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, IR Iran Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, IR Iran
en 10.17795/semj37365 The Association Between Menarche Age and First Offspring Sex Ratio The Association Between Menarche Age and First Offspring Sex Ratio research-article research-article Conclusions

Women of younger menarche age will have younger first pregnancy ages and a greater chance of having a male first offspring.

Results

The mean age of the participants was 29.6 ± 7.09, their mean menarche age was 13.25 ± 1.21, and the mean age of their first pregnancy was 23.9 ± 4.35. Total OSR was 0.932. The OSR (calculated as the proportion of male to female offspring) was higher when the menarche age was younger (P < 0.05). In women of younger pregnancy age, the OSR was higher (P < 0.05). First pregnancy age was younger in women with a menarche age under 13 years (P < 0.05).

Background

Offspring sex ratio (OSR) serves as an important social factor, and various other factors are hypothesized to be associated with it, such as maternal diet, time of ovulation and insemination, environmental phenomena, parental age, and infertility treatment.

Objectives

This research was performed to assess the association between mothers’ menarche age, first pregnancy age, and sex ratio of first offspring.

Patients and Methods

In this retrospective study, 2,000 Iranian women of reproductive age were recruited to assess their menarche age, first pregnancy age, and first OSR.

Conclusions

Women of younger menarche age will have younger first pregnancy ages and a greater chance of having a male first offspring.

Results

The mean age of the participants was 29.6 ± 7.09, their mean menarche age was 13.25 ± 1.21, and the mean age of their first pregnancy was 23.9 ± 4.35. Total OSR was 0.932. The OSR (calculated as the proportion of male to female offspring) was higher when the menarche age was younger (P < 0.05). In women of younger pregnancy age, the OSR was higher (P < 0.05). First pregnancy age was younger in women with a menarche age under 13 years (P < 0.05).

Background

Offspring sex ratio (OSR) serves as an important social factor, and various other factors are hypothesized to be associated with it, such as maternal diet, time of ovulation and insemination, environmental phenomena, parental age, and infertility treatment.

Objectives

This research was performed to assess the association between mothers’ menarche age, first pregnancy age, and sex ratio of first offspring.

Patients and Methods

In this retrospective study, 2,000 Iranian women of reproductive age were recruited to assess their menarche age, first pregnancy age, and first OSR.

Menarche Age;First Offspring Sex Ratio;First Pregnancy Age;Iran Menarche Age;First Offspring Sex Ratio;First Pregnancy Age;Iran http://www.emedicalj.portal.tools/index.php?page=article&article_id=37365 Ladan Haghighi Ladan Haghighi Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran Neda Hashemi Neda Hashemi Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran Yousef Moradi Yousef Moradi Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, IR Iran Niloofar Barzegar Niloofar Barzegar Iran University of Medical Sciences, Tehran, IR Iran Iran University of Medical Sciences, Tehran, IR Iran Zahra Najmi Zahra Najmi Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2166517342 Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran; Endometriosis Research Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2166517342