Iranian Red Crescent Medical Journal Iranian Red Crescent Medical Journal Iran Red Crescent Med J http://www.ircmj.com 2074-1804 2074-1812 10.5812/ircmj en jalali 2017 6 24 gregorian 2017 6 24 16 4
en 10.5812/ircmj.12458 CCR5 on the NK Cells and its Ligand (RANTES) Expressions are Disrupted in South-Eastern Iranian Patients With Chronic Hepatitis B Infection CCR5 on the NK Cells and its Ligand (RANTES) Expressions are Disrupted in South-Eastern Iranian Patients With Chronic Hepatitis B Infection research-article research-article Background:

CCR5 is a receptor for CCL3 (MIP-1 α), CCL4 (MIP-1 α) and CCL5 (regulated on activation normal T cell expressed and secreted (RANTES)) and play important roles in recruitment of NK cells to the HBV infected liver.

Objectives:

The main purpose of this study was to investigate the expression levels of CCR5 on the NK cells and also serum levels of RANTES in chronic HBV infected (CHI) patients.

Materials and Methods:

In this descriptive study 63 CHI patients and 96 healthy controls were evaluated regarding CCR5 expression on the NK cells and serum levels of RANTES using flow cytometry and ELISA techniques, respectively. Real-Time PCR technique also was used for HBV-DNA quantification.

Results:

The results revealed that CCR5 expressing NK cells and serum levels of RANTES were decreased significantly in the CHI patients in compare to healthy control.

Conclusions:

Based on the results it can be concluded that NK cells of Iranian CHI patients are unable to express adequate levels of CCR5 and expression levels of RANTES by immune cells also are defected in CHI patients, hence, the migration of NK cells to the infected hepatocytes and HBV eradication from the cells is interrupted.

Background:

CCR5 is a receptor for CCL3 (MIP-1 α), CCL4 (MIP-1 α) and CCL5 (regulated on activation normal T cell expressed and secreted (RANTES)) and play important roles in recruitment of NK cells to the HBV infected liver.

Objectives:

The main purpose of this study was to investigate the expression levels of CCR5 on the NK cells and also serum levels of RANTES in chronic HBV infected (CHI) patients.

Materials and Methods:

In this descriptive study 63 CHI patients and 96 healthy controls were evaluated regarding CCR5 expression on the NK cells and serum levels of RANTES using flow cytometry and ELISA techniques, respectively. Real-Time PCR technique also was used for HBV-DNA quantification.

Results:

The results revealed that CCR5 expressing NK cells and serum levels of RANTES were decreased significantly in the CHI patients in compare to healthy control.

Conclusions:

Based on the results it can be concluded that NK cells of Iranian CHI patients are unable to express adequate levels of CCR5 and expression levels of RANTES by immune cells also are defected in CHI patients, hence, the migration of NK cells to the infected hepatocytes and HBV eradication from the cells is interrupted.

Chronic HBV Infection;CCR5;RANTES;NK Cells Chronic HBV Infection;CCR5;RANTES;NK Cells http://www.ircmj.com/index.php?page=article&article_id=12458 Vahid Mirzaee Vahid Mirzaee Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran; Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran, Tel: +98-39182200019, Fax: +98-03918220022 Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran; Department of Internal Medicine, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran, Tel: +98-39182200019, Fax: +98-03918220022 Jahanbano Shahriari Jahanbano Shahriari Hematology Laboratory, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, IR Iran Hematology Laboratory, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, IR Iran Masomeh Hajghani Masomeh Hajghani Hematology Laboratory, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, IR Iran Hematology Laboratory, Bahonar Hospital, Kerman University of Medical Sciences, Kerman, IR Iran
en 10.5812/ircmj.15115 A Comparative Serological Study of Toxoplasmosis in Pregnant Women by CLIA and ELISA Methods in Chalus City Iran A Comparative Serological Study of Toxoplasmosis in Pregnant Women by CLIA and ELISA Methods in Chalus City Iran research-article research-article Results:

Of the 50 samples tested by the ELISA method, 26 samples (52%) were positive for IgG . No samples were positive for IgM. Of the 50 samples tested by the Chemiluminescence method, 28 samples (56%) were positive for IgG. No samples were positive for IgM.

Conclusions:

A significant relationship between the age of the youngest child and the infection rate was seen. No significant correlation between age, number of individuals in the household, number of children, location, type of construction, consumption of greens, the way of greens and meat consumption, drug use, history of stillbirth and infection levels was seen.

Objectives:

Since no research compared these two methods, we decided to compare these methods and determine which method works better for diagnosis of toxoplasmosis.

Patients and Methods:

In this study, 50 pregnant women who referred to the Chalus Health Center laboratory were included and the blood samples were tested for presence of IgG and IgM antibodies of Toxoplasma gondii by both ELISA and Chemiluminescence methods.

Background:

Toxoplasmosis is the most common disease in humans and animals (zoonosis) caused by the protozoan parasite Toxoplasma gondii. The disease is usually appeared as asymptomatic in immunocompromised individuals but its most common symptom is lymphadenopathy. Shortly before or during the first trimester of pregnancy, this disease can be transferred to the fetus and cause serious infection in the fetus. In late pregnancy (third trimester), the complications of this infection is very low or unsigned. Due to the absence of non-specific clinical symptoms or slight infection in pregnant women, prenatal diagnosis is often impossible.

Results:

Of the 50 samples tested by the ELISA method, 26 samples (52%) were positive for IgG . No samples were positive for IgM. Of the 50 samples tested by the Chemiluminescence method, 28 samples (56%) were positive for IgG. No samples were positive for IgM.

Conclusions:

A significant relationship between the age of the youngest child and the infection rate was seen. No significant correlation between age, number of individuals in the household, number of children, location, type of construction, consumption of greens, the way of greens and meat consumption, drug use, history of stillbirth and infection levels was seen.

Objectives:

Since no research compared these two methods, we decided to compare these methods and determine which method works better for diagnosis of toxoplasmosis.

Patients and Methods:

In this study, 50 pregnant women who referred to the Chalus Health Center laboratory were included and the blood samples were tested for presence of IgG and IgM antibodies of Toxoplasma gondii by both ELISA and Chemiluminescence methods.

Background:

Toxoplasmosis is the most common disease in humans and animals (zoonosis) caused by the protozoan parasite Toxoplasma gondii. The disease is usually appeared as asymptomatic in immunocompromised individuals but its most common symptom is lymphadenopathy. Shortly before or during the first trimester of pregnancy, this disease can be transferred to the fetus and cause serious infection in the fetus. In late pregnancy (third trimester), the complications of this infection is very low or unsigned. Due to the absence of non-specific clinical symptoms or slight infection in pregnant women, prenatal diagnosis is often impossible.

Toxoplasma;Toxoplasmosis in Pregnancy;Congenital Infection;Enzyme-Linked Immunosorbent Assay Toxoplasma;Toxoplasmosis in Pregnancy;Congenital Infection;Enzyme-Linked Immunosorbent Assay http://www.ircmj.com/index.php?page=article&article_id=15115 Zahra Elahian Firouz Zahra Elahian Firouz Department of Microbiology, Islamic Azad University, Science and Research Ayatollah Amoli Branch, Amol, IR Department of Microbiology, Islamic Azad University, Science and Research Ayatollah Amoli Branch, Amol, IR Hami Kaboosi Hami Kaboosi Department of Microbiology, Islamic Azad University, Science and Research Ayatollah Amoli Branch, Amol, IR Department of Microbiology, Islamic Azad University, Science and Research Ayatollah Amoli Branch, Amol, IR Abdolreza Faghih Nasiri Abdolreza Faghih Nasiri Department of Infectious Disease, Iran Blood Transfer Organization, Sari, IR Iran Department of Infectious Disease, Iran Blood Transfer Organization, Sari, IR Iran Seyed Saleh Tabatabaie Seyed Saleh Tabatabaie ENT-HNS Research Center, Hazrate Rasool Hospital, Iran University of Medical Sciences, Tehran, IR Iran ENT-HNS Research Center, Hazrate Rasool Hospital, Iran University of Medical Sciences, Tehran, IR Iran Farideh Golhasani-Keshtan Farideh Golhasani-Keshtan Department of Physiology, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Physiology, Mashhad University of Medical Sciences, Mashhad, IR Iran Fatemeh Zaboli Fatemeh Zaboli Department of Mycology, Islamic Azad University, Science and Research Ayatollah Amoli Branch, Amol, IR Iran; Department of Mycology, Islamic Azad University, Science and Research Ayatollah Amoli Branch, Amol, IR Iran. Tel: +98-1212517001, Fax: +98-1212517001 Department of Mycology, Islamic Azad University, Science and Research Ayatollah Amoli Branch, Amol, IR Iran; Department of Mycology, Islamic Azad University, Science and Research Ayatollah Amoli Branch, Amol, IR Iran. Tel: +98-1212517001, Fax: +98-1212517001
en 10.5812/ircmj.11894 Iranian Nurses’ Perception of Patient Safety Culture Iranian Nurses’ Perception of Patient Safety Culture research-article research-article Background:

In recent decades, patient safety has become a high priority health system issue, due to the high potential of occurring adverse events in health facilities.

Objectives:

This study was aimed to survey patient safety culture in 2 Iranian educational hospitals.

Materials and Methods:

In a descriptive, cross-sectional survey, a hospital survey on patient safety culture, was used in two teaching hospitals in Yazd, Iran during 2012. Study population was comprised of the same hospitals' nurses. Stratified-random sampling method was used and distributed among a total of 340 randomly-selected nurses from different units. From all distributed questionnaires, 302 ones were answered completely and afterwards analyzed using SPSS 17. Dimensional- and item-level positive scores were used for results reporting. Additionally descriptive statistics (mean and standard deviation), independent sample t-test and ANOVA were sued for data analyzing.

Results:

Research findings demonstrated that both hospitals had low to average scores in all dimensions of patient safety culture. Non-punitive response to error, staffing and frequency of events reported had the lowest positive scores of patient safety dimensions with scores 15.26, 19.26, 16.65, 30 and 32.87, 31.10 respectively in Shahid Sadoughi and Shahid Rahnemoon Hospitals. Also only 29.20 and 28.80 percent of nurses in Shahid Sadoughi and Shahid Rahnemoon Hospitals, respectively, evaluated the patient safety grade of their hospital as “excellent” and “very good”. Indeed, the studied hospitals had a statistical difference in 3 dimensions of patient safety culture (frequency of events reported, organizational learning and staffing). (P ≤ 0.05)

Conclusions:

Our study results were indicating of the challenge of weak patient safety culture, in educational hospitals. Therefore, the issue should be integrated to all policy makers and managerial initiatives in our health system, as a top priority.

Background:

In recent decades, patient safety has become a high priority health system issue, due to the high potential of occurring adverse events in health facilities.

Objectives:

This study was aimed to survey patient safety culture in 2 Iranian educational hospitals.

Materials and Methods:

In a descriptive, cross-sectional survey, a hospital survey on patient safety culture, was used in two teaching hospitals in Yazd, Iran during 2012. Study population was comprised of the same hospitals' nurses. Stratified-random sampling method was used and distributed among a total of 340 randomly-selected nurses from different units. From all distributed questionnaires, 302 ones were answered completely and afterwards analyzed using SPSS 17. Dimensional- and item-level positive scores were used for results reporting. Additionally descriptive statistics (mean and standard deviation), independent sample t-test and ANOVA were sued for data analyzing.

Results:

Research findings demonstrated that both hospitals had low to average scores in all dimensions of patient safety culture. Non-punitive response to error, staffing and frequency of events reported had the lowest positive scores of patient safety dimensions with scores 15.26, 19.26, 16.65, 30 and 32.87, 31.10 respectively in Shahid Sadoughi and Shahid Rahnemoon Hospitals. Also only 29.20 and 28.80 percent of nurses in Shahid Sadoughi and Shahid Rahnemoon Hospitals, respectively, evaluated the patient safety grade of their hospital as “excellent” and “very good”. Indeed, the studied hospitals had a statistical difference in 3 dimensions of patient safety culture (frequency of events reported, organizational learning and staffing). (P ≤ 0.05)

Conclusions:

Our study results were indicating of the challenge of weak patient safety culture, in educational hospitals. Therefore, the issue should be integrated to all policy makers and managerial initiatives in our health system, as a top priority.

Patients, Patient Safety, Nurses;Hospital Patients, Patient Safety, Nurses;Hospital http://www.ircmj.com/index.php?page=article&article_id=11894 Mohammad Amin Bahrami Mohammad Amin Bahrami Department of Healthcare Management, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran; Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran Department of Healthcare Management, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran; Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran Mahjabin Chalak Mahjabin Chalak Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Razieh Montazeralfaraj Razieh Montazeralfaraj Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran; Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran. Tel: +98-9132564206 Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran; Hospital Management Research Center, Shahid Sadoughi Hospital, Yazd, IR Iran. Tel: +98-9132564206 Arefeh Dehghani Tafti Arefeh Dehghani Tafti Department of Epidemiology and Biostatistics, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran Department of Epidemiology and Biostatistics, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
en 10.5812/ircmj.11989 Sociodemographic Characteristics of Pregnant Women Exposed to Domestic Violence During Pregnancy in an Iranian Setting Sociodemographic Characteristics of Pregnant Women Exposed to Domestic Violence During Pregnancy in an Iranian Setting research-article research-article Background:

Domestic violence refers to any type of physical, sexual, and psychological abuse enforced in the setting of familial relationships. Domestic violence has a significant relationship with poor outcome among pregnant women. Success in resolving this social phenomenon rests on accurate assessment of the society and the factors associated with violence in that specific community.

Objectives:

The present study was conducted to assess the demographic characteristics of pregnant women exposed to different types of domestic violence during pregnancy in Iranian setting.

Patients and Methods:

This is a descriptive-analytic, cross-sectional study. Sampling was done with convenience sampling method. in the current study, 301 pregnant women aged 15-45 years of Iranian nationality who were referred to the hospital for delivery or abortion, regardless of the gestational age, were selected as the subjects. Data collection tools consisted of a sociodemographic questionnaire and a violence checklist. Violence was assessed using Revised Conflict Tactics Scale (CTS2). Data were analyzed using descriptive and analytic statistics on SPSS version 16 (SPSS, Chicago, IL, USA) and STATA version 10. The characteristics of the participants were presented as mean ± SD or number and percentage. Differences between variables were determined by the χ2 test, and multivariate logistic regression. P < 0.05 was considered significant.

Results:

According to the findings, 34.56% of participants had experienced psychological violence, 28.24% physical violence, and 3.65% sexual violence. Multivariate logistic regression revealed a statistically significant relationship only in the case of physical violence and history of penal conviction for partner (Adjusted Odds Ratio (AOR) = 12.60) and a patriarchal household (AOR = 16.75).

Conclusions:

As domestic violence is greatly influenced by the customs and cultures of each community, no single strategy can be adopted to resolve it universally. Simultaneously, it is necessary to adopt comprehensive measures to control factors associated with domestic violence in the healthcare, judiciary, and the educational systems in order to prevent and curb this social challenge.

Background:

Domestic violence refers to any type of physical, sexual, and psychological abuse enforced in the setting of familial relationships. Domestic violence has a significant relationship with poor outcome among pregnant women. Success in resolving this social phenomenon rests on accurate assessment of the society and the factors associated with violence in that specific community.

Objectives:

The present study was conducted to assess the demographic characteristics of pregnant women exposed to different types of domestic violence during pregnancy in Iranian setting.

Patients and Methods:

This is a descriptive-analytic, cross-sectional study. Sampling was done with convenience sampling method. in the current study, 301 pregnant women aged 15-45 years of Iranian nationality who were referred to the hospital for delivery or abortion, regardless of the gestational age, were selected as the subjects. Data collection tools consisted of a sociodemographic questionnaire and a violence checklist. Violence was assessed using Revised Conflict Tactics Scale (CTS2). Data were analyzed using descriptive and analytic statistics on SPSS version 16 (SPSS, Chicago, IL, USA) and STATA version 10. The characteristics of the participants were presented as mean ± SD or number and percentage. Differences between variables were determined by the χ2 test, and multivariate logistic regression. P < 0.05 was considered significant.

Results:

According to the findings, 34.56% of participants had experienced psychological violence, 28.24% physical violence, and 3.65% sexual violence. Multivariate logistic regression revealed a statistically significant relationship only in the case of physical violence and history of penal conviction for partner (Adjusted Odds Ratio (AOR) = 12.60) and a patriarchal household (AOR = 16.75).

Conclusions:

As domestic violence is greatly influenced by the customs and cultures of each community, no single strategy can be adopted to resolve it universally. Simultaneously, it is necessary to adopt comprehensive measures to control factors associated with domestic violence in the healthcare, judiciary, and the educational systems in order to prevent and curb this social challenge.

Pregnant Women;Domestic Violence;Pregnancy;Iran Pregnant Women;Domestic Violence;Pregnancy;Iran http://www.ircmj.com/index.php?page=article&article_id=11989 Nayereh Azam Hajikhani Golchin Nayereh Azam Hajikhani Golchin Department of Midwifery, Islamic Azad University, Gorgan Branch, Gorgan, IR Iran; Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Midwifery, Islamic Azad University, Gorgan Branch, Gorgan, IR Iran; Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Zeinab Hamzehgardeshi Zeinab Hamzehgardeshi Department of Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran; Department of Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran. Tel: +98-1512267342-5, Fax: +98-1512268915 Department of Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran; Department of Midwifery, Mazandaran University of Medical Sciences, Sari, IR Iran. Tel: +98-1512267342-5, Fax: +98-1512268915 Leila Hamzehgardeshi Leila Hamzehgardeshi Department of Family Health, Public Health Center, Mazandaran University of Medical Sciences, Sari, IR Iran Department of Family Health, Public Health Center, Mazandaran University of Medical Sciences, Sari, IR Iran Mahboobeh Shirzad Ahoodashti Mahboobeh Shirzad Ahoodashti Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran Department of Internal Medicine, Mazandaran University of Medical Sciences, Sari, IR Iran
en 10.5812/ircmj.12206 Early Surfactant Therapy With Nasal Continuous Positive Airway Pressure or Continued Mechanical Ventilation in Very Low Birth Weight Neonates With Respiratory Distress Syndrome Early Surfactant Therapy With Nasal Continuous Positive Airway Pressure or Continued Mechanical Ventilation in Very Low Birth Weight Neonates With Respiratory Distress Syndrome research-article research-article Background:

Various strategies have been suggested for the treatment of respiratory distress syndrome (RDS).

Objectives:

The aim of this study was to compare the efficacies of two common methods of RDS management among neonates with low birth weight.

Patients and Methods:

A cohort study was conducted on 98 neonates with definite diagnosis of RDS during 2008-2009. The neonates were divided into two groups by a blinded supervisor using simple randomization (odd and even numbers). Forty-five cases in the first group were treated with intubation, surfactant therapy, extubation (INSURE method) followed by nasal continuous positive airway pressure (N.CPAP) and 53 cases in the second group underwent intubation, surfactant therapy followed by mechanical ventilation (MV).

Results:

Five (11.1%) cases in the first group and 23 (43%) cases in the second group expired during the study. The rates of MV dependency among cases with INSURE failure and cases in the MV group were 37% and 83%, respectively (P < 0.001). Birth weight (BW) (P = 0.017), presence of retinopathy of prematurity (P = 0.022), C/S delivery (P = 0.029) and presence of lung bleeding (P = 0.010) could significantly predict mortality in the second group, although only BW (P = 0.029) had a significant impact on the mortality rate in the first group. Moreover, BW was significantly related to the success rate in the first group (P = 0.001).

Conclusions:

Our findings demonstrated that INSURE plus NCPAP was more effective than the routine method (permanent intubation after surfactant prescription). In addition, the lower rates of mortality, MV dependency, duration of hospitalization, and complications were observed in cases treated with the INSURE method compared to the routine one.

Background:

Various strategies have been suggested for the treatment of respiratory distress syndrome (RDS).

Objectives:

The aim of this study was to compare the efficacies of two common methods of RDS management among neonates with low birth weight.

Patients and Methods:

A cohort study was conducted on 98 neonates with definite diagnosis of RDS during 2008-2009. The neonates were divided into two groups by a blinded supervisor using simple randomization (odd and even numbers). Forty-five cases in the first group were treated with intubation, surfactant therapy, extubation (INSURE method) followed by nasal continuous positive airway pressure (N.CPAP) and 53 cases in the second group underwent intubation, surfactant therapy followed by mechanical ventilation (MV).

Results:

Five (11.1%) cases in the first group and 23 (43%) cases in the second group expired during the study. The rates of MV dependency among cases with INSURE failure and cases in the MV group were 37% and 83%, respectively (P < 0.001). Birth weight (BW) (P = 0.017), presence of retinopathy of prematurity (P = 0.022), C/S delivery (P = 0.029) and presence of lung bleeding (P = 0.010) could significantly predict mortality in the second group, although only BW (P = 0.029) had a significant impact on the mortality rate in the first group. Moreover, BW was significantly related to the success rate in the first group (P = 0.001).

Conclusions:

Our findings demonstrated that INSURE plus NCPAP was more effective than the routine method (permanent intubation after surfactant prescription). In addition, the lower rates of mortality, MV dependency, duration of hospitalization, and complications were observed in cases treated with the INSURE method compared to the routine one.

Respiration, Artificial;Infant, Newborn;Respiratory Distress Syndrome, Newborn Respiration, Artificial;Infant, Newborn;Respiratory Distress Syndrome, Newborn http://www.ircmj.com/index.php?page=article&article_id=12206 Bita Najafian Bita Najafian Department of Pediatrics, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Pediatrics, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Seyed Hasan Fakhraie Seyed Hasan Fakhraie Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Seyed Abulfazl Afjeh Seyed Abulfazl Afjeh Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2188600067 Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2188600067 Mohammad Kazemian Mohammad Kazemian Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Pediatrics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Majid Shohrati Majid Shohrati Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Amin Saburi Amin Saburi Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.12329 Characterization of Diarrheagenic Antimicrobial Resistant Escherichia coli Isolated From Pediatric Patients in Tehran, Iran Characterization of Diarrheagenic Antimicrobial Resistant Escherichia coli Isolated From Pediatric Patients in Tehran, Iran research-article research-article Background:

Acute infectious diarrhea is one of the most important causes of morbidity and mortality worldwide.

Objectives:

The objective of this study was to characterize antimicrobial resistant diarrheagenic Escherichia coli strains isolated from diarrheic children in Tehran, IR Iran.

Patients and Methods:

In total, 550 stool samples from diarrheic pediatric patients, aged less than 60 months, were collected and immediately transferred to the laboratory. Isolation and identification of E. coli strains was done using bacteriological methods. Antimicrobial susceptibility testing was performed using the disk diffusion technique. Multiplex PCR was used to detect aadA1, tetA, tetB, dfrA1, qnr, aac (3)-IV, sul1, blaSHV, CITM, cat1, and cmlA antibiotic resistance genes.

Results:

From the total of 550 fecal samples examined, 154 samples (28%) were positive for diarraheagenic E. coli. High rates of antibiotic resistance were seen against penicillin ﴾100%), ampicillin ﴾89.6%﴿ and tetracycline ﴾83.1%﴿. Resistance against ciprofloxacin was low ﴾28.6%﴿. The prevalence of different resistance genes in the studied strains varied from 96.10% for aadA1 gene to 40.25% for sul1 gene. The frequencies of aadA1, tetA, tetB, dfrA1, qnr, aac(3)-IV, sul1, blaSHV, CITM, cat1, and cmlA genes were 96.10%, 85.06%, 84.41%, 51.94%, 72.07%, 54.54%, 40.25%, 57.79%, 90.25%, 59.74% and 60.38%, respectively.

Conclusions:

Our results indicated that antibiotic resistance is increasing in diarraheagenic E. coli strains in Iran. It is imperative to develop strategies for prevention and control of resistant organisms. Changes in patterns of resistance against commonly used antibiotics in Iran indicate that an applied surveillance system and introduction of guidelines for appropriate antibiotic prescription are necessary.

Background:

Acute infectious diarrhea is one of the most important causes of morbidity and mortality worldwide.

Objectives:

The objective of this study was to characterize antimicrobial resistant diarrheagenic Escherichia coli strains isolated from diarrheic children in Tehran, IR Iran.

Patients and Methods:

In total, 550 stool samples from diarrheic pediatric patients, aged less than 60 months, were collected and immediately transferred to the laboratory. Isolation and identification of E. coli strains was done using bacteriological methods. Antimicrobial susceptibility testing was performed using the disk diffusion technique. Multiplex PCR was used to detect aadA1, tetA, tetB, dfrA1, qnr, aac (3)-IV, sul1, blaSHV, CITM, cat1, and cmlA antibiotic resistance genes.

Results:

From the total of 550 fecal samples examined, 154 samples (28%) were positive for diarraheagenic E. coli. High rates of antibiotic resistance were seen against penicillin ﴾100%), ampicillin ﴾89.6%﴿ and tetracycline ﴾83.1%﴿. Resistance against ciprofloxacin was low ﴾28.6%﴿. The prevalence of different resistance genes in the studied strains varied from 96.10% for aadA1 gene to 40.25% for sul1 gene. The frequencies of aadA1, tetA, tetB, dfrA1, qnr, aac(3)-IV, sul1, blaSHV, CITM, cat1, and cmlA genes were 96.10%, 85.06%, 84.41%, 51.94%, 72.07%, 54.54%, 40.25%, 57.79%, 90.25%, 59.74% and 60.38%, respectively.

Conclusions:

Our results indicated that antibiotic resistance is increasing in diarraheagenic E. coli strains in Iran. It is imperative to develop strategies for prevention and control of resistant organisms. Changes in patterns of resistance against commonly used antibiotics in Iran indicate that an applied surveillance system and introduction of guidelines for appropriate antibiotic prescription are necessary.

Escherichia coli;child;Multiplex Polymerase Chain Reaction Escherichia coli;child;Multiplex Polymerase Chain Reaction http://www.ircmj.com/index.php?page=article&article_id=12329 Maryam Heidary Maryam Heidary Department of Microbiology, Falavarjan Branch, Islamic Azad University, Falavarjan, IR Iran Department of Microbiology, Falavarjan Branch, Islamic Azad University, Falavarjan, IR Iran Hassan Momtaz Hassan Momtaz Department of Microbiology, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran; Department of Microbiology, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran. Tel/Fax: +98-3361064 Department of Microbiology, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran; Department of Microbiology, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran. Tel/Fax: +98-3361064 Mahboobeh Madani Mahboobeh Madani Department of Microbiology, Falavarjan Branch, Islamic Azad University, Falavarjan, IR Iran Department of Microbiology, Falavarjan Branch, Islamic Azad University, Falavarjan, IR Iran
en 10.5812/ircmj.12332 The Performance of the Ethics Committees in Teaching Hospitals Affiliated With Mashhad University of Medical Sciences The Performance of the Ethics Committees in Teaching Hospitals Affiliated With Mashhad University of Medical Sciences research-article research-article Patients and Methods

Subjects of this study include teaching hospitals in Mashhad, affiliated with Mashhad University of Medical Sciences and the tool used in gathering the data was a questionnaire, completed based on the information provided by the proceedings of the meetings held by the ethics committees. Also, for the purpose of gathering the suggestions, specifically on the improvement of the performance, a meeting was held with the representatives from hospitals' ethics committees. During the meeting, work reports were presented and recommendations made, based on those presentations. .

Results

Findings of the present study suggest that all hospitals under study, have an ethics committee, of which 85.7% operate in combination with other committees. The composition of the members of the committees, in 57.1% of the hospitals, was based on the guidelines for hospital evaluation.

Conclusions

For the performance of the medical ethics committees to improve, it is recommended that the hospital administration and evaluation section, hold regular meetings and oblige members to participate more actively.

Background

During the last three decades, ethics committees have been formed with a growing trend. These committees have a satisfactory and effective impact on the pattern of patient care and its performance. The medical ethics committee is considered one of the most active committees in hospitals, having the aim of providing necessary approaches for the optimal use of the findings in empirical science and diagnostic treatment and observance of Islamic noble values in performing medical affairs.

Objectives

The aim of this study is to assess the performance of the ethics committees, in the teaching hospitals affiliated with Mashhad University of Medical Sciences, in Mashhad.

Patients and Methods

Subjects of this study include teaching hospitals in Mashhad, affiliated with Mashhad University of Medical Sciences and the tool used in gathering the data was a questionnaire, completed based on the information provided by the proceedings of the meetings held by the ethics committees. Also, for the purpose of gathering the suggestions, specifically on the improvement of the performance, a meeting was held with the representatives from hospitals' ethics committees. During the meeting, work reports were presented and recommendations made, based on those presentations. .

Results

Findings of the present study suggest that all hospitals under study, have an ethics committee, of which 85.7% operate in combination with other committees. The composition of the members of the committees, in 57.1% of the hospitals, was based on the guidelines for hospital evaluation.

Conclusions

For the performance of the medical ethics committees to improve, it is recommended that the hospital administration and evaluation section, hold regular meetings and oblige members to participate more actively.

Background

During the last three decades, ethics committees have been formed with a growing trend. These committees have a satisfactory and effective impact on the pattern of patient care and its performance. The medical ethics committee is considered one of the most active committees in hospitals, having the aim of providing necessary approaches for the optimal use of the findings in empirical science and diagnostic treatment and observance of Islamic noble values in performing medical affairs.

Objectives

The aim of this study is to assess the performance of the ethics committees, in the teaching hospitals affiliated with Mashhad University of Medical Sciences, in Mashhad.

Task Performance and Analysis;Ethics Committees;Hospitals, Teaching;Iran Task Performance and Analysis;Ethics Committees;Hospitals, Teaching;Iran http://www.ircmj.com/index.php?page=article&article_id=12332 Marziyhe Meraji Marziyhe Meraji Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad University of Medical Sciences and Health Services, Mashhad, IR Iran Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad University of Medical Sciences and Health Services, Mashhad, IR Iran Farahnaz Sadoughi Farahnaz Sadoughi Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188793805, Fax: +98-2188883334 Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188793805, Fax: +98-2188883334 Nahid Ramezan Ghorbani Nahid Ramezan Ghorbani Department of Development and Cooperation of Information and Scientific Publications, Undersecretary for Research and Technology, Ministry of Health and Medical Education, Tehran, IR Iran Department of Development and Cooperation of Information and Scientific Publications, Undersecretary for Research and Technology, Ministry of Health and Medical Education, Tehran, IR Iran Azar Nezami Azar Nezami Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran
en 10.5812/ircmj.13355 Health Status, Intention to Seek Health Examination, and Participation in Health Education Among Taxi Drivers in Jinan, China Health Status, Intention to Seek Health Examination, and Participation in Health Education Among Taxi Drivers in Jinan, China research-article research-article Background:

Taxi drivers are exposed to various risk factors such as work overload, stress, an irregular diet, and a sedentary lifestyle, which make these individuals vulnerable to many diseases. This study was designed to assess the health status of this occupational group.

Objectives:

The objective was to explore the health status, the intention to seek health examination, and participation in health education among taxi drivers in Jinan, China.

Patients and Methods:

The sample-size was determined scientifically. The systematic sampling procedure was used for selecting the sample. Four hundred taxi drivers were randomly selected from several taxi companies in Jinan. In total, 396 valid questionnaires (from 370 males and 26 females) were returned. Health status, intention to seek health examination, and participation in health education were assessed by a self-designed questionnaire. Other personal information including sex, age, ethnicity, marital status, years of employment as a taxi driver, education level, and habits were also collected.

Results:

This survey revealed that 54.8% of taxi drivers reported illness in the last two weeks and 44.7% of participants reported chronic diseases. The prevalence rates of hypertension, diabetes mellitus, gastroenteritis, arthritis, and heart disease were 18.2%, 8.8%, 26%, 18.4%, and 4.8% of questioned taxi drivers, respectively. Significant self-reported symptoms included fatigue, waist and back pain, headache, dyspepsia, and dry throat affecting 49.7%, 26.2%, 23.5%, 26%, and 27% of participants, respectively. In total, 90.1% of subjects thought that it was necessary to receive a regular health examination. Only 17.9% of subjects had been given information about health education, and significantly, more than 87% of subjects who had been given information about health education reported that the information had been helpful.

Conclusions:

Taxi drivers’ health was poor in our survey. Thus, using health education interventions to improve knowledge and change in behaviors are necessary and effective programs that improve the health of individuals in this special occupational group are needed.

Background:

Taxi drivers are exposed to various risk factors such as work overload, stress, an irregular diet, and a sedentary lifestyle, which make these individuals vulnerable to many diseases. This study was designed to assess the health status of this occupational group.

Objectives:

The objective was to explore the health status, the intention to seek health examination, and participation in health education among taxi drivers in Jinan, China.

Patients and Methods:

The sample-size was determined scientifically. The systematic sampling procedure was used for selecting the sample. Four hundred taxi drivers were randomly selected from several taxi companies in Jinan. In total, 396 valid questionnaires (from 370 males and 26 females) were returned. Health status, intention to seek health examination, and participation in health education were assessed by a self-designed questionnaire. Other personal information including sex, age, ethnicity, marital status, years of employment as a taxi driver, education level, and habits were also collected.

Results:

This survey revealed that 54.8% of taxi drivers reported illness in the last two weeks and 44.7% of participants reported chronic diseases. The prevalence rates of hypertension, diabetes mellitus, gastroenteritis, arthritis, and heart disease were 18.2%, 8.8%, 26%, 18.4%, and 4.8% of questioned taxi drivers, respectively. Significant self-reported symptoms included fatigue, waist and back pain, headache, dyspepsia, and dry throat affecting 49.7%, 26.2%, 23.5%, 26%, and 27% of participants, respectively. In total, 90.1% of subjects thought that it was necessary to receive a regular health examination. Only 17.9% of subjects had been given information about health education, and significantly, more than 87% of subjects who had been given information about health education reported that the information had been helpful.

Conclusions:

Taxi drivers’ health was poor in our survey. Thus, using health education interventions to improve knowledge and change in behaviors are necessary and effective programs that improve the health of individuals in this special occupational group are needed.

Health Status;Health Surveys;Occupational Disease;Health Education;Health Services Needs and Demand Health Status;Health Surveys;Occupational Disease;Health Education;Health Services Needs and Demand http://www.ircmj.com/index.php?page=article&article_id=13355 Yan Yang Yan Yang Health Examination Center, QiLu Hospital of Shandong University, Jinan, China; Health Examination Center, QiLu Hospital of Shandong University, Jinan, China. Tel: +86-53182166920, Fax: +86-53182166921 Health Examination Center, QiLu Hospital of Shandong University, Jinan, China; Health Examination Center, QiLu Hospital of Shandong University, Jinan, China. Tel: +86-53182166920, Fax: +86-53182166921 Xiao-sheng Fan Xiao-sheng Fan Department of Cardiology People’s Hospital of LaiWu, LaiWu, China Department of Cardiology People’s Hospital of LaiWu, LaiWu, China Cui-huan Tian Cui-huan Tian Health Examination Center, QiLu Hospital of Shandong University, Jinan, China Health Examination Center, QiLu Hospital of Shandong University, Jinan, China Wei Zhang Wei Zhang Health Examination Center, QiLu Hospital of Shandong University, Jinan, China Health Examination Center, QiLu Hospital of Shandong University, Jinan, China Jie Li Jie Li Health Examination Center, QiLu Hospital of Shandong University, Jinan, China Health Examination Center, QiLu Hospital of Shandong University, Jinan, China Shu-qing Li Shu-qing Li Health Examination Center, QiLu Hospital of Shandong University, Jinan, China Health Examination Center, QiLu Hospital of Shandong University, Jinan, China
en 10.5812/ircmj.12334 Comparing GlideScope Video Laryngoscope and Macintosh Laryngoscope Regarding Hemodynamic Responses During Orotracheal Intubation: A Randomized Controlled Trial Comparing GlideScope Video Laryngoscope and Macintosh Laryngoscope Regarding Hemodynamic Responses During Orotracheal Intubation: A Randomized Controlled Trial research-article research-article Background:

To determine if the GlideScope® videolaryngoscope (GVL) could attenuate the hemodynamic responses to orotracheal intubation compared with conventional Macintosh laryngoscope.

Objectives:

The aim of this relatively large randomized trial was to compare the hemodynamic stress responses during laryngoscopy and tracheal intubation using GVL versus MCL amongst healthy adult individuals receiving general anesthesia for elective surgeries.

Patients and Methods:

Ninety five healthy adult patients with American Society of Anesthesiologists physical status class I or II that were scheduled for elective surgery under general anesthesia were randomly allocated to either Macintosh or GlideScope arms. All patients received a standardized protocol of general anesthesia. Hemodynamic changes associated with intubation were recorded before and at 1, 3 and 5 minutes after the intubation. The time taken to perform endotracheal intubation was also noted in both groups.

Results:

Immediately before laryngoscopy (pre-laryngoscopy), the values of all hemodynamic variables did not differ significantly between the two groups (All P values > 0.05). Blood pressures and HR values changed significantly over time within the groups. Time to intubation was significantly longer in the GlideScope (15.9 ± 6.7 seconds) than in the Macintosh group (7.8 ± 3.7 sec) (P< 0.001). However, there were no significant differences between the two groups in hemodynamic responses at all time points.

Conclusions:

The longer intubation time using GVL suggests that the benefit of GVL could become apparent if the time taken for orotracheal intubation could be decreased in GlideScope group.

Background:

To determine if the GlideScope® videolaryngoscope (GVL) could attenuate the hemodynamic responses to orotracheal intubation compared with conventional Macintosh laryngoscope.

Objectives:

The aim of this relatively large randomized trial was to compare the hemodynamic stress responses during laryngoscopy and tracheal intubation using GVL versus MCL amongst healthy adult individuals receiving general anesthesia for elective surgeries.

Patients and Methods:

Ninety five healthy adult patients with American Society of Anesthesiologists physical status class I or II that were scheduled for elective surgery under general anesthesia were randomly allocated to either Macintosh or GlideScope arms. All patients received a standardized protocol of general anesthesia. Hemodynamic changes associated with intubation were recorded before and at 1, 3 and 5 minutes after the intubation. The time taken to perform endotracheal intubation was also noted in both groups.

Results:

Immediately before laryngoscopy (pre-laryngoscopy), the values of all hemodynamic variables did not differ significantly between the two groups (All P values > 0.05). Blood pressures and HR values changed significantly over time within the groups. Time to intubation was significantly longer in the GlideScope (15.9 ± 6.7 seconds) than in the Macintosh group (7.8 ± 3.7 sec) (P< 0.001). However, there were no significant differences between the two groups in hemodynamic responses at all time points.

Conclusions:

The longer intubation time using GVL suggests that the benefit of GVL could become apparent if the time taken for orotracheal intubation could be decreased in GlideScope group.

Laryngoscopes;Intubation;Hemodynamic Responses Laryngoscopes;Intubation;Hemodynamic Responses http://www.ircmj.com/index.php?page=article&article_id=12334 Ali Reza Pournajafian Ali Reza Pournajafian Department of Anaesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IR Iran Department of Anaesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IR Iran Mohammad Reza Ghodraty Mohammad Reza Ghodraty Department of Anaesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IR Iran Department of Anaesthesiology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, IR Iran Seyed Hamid Reza Faiz Seyed Hamid Reza Faiz Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran Poupak Rahimzadeh Poupak Rahimzadeh Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran Hamidreza Goodarzynejad Hamidreza Goodarzynejad Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IR Iran Enseyeh Dogmehchi Enseyeh Dogmehchi Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran; Department of Anesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188947672, Fax: +98-2188942622 Department of Anaesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran; Department of Anesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188947672, Fax: +98-2188942622
en 10.5812/ircmj.12437 Evaluation of FcγRIIIB-NA1/NA2 Polymorphism in Visceral Leishmaniasis Evaluation of FcγRIIIB-NA1/NA2 Polymorphism in Visceral Leishmaniasis research-article research-article Conclusions:

According to our results, it is likely that the increased frequency of the FcγRIIIB-NA1/NA2 genotype is associated with impaired immune responses against VL and its subsequent clearance from the patient.

Results:

Our results indicated that polymorphisms within the FcγRIIIB gene (that lead to the expression of the NA1/NA2 isoforms) are significantly associated with VL. The results demonstrated that the genotype heterozygotic for FcγRIIIB-NA1/NA2 expression was significantly increased in VL patients, group 1 when compared to groups 2 and 3. Conversely, there is a decrease in homozygous NA1 and NA2 genotypes in VL patients; however, the overall frequency of NA1 and NA2 alleles appear similar across the three cohorts examined.

Objectives:

The main aim of this study was to evaluate the FcγRIIIB-NA1/NA2 polymorphism in the FcγRIIIB gene of VL patients in comparison to healthy controls.

Patients and Methods:

In this cross-sectional study, three groups; 54 seropositive patients with clinical presentation of VL (group 1), 104 seropositive patients without clinical presentation (group 2), and 104 healthy controls (group 3) were evaluated with respect to the FcγRIIIB-NA1/NA2 polymorphism using a PCR-SSP method. The titration of anti-leishmania antibodies was analyzed using an immunoflorescence technique.

Background:

Several lines of evidence demonstrating that innate and adaptive immunity play important roles in the defense against visceral leishmaniasis (VL). A polymorphism within the FcγRIIIB gene can lead to the expression of three variants of NA1, NA2, and the combined one (NA1/NA2) which alters affinity of IgG to its receptor.

Conclusions:

According to our results, it is likely that the increased frequency of the FcγRIIIB-NA1/NA2 genotype is associated with impaired immune responses against VL and its subsequent clearance from the patient.

Results:

Our results indicated that polymorphisms within the FcγRIIIB gene (that lead to the expression of the NA1/NA2 isoforms) are significantly associated with VL. The results demonstrated that the genotype heterozygotic for FcγRIIIB-NA1/NA2 expression was significantly increased in VL patients, group 1 when compared to groups 2 and 3. Conversely, there is a decrease in homozygous NA1 and NA2 genotypes in VL patients; however, the overall frequency of NA1 and NA2 alleles appear similar across the three cohorts examined.

Objectives:

The main aim of this study was to evaluate the FcγRIIIB-NA1/NA2 polymorphism in the FcγRIIIB gene of VL patients in comparison to healthy controls.

Patients and Methods:

In this cross-sectional study, three groups; 54 seropositive patients with clinical presentation of VL (group 1), 104 seropositive patients without clinical presentation (group 2), and 104 healthy controls (group 3) were evaluated with respect to the FcγRIIIB-NA1/NA2 polymorphism using a PCR-SSP method. The titration of anti-leishmania antibodies was analyzed using an immunoflorescence technique.

Background:

Several lines of evidence demonstrating that innate and adaptive immunity play important roles in the defense against visceral leishmaniasis (VL). A polymorphism within the FcγRIIIB gene can lead to the expression of three variants of NA1, NA2, and the combined one (NA1/NA2) which alters affinity of IgG to its receptor.

Polymorphism, Genetic;Leishmaniasis, Visceral;Iran Polymorphism, Genetic;Leishmaniasis, Visceral;Iran http://www.ircmj.com/index.php?page=article&article_id=12437 Mohammad Abasi Mohammad Abasi Faculty of Medicine, Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran Faculty of Medicine, Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran Pegah Lotfi Pegah Lotfi Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran Ahad Bazmani Ahad Bazmani Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Mohamad Matini Mohamad Matini Department of Parasitology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran Department of Parasitology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran Mehrdad Hajilooi Mehrdad Hajilooi Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran; Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-8118250509, Fax: +98-8118254073 Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran; Department of Immunology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IR Iran. Tel: +98-8118250509, Fax: +98-8118254073
en 10.5812/ircmj.13395 Psychological Factors Explaining the Referral Behavior of Iranian Family Physicians Psychological Factors Explaining the Referral Behavior of Iranian Family Physicians research-article research-article Results:

The finding revealed that intention of family physicians to reduce referral rate of patients to specialists was significantly related to two theory-based variables of subjective norms (r = 0.38, P < 0.001) and perceived behavioral control (r = 0.43, P < 0.001), and not to attitudes. A stepwise regression entering direct measures of the theory variables explained 35% of the variance on the intention, with perceived behavioral control being the strongest predictor. Adding background variables to the model achieved further 5% by variables of practice size and past referral rate behavior.

Conclusions:

The results indicated that psychological variables of the theory of planned behavior could explain a noticeable proportion of variance in family physician's intention to decrease the rate of referring patients with respiratory diseases to medical specialists. The intention is primarily influenced by normative and control considerations. These findings contribute to a better understanding of referral decisions by family physicians and are of great value in developing interventions to reduce the variation in referral rate of patients to medical specialists at primary care health centers.

Objectives:

This study examined utility of the theory of planned behavior to explain intention of Iranian family physicians to reduce referral rate of patients with respiratory diseases to medical specialist.

Patients and Methods:

An exploratory cross-sectional study, employing a correlational design directed by the theory of planned behavior was conducted. A questionnaire was developed based on an eliciting study and review of literature. One hundred and seventy-four family physicians working at primary care centers in two provinces of Iran completed the questionnaire (response rate of 86%).

Background:

The recently developed policy of the family practice program in rural regions of Iran faced some challenges such as inefficient referral system. The health insurance organizations (purchaser) and health policy makers are concerned about the high rate of patient referrals from family physicians to specialists due to imposing unnecessary services and costs.

Results:

The finding revealed that intention of family physicians to reduce referral rate of patients to specialists was significantly related to two theory-based variables of subjective norms (r = 0.38, P < 0.001) and perceived behavioral control (r = 0.43, P < 0.001), and not to attitudes. A stepwise regression entering direct measures of the theory variables explained 35% of the variance on the intention, with perceived behavioral control being the strongest predictor. Adding background variables to the model achieved further 5% by variables of practice size and past referral rate behavior.

Conclusions:

The results indicated that psychological variables of the theory of planned behavior could explain a noticeable proportion of variance in family physician's intention to decrease the rate of referring patients with respiratory diseases to medical specialists. The intention is primarily influenced by normative and control considerations. These findings contribute to a better understanding of referral decisions by family physicians and are of great value in developing interventions to reduce the variation in referral rate of patients to medical specialists at primary care health centers.

Objectives:

This study examined utility of the theory of planned behavior to explain intention of Iranian family physicians to reduce referral rate of patients with respiratory diseases to medical specialist.

Patients and Methods:

An exploratory cross-sectional study, employing a correlational design directed by the theory of planned behavior was conducted. A questionnaire was developed based on an eliciting study and review of literature. One hundred and seventy-four family physicians working at primary care centers in two provinces of Iran completed the questionnaire (response rate of 86%).

Background:

The recently developed policy of the family practice program in rural regions of Iran faced some challenges such as inefficient referral system. The health insurance organizations (purchaser) and health policy makers are concerned about the high rate of patient referrals from family physicians to specialists due to imposing unnecessary services and costs.

Physicians, Primary Care;Referral and Consultation;Iran Physicians, Primary Care;Referral and Consultation;Iran http://www.ircmj.com/index.php?page=article&article_id=13395 Bahram Mohaghegh Bahram Mohaghegh School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran Hesam Seyedin Hesam Seyedin Health Management and Economic Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran Health Management and Economic Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran Arash Rashidian Arash Rashidian Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Hamid Ravaghi Hamid Ravaghi Health Management and Economic Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran Health Management and Economic Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran Nader Khalesi Nader Khalesi School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran; School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran. Tel: +98-2188794302 School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran; School of Health Management and Information Sciences, Iran University of Medical Sciences, Iranian Ministry of Health and Medical Education, Tehran, IR Iran. Tel: +98-2188794302 Hossein Kazemeini Hossein Kazemeini Ministry of Health and Education of Iran, Tehran, IR Iran Ministry of Health and Education of Iran, Tehran, IR Iran
en 10.5812/ircmj.13421 Challenges in Evaluating Clinical Governance Systems in Iran: A Qualitative Study Challenges in Evaluating Clinical Governance Systems in Iran: A Qualitative Study research-article research-article Background:

In spite of the pivotal role of clinical governance in enhancing quality of services provided by hospitals across the country, a scientific framework with specific criteria for evaluating hospitals has not been developed so far.

Objectives:

This study was conducted with the aim to identify the challenges involved in evaluating systems of clinical governance in Iran.

Materials and Methods:

For the purposes of this qualitative study, 15 semi-structured interviews with experts in the field were conducted in 2011 and the data were analyzed using framework analysis method.

Results:

Five major challenges in evaluating clinical governance include managing human resources, improving clinical quality, managing development, organizing clinical governance, and providing patient-oriented healthcare system.

Conclusions:

Healthcare system in Iran requires a clinical governance program which has a patient-oriented approach in philosophy, operation, and effectiveness in order to meet the challenges ahead.

Background:

In spite of the pivotal role of clinical governance in enhancing quality of services provided by hospitals across the country, a scientific framework with specific criteria for evaluating hospitals has not been developed so far.

Objectives:

This study was conducted with the aim to identify the challenges involved in evaluating systems of clinical governance in Iran.

Materials and Methods:

For the purposes of this qualitative study, 15 semi-structured interviews with experts in the field were conducted in 2011 and the data were analyzed using framework analysis method.

Results:

Five major challenges in evaluating clinical governance include managing human resources, improving clinical quality, managing development, organizing clinical governance, and providing patient-oriented healthcare system.

Conclusions:

Healthcare system in Iran requires a clinical governance program which has a patient-oriented approach in philosophy, operation, and effectiveness in order to meet the challenges ahead.

Clinical Governance;Qualitative Research;Iran Clinical Governance;Qualitative Research;Iran http://www.ircmj.com/index.php?page=article&article_id=13421 Elaheh Hooshmand Elaheh Hooshmand Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, IR Iran Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, IR Iran Sogand Tourani Sogand Tourani Hospital Management Research Center, Iran University of Medical Sciences, Tehran, IR Iran; School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; , School of Health Management and Information Sciences, Iran University of Medical Sciences, P.O. Box: 1995614111, Tehran, IR Iran. Tel: +98-9123458077, Fax: +98-2188883334 Hospital Management Research Center, Iran University of Medical Sciences, Tehran, IR Iran; School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; , School of Health Management and Information Sciences, Iran University of Medical Sciences, P.O. Box: 1995614111, Tehran, IR Iran. Tel: +98-9123458077, Fax: +98-2188883334 Hamid Ravaghi Hamid Ravaghi School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran Hossein Ebrahimipour Hossein Ebrahimipour Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, IR Iran Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, IR Iran
en 10.5812/ircmj.12580 Randomized Comparison of Nylon Versus Absorbing Polyglactin 910 for Fascial Closure in Caesarean Section Randomized Comparison of Nylon Versus Absorbing Polyglactin 910 for Fascial Closure in Caesarean Section research-article research-article Background:

Regardless of numerous advances in surgical techniques, selection of the best technique to sew up wounds and the best suture material are still controversial. Several postoperative complications, including wound infection, stitched wound, chronic incision pain, wound dehiscence and hernia stitches result from many factors such as used suture material.

Objectives:

The aim of the present study was to investigate the complications of pfannenstiel incision and nylon/ polyglactin 910 sutures utilization in patients undergoing c-section cesarean.

Patients and Methods:

This clinical trial was conducted on 120 women who underwent caesarean section at Imam-Ali hospital in Zabol, Iran. In this study, patients were equally divided into two groups of 60 people (50% in nylon suture and 50% in polyglactin 910 sutures). Patients of the two groups were investigated by a gynecologist 24-48 hours after the operation, a week later and on the sixth month of surgery. Moreover, time of wound dehiscence and treatment duration, the level of sinus infection, chronic incision pain and incision hernia were studied. The results were analyzed by SPSS software. P ≤ 0.05 was considered as statistically significant.

Results:

One hundred and twenty patients undergoing a cesarean section at Imam-Ali hospital in Zabol were recruited into the study, 60 in the Nylon group and 60 in Polyglactin 910group. Our data demonstrated a statistically higher incidence of suture sinus and chronic incision pain in the nylon group (P < 0.05). No statistically significant difference in wound stitch and incision hernia was demonstrated between the suture groups.

Conclusions:

The results of our trial did not demonstrate a significant difference between absorbing polyglactin 910 (PDS) and nylon regarding incision hernia, wound infection and wound dehiscence. However, subjects sutured with PDS were less likely to experience chronic incision pain and wound stitch. Therefore, PDS appears to be the optimal choice for fascial closure after cesarean section.

Background:

Regardless of numerous advances in surgical techniques, selection of the best technique to sew up wounds and the best suture material are still controversial. Several postoperative complications, including wound infection, stitched wound, chronic incision pain, wound dehiscence and hernia stitches result from many factors such as used suture material.

Objectives:

The aim of the present study was to investigate the complications of pfannenstiel incision and nylon/ polyglactin 910 sutures utilization in patients undergoing c-section cesarean.

Patients and Methods:

This clinical trial was conducted on 120 women who underwent caesarean section at Imam-Ali hospital in Zabol, Iran. In this study, patients were equally divided into two groups of 60 people (50% in nylon suture and 50% in polyglactin 910 sutures). Patients of the two groups were investigated by a gynecologist 24-48 hours after the operation, a week later and on the sixth month of surgery. Moreover, time of wound dehiscence and treatment duration, the level of sinus infection, chronic incision pain and incision hernia were studied. The results were analyzed by SPSS software. P ≤ 0.05 was considered as statistically significant.

Results:

One hundred and twenty patients undergoing a cesarean section at Imam-Ali hospital in Zabol were recruited into the study, 60 in the Nylon group and 60 in Polyglactin 910group. Our data demonstrated a statistically higher incidence of suture sinus and chronic incision pain in the nylon group (P < 0.05). No statistically significant difference in wound stitch and incision hernia was demonstrated between the suture groups.

Conclusions:

The results of our trial did not demonstrate a significant difference between absorbing polyglactin 910 (PDS) and nylon regarding incision hernia, wound infection and wound dehiscence. However, subjects sutured with PDS were less likely to experience chronic incision pain and wound stitch. Therefore, PDS appears to be the optimal choice for fascial closure after cesarean section.

Surgery, Sutures;Caesarean Section;Polygalactin 910 Surgery, Sutures;Caesarean Section;Polygalactin 910 http://www.ircmj.com/index.php?page=article&article_id=12580 Kolsoum Rezaie Kahkhaie Kolsoum Rezaie Kahkhaie Medicinal Plants Research Center, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran Medicinal Plants Research Center, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran Khadije Rezaie Keikhaie Khadije Rezaie Keikhaie Department of Perinatalogy, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran; Department of Perinatalogy, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran. Tel: +98-9158465428 Department of Perinatalogy, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran; Department of Perinatalogy, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran. Tel: +98-9158465428 Aziz Shahreki Vahed Aziz Shahreki Vahed Nursing and Midwifery School, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran Nursing and Midwifery School, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran Mahboobeh Shirazi Mahboobeh Shirazi Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, IR Iran Maternal, Fetal and Neonatal Research Center, Tehran University of Medical Sciences, IR Iran Nooshin Amjadi Nooshin Amjadi Department of Perinatalogy, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran Department of Perinatalogy, Zabol University of Medical Sciences (ZBUMS), Zabol, IR Iran
en 10.5812/ircmj.12607 Prioritizing the Determinants of Social-health Inequality in Iran: A Multiple Attribute Decision Making Application Prioritizing the Determinants of Social-health Inequality in Iran: A Multiple Attribute Decision Making Application research-article research-article Background:

One of the main challenges of healthcare systems of developing countries is health inequality. Health inequality means inequality in individuals’ ability and proper functioning, resulting in inequality in social status and living conditions, which thwarts social interventions implemented by the government.

Objectives:

This study aimed to determine and prioritize the social determinants of health inequality in Iran.

Materials and Methods:

This was a mixed method study with two phases of qualitative and quantitative research. The study population consisted of experts dealing with social determinants of health. A purposive, stratified and non-random sampling method was used. Semi-structured interviews were conducted to collect qualitative data along with a multiple attribute decision making method for the quantitative phase of the research in which the TOPSIS technique was employed for prioritization. The qualitative findings were entered into NVivo for analysis, as were the quantitative data entered into MATLAB software.

Results:

The results approved the suitability of the conceptual framework of social determinants of health suggested by the WHO (world health organization) for studying social determinants of health inequality; however, this framework general and theoretical rather than a guideline for practice. Thus, in this study, 15 themes and 31 sub-themes were determined as social determinants of social health inequality in Iran. Based on the findings of the quantitative phase of our research, socioeconomic status, living facilities such as housing, and social integrity had the greatest effect on decreasing health inequality.

Conclusions:

A major part of the inequality in health distribution is avoidable because they are mostly caused by adjustable factors like economic conditions, educational conditions, employment, living facilities, etc. As in the majority of developing countries the living and health conditions are the same as Iran, the findings of this study may be applicable for other developing countries.

Background:

One of the main challenges of healthcare systems of developing countries is health inequality. Health inequality means inequality in individuals’ ability and proper functioning, resulting in inequality in social status and living conditions, which thwarts social interventions implemented by the government.

Objectives:

This study aimed to determine and prioritize the social determinants of health inequality in Iran.

Materials and Methods:

This was a mixed method study with two phases of qualitative and quantitative research. The study population consisted of experts dealing with social determinants of health. A purposive, stratified and non-random sampling method was used. Semi-structured interviews were conducted to collect qualitative data along with a multiple attribute decision making method for the quantitative phase of the research in which the TOPSIS technique was employed for prioritization. The qualitative findings were entered into NVivo for analysis, as were the quantitative data entered into MATLAB software.

Results:

The results approved the suitability of the conceptual framework of social determinants of health suggested by the WHO (world health organization) for studying social determinants of health inequality; however, this framework general and theoretical rather than a guideline for practice. Thus, in this study, 15 themes and 31 sub-themes were determined as social determinants of social health inequality in Iran. Based on the findings of the quantitative phase of our research, socioeconomic status, living facilities such as housing, and social integrity had the greatest effect on decreasing health inequality.

Conclusions:

A major part of the inequality in health distribution is avoidable because they are mostly caused by adjustable factors like economic conditions, educational conditions, employment, living facilities, etc. As in the majority of developing countries the living and health conditions are the same as Iran, the findings of this study may be applicable for other developing countries.

Social Determinants of Health;Socioeconomic Factors;Iran Social Determinants of Health;Socioeconomic Factors;Iran http://www.ircmj.com/index.php?page=article&article_id=12607 Rouhollah Zaboli Rouhollah Zaboli Department of Health Services Management, School of Health, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Department of Health Services Management, School of Health, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Sogand Tourani Sogand Tourani Hospital Management Research Centre, Iran University of Medical Sciences, Tehran, IR Iran; Hospital Management Research Centre, Iran University of Medical Sciences, P.O. Box: 1995614111, Tehran, IR Iran. Tel: +98-9122351067, Fax: +98-2188883334 Hospital Management Research Centre, Iran University of Medical Sciences, Tehran, IR Iran; Hospital Management Research Centre, Iran University of Medical Sciences, P.O. Box: 1995614111, Tehran, IR Iran. Tel: +98-9122351067, Fax: +98-2188883334 Seyed Hesam Seyedin Seyed Hesam Seyedin Health Management and Economics Research Centre, Iran University of Medical Sciences, Tehran, IR Iran Health Management and Economics Research Centre, Iran University of Medical Sciences, Tehran, IR Iran Alireza Oliaie Manesh Alireza Oliaie Manesh Department of Healthcare Financing and Payment, National Institution of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran Department of Healthcare Financing and Payment, National Institution of Health Research, Tehran University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.12686 Personality Factors Underlying Suicidal Behavior Among Military Youth Personality Factors Underlying Suicidal Behavior Among Military Youth research-article research-article Conclusions:

Based on these results, neuroticism might increase suicide, but extraversion and conscientiousness personality traits are associated with a reduced risk of suicide.

Results:

There was a significant positive correlation (r = 0.323) between neuroticism and suicide ideation; however, significant negative correlations existed between three other personality traits --extraversion [r = -0.306], agreeableness [r = -0.227], and conscientiousness [r = -0.271] and suicidal ideation. Unlike neuroticism, extraversion and conscientiousness personality factors could reduce significantly (as much 14% as are predicted) levels of suicidal ideation.

Patients and Methods:

The study population comprised of the Iranian Armed Forces. To recruit the sample of the research, 1659 soldiers were selected by multistage sampling. Data were collected using the Beck Scale for Suicide Ideation (BSSI) and NEO-Five Factor Inventory.

Objectives:

One of the underlying factors in suicidal behavior is individuals' personality.

Background:

Suicidal behavior is one the most significant mental health problems in the military. Militaries are closed systems that operate in particular situations. Military service is associated with certain stressful conditions. On this basis, there is likely of trauma in the military environment. Measures of suicidal behavior are pathologically complex. A range of biological, psychological, social, and institutional factors are involved in the incidence and prevalence of these behaviors.

Conclusions:

Based on these results, neuroticism might increase suicide, but extraversion and conscientiousness personality traits are associated with a reduced risk of suicide.

Results:

There was a significant positive correlation (r = 0.323) between neuroticism and suicide ideation; however, significant negative correlations existed between three other personality traits --extraversion [r = -0.306], agreeableness [r = -0.227], and conscientiousness [r = -0.271] and suicidal ideation. Unlike neuroticism, extraversion and conscientiousness personality factors could reduce significantly (as much 14% as are predicted) levels of suicidal ideation.

Patients and Methods:

The study population comprised of the Iranian Armed Forces. To recruit the sample of the research, 1659 soldiers were selected by multistage sampling. Data were collected using the Beck Scale for Suicide Ideation (BSSI) and NEO-Five Factor Inventory.

Objectives:

One of the underlying factors in suicidal behavior is individuals' personality.

Background:

Suicidal behavior is one the most significant mental health problems in the military. Militaries are closed systems that operate in particular situations. Military service is associated with certain stressful conditions. On this basis, there is likely of trauma in the military environment. Measures of suicidal behavior are pathologically complex. A range of biological, psychological, social, and institutional factors are involved in the incidence and prevalence of these behaviors.

Personality;Military Personnel;Behavior;Suicide Personality;Military Personnel;Behavior;Suicide http://www.ircmj.com/index.php?page=article&article_id=12686 Abdollah Soltaninejad Abdollah Soltaninejad Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9126237032 Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran; Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-9126237032 Ali Fathi-Ashtiani Ali Fathi-Ashtiani Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Khodabakhsh Ahmadi Khodabakhsh Ahmadi Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Hediye Sadat Mirsharafoddini Hediye Sadat Mirsharafoddini Department of Economic, Firoozkooh Branch, Islamic Azad University, Firoozkooh, IR Iran Department of Economic, Firoozkooh Branch, Islamic Azad University, Firoozkooh, IR Iran Alireza Nikmorad Alireza Nikmorad Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran Motahare Pilevarzadeh Motahare Pilevarzadeh Nursing and Midwifery Faculty, Jiroft University of Medical Sciences, Jiroft, IR Iran Nursing and Midwifery Faculty, Jiroft University of Medical Sciences, Jiroft, IR Iran
en 10.5812/ircmj.12732 Irrigation of Abdomen With Imipenem Solution Decreases Surgical Site Infections in Patients With Perforated Appendicitis: A Randomized Clinical Trial Irrigation of Abdomen With Imipenem Solution Decreases Surgical Site Infections in Patients With Perforated Appendicitis: A Randomized Clinical Trial research-article research-article Conclusions:

The study findings revealed that peritoneal lavage with imipenem solution (1 mg/mL) decreases the rate of post-operative SSIs in patients with perforated appendicitis in comparison to patients irrigated with normal saline alone. These patients also had shorter hospital stay, and lower hospital costs.

Results:

Imipenem solution irrigation was associated with significant clinical improvement at one-month follow-up. The experimental group presented with significantly lower rate of SSIs and shorter length of hospital stay. The experimental group had lower rate of SSIs compared to the control group (4.4% vs. 22.2%, respectively) (p= 0.013). The duration of hospital stay was nearly one day longer in control group (5.84 ± 2.58 days) vs. experimental group (4.91 ± 1.29 days) (P = 0.034), and hospital costs were $50 lower in experimental group ($500 ± $292) vs. control group ($450 ± $170) (P = 0.281).

Patients and Methods:

In this randomized single-blind parallel-group clinical trial, we enrolled 90 patients with perforated appendicitis with 12-50 years of age and randomly allocated them into experimental group (n = 45) and control group (n = 45). The control group received peritoneal irrigation with normal saline (0.9%) and experimental group underwent peritoneal irrigation with imipenem solution (1 mg/mL). All surgical procedures were performed in Imam Reza Hospital of Kermanshah University of Medical Sciences. The study primary outcome was surgical site infections (including wound infection and abdominal abscess) and the secondary outcomes were length of hospital stay and hospital cost. Chi-squared and t-tests were used to analyze the study data.

Background:

Perforated appendicitis is one of the most common causes of acute abdomen requiring emergent surgery for immediate appendectomy and peritoneal cavity irrigation; however, the efficacy of irrigation with antibiotic solutions is controversial.

Objectives:

The aim of this study was to assess the efficacy of imipenem solution irrigation on post-operative surgical site infections (SSIs), hospital length of stay, and hospital costs. We hypothesized that there would be lower rate of SSIs, a shorter hospital stay, and lower hospital cost in patients with perforated appendicitis who received peritoneal cavity irrigation with imipenem solution in comparison to their counterparts who received irrigation with normal saline.

Conclusions:

The study findings revealed that peritoneal lavage with imipenem solution (1 mg/mL) decreases the rate of post-operative SSIs in patients with perforated appendicitis in comparison to patients irrigated with normal saline alone. These patients also had shorter hospital stay, and lower hospital costs.

Results:

Imipenem solution irrigation was associated with significant clinical improvement at one-month follow-up. The experimental group presented with significantly lower rate of SSIs and shorter length of hospital stay. The experimental group had lower rate of SSIs compared to the control group (4.4% vs. 22.2%, respectively) (p= 0.013). The duration of hospital stay was nearly one day longer in control group (5.84 ± 2.58 days) vs. experimental group (4.91 ± 1.29 days) (P = 0.034), and hospital costs were $50 lower in experimental group ($500 ± $292) vs. control group ($450 ± $170) (P = 0.281).

Patients and Methods:

In this randomized single-blind parallel-group clinical trial, we enrolled 90 patients with perforated appendicitis with 12-50 years of age and randomly allocated them into experimental group (n = 45) and control group (n = 45). The control group received peritoneal irrigation with normal saline (0.9%) and experimental group underwent peritoneal irrigation with imipenem solution (1 mg/mL). All surgical procedures were performed in Imam Reza Hospital of Kermanshah University of Medical Sciences. The study primary outcome was surgical site infections (including wound infection and abdominal abscess) and the secondary outcomes were length of hospital stay and hospital cost. Chi-squared and t-tests were used to analyze the study data.

Background:

Perforated appendicitis is one of the most common causes of acute abdomen requiring emergent surgery for immediate appendectomy and peritoneal cavity irrigation; however, the efficacy of irrigation with antibiotic solutions is controversial.

Objectives:

The aim of this study was to assess the efficacy of imipenem solution irrigation on post-operative surgical site infections (SSIs), hospital length of stay, and hospital costs. We hypothesized that there would be lower rate of SSIs, a shorter hospital stay, and lower hospital cost in patients with perforated appendicitis who received peritoneal cavity irrigation with imipenem solution in comparison to their counterparts who received irrigation with normal saline.

Appendicitis; Peritoneal Lavage; Surgical Site Infection; Wound Infection; Abdominal Abscess; Iran Appendicitis; Peritoneal Lavage; Surgical Site Infection; Wound Infection; Abdominal Abscess; Iran http://www.ircmj.com/index.php?page=article&article_id=12732 Mohammad Ali Hesami Mohammad Ali Hesami Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran Hamid Alipour Hamid Alipour Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran. Tel: +98-9123101898, Fax: +98-8314276301 Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran; Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran. Tel: +98-9123101898, Fax: +98-8314276301 Hamed Nikoupour Daylami Hamed Nikoupour Daylami Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran Department of Surgery, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran Bijan Alipour Bijan Alipour Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, IR Iran Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, IR Iran Shahrzad Bazargan-Hejazi Shahrzad Bazargan-Hejazi Department of Psychiatry, Charles R. Drew University of Medicine and Sciences, and David Geffen School of Medicine, UCLA, USA Department of Psychiatry, Charles R. Drew University of Medicine and Sciences, and David Geffen School of Medicine, UCLA, USA Alireza Ahmadi Alireza Ahmadi Department of Public Health Sciences, Division of Social Medicine, Karolinska Institute, Stockholm, Sweden; Department of Anesthesiology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran Department of Public Health Sciences, Division of Social Medicine, Karolinska Institute, Stockholm, Sweden; Department of Anesthesiology, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IR Iran
en 10.5812/ircmj.12866 Health Information on Internet: Quality, Importance, and Popularity of Persian Health Websites Health Information on Internet: Quality, Importance, and Popularity of Persian Health Websites research-article research-article Objectives:

The current study aimed to first assess the quality, popularity and importance of websites providing Persian health-related information, and second to evaluate the correlation of the popularity and importance ranking with quality score on the Internet.

Materials and Methods:

The sample websites were identified by entering the health-related keywords into four most popular search engines of Iranian users based on the Alexa ranking at the time of study. Each selected website was assessed using three qualified tools including the Bomba and Land Index, Google PageRank and the Alexa ranking.

Results:

The evaluated sites characteristics (ownership structure, database, scope and objective) really did not have an effect on the Alexa traffic global rank, Alexa traffic rank in Iran, Google PageRank and Bomba total score. Most websites (78.9 percent, n = 56) were in the moderate category (8 ≤ x ≤ 11.99) based on their quality levels. There was no statistically significant association between Google PageRank with Bomba index variables and Alexa traffic global rank (P > 0.05).

Conclusions:

The Persian health websites had better Bomba quality scores in availability and usability guidelines as compared to other guidelines. The Google PageRank did not properly reflect the real quality of evaluated websites and Internet users seeking online health information should not merely rely on it for any kind of prejudgment regarding Persian health websites. However, they can use Iran Alexa rank as a primary filtering tool of these websites. Therefore, designing search engines dedicated to explore accredited Persian health-related Web sites can be an effective method to access high-quality Persian health websites.

Background:

The Internet has provided great opportunities for disseminating both accurate and inaccurate health information. Therefore, the quality of information is considered as a widespread concern affecting the human life. Despite the increasingly substantial growth in the number of users, Persian health websites and the proportion of internet-using patients, little is known about the quality of Persian medical and health websites.

Objectives:

The current study aimed to first assess the quality, popularity and importance of websites providing Persian health-related information, and second to evaluate the correlation of the popularity and importance ranking with quality score on the Internet.

Materials and Methods:

The sample websites were identified by entering the health-related keywords into four most popular search engines of Iranian users based on the Alexa ranking at the time of study. Each selected website was assessed using three qualified tools including the Bomba and Land Index, Google PageRank and the Alexa ranking.

Results:

The evaluated sites characteristics (ownership structure, database, scope and objective) really did not have an effect on the Alexa traffic global rank, Alexa traffic rank in Iran, Google PageRank and Bomba total score. Most websites (78.9 percent, n = 56) were in the moderate category (8 ≤ x ≤ 11.99) based on their quality levels. There was no statistically significant association between Google PageRank with Bomba index variables and Alexa traffic global rank (P > 0.05).

Conclusions:

The Persian health websites had better Bomba quality scores in availability and usability guidelines as compared to other guidelines. The Google PageRank did not properly reflect the real quality of evaluated websites and Internet users seeking online health information should not merely rely on it for any kind of prejudgment regarding Persian health websites. However, they can use Iran Alexa rank as a primary filtering tool of these websites. Therefore, designing search engines dedicated to explore accredited Persian health-related Web sites can be an effective method to access high-quality Persian health websites.

Background:

The Internet has provided great opportunities for disseminating both accurate and inaccurate health information. Therefore, the quality of information is considered as a widespread concern affecting the human life. Despite the increasingly substantial growth in the number of users, Persian health websites and the proportion of internet-using patients, little is known about the quality of Persian medical and health websites.

Evaluation Studies;Internet;Health Evaluation Studies;Internet;Health http://www.ircmj.com/index.php?page=article&article_id=12866 Mahnaz Samadbeik Mahnaz Samadbeik Department of Health Information Technology, Lorestan University of Medical Sciences, Khorramabad, IR Iran Department of Health Information Technology, Lorestan University of Medical Sciences, Khorramabad, IR Iran Maryam Ahmadi Maryam Ahmadi Department of Health Information Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Information Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188793805, Fax: +98-2188883334 Department of Health Information Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Information Management, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188793805, Fax: +98-2188883334 Ali Mohammadi Ali Mohammadi Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Beniamin Mohseni Saravi Beniamin Mohseni Saravi Treatment Vice Chancellor Medical Record Department, Mazandaran University of Medical Sciences, Sari, IR Iran Treatment Vice Chancellor Medical Record Department, Mazandaran University of Medical Sciences, Sari, IR Iran
en 10.5812/ircmj.13681 Complementary Treatment in Chronic Pelvic Pain Syndrome: A Case Report Study Complementary Treatment in Chronic Pelvic Pain Syndrome: A Case Report Study case-report case-report Introduction:

The use of traditional medicine has been emerged in the treatment of BPS (bladder pain syndrome) due to its high prevalence and expenses and its insufficient treatment by conventional therapies. Iranian traditional medicine has discussed such diseases. Considering the signs and symptoms of BPS and “reeh”, the proposed mechanism of flatulency as casualty of recurrent circulating pains seems to be a proper diagnose. So, as a preliminary study the authors administered Horse Mint as one of effective traditional herbs on flatulent pain in a patient with BPS.

Case Presentation:

A 60-year-old female was referred with the diagnosis of BPS. Six clinical visits with 2-week intervals were performed for patient, and the NIH-ICSI (National Institutes of Health Interstitial Cystitis Symptom Index) was completed, which was used as a pretreatment symptom quantifier and post-treatment outcome tool. Horse mint (Mentha longifolia) was prescribed twice a day for 12 weeks.

Discussion:

Clinical visits showed alleviation of signs, symptoms, and changes in the patient's NIH-ICSI score, suggesting further studies on this field.

Introduction:

The use of traditional medicine has been emerged in the treatment of BPS (bladder pain syndrome) due to its high prevalence and expenses and its insufficient treatment by conventional therapies. Iranian traditional medicine has discussed such diseases. Considering the signs and symptoms of BPS and “reeh”, the proposed mechanism of flatulency as casualty of recurrent circulating pains seems to be a proper diagnose. So, as a preliminary study the authors administered Horse Mint as one of effective traditional herbs on flatulent pain in a patient with BPS.

Case Presentation:

A 60-year-old female was referred with the diagnosis of BPS. Six clinical visits with 2-week intervals were performed for patient, and the NIH-ICSI (National Institutes of Health Interstitial Cystitis Symptom Index) was completed, which was used as a pretreatment symptom quantifier and post-treatment outcome tool. Horse mint (Mentha longifolia) was prescribed twice a day for 12 weeks.

Discussion:

Clinical visits showed alleviation of signs, symptoms, and changes in the patient's NIH-ICSI score, suggesting further studies on this field.

Medicine, Traditional;Pelvic Pain;Treatment Medicine, Traditional;Pelvic Pain;Treatment http://www.ircmj.com/index.php?page=article&article_id=13681 Seied Amirhossein Latifi Seied Amirhossein Latifi School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran; School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2156354492, Fax: +98-2155601274 School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran; School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2156354492, Fax: +98-2155601274 Bagher Minaiee Bagher Minaiee School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Histology, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran; Department of Histology, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Mohammad Kamalinejad Mohammad Kamalinejad Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University, Tehran, IR Iran Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University, Tehran, IR Iran Esmaeil Nazem Esmaeil Nazem School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, IR Iran Shahram Gooran Shahram Gooran Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.12950 Various Indicators for the Assessment of Hospitals' Performance Status: Differences and Similarities Various Indicators for the Assessment of Hospitals' Performance Status: Differences and Similarities research-article research-article Background

Hospitals are the most costly operational and really important units of health system because they consume about 50%-89% of total health resources. Therefore efficient use of resources could help in saving and reallocating the financial and physical resources.

Objectives

The aim of this study was to obtain an overview of hospitals' performance status by applying different techniques, to compare similarities and differences between these methods and suggest the most comprehensive and practical method of appraisal for managers and policy makers.

Patients and Methods

This is a cross sectional study conducted in all hospitals of Ahvaz (eight hospitals affiliated with Jundishapur University of Medical Sciences and eight non-affiliated hospitals) during 2007 to 2011. Two kinds of data were collected through separate special checklists. Excel 2007 and Windeap 2.1 software were applied for data analysis.

Results

The present findings show that the average of bed occupancy rate (BOR) in the studied hospitals was about 65.91 ± 1.16. The maximum number of inefficient hospitals in the present study happened in the years 2007, 2008 and 2010 (four hospitals) but there were two hospitals in the third part of the present graph which had maximum level of efficiency and optimal level of productivity in the years 2007 and 2009. Data Envelopment Analysis (DEA) showed that the mean score of technical efficiency for the studied hospitals is 0.924 ± 0.105 with the minimum of 0.585 ± 0.905 for hospital number 1. Furthermore It shows that only five hospitals (31.25%) reach complete technical efficiency (TE) scores across all five years of 2007-11 (TE = 1).

Conclusions

Results of the present and similar studies should be considered for the future planning and resource allocation of Iranian public hospitals. At the same time it is very important to consider need assessment results for each region according to its potentials, population under the coverage and other geographical and cultural indices. Furthermore because of potential limitations of each of the above models it is highly recommended to apply different methods of performance evaluation to reach a complete and real status view of the hospitals for future planning.

Background

Hospitals are the most costly operational and really important units of health system because they consume about 50%-89% of total health resources. Therefore efficient use of resources could help in saving and reallocating the financial and physical resources.

Objectives

The aim of this study was to obtain an overview of hospitals' performance status by applying different techniques, to compare similarities and differences between these methods and suggest the most comprehensive and practical method of appraisal for managers and policy makers.

Patients and Methods

This is a cross sectional study conducted in all hospitals of Ahvaz (eight hospitals affiliated with Jundishapur University of Medical Sciences and eight non-affiliated hospitals) during 2007 to 2011. Two kinds of data were collected through separate special checklists. Excel 2007 and Windeap 2.1 software were applied for data analysis.

Results

The present findings show that the average of bed occupancy rate (BOR) in the studied hospitals was about 65.91 ± 1.16. The maximum number of inefficient hospitals in the present study happened in the years 2007, 2008 and 2010 (four hospitals) but there were two hospitals in the third part of the present graph which had maximum level of efficiency and optimal level of productivity in the years 2007 and 2009. Data Envelopment Analysis (DEA) showed that the mean score of technical efficiency for the studied hospitals is 0.924 ± 0.105 with the minimum of 0.585 ± 0.905 for hospital number 1. Furthermore It shows that only five hospitals (31.25%) reach complete technical efficiency (TE) scores across all five years of 2007-11 (TE = 1).

Conclusions

Results of the present and similar studies should be considered for the future planning and resource allocation of Iranian public hospitals. At the same time it is very important to consider need assessment results for each region according to its potentials, population under the coverage and other geographical and cultural indices. Furthermore because of potential limitations of each of the above models it is highly recommended to apply different methods of performance evaluation to reach a complete and real status view of the hospitals for future planning.

Pabon Lasso, DEA, Malmquist Index, Hospital Performance Pabon Lasso, DEA, Malmquist Index, Hospital Performance http://www.ircmj.com/index.php?page=article&article_id=12950 Farhad Lotfi Farhad Lotfi School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran Rohollah Kalhor Rohollah Kalhor Research Center for Health Information Management, Hormozgan University of Medical Sciences, Bandar Abbas, IR Iran; Department of Health Service Management, School of Public Health, Qazvin University of Medical Sciences, Qazvin, IR Iran Research Center for Health Information Management, Hormozgan University of Medical Sciences, Bandar Abbas, IR Iran; Department of Health Service Management, School of Public Health, Qazvin University of Medical Sciences, Qazvin, IR Iran Peivand Bastani Peivand Bastani School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran Nasrin Shaarbafchi Zadeh Nasrin Shaarbafchi Zadeh School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188671615 School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188671615 Maryam Eslamian Maryam Eslamian Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; Research Center for Health Services Management, Institute of Futures Studies in Health, School of Management and Medical Information Science, Kerman University of Medical Sciences, Kerman, IR Iran Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran; Research Center for Health Services Management, Institute of Futures Studies in Health, School of Management and Medical Information Science, Kerman University of Medical Sciences, Kerman, IR Iran Mohammad Reza Dehghani Mohammad Reza Dehghani Treatment Deputy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Treatment Deputy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran Mohamad Zakaria Kiaee Mohamad Zakaria Kiaee Department of Health Service Management, School of Public Health, Qazvin University of Medical Sciences, Qazvin, IR Iran Department of Health Service Management, School of Public Health, Qazvin University of Medical Sciences, Qazvin, IR Iran
en 10.5812/ircmj.11798 Ankylosing Spondylitis in Iran; Late Diagnosis and Its Causes Ankylosing Spondylitis in Iran; Late Diagnosis and Its Causes research-article research-article Conclusions:

In this study, delay in diagnosis was similar to other studies. Educating physicians to careful history taking especially in the case of IBP, non-musculoskeletal symptoms such as uveitis and precise physical examination are important in early diagnosis.

Patients and Methods:

Sixty patients, (53 males, 7 females) with a diagnosis of AS according to the modified New York criteria were recruited. Diagnosis delay was defined as the interval between a patient’s first spondyloarthritic symptoms [inflammatory back pain (IBP), inflammatory arthritis, enthesopathy and uveitis] and a correct diagnosis of AS.

Results:

The average age of patients at diagnosis of AS was 36.4 ± 4.5 years and the average of delay in diagnosis was 6.2 ± 3.5 years. The most common diagnosis at the first visit was disc herniation (68.3%). Delay in diagnosis of Human Leukocyte Antigen (HLA-B27) positive and negative patients were 4.6 ± 2.2 years and 10.1 ± 3.2 years, respectively (P = 0.0001). Diagnosis delay in patients with morning stiffness and IBP were significantly shorter than that of patients without these symptoms (P = 0.0001 and P = 0.001, respectively). Patients with uveitis had the shortest diagnosis delay (P = 0.02). The Bath Ankylosing spondylitis disease activity index (BASDAI) was not significantly different in early (< 3years) and late (> 3years) diagnosis (3.3 ± 0.9 and 3.6 ± 0.7, respectively) (P = 0.18), but the Both ankylosing spondylitis functional index (BASFI) was significantly different between them (3.3 ± 1.0 and 4.1 ± 0.7 respectively) (P = 0.001).

Background:

Ankylosing spondylitis (AS) is a chronic destructive and inflammatory disease of the axial skeleton manifested by back pain and progressive stiffness of the spine.

Objectives:

The aim of the present cross-sectional study was to evaluate and identify factors leading to delayed diagnosis of AS in Iranian patients.

Conclusions:

In this study, delay in diagnosis was similar to other studies. Educating physicians to careful history taking especially in the case of IBP, non-musculoskeletal symptoms such as uveitis and precise physical examination are important in early diagnosis.

Patients and Methods:

Sixty patients, (53 males, 7 females) with a diagnosis of AS according to the modified New York criteria were recruited. Diagnosis delay was defined as the interval between a patient’s first spondyloarthritic symptoms [inflammatory back pain (IBP), inflammatory arthritis, enthesopathy and uveitis] and a correct diagnosis of AS.

Results:

The average age of patients at diagnosis of AS was 36.4 ± 4.5 years and the average of delay in diagnosis was 6.2 ± 3.5 years. The most common diagnosis at the first visit was disc herniation (68.3%). Delay in diagnosis of Human Leukocyte Antigen (HLA-B27) positive and negative patients were 4.6 ± 2.2 years and 10.1 ± 3.2 years, respectively (P = 0.0001). Diagnosis delay in patients with morning stiffness and IBP were significantly shorter than that of patients without these symptoms (P = 0.0001 and P = 0.001, respectively). Patients with uveitis had the shortest diagnosis delay (P = 0.02). The Bath Ankylosing spondylitis disease activity index (BASDAI) was not significantly different in early (< 3years) and late (> 3years) diagnosis (3.3 ± 0.9 and 3.6 ± 0.7, respectively) (P = 0.18), but the Both ankylosing spondylitis functional index (BASFI) was significantly different between them (3.3 ± 1.0 and 4.1 ± 0.7 respectively) (P = 0.001).

Background:

Ankylosing spondylitis (AS) is a chronic destructive and inflammatory disease of the axial skeleton manifested by back pain and progressive stiffness of the spine.

Objectives:

The aim of the present cross-sectional study was to evaluate and identify factors leading to delayed diagnosis of AS in Iranian patients.

Spondylitis, Ankylosing;Delayed Diagnosis;Back Pain Spondylitis, Ankylosing;Delayed Diagnosis;Back Pain http://www.ircmj.com/index.php?page=article&article_id=11798 Mehrzad Hajialilo Mehrzad Hajialilo Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Amir Ghorbanihaghjo Amir Ghorbanihaghjo Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran; Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4113364666, Fax: +98-4114426078 Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran; Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4113364666, Fax: +98-4114426078 Alireza Khabbazi Alireza Khabbazi Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Suosan Kolahi Suosan Kolahi Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Nadereh Rashtchizadeh Nadereh Rashtchizadeh Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
en 10.5812/ircmj.10846 Perception of Medical University Members From Nutritional Health in the Quran Perception of Medical University Members From Nutritional Health in the Quran research-article research-article Background:

Desirable health is impossible without good nutrition, and Allah has addressed us on eating foods in 118 verses.

Objectives:

This study aimed to describe the medical university faculty members’ perceptions of nutritional health in the Quran, revealing the important role of faculty members.

Materials and Methods:

This qualitative study was conducted with a phenomenological approach. Homogeneous sampling was performed in a final sample size of 16 subjects. The Colaizzi's phenomenological method was applied for data analysis.

Results:

Three main categories were extracted from the data analysis, including the importance of nutrition in the Quran (referring to certain fruits, vegetables and foods, illustrating and venerating the heavenly ones, nutritional recommendations, revealing the healing power of honey and the effects of fruits and vegetables on physical and social health); reasons of different foods being lawful (halal) and unlawful (haram) (religious slaughter, wine, meats, consequences of consuming haram materials, general expression of halal and haram terms); and fasting (fasting and physical health, fasting and mental health).

Conclusions:

What has been mentioned in the Quran is what scientists have achieved over the time, since the Quran is governed by logic. Although we do not know the reasons for many things in the Quran, we consider it as the foundation.

Background:

Desirable health is impossible without good nutrition, and Allah has addressed us on eating foods in 118 verses.

Objectives:

This study aimed to describe the medical university faculty members’ perceptions of nutritional health in the Quran, revealing the important role of faculty members.

Materials and Methods:

This qualitative study was conducted with a phenomenological approach. Homogeneous sampling was performed in a final sample size of 16 subjects. The Colaizzi's phenomenological method was applied for data analysis.

Results:

Three main categories were extracted from the data analysis, including the importance of nutrition in the Quran (referring to certain fruits, vegetables and foods, illustrating and venerating the heavenly ones, nutritional recommendations, revealing the healing power of honey and the effects of fruits and vegetables on physical and social health); reasons of different foods being lawful (halal) and unlawful (haram) (religious slaughter, wine, meats, consequences of consuming haram materials, general expression of halal and haram terms); and fasting (fasting and physical health, fasting and mental health).

Conclusions:

What has been mentioned in the Quran is what scientists have achieved over the time, since the Quran is governed by logic. Although we do not know the reasons for many things in the Quran, we consider it as the foundation.

Nutritional Sciences;Quran;Faculty Member;Phenomenology Nutritional Sciences;Quran;Faculty Member;Phenomenology http://www.ircmj.com/index.php?page=article&article_id=10846 Shahin Salarvand Shahin Salarvand Faculty of Nursing and Midwifery, Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran; Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Kamalvand Campus, kilometer 4 Broujerd Road, Khorramabad, IR Iran. Tel: +98-9161590560, Fax: +98-6616200150 Faculty of Nursing and Midwifery, Hepatitis Research Center, Lorestan University of Medical Sciences, Khorramabad, IR Iran; Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Kamalvand Campus, kilometer 4 Broujerd Road, Khorramabad, IR Iran. Tel: +98-9161590560, Fax: +98-6616200150 Yadollah Pournia Yadollah Pournia Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, IR Iran Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, IR Iran
en 10.5812/ircmj.9849 Aortic Dissection and Postpartum Cardiomyopathy in a Postpartum Young Woman: A Case Report Study Aortic Dissection and Postpartum Cardiomyopathy in a Postpartum Young Woman: A Case Report Study case-report case-report Introduction:

Aortic dissection is a rare condition in young women and usually related with congenital anomalies of aorta and connective tissue disorders. We reported a 34-year-old postpartum woman with aortic dissection.

Case Presentation:

The patient complained of respiratory distress and weakness with no abdominal pain or chest pain 20 days after delivery and had no history of hypertension during pregnancy and perinatal or prior heart disease. Postpartum cardiomyopathy and left ventricular dysfunction were diagnosed by imaging study and cardiac enzyme level. Finally, CT-scan was performed and showed aortic dissection. The patient underwent surgery and after surgery, she was alive without any problem.

Conclusions:

Patients with peripartum cardiomyopathy and aortic dissection could be cured with good medical care.

Introduction:

Aortic dissection is a rare condition in young women and usually related with congenital anomalies of aorta and connective tissue disorders. We reported a 34-year-old postpartum woman with aortic dissection.

Case Presentation:

The patient complained of respiratory distress and weakness with no abdominal pain or chest pain 20 days after delivery and had no history of hypertension during pregnancy and perinatal or prior heart disease. Postpartum cardiomyopathy and left ventricular dysfunction were diagnosed by imaging study and cardiac enzyme level. Finally, CT-scan was performed and showed aortic dissection. The patient underwent surgery and after surgery, she was alive without any problem.

Conclusions:

Patients with peripartum cardiomyopathy and aortic dissection could be cured with good medical care.

Aortic Aneurysm, Familial Thoracic 1;Cardiomyopathies;Peripartum Period;Women Aortic Aneurysm, Familial Thoracic 1;Cardiomyopathies;Peripartum Period;Women http://www.ircmj.com/index.php?page=article&article_id=9849 Rozita Jalalian Rozita Jalalian Department of Cardiology, Babol University of Medical Sciences, Babol, IR Iran; Department of Cardiology, Babol University of Medical Sciences, Babol, IR Iran. Tel: 98-1512224002, Fax: 98-1512224002 Department of Cardiology, Babol University of Medical Sciences, Babol, IR Iran; Department of Cardiology, Babol University of Medical Sciences, Babol, IR Iran. Tel: 98-1512224002, Fax: 98-1512224002 Mehrdad Saravi Mehrdad Saravi Department of Cardiology, Babol University of Medical Sciences, Babol, IR Iran Department of Cardiology, Babol University of Medical Sciences, Babol, IR Iran Bahar Banasaz Bahar Banasaz Department of Internal Medicine, Babol University of Medical Sciences, Babol, IR Iran Department of Internal Medicine, Babol University of Medical Sciences, Babol, IR Iran
en 10.5812/ircmj.13506 Effect of Self-regulation Training on Management of Type 2 Diabetes Effect of Self-regulation Training on Management of Type 2 Diabetes research-article research-article Background:

Diabetes is the most common metabolic disorder which is required to be taken under control. According to some studies, the impact of self-regulation on health has been considered as a monitoring strategy to achieve individual’s goals.

Objectives:

This study, which was performed in 2012, aimed at determining the consequences of self-regulation on controlling type 2 diabetes.

Patients and Methods:

In this double-blind clinical trial, 60 patients with type 2 diabetes - who were referred to Diabetes Clinic of Bisto-Dou Bahman Hospital in Gonabad, Iran - were divided randomly into case and control groups. Self-regulation questionnaire, nutritional information and physical activity checklists were completed by both groups once at the beginning and once at end of the training. Fasting blood sugar (FBS) of both groups were measured as well. Case group was trained for a month, whereas the control group received no special training. Data were analyzed by SPSS version 19 software, K-square and paired t-tests.

Results:

Comparing the case with the control group before and after the training showed that teaching patients self-regulatory strategies had significant impact on lowering blood sugar (-16.50 vs. -2.47, P < 0.001), observing dietary behaviors (5.97 vs. -0.87, P < 0.001) and increasing physical activities (6.2 vs. -0.73, P < 0.001) of the former group.

Conclusions:

Learning self-regulations has a role to play in controlling type 2 diabetes. Therefore, it is suggested to professionals in healthcare centers to educate patients about self-regulatory techniques and use them as auxiliary methods for keeping type 2 diabetes under control.

Background:

Diabetes is the most common metabolic disorder which is required to be taken under control. According to some studies, the impact of self-regulation on health has been considered as a monitoring strategy to achieve individual’s goals.

Objectives:

This study, which was performed in 2012, aimed at determining the consequences of self-regulation on controlling type 2 diabetes.

Patients and Methods:

In this double-blind clinical trial, 60 patients with type 2 diabetes - who were referred to Diabetes Clinic of Bisto-Dou Bahman Hospital in Gonabad, Iran - were divided randomly into case and control groups. Self-regulation questionnaire, nutritional information and physical activity checklists were completed by both groups once at the beginning and once at end of the training. Fasting blood sugar (FBS) of both groups were measured as well. Case group was trained for a month, whereas the control group received no special training. Data were analyzed by SPSS version 19 software, K-square and paired t-tests.

Results:

Comparing the case with the control group before and after the training showed that teaching patients self-regulatory strategies had significant impact on lowering blood sugar (-16.50 vs. -2.47, P < 0.001), observing dietary behaviors (5.97 vs. -0.87, P < 0.001) and increasing physical activities (6.2 vs. -0.73, P < 0.001) of the former group.

Conclusions:

Learning self-regulations has a role to play in controlling type 2 diabetes. Therefore, it is suggested to professionals in healthcare centers to educate patients about self-regulatory techniques and use them as auxiliary methods for keeping type 2 diabetes under control.

Diabetes Mellitus, Type 2;Nutritional Sciences;Motor Activity Diabetes Mellitus, Type 2;Nutritional Sciences;Motor Activity http://www.ircmj.com/index.php?page=article&article_id=13506 Jahanshir Tavakolizadeh Jahanshir Tavakolizadeh Department of Basic Medical Sciences, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, IR Iran Department of Basic Medical Sciences, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, IR Iran Mehri Moghadas Mehri Moghadas Health and Treatment Network of Bajestan, Gonabad University of Medical Sciences, Gonabad, IR Iran; Health and Treatment Network of Bajestan, Gonabad University of Medical Sciences, Gonabad, IR Iran. Tel: +98-5337225027 Health and Treatment Network of Bajestan, Gonabad University of Medical Sciences, Gonabad, IR Iran; Health and Treatment Network of Bajestan, Gonabad University of Medical Sciences, Gonabad, IR Iran. Tel: +98-5337225027 Hami Ashraf Hami Ashraf Department of Research and Education, Razavi Hospital, Mashhad, IR Iran Department of Research and Education, Razavi Hospital, Mashhad, IR Iran
en 10.5812/ircmj.14914 The PI3K/AKT Pathway and FOXO3a Transcription Factor Mediate High Glucose-Induced Apoptosis in Neonatal Rat Ventricular Myocytes The PI3K/AKT Pathway and FOXO3a Transcription Factor Mediate High Glucose-Induced Apoptosis in Neonatal Rat Ventricular Myocytes research-article research-article Materials and Methods:

NRVMs were adopted as the cell model to investigate the roles of PI3K/AKT and FOXO3a in mediating hyperglycemia-induced apoptosis in cardiomyocytes. Annexin-V-FITC staining and PI staining were used to evaluate the apoptosis in NRVMs under indicated conditions of serum starvation, high glucose exposure, and pharmacological or genetic manipulations on the expressions of PI3K/AKT and FOXO3a. Western blotting was conducted to evaluate the cytoplasmic/nuclear localization of FOXO3a in NRVMs exposed to high glucose. FOXO3a transcriptional activity was measured by luciferase reporter assay.

Conclusions:

The PI3K/AKT pathway mediated hyperglycemia-induced apoptosis of NRVMs through the translocation of FOXO3a to nuclei and the resultant enhanced transcriptional activity of FOXO3.

Results:

High glucose (30 mM) induced significant apoptosis in serum-starved NRVMs as compared with normal glucose (5 mM) control (12.01 ± 0.76% vs. 2.86 ± 0.55%; P < 0.001). Treatment with IGF1 attenuated hyperglycemia-induced apoptosis by 68% (3.23 ± 0.76% vs. 9.97 ± 1.29%; P < 0.001; n = 3) in comparison with the non-treated control. Treatment with PI3K inhibitor LY294002 enhanced hyperglycemia-induced apoptosis by 109% (20.83 ± 1.87% vs. 9.97 ± 1.29%; P < 0.001; n = 3) in comparison with the non-treated control. Over-expression of AKT by transduction with CA-AKT attenuated hyperglycemia-induced apoptosis by 47% (5.48 ± 0.35% vs.10.31 ± 0.94%; P < 0.001; n = 3) in comparison with the empty-vector control. Transduction with DN-AKT enhanced high glucose-induced apoptosis by 105% (21.13 ± 1.11% vs. 10.31 ± 0.94%; P < 0.001; n = 3) in comparison with the empty-vector control. Western blotting showed that high glucose induced a significant increase in FOXO3a nuclear localization. Luciferase reporter assay showed that high glucose induced a significant increase of 310% (P < 0.001; n = 3) in FOXO3a transcriptional activity against Fas ligand when NRVMs were transducted with TM-FOXO3a in comparison with the empty-vector control.

Objectives:

In this experimental study, we investigated the mechanisms of the PI3K/AKT pathway and FOXO3a in mediating hyperglycemia-induced apoptosis in neonatal rat ventricular myocytes (NRVMs).

Background:

PI3K/AKT pathway plays major roles in regulating cardiomyocyte metabolism. The roles of PI3K/AKT pathway and FOXO3a in mediating high glucose-induced apoptosis in cardiomyocytes remain unclear.

Materials and Methods:

NRVMs were adopted as the cell model to investigate the roles of PI3K/AKT and FOXO3a in mediating hyperglycemia-induced apoptosis in cardiomyocytes. Annexin-V-FITC staining and PI staining were used to evaluate the apoptosis in NRVMs under indicated conditions of serum starvation, high glucose exposure, and pharmacological or genetic manipulations on the expressions of PI3K/AKT and FOXO3a. Western blotting was conducted to evaluate the cytoplasmic/nuclear localization of FOXO3a in NRVMs exposed to high glucose. FOXO3a transcriptional activity was measured by luciferase reporter assay.

Conclusions:

The PI3K/AKT pathway mediated hyperglycemia-induced apoptosis of NRVMs through the translocation of FOXO3a to nuclei and the resultant enhanced transcriptional activity of FOXO3.

Results:

High glucose (30 mM) induced significant apoptosis in serum-starved NRVMs as compared with normal glucose (5 mM) control (12.01 ± 0.76% vs. 2.86 ± 0.55%; P < 0.001). Treatment with IGF1 attenuated hyperglycemia-induced apoptosis by 68% (3.23 ± 0.76% vs. 9.97 ± 1.29%; P < 0.001; n = 3) in comparison with the non-treated control. Treatment with PI3K inhibitor LY294002 enhanced hyperglycemia-induced apoptosis by 109% (20.83 ± 1.87% vs. 9.97 ± 1.29%; P < 0.001; n = 3) in comparison with the non-treated control. Over-expression of AKT by transduction with CA-AKT attenuated hyperglycemia-induced apoptosis by 47% (5.48 ± 0.35% vs.10.31 ± 0.94%; P < 0.001; n = 3) in comparison with the empty-vector control. Transduction with DN-AKT enhanced high glucose-induced apoptosis by 105% (21.13 ± 1.11% vs. 10.31 ± 0.94%; P < 0.001; n = 3) in comparison with the empty-vector control. Western blotting showed that high glucose induced a significant increase in FOXO3a nuclear localization. Luciferase reporter assay showed that high glucose induced a significant increase of 310% (P < 0.001; n = 3) in FOXO3a transcriptional activity against Fas ligand when NRVMs were transducted with TM-FOXO3a in comparison with the empty-vector control.

Objectives:

In this experimental study, we investigated the mechanisms of the PI3K/AKT pathway and FOXO3a in mediating hyperglycemia-induced apoptosis in neonatal rat ventricular myocytes (NRVMs).

Background:

PI3K/AKT pathway plays major roles in regulating cardiomyocyte metabolism. The roles of PI3K/AKT pathway and FOXO3a in mediating high glucose-induced apoptosis in cardiomyocytes remain unclear.

Myocytes, Cardiac;Apoptosis;gleditsioside B Myocytes, Cardiac;Apoptosis;gleditsioside B http://www.ircmj.com/index.php?page=article&article_id=14914 Weiguo Bao Weiguo Bao Department of Cardiac Surgery, Second Hospital of Shandong University, Jinan, PR China Department of Cardiac Surgery, Second Hospital of Shandong University, Jinan, PR China Feng Pan Feng Pan Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Ling Chen Ling Chen Department of Cardiac Surgery, Second Hospital of Shandong University, Jinan, PR China Department of Cardiac Surgery, Second Hospital of Shandong University, Jinan, PR China Guohai Su Guohai Su Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Xiaoyuan Gao Xiaoyuan Gao Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Ying Li Ying Li Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Qiang Sun Qiang Sun Department of Cardiac Surgery, Second Hospital of Shandong University, Jinan, PR China Department of Cardiac Surgery, Second Hospital of Shandong University, Jinan, PR China Jinhui Sun Jinhui Sun Department of Cardiac Surgery, Second Hospital of Shandong University, Jinan, PR China Department of Cardiac Surgery, Second Hospital of Shandong University, Jinan, PR China Kun He Kun He Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China Hui Song Hui Song Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China; School of Public Health, Shandong University, Jinan, PR China; Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China, Tel: +86-13370582767 Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China; School of Public Health, Shandong University, Jinan, PR China; Department of Cardiology, Jinan Central Hospital of Shandong University, Jinan, PR China, Tel: +86-13370582767
en 10.5812/ircmj.15603 Design and Construct an Optical Device to Determine Relative Blood Volume in Patients Undergoing Hemodialysis Design and Construct an Optical Device to Determine Relative Blood Volume in Patients Undergoing Hemodialysis research-article research-article Objectives

The main objective of this study was to design and construct an optical device to determine the RBV in patients undergoing hemodialysis, during the process.

Materials and Methods

After initial studies in order to select a proper sensor, using the ORCAD software, an analog circuit was designed. The implementation and modification of the circuit was done by the clinical tests, using expired blood. Afterwards, for calculation the RBV, controlling the display, data storage and sending it to the computer, an ATmega16 microcontroller was used. For programing the microcontroller, CodeVision software and then Altium Designer software were used for the circuit compression, in order to design the printed circuit board. Finally, all parts of the analog and digital circuit, AC to DC converter and the LCD were embedded in a box.

Background

Occurrence of hypotension during hemodialysis in nearly 20-30% of patients, shows is the necessity of continuous monitoring the patients' blood pressure during hemodialysis. Since directly and non-invasively continuous blood pressure monitoring, is not easy, finding a parameter related to blood pressure, for indirect monitoring is of great value. Related blood volume (RBV) is one of the parameters, related to blood pressure and have a good potential to reflect the patient’s hemodynamic condition.

Results

After finalization of the device and before testing it in a real situation, expired blood was used for final evaluation. The evaluation was done by changing the blood concentration, at the start point by adding water to it. In fact, the device can track the changes in blood concentration and display the RBV. After this evaluation, the device was tested in a clinical situation. The results showed there are no interactions between this device and the other devices used in the dialysis section and it can work properly in order to measure the RBV.

Conclusions

Considering the hypotension and its consequences in a patient on hemodialysis, solving this problem seems necessary. One method for preventing this, is to use the blood pressure related parameters and one of these parameters is the RBV. In this study, in order to measure the RBV, a device was designed and evaluated by expired blood and also tested in a clinical situation. Results showed that the device could work properly in order to measure the RBV.

Objectives

The main objective of this study was to design and construct an optical device to determine the RBV in patients undergoing hemodialysis, during the process.

Materials and Methods

After initial studies in order to select a proper sensor, using the ORCAD software, an analog circuit was designed. The implementation and modification of the circuit was done by the clinical tests, using expired blood. Afterwards, for calculation the RBV, controlling the display, data storage and sending it to the computer, an ATmega16 microcontroller was used. For programing the microcontroller, CodeVision software and then Altium Designer software were used for the circuit compression, in order to design the printed circuit board. Finally, all parts of the analog and digital circuit, AC to DC converter and the LCD were embedded in a box.

Background

Occurrence of hypotension during hemodialysis in nearly 20-30% of patients, shows is the necessity of continuous monitoring the patients' blood pressure during hemodialysis. Since directly and non-invasively continuous blood pressure monitoring, is not easy, finding a parameter related to blood pressure, for indirect monitoring is of great value. Related blood volume (RBV) is one of the parameters, related to blood pressure and have a good potential to reflect the patient’s hemodynamic condition.

Results

After finalization of the device and before testing it in a real situation, expired blood was used for final evaluation. The evaluation was done by changing the blood concentration, at the start point by adding water to it. In fact, the device can track the changes in blood concentration and display the RBV. After this evaluation, the device was tested in a clinical situation. The results showed there are no interactions between this device and the other devices used in the dialysis section and it can work properly in order to measure the RBV.

Conclusions

Considering the hypotension and its consequences in a patient on hemodialysis, solving this problem seems necessary. One method for preventing this, is to use the blood pressure related parameters and one of these parameters is the RBV. In this study, in order to measure the RBV, a device was designed and evaluated by expired blood and also tested in a clinical situation. Results showed that the device could work properly in order to measure the RBV.

Blood Volume;Hypotension;Renal Dialysis;Optical Devices;Blood Blood Volume;Hypotension;Renal Dialysis;Optical Devices;Blood http://www.ircmj.com/index.php?page=article&article_id=15603 Banafshe Dormanesh Banafshe Dormanesh Department of Pediatric Nephrology, AJA University of Medical Sciences, Tehran, IR Iran Department of Pediatric Nephrology, AJA University of Medical Sciences, Tehran, IR Iran Shahnaz Tofangchiha Shahnaz Tofangchiha Department of Internal Medicine, AJA University of Medical Sciences, Tehran, IR Iran; Department of Internal Medicine, AJA University of Medical Sciences, Tehran, IR Iran. Tel: +98-2185955616, Fax: +98-2185955616 Department of Internal Medicine, AJA University of Medical Sciences, Tehran, IR Iran; Department of Internal Medicine, AJA University of Medical Sciences, Tehran, IR Iran. Tel: +98-2185955616, Fax: +98-2185955616 Vahid Abouei Vahid Abouei Department of Pediatric Nephrology, AJA University of Medical Sciences, Tehran, IR Iran Department of Pediatric Nephrology, AJA University of Medical Sciences, Tehran, IR Iran Hani Sharifian Hani Sharifian Department of Pediatric Nephrology, AJA University of Medical Sciences, Tehran, IR Iran Department of Pediatric Nephrology, AJA University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.16314 An Educational Program Based on the Successful Aging Approach on Health-Promoting Behaviors in the Elderly: A Clinical Trial Study An Educational Program Based on the Successful Aging Approach on Health-Promoting Behaviors in the Elderly: A Clinical Trial Study research-article research-article Conclusions:

Focusing on successful aging and adopting HPBs can prevent and decrease aging problems which in turn decreases the financial burden and related costs. This is especially important for the policy and decision makers of the health systems.

Results:

The mean age of the participants in this study was 65.9 ± 3.6 (range 60-73). Results showed a statistically significant difference between the intervention and control group after the intervention in the mean scores of awareness of aging facts and score of health promoting behaviors.

Patients and Methods:

This clinical trial study was conducted on 464 Iranian elderly people over 60 years who were admitted at Health Houses for 12 months. Participants were selected through a two-stage cluster sampling and were placed in the control and intervention groups (232 participants in each group). The data collection tools included: a demographic checklist, Palmore Facts on Aging Quiz and the second version of Health Promoting Lifestyle Profile. The intervention was designed based on adult strategy education in five 45-minute sessions. The data obtained 3 months after the intervention were compared with the data obtained before the intervention. The data were analyzed using the descriptive and analytical tests such as paired T-test with SPSS version 20, at the statistical significant level 0.05.

Background:

Many criteria of successful aging are directly connected with Health-Promoting Behaviors.

Objectives:

The current study aimed to evaluate the effect of an educational program based on the successful aging approach on health promoting behaviors in the elderly.

Conclusions:

Focusing on successful aging and adopting HPBs can prevent and decrease aging problems which in turn decreases the financial burden and related costs. This is especially important for the policy and decision makers of the health systems.

Results:

The mean age of the participants in this study was 65.9 ± 3.6 (range 60-73). Results showed a statistically significant difference between the intervention and control group after the intervention in the mean scores of awareness of aging facts and score of health promoting behaviors.

Patients and Methods:

This clinical trial study was conducted on 464 Iranian elderly people over 60 years who were admitted at Health Houses for 12 months. Participants were selected through a two-stage cluster sampling and were placed in the control and intervention groups (232 participants in each group). The data collection tools included: a demographic checklist, Palmore Facts on Aging Quiz and the second version of Health Promoting Lifestyle Profile. The intervention was designed based on adult strategy education in five 45-minute sessions. The data obtained 3 months after the intervention were compared with the data obtained before the intervention. The data were analyzed using the descriptive and analytical tests such as paired T-test with SPSS version 20, at the statistical significant level 0.05.

Background:

Many criteria of successful aging are directly connected with Health-Promoting Behaviors.

Objectives:

The current study aimed to evaluate the effect of an educational program based on the successful aging approach on health promoting behaviors in the elderly.

Community Health Planning;Aging;Health Promoting Intervention Community Health Planning;Aging;Health Promoting Intervention http://www.ircmj.com/index.php?page=article&article_id=16314 Fatemeh Estebsari Fatemeh Estebsari Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran Mohammad Hossein Taghdisi Mohammad Hossein Taghdisi Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Alvand Ave., Tehran, IR Iran. Tel/Fax: +98-2188779118 Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, IR Iran; Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Alvand Ave., Tehran, IR Iran. Tel/Fax: +98-2188779118 Abbas Rahimi Foroushani Abbas Rahimi Foroushani Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Hasan Eftekhar Ardebili Hasan Eftekhar Ardebili Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Davoud Shojaeizadeh Davoud Shojaeizadeh Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran