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Background & objectives: In recent years, the hypothesis of using anti-androgens has been increasingly addressed in the treatment of acne in women. One of these drugs is flutamide, which there is no strong evidence of its efficacy in treatment of acne in women. The aim of this study was to compare the effect of combination therapy of flutamide-cyproterone compound with flutamide-doxycycline in severe type of acne in women.
Methods: In an interventional study, patients were divided in to two groups. One group (n=30) received flutamide - cyproterone compound and another group (n=30) received flutamide-doxycycline which were followed for six months. Both groups also received 1% topical clindamycin twice a day. Counting the number of lesions, changes in severity index and grading of acne were used to evaluate the patients. Patient satisfaction was also evaluated.
Results: The mean age in the flutamide-doxycycline group was 19.4±4.67 and in the flutamide-cyproterone compound group was 19.06±11.3. This difference was not statistically significant. The mean of the acne severity index at the onset of intervention between the two groups was not significant (p= 0.7). The mean of the acne severity index at the start of treatment in the flutamide-doxycycline group was 306.07±155.46 and at the end of treatment reached to 19.18±19.5, and also in the flutamide-cyproterone compound group, decreased from 293.21±15.21 to 10.5±21.8 at the end of treatment. This difference was not statistically significant (p=0.1).
Conclusion: Both therapeutic regimen were effective in the treatment of severe type of acne and can possibly be used as an alternative treatment for severe acne.

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Background & objectives: Oxaliplatin is a third-generation of platinum drug which is the main therapeutic agent for the treatment of colorectal cancer. Oxaliplatin not only inhibits DNA replication but also transcription and also induces apoptosis or necrosis in cancer cells and rapidly dividing cell lines. Although it is widely used clinically, there is no enough information regarding its effect on ovarian structure. This study was designed to determine morphometric features of 30- and 60-day-old offspring ovaries using precise and unbiased stereological technique following administration of oxaliplatin during perinatal period in mice.
Methods: In the present experimental study, 32 adult female mice were used for experimental (pre-pregnant, pregnant and lactation) and control groups. Mice were placed in separate cages for mating. Control group received 0.2 ml saline intraperitoneally (IP) during 21 days of pre-pregnancy, pregnancy and lactation periods. Experimental groups including pre-pregnancy, pregnancy and lactation groups received 3 mg/kg oxaliplatin thrice in a week IP during 21 days before mating, during pregnancy and lactation periods, respectively. At the 30th and 60th postnatal days (PND), the offspring were euthanized and the ovaries from eight offspring in each group were collected for stereological analysis.
Results: The results showed that the mean volume oocytes of antral and preantral follicles and also the mean volume of antral follicles were decreased in experimental groups in comparison with the control group in 30 PND offspring (p<0.05). In 60 PND, offspring, the total volume of follicles, mean volume of antral follicles and also mean volume of oocyte of antral follicles in experimental groups showed significant decrease in comparison with the control group (p<0.05). Total volume of ovary, cortical volume and mean volume of preantral follicles decreased in pregnant experimental group compared to control group (p<0.05).
Conclusion: The present results demonstrated that oxaliplatin induces adverse effect on the morphometrical features of the ovary following administration during the perinatal period especially in pregnancy time.

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Background & objectives: The main motivator of hospitals is manpower. The expansion and complexity of educational medical centers and the appearance of new diseases such as Covid-19 have increased the need for effective management. During the Covid-19 crisis, in which hospitals are at the forefront, special measures should be taken for better management in critical situations. The current study has been conducted with the aim of identifying the main factors affecting management in crisis and its control.
Methods: The study method was the "Mix Method" performed in two stages. The first stage was exploratory; in this stage 19 university experts as a research sample were selected by simple random sampling. The second stage was a quantitative, confirmative, and survey study. 202 patients were selected randomly as a research sample from both educational-medical centers involved in Covid-19 of Ardabil city. Data were collected by using a questionnaire. Descriptive analysis of data was performed using SPSS software for heuristic factor analysis, and LISREL software was also used for confirmatory factor analysis and finding correlations between factors.
Results: In this study, 17 factors were identified and confirmed, affecting the crisis management in 5 dimensions, including; safety training, crisis control, trust in human resources, sense of vulnerability, the physical and mental health, transparency, justice, participation in decision-making, trust in the manager, honesty, the expectation of needs, efficiency, reward, elimination of stresses, fulfillment of manager's promises, controlling of crisis, inter-sectorial solidity. There was a significant correlation between factors with latent variables.
Conclusion: From the perspective of management, being prepared and training the committed forces are very important in controlling the crisis. Manpower plays the main role in the Covid-19 crisis and treating patients, so paying attention to them by considering the factors and dimensions of leadership, social, motivation, organization, and quickness has high importance.
 

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Background & objectives: Considering the importance of professional commitment in medical services, it is necessary to provide an appropriate questionnaire to measure professional commitment and behavior. Therefore, the present study was conducted with the aim of investigating the psychometric properties of the questionnaire "Patients' views regarding the observance of professional behavior by specialist doctors".
Methods: The present study is a psychometric research that was conducted in four phases. The first phase of this study was based on a professional behavior tool guide, review of texts and collection of experts' opinions. in  the second phase , determining the validity of items in the form of the face and content validity, in the third phase , the pilot study, and in the fourth phase,instrument reliability was conducted in two ways: internal consistency and instrument stability.
Results: A pool of 50 items was formed to design the questionnaire. After interviewing the study population and removing overlapping items, the number of items was reduced to 31 items. The results of CVR calculation showed that out of the total of 31 items, 13 items had a cutoff point less than 0.42, which were removed, and 18 items with a CVR score > 0.62 remained according to the opinion of the research team. In the face validity stage, the Impact factor < 1.5 was used as the basis for exclusion, and all the items had a high impact factor, and finally, the draft of the questionnairewas approved with the same 18 items. Cronbach's alpha coefficient was 0.88 and the internal correlation coefficient of the questionnairewas 0.93, which indicated the appropriate reliability of the questionnaire.
Conclusion: Based on the results of the present study, the questionnaire on "Patients' views regarding the observance of professional behavior by a specialist physician" in Iranian society has the necessary content and face validity and adequate reliability. By using this questionnaire, hospital officials can check the status of professional ethics of their specialist physician from the patients' point of view and take effective measures to eliminate the shortcomings.
 

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Background & objectives: This research has been carried out in order to optimize technology development policies and reduce the costs of health technology development centers in universities of medical sciences. Identifying the influential factors in the growth of technology units helps the growth centers to more efficiently use the growth of knowledge-based companies and the development and progress of innovative entrepreneurs as a host environment for technology growth.
Methods: The current study is a qualitative research that was conducted by extracting qualitative data through semi-structured interviews with 31 managers of growth centers and managers of units located in growth centers and experts in the field of health entrepreneurship. It has been coded and categorized in three stages and the main and subcategories have been identified.
Results: The results show that for the growth of technology units in health technology growth centers, two basic variables of the growth center program and infrastructure have an effect on the efficiency of the centers and the growth of the units. This is despite the fact that according to the regional capacities of Type 3 medical sciences universities in the country, growth program factors have introduced more categories and less focus has been placed on infrastructure, so the growth plan is good. It can have a bigger share.
Conclusion: This research shows what categories are expected from the growth plan and infrastructures of health technology growth centers in few universities.
 

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Background & objectives: Even though clinical empathy is one of the clinical competencies of medical students and there is a high emphasis on teaching and learning, it decreases during medical education. This study investigated the relationship between burnout, quality of life and clinical empathy in medical students.
Methods: this exploratory cross-sectional study used the Jefferson empathy questionnaire, WHO quality of life questionnaire and burnout inventory. All three questionnaires are standard, and their validity and reliability have been confirmed in various studies in Iran. The research population was the Ardabil University of Medical Sciences internship medical students, for which the census sampling method was used. Various statistical tests, such as Pearson and spearman correlation, Chi-square, etc., were used for data analysis.
Results: Out of 130 students, 128 (98.4%) completed all of the questionnaires. Data analysis showed that 98% of students suffered from moderate burnout and 2% of them had severe burnout. About 44% of students were satisfied or very satisfied with their health status and 33% of students were dissatisfied or very dissatisfied. The mean score of clinical empathy in students was 79.46±9.82. Data analysis showed a statistically significant inverse relationship between quality of life and burnout (p=0.0001).
Conclusions: Considering that the situation of students was not very favorable in terms of all three variables, non-curricular programs seem to be essential for improving student adaptation mechanisms to the job-related situations in medical students and promoting clinical empathy.
 

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Background & Objective: Futile or fruitless life-saving interventions are in conflict with the four principles of medical ethics, which are not only ineffective for the patients, but also have a high burden on society. Therefore, this study aimed to determine the causes of unsuccessful life-saving treatment and interventions from the point of view of care providers in the neurology and neurosurgery departments of Tehran University of Medical Sciences hospitals.
Methods: The present study is a descriptive cross-sectional study that was conducted on 64 doctors and 72 nurses working in hospitals affiliated to the Tehran University of Medical Sciences in 2018. A 25-item researcher-made questionnaire was used to collect data. Spss-24 software and descriptive statistics tests were used to analyze data.
Results: The average age of doctors and nurses was 34.25±5.1 and 35.12±8.2 years, respectively. From the point of view of physicians and nurses, the most important reason for the ineffective provision of life-saving services was the lack of legal, moral and Islamic permission and guidelines to cut off life support devices and the lack of resuscitation in patients facing death (end stages of life).
Conclusion: The results of this study showed that, from the point of view of nurses, the most common reasons for providing futile care and cure are the moral and humane obligation of the treatment and care team to provide ineffective life-saving interventions, and from the point of view of the physician, the lack of legal, ethical and religious permission and instructions to cut off life support devices in patients has resulted in death. Some of the causes of unnecessary care were presented in this study, and some of these causes cannot be solved without solving theoretical problems and practical expert studies. Developing guidelines to define futile treatment, especially in end-of-life care, and providing solutions to control and manage treatment and unsuccessful life-saving interventions seems necessary.
                                      
 

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