Health impact assessment and evaluation of economic costs attributed to PM2.5 air pollution using BenMAP-CE.

Air pollution is considered the most prominent public health. Economically, air pollution imposes additional costs on governments. This study aimed to quantify health effects and associated economic values of reducing PM2.5 air pollution using BenMAP-CE in Qom in 2019. The air quality data were acquired from Qom Province Environmental Protection Agency, and the population data were collected from Qom Province Management and Planning Organization website. The number of deaths due to Stroke, Chronic Obstructive Pulmonary Disease, Lung Cancer, and Ischemic Heart Disease attributable to PM2.5 were estimated using BenMAP-CE based on two control scenarios, 2.4 and 10 µg/m3, known as scenarios I and II, respectively. The associated economic effect of premature deaths was assessed by value of a statistical life (VSL) approach. The annual average of PM2.5 concentration was found to be 16.32 µg/m3 (SD: 9.93). A total of 4694.5 and 2475.94 premature deaths in scenarios I and II were found to be attributable to PM2.5 in overall, respectively. The total associated cost was calculated to be 855.91 and 451.40 million USD in scenarios I and II, respectively. The total years of life lost due to PM2.5 exposure in 2019 was 158,657.06 and 78,351.51 in scenarios I and II, respectively. The results of both health and economic assessment indicate the importance of solving the air pollution problem in Qom, as well as other big cities in Iran. The elimination of limitations, such as insufficient local data, should be regarded in future studies.

Customers' satisfaction with the Iranian health system reform plan.

BACKGROUND AND AIM: Customer's satisfaction is one of the main goals of the health system because it is effective on the desire of external customers for using the services of the health system and also the quality and quantity of the provided care for the internal customers and eventually the health of the society. Considering the importance of the subject, the present study was designed to determine the customers' satisfaction with the health system reform plan in the field of health. MATERIALS AND METHODS: Participants in the present content analysis qualitative study were 22 technical and operational managers and 118 health-care providers, and 15 recipients of health services referring to the health centers in Qom; who individually answered the questions of the interview guide. The gathered qualitative data were analyzed using conventional qualitative content analysis. RESULTS: Customers' satisfaction with the health system reform plan was categorized into six themes of decreased trust of the caregivers, wasting caregivers' time in the health units, increased provision of services to the caregivers, decreased motivation for work, occupational burnout, and a sense of petition in the care providers. CONCLUSIONS: Although external customers were satisfied with some services of the health system reform such as providing various free services, follow-up the patients, and beautification the environment of the health centers; but there are multiple weaknesses in this plan that would cause dissatisfaction in the external and internal customers. More studies seem necessary to better determine the different aspects of the satisfaction in the caregivers and care.

Serum Endostatin Levels in Oral Squamous Cell Carcinoma.

INTRODUCTION: Endostatin is a C-terminal proteolytic fragment of collagen XVIII and, as with angiostatin and thrombospondin, is known as an antiangiogenic agent. The aim of this study was to assess the level of serum endostatin in patients with oral squamous cell carcinoma (SCC), and its association with the clinicopathological characteristics of the tumor. MATERIALS AND METHODS: Using an enzyme-linked immunosorbent assay (ELISA) kit, we investigated the circulating levels of endostatin in the blood serum of 45 patients with oral SCC and 45 healthy controls. RESULTS: The mean level of serum endostatin in patients was significantly lower (68.8±85 ng/ml) than in healthy controls (175.6±73 ng/ml) (P<0.001). Serum endostatin levels were significantly lower in patients with lymph node metastasis compared with patients without lymph node metastasis (P<0.001). In addition, serum endostatin level was associated with higher histological grade (P<0.001). There were no apparent correlations between serum endostatin concentration and clinicopathological features such as age, gender, and tumor stage (P>0.05). CONCLUSION: Findings of the present study suggest the prognostic and anti-metastatic role of endostatin, and this may be used as a tool for monitoring tumor progression.