Background The increasing prevalence of non-communicable diseases (NCDs) has some major implications on many countries to achieve universal health coverage. This study aimed to investigate the implementation of Global School-based Student Health Survey (GSHS), which is used to assess the risk factors of NCDs among children and adolescents in the eastern Mediterranean region (EMR). Methods This study was a meta-analysis and systematic literature review of 2001–2018 published studies, which were found by searching PubMed, Google Scholar, WHO, and CDC databases. In this study, the target group was students aged between 13 and 17 years old. GSHS implementation as well as risk factors of NCDs were compared across different countries. The random-effect model for meta-analysis was considered at 95% confidence interval. Result In the EMR, 19 countries have implemented GSHS at least once following the survey manual (37 surveys). Overall, 201,795 students were included in our analysis. The overall estimation prevalence rateof the overweight was 24.5% (20.6–28.8), obesity was 7.3% (5.4–9.5), insufficient physical activity was 82.4% (80.7–84.1), tobacco usage was 14.3% (10.53–18.67), and smoking was 9.6% (8.1–11.3), respectively. Among those aged 13 to 17 years old, these rates were estimated as 19.8 (13.2–27.3), 9.7 (6.2–14.0), 86.1 (84.1–87.9), 17.8 (11.8–24.7), and 11.5 (9.4–13.8), respectively. Conclusion GSHS has been widely implemented across EMR countries. Using nationally representative data, the results show that more efforts are needed to target the NCDs risk factors among adolescents in the region.

BACKGROUND: Colonoscopy is generally a safe procedure with a limited number of adverse events. Few studies have addressed the rate of adverse events in teaching hospitals. This study aimed to investigate the rate of complications after colonoscopy performed by gastroenterology fellows in a teaching hospital in Tehran. METHODS: A historical cohort study was carried out to link the colonoscopy reports and the hospital information system to identify serious adverse events leading to unplanned hospitalization, unplanned procedures or interventions (e.g. surgery), prolongation of existing hospitalization, or death within 30 days after colonoscopy. RESULTS: We included 9928 colonoscopies (mean age of the patients 53.0±15.9 years, 52.3% men) in this study. In-hospital patients comprised (34.8%) of the procedures. The indications of colonoscopy included 7137 diagnostic (71.9%), and 2519 screening (25.4%) reasons. Colorectal polyps were found in 2005 (20.2%) patients. Major complications were seen in 17 patients (0.2%), including serious bleeding in seven patients, cardiopulmonary complications in five patients, perforation in four patients, and sepsis in one patient. CONCLUSION: Serious adverse events after colonoscopy are relatively rare. The rate of complications does not appear to be higher in an academic teaching hospital when performed by fellows under supervision.

Introduction: One of the most important 2015-post agendas of countries’ health systems is achieving Universal Health Coverage (UHC), so countries should monitor the activities carried out. The present study aimed to investigate the UHC status two years after Health Transformation Plan (HTP) in Iran. Methods: This is a secondary analysis of the national household income and expenditure survey (with close 40,000 households as the survey sample). The survey was used to estimate financial protection indicators (out-of-pocket payment, catastrophic and impoverishment health expenditure) in 2016. Estimation for service coverage index provided by international databases was applied at the country level. Indicators of financial protection and service coverage were evaluated in relation to each other using the World Health Organization joint levels assessment method, which indicates UHC attainment in terms of a plot with four zones. The relationship was estimated for the entire population, first quintile, and fifth quintile in 2000, 2017, and 2030. Results: The average per capita of OOP annually was 1,940,613 Rials (162.415 PPP int $). About 15.85% of households endured catastrophic health expenditures at the 10% threshold. The impoverishment health expenditure is about 0.6. Accordingly, Iran is on the border between zones 1 and 2 in 2017 in terms of achieving UHC and will move to zone 1 in 2030 with the current trend. Conclusion: According to the results of this study, universal health coverage has not been achieved even despite the implementation of the HTP. Even with improved service coverage, achieving UHC by 2030 may seem impossible with the current trends.

Background Neurological involvement including CNS demyelination syndromes following SARS-CoV-2 infection have been reported as extra-pulmonary involvement in patients with COVID-19. Besides, immune-mediated central nervous system involvement is a rare phenomenon that is considered to be one of the most important and serious complications of vaccines as well. While regarding the recent pandemic and worldwide use of the COVID-19 vaccines investigating serious life-threatening side effects is worth considering. Case presentation: This article reported a young male Iranian patient without any past medical history and neurological problems who presented acute disorientation due to acute central nervous system demyelination approximately one month after receiving the first dosage of Sinopharm BIBP COVID-19 vaccine. Based on extended clinical investigations the patient had undergone the treatment with the highly probable diagnosis of acute disseminated encephalomyelitis syndrome. Conclusion In this article clinical presentation, diagnosis, and treatment of the patient with the diagnosis of ADEM following COVID-19 vaccine administration have been discussed. It seems for timely diagnosis and access to a safer state in our global immunization, reporting and evaluating the diagnosis approach and challenges in treatment and patient recovery regarding rare and adverse effects is worth considering.

Backgrounds: Measuring the effective coverage of essential health services is necessary for monitoring progress towards Universal Health Coverage (UHC). So, this study aimed to assess the geographic variations in key maternal and child indicators (as essential health services) provided at the primary health care (PHC) level in terms of their crude and effective coverage, and also to investigate the relationship between the effective coverage and health expenditures in the national and sub-national level of Iran. Methods: This study was a secondary analysis, which analyzed the spatial distribution of six key maternal and child health indicators using the latest available data of Demographic Health Survey-DHS (2010) across 31 provinces of Iran. Moreover, two composite indicators, the crude, and the effective coverage were calculated. The median cut-off was used to compare provinces situations. Furthermore, the relationship between coverage indicators and total health expenditure per capita was evaluated. Results: At the national level, the crude and the effective composite coverage were 89.56 and 77.22%, respectively. Also, the medians of composite crude and effective service coverage in the provinces were 90.25 and 77.62%, respectively. There was no significant difference between urban and rural areas. Conclusions: in this study, we found that there is a significant gap between crude and effective service coverage of the selected indicators. Overall, coverage indicators of maternal services were higher compared to those of children. In addition, geographic variations in key Indicators of maternal and child health services coverage among provinces were almost high. Although the services are free of charge in the rural areas, they did not have higher coverage than those of urban areas. PHC services in Iran are far away from reaching the desired coverage and achieving UHC.