Showing 12 results for Safari
I Najafi , M Hosseini , S Safari , A Shojaee, A Sharifi, M Mehrani , R Babaee ,
Volume 5, Issue 4 (11 2010)
Abstract
Background & objectives: In the management of crush syndrome, the way of treating compartment syndrome is controversial. The aim of this study was to evaluate the outcomes of compartment syndrome treatment after Bam earthquake.
Methods: Clinical and laboratory findings of all fasciotomized patients in Bam earthquake were analyzed. Then nonfasciotomized patients with same characteristics were selected and the outcomes of two groups were compared.
Results: Fasciotomy for 107 injured out of 2962 hospitalized patients, was performed (46% female). Mean age of fasciotomized patients was 27.4±9.7 years (min=10, max=65 year). There were not significant differences in the final outcome of two groups with the same clinical, biochemical and demographic characteristics.
Conclusions: Fasciotomy for 107 injured out of 2962 hospitalized patients, was performed (46% female). Mean age of fasciotomized patients was 27.4±9.7 years (min=10, max=65 year). There were not significant differences in the final outcome of two groups with the same clinical, biochemical and demographic characteristics.
B Yazdanpanah, M Safari, P Angha, M Karami, M Emadi, S Yazdanpanah, A Pourbehesht,
Volume 7, Issue 4 (16 2012)
Abstract
Background and Objectives: Diabetes is a major health issue worldwide. This study evaluates whether a community-based participatory program may improve diabetes care in adult in west area of Yasouj.
Methods: A community based participatory research was designed. A local leading group was established consisted of academic researchers, local leaders, health providers and public representatives. All the 30-65 years old residents of designated area (2569 persons) were screened for detecting diabetes anthropometric measurements and biochemical tests were measured. Educational interventions about improving the diet and physical activities were performed for high risk individuals through a 3-months period.
Results: Out of 2569 individuals, 1336 were at high risk. Approximately 228 persons (17%) identified having diabetes. After the intervention, the mean FBS, HbA1C, TG and cholesterol of participant significantly decreased (p<0.05), decreasing in systolic and diastolic blood pressure and body mass index were seen however this was not statistically significant. The mean physical activity and exercise increased and consumption of frying foods, saturated oil decreased significantly.
Conclusion: Community-Based Participatory cares could be a feasible model for control of diabetes and its risk factors.
N Vahabi, F Zayeri, E Fazeli Moghadam , M Safari, F Ebrahimzadeh,
Volume 11, Issue 3 (Vol 11, No 3 2015)
Abstract
Background and Objectives: Disorders of height and weight growth are the most important health disorders affecting children younger than two in developing societies. Failure to treat these disorders can lead to the increased mortality and mental, emotional or physical disability. The objective of this study was to investigate the growth trends of children and the factors affecting it.
Methods: This retrospective cohort study was conducted on 2030 children younger than two in Khorramabad, Iran who were selected using stratified and cluster sampling. Based on household records, the weight growth trend was recorded as a four-level variable (decline, stagnation, slowness and desirable) and the the height growth trend was recorded as a three-level variable (stagnation, slowness and desirable); finally, the data were modeled using a longitudinal marginal model and the SAS software version 9.2.
Results: The incidence of at least one decline in the weight growth curve and one stagnation in the height growth curve was 14.2% and 10.4%, respectively. The child’s age and the maternal educational level had a significant effect on the growth trends. However, the sex, parity and the exclusive breastfeeding during the first six months had no significant relationship with the growth trends.
Conclusion: Given the results and the relatively high prevalence of growth disorders among children, it seems that increasing the awareness of low literate women about feeding of the children is the most important approach to manage growth disorders. Additionally, health-care professionals should mostly focus on monitoring the growth of children older than 12 months.
R Safari Faramani, H Akbarin, Aa Haghdoost, A Beigzadeh, Ah Takian, R Malekzadeh, E Mostafavi, H Sharifi,
Volume 12, Issue 1 (Vol 12, No.1 2016)
Abstract
Background and Objectives: Taking into account the roles and positions of WHO Collaborating Centers (WHOCCs) in the furtherance of national goals and the great impact of their interaction as well as cooperative relations between these centres, this study was conducted to assess the current status of WHOCCs, identify opportunities and threats, and provide practical solutions to solve WHOCCs problems.
Methods: This cross-sectional study was conducted using an open-ended questionnaire in 2014. The questionnaire revolved around the WHOCCs' status in terms of goal achievement, manpower problems, financial resources, communications, as well as suggestions to solve problems in these domains. These findings were approved in the second convention of the heads of WHOCCs in Kerman in 2014 and the questionnaires of the second phase were distributed and completed by participants. Data were analyzed using the content analysis method.
Results: The majority of the centres assessed their performance regarding the national goals (11.59) in comparison with international goals (14.20), and self-regulated goal setting (14.7o) in an unfavorable condition. Financial problems and lack of recruitment were the most important problems for WHOCCs. The support of the Ministry of Health, WHO, supporting universities, and establishing research networks at national and international levels to foster communication, contracts to share experiences and resources, considering the authors' rights as well as introducing the competencies of centres at national and international levels, were some of the suggestions proposed.
Conclusion: It seems that more support of the WHO, Ministry of Health, and supporting universities is needed to increase financial resources and recruit staff.
B Damari, M Faghihi Juibari , J Najafpoor, M Safari, A Khoshnevisan,
Volume 12, Issue 3 (Vol 12, No 3 2016)
Abstract
Background and Objectives: Social determinants of health affect a wide range of health consequences. The aim of this study was to analyze the effects of social determinants of health factors on survival in patients with malignant brain tumors.
Methods: This cross-sectional retrospective study was done in Imam Khomeini and Shariati Hospitals in 2014. Based on inclusion criteria, the data of 148 patients were collected. The collected data included demographic information (including age, sex, education level, employment status, marital status, health insurance status, number of household members), information about the tumor and disease (stage / grade), The first and the last time of follow-up, type of selected treatment, and the duration of survival after treatment. We used SPSS 15 to analyze data.
Results: Our results showed a significant relationship between survival and variables such as the size of the household, education, employment status, and age. Patients with grade 3 tumors had a lower relative risk of dying while employed patients, patients in the age range 18-30 years, and male patients had a higher relative risk of dying (lower survival).
Conclusion: Lack of reliable databases and appropriate integration and communication between different organizations recording to patient data, and also probable sensitivity in obtaining personal information has led to the lack of systematic information about the impact of social determinants of health. it is recommended that a system of recording integrated information for different disease should be established in the country for designing informed policies based on the evidence.
M Safari, M Sadeghifar, Gh Roshanaei , A Zahiri,
Volume 14, Issue 2 (Vol.14, No.2, 2018)
Abstract
Background and Objectives: Tuberculosis is a chronic bacterial disease and a major cause of morbidity and mortality. It is caused by a Mycobacterium tuberculosis. Awareness of the incidence and number of new cases of the disease is valuable information for revising the implemented programs and development indicators. time series and regression are commonly used models for prediction but these methods require some assumptions. The purpose of this study was to predict new TB cases using the hidden Markov model which does not require many assumption.
Methods: The data used in this study was the monthly number of new TB cases during 2006-2016 identified and recorded in Hamedan Province. Rorecasting the number of new TB cases was done using hidden Markov models using the hidden Markov package in the R software.
Results: According to the AIC and BIC criterion, two states had the best fit to the data, i.e. the data of this study were a mixture of two Poisson distributions with average number of event 5.96 and 10.2 respectively. The results also predicted the number of new cases over the next 24 months based on the hidden Markov model would be between 8 and 9 new cases in each month.
Conclusion: The hidden Markov model is the best model for prediction using the Markov chain. This model, in addition to detection of an appropriate model for the available data, can determine the transition probability matrix, which can help physicians predict the future state of the disease and take preventive measures befor reaching advanced stages.
M Safari, M Abbasi, F Gohari Ensaf , Z Berangi, Gh Roshanaei,
Volume 15, Issue 4 (Vol.15, No.4 2020)
Abstract
Background and Objectives: In survival analysis, using the Cox model to determine the effective factors requires the assumptions whose failure of leads to biased results. The aim of this paper was to determine the factors affecting the survival of metastatic gastric cancer patients using the non-parametric method of Randomized Survival Forest (RSF) model and to compare its result with the Cox model.
Methods: In this retrospective cohort study, 201 patients with metastatic gastric cancer were evaluated in Hamadan Province. Patient survival was calculated from diagnosis to death or end of study. Demographic characteristics (such as gender and age) and clinical variables (including stage, tumor size, etc.) were extracted from the patient records. Factors affecting survival were determined using the Cox model and RSF. Data analysis was performed using the R3.4.3 software and RandomForestSRC and survival packages.
Results: The mean (SD) age of patients was 61.5 (12.9) years old. The Cox model showed that chemotherapy (p=0.033) was effective in survival, and the results of fitting the RSF model showed that the most important variables affecting survival were type of surgery, location of metastasis, chemotherapy, age, tumor grade, surgery, number of involved lymph nodes, sex and radiotherapy. Based on the model appropriateness, the RSF model with log-rank split rule had a better performance compared to the Cox model.
Conclusion: If the number of variables is high and there is a relationship between the variables, the RSF method identifies the important and effective variables on survival with high accuracy without requiring restrictive assumptions compared to the Cox model.
F Najafi, Gh Moradi, M Mohamadi Bolbanabad , S Rezaei, R Safari Faramani , B Karami Matin , B Piroozi, S Darvishi, T Mohamadi, Sh Amiri Hoseini, B Zarei, A Azadnia,
Volume 16, Issue 3 (Vol.16, No.3 2020)
Abstract
Background and Objectives: On 12 November 2017, an earthquake with a magnitude of 7.3 on the Richter scale occurred in Kermanshah Province. Explaining the challenges and needs of the victims in such circumstances can be an important source of information for future planning and better management of such conditions. Thus, the purpose of this study was to explain the challenges and needs of the earthquake victims.
Methods: This study was a qualitative study. Twenty-nine semi-structured interviews were conducted with managers, policymakers, and health and emergency relief providers in earthquake areas, and 10 focused group discussions were held with earthquake victims from December to February 2016. The data were analyzed using conventional content analysis.
Results: The needs and challenges in Kermanshah earthquake were classified into three periods after the earthquake: 1. Challenges and needs in the first few days with three sub-categories including management, rescue services, and urgent care, 2- Challenges and needs in the first few weeks after the earthquake with three sub-categories including housing and emergency assistance, public health services, and access to health care; and 3. Needs and challenges in several months after the earthquake with four sub-categories including economic, social, infrastructural and health service needs.
Conclusion: Lack of unity of command was the main challenge in this earthquake. Another point was the health needs of victim earthquakes over time. Therefore, dispatching of aid forces to the affected areas during natural disasters should be based on planning and needs.
Malihe Safari, Salman Khazaei, , Mohammad Abbasi, Ghodratollah Roshanaei,
Volume 17, Issue 2 (Vol 17,No.2, Summer 2021 2021)
Abstract
Background and Objectives: The incidence of rectal cancer is increasing in developing societies, especially in younger age groups. The aim of this study was to evaluate the factors affecting the survival of patients with rectal cancer in the presence of competing risks.
Methods: In this retrospective cohort study, the data of 121 patients with rectal cancer during 2001-2017 were studied. Death related to cancer progression was considered as the interest outcome and other causes of death were considered as competing risks. Cause-specific and sub-distribution hazard models were used to investigate the factors affecting patient survival in the presence of competing risk.
Results: The mean (SD) age of the patients was 53.4 (13.9) years and 68 patients (56.2%) were male. The results of log-rank test showed that sex, age, metastasis, type of first treatment, rate of penetration into intestinal wall, tumor location, number of lymphomas involved and tumor size had significant effects on the patient survival (P<0.05). Based on cause-specific and sub-distribution hazard models, tumor stage, lymph node metastasis, and tumor grade had significant effects on death hazard due to the cancer progression (P<0.05).
Conclusion: Due to the need to consider competing risks, the results of both competing risk methods showed that tumor grade, lymph node metastasis and stage increased the instantaneous hazard and hazard of cancer death. Therefore, to determine the specific risk factors for each cause of death in the survival analysis, competing risk methods should be used if there is more than one cause of death.
Zahra Jaafari, Zahra Abdolahinia, Hajar Ghasemi, Ali Esmaeilpour, Saeideh Mahmoodzadeh, Ali Bahaodini, Seyed Vahid Ahmadi Tabatabaei, Najmeh Safa, Hamid Reza Tohidinik, Ali Akbar Haghdoost, Ali Sharifi, Vahid Yazdi-Feyzabadi, Hamid Safari,
Volume 17, Issue 2 (Vol 17,No.2, Summer 2021 2021)
Abstract
Background and Objectives: low utility of health care services is one of the main determinants of not achieving desired health indicators in urban areas. This study aimed to investigate the barriers and facilitators of receiving health services from health centers in Kerman city, Iran.
Methods: This study was a qualitative study with a content analysis approach conducted in 2020. After selecting health centers with the experience of desirable or low utility services, purposive sampling continued until information saturation. A total of 78 staff members, recipients, and non-recipients of services citizens were interviewed semi-structured and face-to-face at health centers. All interviews were recorded and coded manually and then reviewed and analyzed using directional content analysis.
Results: The essential services for children and mothers, free services, and service providers' behavior were mentioned as facilitators of referral. Distance and physical factors, knowledge of different types of services, preference of private centers, time access, view of people on regular visits to centers, addresses and telephone numbers registered in the system, responsiveness to health needs, fear of disease disclosure, lack of human resources in the centers, and service providers' behavior, were among the barriers of visiting the centers.
Conclusion: According to the results of this study, an accurate understanding of the under-coverage people's views and perceptions can help national and local planners and policymakers design the necessary strategies to increase the use of health services in urban health centers.
Maryam Aghajarinezhad, Yahya Salimi, Shahab Rezaeian, Ghobad Moradi, Fatemeh Khosravi Shadmani, Roya Safari Faramani, Ebrahim Shakiba, Yahya Pasdar, Behrooz Hamzeh, Nayebali Rezvani, Mitra Darbandi, Farid Najafi,
Volume 18, Issue 2 (Vol.18, No.2, Summer 2022 2022)
Abstract
Background and Objectives: Serological studies are based on the detection of antibodies. However, the produced antibodies decrease over time; therefore, such methods cannot provide a valid estimate of prevalence and incidence. The present study aimed to determine the serum prevalence and cumulative incidence in the Ravansar cohort population (Youth and RaNCD Cohort) in October 2020.
Methods: A random sample of 716 people aged > 18 years old were selected from the participants in the Ravansar cohort study in October 2020. Euroimmun anti-SARS COV-2 IgG ELISA kits (Lübeck, Germany) were used to measure antibody levels. Seroprevalence was estimated with considering of cut-off = 1, and cumulative incidence (modified and modified based on test specificity) was determined using modeling.
Results: In the present study, the serum prevalence of COVID-19 viral infection in the Ravansar cohort population from 22 October 2020 to 18 November 2020 was estimated to be %35.16 (95%CI: %31.64, %38.79). Modified Cumulative incidence and modified based on test characteristics from 20 February to 18 November 2020 were estimated to be %68.85 and %67.71, respectively.
Conclusion: Although very high cumulative incidence may be a sign of approaching herd immunity, adherence to health protocols is still recommended due to the potential role of asymptomatic cases in transmitting the disease to other members of the community; and the presence of new variants of the virus and reduced antibody levels should be considered.
Fariba Zomorrodi Zare, Fatemeh Khosravi Shadmani, Roya Safari Faramani, Fatemeh Torkamanasadi, Yazdan Rezaei, Farid Najafi,
Volume 20, Issue 1 (Vol.20, No.1, Spring 2024)
Abstract
Background and Objectives: During the COVID-19 pandemic, vaccination was crucial in preventing the spread of SARS-CoV-2 and saving numerous lives. Countries implementing COVID-19 vaccination programs have reported significant reductions in cases, ICU admissions, and COVID-19-related deaths. This study aimed to evaluate the effectiveness of vaccines used in Hamadan province, explicitly focusing on their impact on hospitalization and death caused by COVID-19.
Methods: A test-negative case-control design (TND) was conducted involving patients aged 12 and above who were admitted to hospitals in Hamadan province, Iran, and had symptoms of acute respiratory diseases. Data were extracted from hospital and health system databases. Multiple logistic regression analysis was performed to estimate vaccine effectiveness for the first, second, and reminder doses in prevention of hospitalization, and severe outcomes (ICU admission or death).
Results: The study was conducted on 3,702 patients, and the maximum effectiveness of vaccines against hospitalization was 50% for patients who received a booster dose. The effectiveness of the first dose of vaccine on severe outcomes (admission to ICU or death) was estimated as 42%, but the effectiveness of the vaccines in the second and booster doses were not significant.
Conclusion: Despite the predominant use of inactivated virus vaccines and delayed initiation of vaccination in Iran, this study shows the effect of vaccination on reducing hospitalization and improving the outcomes of COVID-19. The use of more effective vaccines at a more appropriate time plays an important role in reducing the burden on health services and preventing further transmission in future epidemics.
