Appointment scheduling systems are potentially useful tools for enhancing the patient satisfaction. This study was conducted to inspect patient's needs and satisfaction of the current status of appointment scheduling systems in outpatient clinics. This cross-sectional study was conducted in 10 outpatient clinics with different specializations. The outpatient clinics were selected based on the stratified randomization method. Data were collected using a questionnaire from December 2016 to March 2017. The questionnaire reliability was measured with the participation of 15 patients using the test-retest method. The content validity was also evaluated by 13 experts. A total of 319 patients completed the survey. The mean score of overall patient satisfaction and the patient satisfaction of the clinic environment were 6.73 ± 0.16 and 8.30 ± 0.12, respectively. The average waiting time was 64.2 ± 3.45 min. The service time took on an average 9.85 ± 0.37 min. The patient satisfaction of the clinic environment (P = 0.023), length of waiting time (P = 0.001), and duration of service time (P = 0.005) had a statistically significant association with overall patient satisfaction. Based on the results, the need for improving overall patient satisfaction score was felt. The patient satisfaction of waiting time, service time, and clinic environment had the greatest influence on overall patient satisfaction. Furthermore, it is recommended that a web-based appointment scheduling system should be implemented.

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The objective of the current research was to compare the impact of balance and stabilizing trainings on balance indices in patients with nonspecific chronic low back pain. In this randomized, controlled, single-blinded clinical trial, 20 people suffering from nonspecific chronic low back pain were randomly assigned to two groups of balance and stabilizing trainings. Trainings of both groups were performed for 6 weeks and four sessions per week. The overall, lateral, and anterior-posterior stability indices, pain, and disability were measured using Biodex balance system, visual analog scale, and Oswestry scale, before and after treatment, respectively. Paired t-test and independent t-test were used for analyzing the data. In the balance group, the pain severity was changed from 6.33 ± 1.63 to 4.33 ± 2.6 (P = 0.005) and dynamic anterior-posterior stability index in the standing position on left leg with closing eyes was changed from 5.56 ± 2.25 to 3.45 ± 1. 57 (P = 0.03). In the stabilizing group, pain severity was changed from 4. 16 ± 1.47 to 1.33 ± 0.81 (P = 0.0001) and disability index was changed from 17.33 ± 5.60 to 5.33 ± 3.93 (P = 0.01). Reduction in pain and disability in the stabilizing group and increase in two balance indices were significant in the balance training group compared to those in other group (P < 0.05). Research findings revealed that the impact of stabilizing trainings was significant in reducing pain and disability compared to that in balance trainings.

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The ethosomal carrier system can increase the penetration of azelaic acid into the stratum corneum, but ethosomes have both physical (particle aggregation or fusion) and chemical instability (chemical interaction of active ingredients during storage) that are often encountered in long-term storage. The aim of this study is to acquire proethosome formula of azelaic acid with lyoprotectant which has better stability than ethosomes of azelaic acid. Azelaic acid proethosomes were measured its absorbance using an ultraviolet-visible is spectrophotometer at a wavelength of 204 nm to obtain a percentage of entrapment efficiency (EE%). Proethosomes particle size was obtained from the analysis using particle size analyzer. Proethosomes consisting of phosphatidylcholine, ethanol, and propylene glycol were prepared by a thin-layer hydration process. After that, it was added with lyoprotectants such as trehalose, glucose, and mannitol before it was freeze-dried. Physical stability was studied with physical appearance, EE, and particle size. Chemical stability study determined the level of azelaic acid. Both tests were evaluated every 2 weeks for 8-week storage at 4°C and 27°C. Least entrapment efficiency and particle size changes was proethosomes with trehalose addition from 92.06% and 261.0 nm became 68.92% and 957.7 nm at 27°C, meanwhile at 4°C became 77.47% and 439.4 nm. While the highest percentage of azelaic acid content in proethosomes with trehalose was 62.07% (at 27°C) and without lyoprotectant 69.40%. Based on their characteristic, it can be assumed that, azelaic acid proethosomes with trehalose have the best stability than ethosomes and proethosomes with other lyoprotectants.

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Type 2 diabetes is the most common cause of hyperglycemia. It has different prevalence in various populations. It has been found out that type 2 diabetes is a genetic disorder; however, its inheritance and its type have not been well defined. In studying the genes involved in the development of diabetes, several genes have been introduced as candidates; however, the gene or genes involved in diabetes cannot be identified yet. As family diabetes has not been studied in Iran so far, this study was conducted on a population aged over 20 years in east of Tehran. In a population of 14,687 people living in east of Tehran, 180 families with type 2 diabetes were identified. In this research, 802 subjects were female and 792 were male. After oral glucose tolerance test, 40.7% of females and 32.3% of males had diabetes. The incidence of diabetes in females was significantly higher than that in males (P < 0.001). It was found that 656 diabetic patients had age over 20 years, which most of them had age between 41 and 70 years. The highest number of diabetic patients was in the age group of 51–60 years. The percentage of offspring and siblings involvement in this sample was 44% and 53%, respectively. The highest level of involvement among the first-degree family members belonged to sister-brother, followed by father-daughter. This study shows the relationship between family diabetes in Iranian families in a demographic study. By recognizing the family relations, effective measures can be taken to prevent this disease. In the case of type 2 diabetes development in one member of family, the incidence of diabetes in other family members would increase by up to 50%. Thus, screening is suggested for all type 2 diabetic family members continuously so that the disease to be immediately diagnosed and treated to prevent major complications of diabetes.

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