AIM:To investigate the effect of wearing corneoscleral contact lens on visual acuity, and corneal parameters in keratoconus patients.METHODS:In this prospective study, 43 cases(83 eyes)with keratoconus were included and examined. A corneoscleral contact lens was fitted, and thorough exams were carried out at baseline, 3 and 6 mo after wearing lenses, including slit lamp examination, objective and subjective refraction, uncorrected visual acuity(UCVA), and best-corrected visual acuity(BCVA), keratometry(Kmax, K1 and K2), central corneal thickness and endothelial cells count.RESULTS: Mean BCVA(LogMAR)improved from 0.34±0.23 with the spectacles to 0.03±0.05 with the corneoscleral contact lenses in 6 mo(P<0.001). Kmax changed from 52.80±5.93 D to 51.51±5.64 D in 6 mo(P<0.001), central corneal thickness changed from 483.84±34.69 μm to 476.28±35.38 μm(P<0.001), and endothelial cell count changed from 2559.18±275.7 cells/mm2 to 2572.73±274.3 cells/mm2 after wearing corneoscleral contact lens for 6 mo(P<0.001).CONCLUSION: Corneoscleral lenses could significantly increase visual acuity, since there were no clinical noticeable changes in the corneal parameters, this lenses can be used safely in patients with keratoconus.

Objectives: Stuttering is a speech disorder characterized by the repetition of sounds, syllables, or words; prolongation of sounds; and interruptions in speech. Telepractice allows speech services to be delivered to patients regardless of their location. This review investigated factors influencing the use of telepractice in stuttering treatment. Methods: Articles related to the application of telepractice in stuttering were searched using the Scopus, Web of Science, PubMed, Cochrane, and ProQuest databases without consideration of any time limit. Initially, 79 articles were found and after application of the inclusion and exclusion criteria, 15 articles were selected for the review study. Data were analyzed by using the content analysis method and synthesized narratively. Results: Factors influencing the use of telepractice in stuttering treatment were categorized into individual, technical, clinical, and economic factors. Providing access to healthcare services, maintaining personal privacy, and allowing flexibility in arranging appointments were among individual factors. In terms of the technical factors, technical problems and Internet speed were addressed. Clinical factors were divided into positive and negative outcomes, and economic factors were mainly related to time and cost savings. Conclusions Although patients may benefit from using telepractice, the widespread adoption of this technology can be hindered by some technical and non-technical factors. Because telepractice can be employed as a complementary method to treat stuttering, more attention should be paid to the required infrastructure and factors that may negatively impact the use of this technology.

PURPOSE: An injury surveillance information system (ISIS) collects, analyzes, and distributes data on injuries to promote health care delivery. The present study aimed to review the data elements and functional requirements of this system. METHOD: This study was conducted in 2019. Studies related to injury surveillance system were searched from January 2000 to September 2019 via the databases of PubMed, Web of Knowledge, ScienceDirect, and Scopus. Articles related to the epidemiology of injury, population survey, and letters to the editor were excluded, while the review and research articles related to ISISs were included in the study. Initially 324 articles were identified, and finally 22 studies were selected for review. Having reviewed the articles, the data needed were extracted and the results were synthesized narratively. RESULTS: The results showed that most of the systems reviewed in this study used the minimum data set suggested by the World Health Organization injury surveillance guidelines along with supplementary data. The main functions considered for the system were injury track, data analysis, report, data linkage, electronic monitoring and data dissemination. CONCLUSION ISISs can help to improve healthcare planning and injury prevention. Since different countries have various technical and organizational infrastructures, it is essential to identify system requirements in different settings.
Datasets as Topic ; Delivery of Health Care ; Health Information Systems ; Health Planning ; Humans ; Public Health Surveillance ; methods ; Wounds and Injuries ; prevention & control

OBJECTIVES: Genetic disorders are the main causes of many other diseases. Integrating genetic data into Electronic Health Records (EHRs) can facilitate the management of genetic information and care of patients in clinical practices. The aim of this study was to identify the main requirements for integrating genetic data into the EHR system from the medical geneticists' perspectives. METHODS: The research was completed in 2018 and consisted of two phases. In the first phase, the main requirements for integrating genetic data into the EHR system were identified by reviewing the literature. In the second phase, a 5-point Likert scale questionnaire was developed based on the literature review and the results derived from the first phase. Then, the Delphi method was applied to reach a consensus about the integration requirements. RESULTS: The findings of the first phase showed that data elements, including patients' and healthcare providers' personal data, clinical and genetic data, technical infrastructure, security issues and functional requirements, should be taken into account before data integration. In the second phase, a consensus was reached for most of the items (mean ≥3.75). The items with a mean value of less than 2.5 did not achieve a consensus and were removed from the final list. CONCLUSIONS: The integration of genetic data into the EHRs can provide a ground for increasing accuracy and precision in the diagnosis and treatment of genetic disorders. Such integration requires adequate investments to identify users' requirements as well as technical and non-technical issues.
Consensus ; Delivery of Health Care ; Diagnosis ; Electronic Health Records ; Genetics ; Humans ; Investments ; Medical Informatics ; Methods

OBJECTIVES: Automated audiometry provides an opportunity to do audiometry when there is no direct access to a clinical audiologist. This approach will help to use hearing services and resources efficiently. The purpose of this study was to review studies related to automated audiometry by focusing on the implementation of an audiometer, the use of transducers and evaluation methods. METHODS: This review study was conducted in 2017. The papers related to the design and implementation of automated audiometry were searched in the following databases: Science Direct, Web of Science, PubMed, and Scopus. The time frame for the papers was between January 1, 2010 and August 31, 2017. Initially, 143 papers were found, and after screening, the number of papers was reduced to 16. RESULTS: The findings showed that the implementation methods were categorized into the use of software (7 papers), hardware (3 papers) and smartphones/tablets (6 papers). The used transducers were a variety of earphones and bone vibrators. Different evaluation methods were used to evaluate the accuracy and the reliability of the diagnoses. However, in most studies, no significant difference was found between automated and traditional audiometry. CONCLUSIONS: It seems that automated audiometry produces the same results compared with traditional audiometry. However, the main advantages of this method; namely, saving costs and increased accessibility to hearing services, can lead to a faster diagnosis of hearing impairment, especially in poor areas.
Audiology ; Audiometry* ; Diagnosis ; Hearing ; Hearing Loss ; Mass Screening ; Methods* ; Transducers

OBJECTIVES: A survival analysis of breast cancer patients in southern Iran according to age has yet to be conducted. This study aimed to quantify the factors contributing to a poor prognosis, using Cox and empirical Bayesian additive hazard (EBAH) models, among young (20-39 years), middle-aged (40-64 years), and elderly (≥ 65 years) women. METHODS: Data from 1,574 breast cancer patients diagnosed from 2002 to 2012 in the cancer registry of Fars Province (southern Iran) were stratified into 3 age groups. The Kaplan-Meier method was used to estimate the overall survival rates. Cox and EBAH models were applied to each age category, and the Akaike information criterion was used to assess the goodness-of-fit of the 2 hazard models. RESULTS: As of December 2012, 212 women (13.5%) in our study population had died, of whom 43 were young (15.3%), 134 middle-aged (11.8%), and 35 elderly (22.3%). The 5-year survival probability by age category was 0.83 (standard error [SE], 0.03), 0.88 (SE, 0.01), and 0.75 (SE, 0.04), respectively. CONCLUSIONS: The Nottingham Prognostic Index was the most effective prognostic factor. The model based on Bayesian methodology performed better with various sample sizes than the Cox model, which is the most widely used method of survival analysis.
Aged* ; Breast Neoplasms* ; Breast* ; Female ; Humans ; Iran* ; Methods ; Prognosis ; Proportional Hazards Models* ; Sample Size ; Survival Rate

OBJECTIVES: A survival analysis of breast cancer patients in southern Iran according to age has yet to be conducted. This study aimed to quantify the factors contributing to a poor prognosis, using Cox and empirical Bayesian additive hazard (EBAH) models, among young (20-39 years), middle-aged (40-64 years), and elderly (≥ 65 years) women.METHODS: Data from 1,574 breast cancer patients diagnosed from 2002 to 2012 in the cancer registry of Fars Province (southern Iran) were stratified into 3 age groups. The Kaplan-Meier method was used to estimate the overall survival rates. Cox and EBAH models were applied to each age category, and the Akaike information criterion was used to assess the goodness-of-fit of the 2 hazard models.RESULTS: As of December 2012, 212 women (13.5%) in our study population had died, of whom 43 were young (15.3%), 134 middle-aged (11.8%), and 35 elderly (22.3%). The 5-year survival probability by age category was 0.83 (standard error [SE], 0.03), 0.88 (SE, 0.01), and 0.75 (SE, 0.04), respectively.CONCLUSIONS: The Nottingham Prognostic Index was the most effective prognostic factor. The model based on Bayesian methodology performed better with various sample sizes than the Cox model, which is the most widely used method of survival analysis.
Aged ; Breast Neoplasms ; Breast ; Female ; Humans ; Iran ; Methods ; Prognosis ; Proportional Hazards Models ; Sample Size ; Survival Rate

OBJECTIVES: A patient accounting system is a subsystem of a hospital information system. This system like other information systems should be carefully designed to be able to meet users' requirements. The main aim of this research was to investigate users' requirements and to determine whether current patient accounting systems meet users' needs or not. METHODS: This was a survey study, and the participants were the users of six patient accounting systems used in 24 teaching hospitals. A stratified sampling method was used to select the participants (n = 216). The research instruments were a questionnaire and a checklist. The mean value of > or =3 showed the importance of each data element and the capability of the system. RESULTS: Generally, the findings showed that the current patient accounting systems had some weaknesses and were able to meet between 70% and 80% of users' requirements. CONCLUSIONS: The current patient accounting systems need to be improved to be able to meet users' requirements. This approach can also help to provide hospitals with more usable and reliable financial information.
Checklist ; Hospital Information Systems ; Hospitals, Teaching ; Humans ; Information Systems ; Needs Assessment

OBJECTIVES: This study aimed to compare nurses' satisfaction with, and expectations of, hospital information systems in two teaching hospitals. METHODS: This was a survey study, which was completed in 2014. The potential participants were 267 nurses who worked in two teaching hospitals and used the same hospital information system. Data were collected using two questionnaires. Both questionnaires were examined in terms of content validity and reliability. RESULTS: The results showed that, for a majority of nurses, their expectations of the system were not met in either hospital. Moreover, there was a significant association between the nurses' expectations and the perceived usefulness of the systems (p < 0.001), between the nurses' expectations and their satisfaction with the systems (p < 0.001), and between the perceived usefulness and nurses' satisfaction with the systems (p < 0.001). CONCLUSIONS: The results suggested that, apart from the technical issues of implementing clinical information systems, non-technical factors should be taken into account. Among them, the nature of clinical tasks and the organizational culture require more attention to allow a successful system to be designed and implemented.
Hospital Information Systems* ; Hospitals, Teaching ; Information Systems ; Medical Informatics Applications ; Nursing* ; Organizational Culture ; Personal Satisfaction ; Reproducibility of Results

OBJECTIVES: Growth velocity is an important factor to monitor for appropriate child growth. This study presents the growth velocity of infants based on length, weight, and head circumference. METHODS: The subjects of this study were 308 neonates (160 boys and 148 girls) born in West Azerbaijan Province of northwestern Iran who were followed from birth for 4 years. The weights and lengths of the subjects were recorded at birth, 1, 2, 4, 6, and 9 months, and 1, 1.5, 2, 3, and 4 years of age, while the head circumferences were measured just up to 1.5 years of age. In this study, the Lambda-Mu-Sigma (LMS) method using LMS Chartmaker Pro (Institute of Child Health, London, UK) was utilized to obtain growth velocity percentiles. RESULTS: After obtaining growth velocity charts for weight, length, and head circumference (5th, 50th, and 95th percentiles), the researchers could deduce that there was a sharp decrease in the velocity growth charts from birth to 2 years of age but these charts remained relatively stable up to 4 years for both sexes. Growth velocities for the length and weight of boys in the present sample are slightly but not significantly greater than those in girls through the first months of infancy and there was no significant difference between girls and boys up to 4 years. CONCLUSIONS: This paper provided the first local growth velocity standards of length, weight, and head circumference for infants by analyzing longitudinal measurements produced for West Azerbaijan Province, which should be updated periodically. It seems that there has been a significant difference between the growth velocity of infants in northwestern Iran and southern Iran within the past few years.
Azerbaijan* ; Child ; Female ; Growth Charts ; Head ; Humans ; Infant* ; Infant, Newborn ; Iran* ; Parturition* ; Weights and Measures ; Child Health