Search published articles
Showing 73 results for Akbari
Parvin Akbari Asbagh, Ali Zamani , Seyed Reza Raees Karami , Mohammad Mahdi Zahrabi , Yasamin Mohammadzadeh ,
Volume 74, Issue 5 (August 2016)
Volume 74, Issue 5 (August 2016)
Abstract
Background: Acute osteomyelitis is one of pediatric emergency which can cause unpleasant complications among them. This is especially accurate if the diagnosis had been delayed or the treatment was inappropriate. There is some misunderstanding in the detection of patients’ hospital files and it’s difficult to detect the diagnostic and treatment malpractice. We performed an investigation of the clinical and paraclinical data in children with acute osteomyelitis.
Methods: We performed a retrospective cross-sectional study in pediatric department of Imam Khomeini University Hospital in Tehran, Iran, from April 1997 to March 2010. The hospital records of all neonates and children from 15 days old to 15 years old were investigated. Patients with any defect in records were excluded from the study. A total of 54 children were included in this study. A questionnaire including clinical features, paraclinical findings and treatment response was completed for all subjects by design's executer. Data were analyzed using the software package SPSS version 16 (IBM, Armonk, NY, USA).
Results: In general, 35 children were male and 19 children were female. The average of age was 5.89 years. Children were divided into 4 groups based on age (less than 2, 2-7, 7-12 and 12-15 years) that majority of them were less than 2 years old (38.9%). The most common symptom and sign were pain (46.3%) and swelling (88.8%) respectively in this study. The most primary presenting symptoms were pain (46.3%) and swelling (24.1%). The comparison of frequency ranges of fever between children younger than 2 years and children 2-15 years old demonstrated a significant different (14.3% vs 84.8%, respectively) (P= 0.001). Staphylococcus aureus was the most commonly isolated organism (73.5%). Thirty-two patients (59.2%) needed surgical procedures in addition to antibiotic therapy that had successful outcome in all cases. The average of treatment duration with intravenous antibiotic was 28.14±12.84 days.
Conclusion: More than half of the children with acute osteomyelitis didn't response to antibiotic therapy and they needed different types of surgeries.
Mahshid Hatami , Mohammad Esmaeil Akbari , Morteza Abdollahi , Marjan Ajami , Yasaman Jamshidinaeini , Sayed Hossein Davoodi ,
Volume 75, Issue 1 (April 2017)
Volume 75, Issue 1 (April 2017)
Abstract
|
Background: Breast cancer is the most common cancer among females in the world. Identifying the nutrients that modify the risk of the disease is one of the key strategies for improving the quality of life and reducing treatment costs. Epidemiological studies support the role of macronutrients and vitamins involved in one carbon metabolism in the etiology of the disease. This study aimed in investigation of the relationship between the intake of macronutrients and vitamins involved in one carbon metabolism with breast cancer risk. Methods: This case-control hospital base study was conducted at Shohada Hospital, Tehran from April to February 2015. Demographic data, physical activity level and nutrients’ intake from diet and supplements were collected through interview from 151 cases and 154 controls. Dietary intake was assessed by a valid and reliable 168-item semi-quantitative food frequency questionnaire. Then intake of macronutrients and B vitamins was assessed by Nutritionist 4 software (First Databank Inc., CA, USA). Comparing categorical variables between the two groups was done by Chi-squared test and the relationship between intake of studied nutrients and risk of breast cancer was determined using logistic regression test. Results: There were no difference in age, menarche age, menopause age, body mass index (BMI), number of live births between two groups. But the difference in physical activity, energy intake, marital status, educational level, occupation, oral contraceptives use was significant (P< 0.001). After modifying the effects of confounding variables, the risk of breast cancer was significantly lower in the highest intake quartile category relative to the lowest quartile category for total protein, total fiber, intake of vitamins B2, B6, B12 and folate (Ptrend< 0.001). Before modifying the effects of confounding variables, the risk of breast cancer was significantly higher in the highest intake quartile category relative to the lowest quartile category for carbohydrate and fat; but after modifying the effects of confounding variables, results were not significant. |
Conclusion: The results showed that high intake of protein, fiber, vitamins B2, B6, B12 and folate are associated with lower risk of breast cancer.
Razieh Akbari, Mehdi Aghili,
Volume 75, Issue 3 (June 2017)
Volume 75, Issue 3 (June 2017)
Abstract
Background: Cancer is a major life-threatening disease that can evoke deep-rooted fear of death and sense of loss of hope. Even the word, cancer, has powerful connotations of anxiety, pain and suffering. Cancer has a great impact on patients’ lives, so the extent to which physicians should inform them of the diagnosis poses a difficult decision in clinical settings. Therefore, truth telling is one of the most important issues in patients- physicians’ relationship. Besides the ethical aspect, telling or not telling the truth has some legal aspects, therefore, it is important to know the effective factors and understand how to deal with this issue especially for incurable diseases such as cancer. Therefore, the aim of this research was to analyses the effective factors in physician’s truth telling to cancer-patients.
Methods: The samples of this descriptive and analytical study, (survey study) consist of 161 cancer-specialists from Tehran University of Medical Sciences who have been selected by simple random sampling method in 2015 and 2016. The data was obtained by survey approach and the data collected using a questionnaire. In order to evaluate the validity and reliability of the research, expert’s opinion and Cronbach alpha coefficient have been used. The questionnaire included scales designed to measure attitude, intention, subjective norms; perceived behavior control. Statistical package for social science software (SPSS) were used to analyses the data. T-test and ANOVA were used to compare groups.
|
Results: Fifty-nine hudred percent male and 41% female physicians took part in this study. The average age of the participants was 43.4±11.27 years. The best person for truth-telling was physician and psychologist. Results showed that there was no significant difference between attitudes of male and female specialist but there was significant difference between oncologist and non-oncologist tendency to tell the truth. Results also showed that there was difference between physician’s behaviors (average 8.87). There was difference between behavior of private and public-private sectors physicians (62.8). Conclusion: Although the results show that there are differences in specialists’ attitude toward truth telling, it is not a good reason for not telling the truth. Although the physicians should consider several factors when telling the truth. |
Ali Mohammad Mosadeghrad , Ali Akbari Sari , Taraneh Yousefinezhadi ,
Volume 75, Issue 4 (July 2017)
Volume 75, Issue 4 (July 2017)
Abstract
Background: Hospital accreditation is a systematic external evaluation of a hospital’s structures, processes and results (outputs/ outcome) by an independent professional accreditation body using pre-established optimum standards. Hospital accreditation has an important role in improving the quality, safety, effectiveness and efficacy of health care services. The effectiveness of an accreditation system depends on the quality and conformity of its methods, standards and surveyors. This study aimed to evaluate the hospital accreditation method from the perspective of Iranian hospital managers.
Methods: This descriptive, applied and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire. The study population consisted of 914 hospital managers. Overall 547 hospital managers were surveyed through stratified random sampling. SPSS software was used for data analysis.
Methods: This descriptive, applied and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire. The study population consisted of 914 hospital managers. Overall 547 hospital managers were surveyed through stratified random sampling. SPSS software was used for data analysis.
| Results: Almost 71.7 percent of hospitals achieved grade one and above in the first round of national accreditation survey. The mean score of managers’ satisfaction of hospital accreditation method was 3.21±0.63 out of 5 (Average). About 38 percent of hospital managers were satisfied with the hospital accreditation method. Most complaints were related to lack of reliability among surveyors and their low knowledge, skills and experience. Hospital managers were satisfied with surveyors’ attitude and adequacy of the number of survey days. Hospital managers mostly believed that accreditation is better to be done by Ministry of Health, compulsory, and every two years. About 95 percent of hospital managers agreed that self-assessment is necessary and beneficial prior to the accreditation survey. Conclusion: Hospital managers were moderately satisfied with the national accreditation system. Developing job description and person specification for accreditation surveyors and recruiting them accordingly, and providing professional education and training for them help improve the effectiveness of Iranian hospital accreditation method. The method of hospital accreditation in Iran has to be changed. Self-assessment, unannounced surveys, review of hospital key performance indicators and patient satisfaction surveys should be added to the current scheduled on-site surveys to enhance the credibility of the accreditation result. |
Mohsen Haghshenas Mojaveri , Zahra Akbarian Rad , Zeynab Shafipour , Somayeh Alizadeh Rokni , Fatemeh Valizadeh ,
Volume 75, Issue 11 (February 2018)
Volume 75, Issue 11 (February 2018)
Abstract
Background: One of the important effects of kangaroo mother care (KMC) in preterm baby is improvement in weight gain and so shortening in hospitalization, but it is not clear that how long of kangaroo mother care is effective in weight gain. The aim of this study was to determine the least effective duration of kangaroo mother care in weight gain in very low birth weights.
Methods: Preterm babies with birth weight less than 1500 gr, without chronic cardiopulmonary disease, congenital anomaly and other medical problem when receiving to 140 ml/kg/d enteral feeding enrolled the study. KMC was started when the baby has been stabled, on the mother’s appetency and ability at bedside. The mean daily weight gain in KMC period was compared with expected that (15 mg/kg/d) for the same baby. The babies with KMC≥ 7 days were divided in three groups on the basis of mean daily KMC duration (< 30 min, 30-60 min and> 60). Statistical study performed by using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and P values of less than 0.05 were considered to be significant.
Results: In this study, 103 preterm baby (47 boys, 56 girls) less than 1500 gr were enrolled, with mean birth weight 1107.85±190.87 gr. Mean weight gain of boys in KMC period and expected that were 324.78±162.66 gr Vs. 127.46±54.66 gr (P< 0.001). In eighty-seven babies who received KMC (7-40 days) mean daily weight gain was 26.69±15.55 gr (P< 0.001). Mean weight gain in KMC period for group with< 30 min (n=19), 402.63±126.29 gr Vs. 167.21±74.20 (P< 0.001), group with 30-60 min (n=54) were 338.79±182.60 gr Vs. 220.36±66.98 (P< 0.001) and group with 60< (n=14) 352.14±236.02 gr Vs. 259.96±112.23 (P= 0.09).
Conclusion: On the basis of this study KMC less than 1 hour per day is effective in weight gain of very low birth weight preterm babies.
Methods: Preterm babies with birth weight less than 1500 gr, without chronic cardiopulmonary disease, congenital anomaly and other medical problem when receiving to 140 ml/kg/d enteral feeding enrolled the study. KMC was started when the baby has been stabled, on the mother’s appetency and ability at bedside. The mean daily weight gain in KMC period was compared with expected that (15 mg/kg/d) for the same baby. The babies with KMC≥ 7 days were divided in three groups on the basis of mean daily KMC duration (< 30 min, 30-60 min and> 60). Statistical study performed by using SPSS software, version 22 (IBM SPSS, Armonk, NY, USA) and P values of less than 0.05 were considered to be significant.
Results: In this study, 103 preterm baby (47 boys, 56 girls) less than 1500 gr were enrolled, with mean birth weight 1107.85±190.87 gr. Mean weight gain of boys in KMC period and expected that were 324.78±162.66 gr Vs. 127.46±54.66 gr (P< 0.001). In eighty-seven babies who received KMC (7-40 days) mean daily weight gain was 26.69±15.55 gr (P< 0.001). Mean weight gain in KMC period for group with< 30 min (n=19), 402.63±126.29 gr Vs. 167.21±74.20 (P< 0.001), group with 30-60 min (n=54) were 338.79±182.60 gr Vs. 220.36±66.98 (P< 0.001) and group with 60< (n=14) 352.14±236.02 gr Vs. 259.96±112.23 (P= 0.09).
Conclusion: On the basis of this study KMC less than 1 hour per day is effective in weight gain of very low birth weight preterm babies.
Ezat-Sadat Haj-Seyed Javadi , Farideh Movahed, Razieh Akbari,
Volume 76, Issue 4 (July 2018)
Volume 76, Issue 4 (July 2018)
Abstract
Background: Labor induction is one of the most public ways carried out global for delivering mothers. The aim of labor induction is to encourage uterine contractions before the spontaneous onset of labor, resultant in vaginal delivery misoprostol is used off-label for a variety of indications in the practice of obstetrics and gynecology, including medication abortion, medical management of miscarriage, induction of labor, cervical ripening before surgical procedures, and the treatment of postpartum hemorrhage. Regarding the importance and lack of similar researches in Iran, this research was done to compare the efficacy of buccal and sublingual misoprostol for labor induction in pregnant women.
Methods: This study was conducted as a randomized double-blind clinical trial from March 2017 to February 2018. In this survey, 200 women were randomly assigned to receive 50 µg buccal misoprostol and sublingual (100 buccal and 100 sublingual) in Kosar Hospital, Qazvin University of Medical Sciences, Iran. The maternal and fetal complications, Bishop score, and time of pain onset and its interval with labor were monitored in two groups and the findings were analyzed.
Results: Research variables were age, gestational age, BMI, number of previous pregnancy, neonatal weight, total dose, Bishop score 1, Bishop score 6, oxytocin, and delivery type. The results showed that there were no differences between Bishop score 6 (P=0.07), and 1 (P=0.36), total dose (P=0.58), neonatal weight (P=0.43), number of pregnancy (P=0.67), BMI (P=0.67), and pregnancy weak (P=0.108) of sublingual group and buccal group. About 43 patients (43%) in buccal and 64 (64%) in sublingual group had vaginal delivery (P=0.05). The frequencies of maternal and fetal complications were similar between two groups.
Conclusion: It can be concluded that there is no difference between efficacy of sublingual and buccal misoprostol in pregnancy results, maternal, and fetal complications, however, it seems that the sublingual group is more effective than buccal group due to the significant amount of vaginal delivery, achieving vaginal delivery in less than 24 hours, and less need for oxytocin.
Methods: This study was conducted as a randomized double-blind clinical trial from March 2017 to February 2018. In this survey, 200 women were randomly assigned to receive 50 µg buccal misoprostol and sublingual (100 buccal and 100 sublingual) in Kosar Hospital, Qazvin University of Medical Sciences, Iran. The maternal and fetal complications, Bishop score, and time of pain onset and its interval with labor were monitored in two groups and the findings were analyzed.
Results: Research variables were age, gestational age, BMI, number of previous pregnancy, neonatal weight, total dose, Bishop score 1, Bishop score 6, oxytocin, and delivery type. The results showed that there were no differences between Bishop score 6 (P=0.07), and 1 (P=0.36), total dose (P=0.58), neonatal weight (P=0.43), number of pregnancy (P=0.67), BMI (P=0.67), and pregnancy weak (P=0.108) of sublingual group and buccal group. About 43 patients (43%) in buccal and 64 (64%) in sublingual group had vaginal delivery (P=0.05). The frequencies of maternal and fetal complications were similar between two groups.
Conclusion: It can be concluded that there is no difference between efficacy of sublingual and buccal misoprostol in pregnancy results, maternal, and fetal complications, however, it seems that the sublingual group is more effective than buccal group due to the significant amount of vaginal delivery, achieving vaginal delivery in less than 24 hours, and less need for oxytocin.
Ali Mohammad Mosadeghrad , Ali Akbari-Sari , Taraneh Yousefinezhadi ,
Volume 76, Issue 5 (August 2018)
Volume 76, Issue 5 (August 2018)
Abstract
Background: Hospital accreditation is a systematic external evaluation of a hospital’s structures, processes and results by an independent professional accreditation body using pre-established optimum standards. This study aimed to evaluate the hospital accreditation system.
Methods: This descriptive and cross-sectional study was carried out between November 2015 and February 2016 using a questionnaire covering accreditation standards, methods, surveyors, implementation and effects. The study population consisted of 161 hospital managers in Tehran province, Iran. Overall 87 hospital managers were surveyed through stratified random sampling.
Results: The mean score of managers’ satisfaction of hospital accreditation system was 2.93 out of 5 score. About 16 percent of managers were satisfied with the hospital accreditation system. Hospital managers were most satisfied with accreditation effects (3.14) and least satisfied with accreditation standards (2.54). Hospital managers were satisfied with surveyors’ attitude, number of survey days and the number of surveyors in the accreditation team. They were least satisfied with the lack of consistency among surveyors, lack of transparency of standards, too many standards and low competency of surveyors. Hospital managers mostly believed that accreditation should be done by Ministry of Health, compulsory, and every two years. About 97 percent of managers agreed that self-assessment is necessary and beneficial prior to the accreditation survey.
Conclusion: Accreditation was moderately successful in Tehran hospitals. Accreditation had the most effect on improving patient safety and meeting patients' rights and least effect on improving employees' job satisfaction and involving doctors in quality improvement. Strengthening Iran hospital accreditation system, training managers and employees on implementing standards, and providing necessary resources make it possible to achieve accreditation goals.
Methods: This descriptive and cross-sectional study was carried out between November 2015 and February 2016 using a questionnaire covering accreditation standards, methods, surveyors, implementation and effects. The study population consisted of 161 hospital managers in Tehran province, Iran. Overall 87 hospital managers were surveyed through stratified random sampling.
Results: The mean score of managers’ satisfaction of hospital accreditation system was 2.93 out of 5 score. About 16 percent of managers were satisfied with the hospital accreditation system. Hospital managers were most satisfied with accreditation effects (3.14) and least satisfied with accreditation standards (2.54). Hospital managers were satisfied with surveyors’ attitude, number of survey days and the number of surveyors in the accreditation team. They were least satisfied with the lack of consistency among surveyors, lack of transparency of standards, too many standards and low competency of surveyors. Hospital managers mostly believed that accreditation should be done by Ministry of Health, compulsory, and every two years. About 97 percent of managers agreed that self-assessment is necessary and beneficial prior to the accreditation survey.
Conclusion: Accreditation was moderately successful in Tehran hospitals. Accreditation had the most effect on improving patient safety and meeting patients' rights and least effect on improving employees' job satisfaction and involving doctors in quality improvement. Strengthening Iran hospital accreditation system, training managers and employees on implementing standards, and providing necessary resources make it possible to achieve accreditation goals.
Hamideh Pakniat , Razieh Akbari ,
Volume 76, Issue 7 (October 2018)
Volume 76, Issue 7 (October 2018)
Abstract
Background: A significant increase in cesarean section in worldwide is known as one of the health system problems. The WHO has estimated that cesarean section in recent years has been 10% in all countries. Despite the increasing popularity of cesarean section, the literature lacks insights about factors affecting the selection of this delivery method. In this vein, this study investigates the factors affecting the choice of cesarean-section from the perspective of pregnant women.
Methods: The sample of this descriptive and analytical study is 200 pregnant women selected using simple random sampling method in Kosar Hospital in Qazvin Province, Iran. The survey questionnaire was used for data collection from March to September of 2017. In order to evaluate the validity and reliability of the research, expert’s opinion and Cronbach alpha coefficient have been used. The questionnaire included scales designed to measure effective factor. Statistical package for social science software (SPSS) version 22 (SPSS Inc., Chicago, IL, USA) were used to analyses the data. T-test and ANOVA were used to compare groups.
Results: The results of prioritizing the items in terms of psychological factors showed that the statements “I am afraid of the pain of normal labor” and “I feel higher stress and anxiety with natural labor were the first priorities”. There was no significant difference between pregnant women who had previous experience and those who did not have a delivery experience. The results of the mean comparison test showed no significant difference between the attitudes of women with previous delivery experience and women who did not have a delivery experience. There were only differences between socio-cultural factors (P= 0.004), factors related to delivery conditions (P= 0.001), consequences of delivery (P= 0.017) among pregnant women with different levels of training.
Conclusion: The results of this study revealed that there is a difference between the attitudes of pregnant women and different levels of education, so pre-pregnancy training should be provided to pregnant women.
Methods: The sample of this descriptive and analytical study is 200 pregnant women selected using simple random sampling method in Kosar Hospital in Qazvin Province, Iran. The survey questionnaire was used for data collection from March to September of 2017. In order to evaluate the validity and reliability of the research, expert’s opinion and Cronbach alpha coefficient have been used. The questionnaire included scales designed to measure effective factor. Statistical package for social science software (SPSS) version 22 (SPSS Inc., Chicago, IL, USA) were used to analyses the data. T-test and ANOVA were used to compare groups.
Results: The results of prioritizing the items in terms of psychological factors showed that the statements “I am afraid of the pain of normal labor” and “I feel higher stress and anxiety with natural labor were the first priorities”. There was no significant difference between pregnant women who had previous experience and those who did not have a delivery experience. The results of the mean comparison test showed no significant difference between the attitudes of women with previous delivery experience and women who did not have a delivery experience. There were only differences between socio-cultural factors (P= 0.004), factors related to delivery conditions (P= 0.001), consequences of delivery (P= 0.017) among pregnant women with different levels of training.
Conclusion: The results of this study revealed that there is a difference between the attitudes of pregnant women and different levels of education, so pre-pregnancy training should be provided to pregnant women.
Sepideh Haghifar , Yasaman Jamshidi Naeini , Mohammad Esmaeil Akbari , Morteza Abdollahi , Mahdi Shadnoush , Marjan Ajami , Sayed Hossein Davoodi ,
Volume 76, Issue 8 (November 2018)
Volume 76, Issue 8 (November 2018)
Abstract
Background: The average age of women with breast cancer in Iran is at least 10 years lower in comparison to developed countries and the incidence of the disease in Iranian women is on a rise. According to studies, diets that are diverse in food groups can play a role in protecting against chronic diseases including cardiovascular diseases and cancer. Diet diversity score is an indicator used to measure diversity between and within food groups. This study aimed to assess the relationship between diet diversity score and breast cancer risk.
Methods: This case-control study was carried out from April 2014 to February 2015 at Shohada Hospital in Tajrish, Tehran. Demographic and anthropometric data of 298 participants including 149 breast cancer cases and 149 apparently healthy women were collected. A valid food frequency questionnaire containing 168 food items was completed to assess usual dietary intake through face to face interviews. Energy was calculated using Nutritionist 4 software (First Databank Inc., Hearst Corp., San Bruno, CA, USA) and diet diversity score was calculated using five food group scoring. Odds ratios with 95% confidence intervals were obtained using logistic regression test to evaluate the association between breast cancer risk and diet diversity score tertiles.
Results: There was no significant difference in weight, height, body mass index between the two groups, but physical activity level and daily energy intake showed a significant difference (P<0.001). After adjusting for the effect of confounding variables including energy, body mass index, physical activity, menopause status, family history of breast cancer, contraceptive use, number of pregnancy, age of menarche and smoking, the risk for developing breast cancer was 86% lower in those in the highest tertile of diet diversity score compared to those in the first tertile (OR=0.14, 95% CI=0.06-0.31). An inverse and significant association was found between breast cancer risk and diversity scores of fruits and milk groups (P<0.001).
Conclusion: Higher diet diversity score is associated with reduced risk of breast cancer.
Methods: This case-control study was carried out from April 2014 to February 2015 at Shohada Hospital in Tajrish, Tehran. Demographic and anthropometric data of 298 participants including 149 breast cancer cases and 149 apparently healthy women were collected. A valid food frequency questionnaire containing 168 food items was completed to assess usual dietary intake through face to face interviews. Energy was calculated using Nutritionist 4 software (First Databank Inc., Hearst Corp., San Bruno, CA, USA) and diet diversity score was calculated using five food group scoring. Odds ratios with 95% confidence intervals were obtained using logistic regression test to evaluate the association between breast cancer risk and diet diversity score tertiles.
Results: There was no significant difference in weight, height, body mass index between the two groups, but physical activity level and daily energy intake showed a significant difference (P<0.001). After adjusting for the effect of confounding variables including energy, body mass index, physical activity, menopause status, family history of breast cancer, contraceptive use, number of pregnancy, age of menarche and smoking, the risk for developing breast cancer was 86% lower in those in the highest tertile of diet diversity score compared to those in the first tertile (OR=0.14, 95% CI=0.06-0.31). An inverse and significant association was found between breast cancer risk and diversity scores of fruits and milk groups (P<0.001).
Conclusion: Higher diet diversity score is associated with reduced risk of breast cancer.
Ali Mohammad Mosadeghrad , Ali Akbari Sari , Taraneh Yousefinezhadi,
Volume 76, Issue 12 (March 2019)
Volume 76, Issue 12 (March 2019)
Abstract
Background: Hospital accreditation is an external evaluation of a hospital’s structures, processes and results by an independent professional accreditation body using pre-established optimum standards. Accreditation has an important role in improving the quality, safety, effectiveness and efficiency of hospital services. This study aimed to examine the effects of hospital accreditation program from hospitals managers’ perspective.
Methods: This descriptive and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire designed to examine accreditation effects on hospital performance, hospital employees, patients, and the society. The study population consisted of 914 hospital managers in Iran. Overall, 547 hospital managers were surveyed through stratified random sampling.
Results: About 71% of hospitals achieved grade one and above accreditation status. The mean score of accreditation positive effects in hospitals was 3.16±0.66 out of 5 (Average). Almost 38% of managers were satisfied with the accreditation results in their hospitals. Hospital accreditation program was successful in improving patient and staff safety, reducing medical errors and enhancing staff competencies. Its success in improving communication, promoting organizational culture, continuous quality improvement, resource utilization, and reducing nosocomial infections and hospital mortality rates was moderate. Accreditation was less successful in improving staff satisfaction, getting physicians involved in process improvement, practicing evidence based medicine, attracting patients and increasing hospital income. A statistically significant correlation was found between hospital size and accreditation results (P=0.038, r=-0.090). There was no correlation between using quality management models and getting better accreditation results (P=0.085). However, there was correlation between using accreditation consultants and positive accreditation results (P=0.045, r=-0.087). Utilizing hospital resources, organizational learning, continuous quality improvement and effective communication had the most effect on accreditation success.
Conclusion: The accreditation program had a moderate effect on hospital performance. It is costly to implement accreditation standards in hospitals. Hence, changes should be made to the accreditation system including accreditation standards and methods in order to have more positive effects on the staff and hospitals’ performance.
Methods: This descriptive and cross-sectional study was carried out in 2015 using a valid and reliable questionnaire designed to examine accreditation effects on hospital performance, hospital employees, patients, and the society. The study population consisted of 914 hospital managers in Iran. Overall, 547 hospital managers were surveyed through stratified random sampling.
Results: About 71% of hospitals achieved grade one and above accreditation status. The mean score of accreditation positive effects in hospitals was 3.16±0.66 out of 5 (Average). Almost 38% of managers were satisfied with the accreditation results in their hospitals. Hospital accreditation program was successful in improving patient and staff safety, reducing medical errors and enhancing staff competencies. Its success in improving communication, promoting organizational culture, continuous quality improvement, resource utilization, and reducing nosocomial infections and hospital mortality rates was moderate. Accreditation was less successful in improving staff satisfaction, getting physicians involved in process improvement, practicing evidence based medicine, attracting patients and increasing hospital income. A statistically significant correlation was found between hospital size and accreditation results (P=0.038, r=-0.090). There was no correlation between using quality management models and getting better accreditation results (P=0.085). However, there was correlation between using accreditation consultants and positive accreditation results (P=0.045, r=-0.087). Utilizing hospital resources, organizational learning, continuous quality improvement and effective communication had the most effect on accreditation success.
Conclusion: The accreditation program had a moderate effect on hospital performance. It is costly to implement accreditation standards in hospitals. Hence, changes should be made to the accreditation system including accreditation standards and methods in order to have more positive effects on the staff and hospitals’ performance.
Zahra Esfandiari, Mohammad Reza Marasi , Fatemeh Estaki , Vahid Sanati , Elnaz Panahi , Nader Akbari , Roya Alsadat Madani, Jila Mosberian Tanha ,
Volume 77, Issue 1 (April 2019)
Volume 77, Issue 1 (April 2019)
Abstract
Background: Nutrition education and introduction of procedures for choosing healthier food have an important role to reduce the rate of non-communicable diseases. It was shown the amount of risk factors of non-communicable diseases such as energy, salt, sugar, fat and trans fatty acid on the traffic light of food labelling. The status of risk is presented through three colors of red, yellow and green that are the signs of risk, precautious and safe use of food. The object of this study was to evaluate the influence of education on the knowledge, attitude and practices of Isfahan University of Medical Sciences students to the traffic light on food labeling.
Methods: This project was an empirical study performed by random sampling of 379 students of nine schools in Isfahan University of Medical Sciences from January 2017 to March 2018. The knowledge, attitude and practices of students toward the traffic light were assessed by self-administered and structured questionnaire. Education was performed face to face with the usage of pamphlet. In the period of three to six months, questionnaires were refilled out by students to determine knowledge, attitude and practice. Descriptive statistics were calculated using SPSS in mean± SD. Paired t-test was performed to assess the influence of education in total score of knowledge, attitudes and practices in test-retest. P value was considered less than 0.05 as statistically significant.
Results: Before education, the average of scores for knowledge, attitude and practice was 1.12±0.84, 14.44±4 and 2.25±2.2, respectively. Afterwards, the scores were increased to 11.72±0.75, 18.67±3.18 and 17.69±4.7 after education. Significant difference was observed in the scores of knowledge, attitude and practice of students before and after education (P<0.05).
Conclusion: Education of traffic light had a significant role in the improvement of knowledge, attitude and to some extent of practice of students in selection of healthier food.
Methods: This project was an empirical study performed by random sampling of 379 students of nine schools in Isfahan University of Medical Sciences from January 2017 to March 2018. The knowledge, attitude and practices of students toward the traffic light were assessed by self-administered and structured questionnaire. Education was performed face to face with the usage of pamphlet. In the period of three to six months, questionnaires were refilled out by students to determine knowledge, attitude and practice. Descriptive statistics were calculated using SPSS in mean± SD. Paired t-test was performed to assess the influence of education in total score of knowledge, attitudes and practices in test-retest. P value was considered less than 0.05 as statistically significant.
Results: Before education, the average of scores for knowledge, attitude and practice was 1.12±0.84, 14.44±4 and 2.25±2.2, respectively. Afterwards, the scores were increased to 11.72±0.75, 18.67±3.18 and 17.69±4.7 after education. Significant difference was observed in the scores of knowledge, attitude and practice of students before and after education (P<0.05).
Conclusion: Education of traffic light had a significant role in the improvement of knowledge, attitude and to some extent of practice of students in selection of healthier food.
Ali Salehi , Mohammad-Ali Abtahi , Seyed-Hossein Abtahi , Hasan Razmjou , Mohammad Tohidi , Mojtaba Akbari , Hamidreza Jahanbani-Ardakani ,
Volume 77, Issue 5 (August 2019)
Volume 77, Issue 5 (August 2019)
Abstract
Background: Retinal vein occlusions are one of the most common form of retinal vascular disorders and could lead to vision loss due to macular edema, macular ischemia and sequelae from neovascularization. Anti-venous endothelial growth factor (anti-VEGF) treatment is the choice strategy of treatment for patients with macular edema secondary to central retinal vein occlusion (CRVO). There is an evidence of body with the controversies regarding increment of choroidal thickness in CRVO condition. The current study was designed to determine whether baseline subfoveal choroidal thickness may be an indicator for visual and anatomical outcome of bevacizumab in patients with CRVO macular edema.
Methods: This study was a prospective clinical cohort study that enrolled in 23 new cases of treatment-naïve central retinal vein occlusion (CRVO) from February to July 2017 who were visited in Feiz Eye Hospital, Isfahan, Iran. Patients received a single injection of bevacizumab and were followed for 30 days. Ratio of subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). Ratio of SFCT of the CRVO eye to the fellow healthy eye (SFCT1/F) was taken as independent variable. Changes of best-corrected visual acuity (BCVA) in LogMAR (ΔBCVA, functional response) and secondary to baseline central macular thickness ratio (CMT2/1, anatomical response) in the CRVO eyes were taken for comparative and correlative analytics.
Results: A total of 46 eyes from 23 patients with the mean age of 64.60±10.19 years were included in this study. Baseline SFCT was higher in CRVO eyes (251.91±46.09 µm) in comparison to the fellow eye (206.95±26.62, P<0.0001). Also central macular thickness in CRVO eyes were significantly higher in CRVO eyes in comparison with fellow eye (531.04±38.22 vs 303.30±33.59, respectively, P<0.05). SFCT1/F, correlated moderately with anatomical (CMT2/1) and strongly with functional response (ΔBCVA).
Conclusion: Bilateral evaluation of SFCT by EDI-OCT in all newly diagnosed CRVO cases is recommended to determine if there is a relative increase in choroidal thickness. This may help predict short-term response to anti-VEGF therapy.
Methods: This study was a prospective clinical cohort study that enrolled in 23 new cases of treatment-naïve central retinal vein occlusion (CRVO) from February to July 2017 who were visited in Feiz Eye Hospital, Isfahan, Iran. Patients received a single injection of bevacizumab and were followed for 30 days. Ratio of subfoveal choroidal thickness (SFCT) was measured using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT). Ratio of SFCT of the CRVO eye to the fellow healthy eye (SFCT1/F) was taken as independent variable. Changes of best-corrected visual acuity (BCVA) in LogMAR (ΔBCVA, functional response) and secondary to baseline central macular thickness ratio (CMT2/1, anatomical response) in the CRVO eyes were taken for comparative and correlative analytics.
Results: A total of 46 eyes from 23 patients with the mean age of 64.60±10.19 years were included in this study. Baseline SFCT was higher in CRVO eyes (251.91±46.09 µm) in comparison to the fellow eye (206.95±26.62, P<0.0001). Also central macular thickness in CRVO eyes were significantly higher in CRVO eyes in comparison with fellow eye (531.04±38.22 vs 303.30±33.59, respectively, P<0.05). SFCT1/F, correlated moderately with anatomical (CMT2/1) and strongly with functional response (ΔBCVA).
Conclusion: Bilateral evaluation of SFCT by EDI-OCT in all newly diagnosed CRVO cases is recommended to determine if there is a relative increase in choroidal thickness. This may help predict short-term response to anti-VEGF therapy.
Nosrat Abedpor , Ali Akbar Movassaghpour Akbari , Zohreh Sanaat ,
Volume 77, Issue 7 (October 2019)
Volume 77, Issue 7 (October 2019)
Abstract
Background: Acute myeloid leukemia (AML) is blood and bone marrow malignancy. Low-density oxidative lipoprotein (oxLDL) is a pro-inflammatory factor that has free radicals in its structure. OxLDL levels are also rising in diseases such as diabetes, cardiovascular disease, and some cancers. Studies have shown that oxLDL and dyslipidemia are more common in patients with various cancers. This study aimed to evaluate the level of blood lipids and oxLDL in these patients with acute myeloid leukemia.
Methods: In a descriptive study, 36 patients who were diagnosed with acute myeloid leukemia from April 2016 to March 2017 were enrolled. This study was done in Shahid Ghazi Blood Department of Imam Reza Hospital, Tabriz University of Medical Sciences, Iran. Basic information including age, sex, type of disease, cause for referrals of the patients were collected. After obtaining informed consent from patients and 12 hours of fasting, 5 cc blood samples were sent to the Central Laboratory of Shahid Ghazi Hospital to measure the level of blood lipids including cholesterol, triglyceride, low density lipoprotein, high density lipoprotein (HDL), and oxLDL levels. Blood lipid and oxLDL levels were measured by automatic analyzer (Abbott Laboratories, Abbott Park, IL, USA) (ELISA method).
Results: 23 patients (54.8%) were male and 19 (45.2%) were female. The mean age of the patients was 44.06±14.48 years. The lowest age was 25 and the highest was 80 years. In the study, the mean serum cholesterol level was 147.64±42.28 mg/dl, the blood triglyceride was 183.28±79.34 mg/dl, the LDL was 84.89±26.35, and the HDL 29±14.51, the mean oxLDL was 1482.5±6031.85 ng/ml.
Conclusion: The results of this study indicate that dyslipidemia in patients with acute myeloid leukemia has not been evident. Concerning oxLDL, an oxidative stress factor involved in acute myeloid leukemia requires further investigation and studies.
Methods: In a descriptive study, 36 patients who were diagnosed with acute myeloid leukemia from April 2016 to March 2017 were enrolled. This study was done in Shahid Ghazi Blood Department of Imam Reza Hospital, Tabriz University of Medical Sciences, Iran. Basic information including age, sex, type of disease, cause for referrals of the patients were collected. After obtaining informed consent from patients and 12 hours of fasting, 5 cc blood samples were sent to the Central Laboratory of Shahid Ghazi Hospital to measure the level of blood lipids including cholesterol, triglyceride, low density lipoprotein, high density lipoprotein (HDL), and oxLDL levels. Blood lipid and oxLDL levels were measured by automatic analyzer (Abbott Laboratories, Abbott Park, IL, USA) (ELISA method).
Results: 23 patients (54.8%) were male and 19 (45.2%) were female. The mean age of the patients was 44.06±14.48 years. The lowest age was 25 and the highest was 80 years. In the study, the mean serum cholesterol level was 147.64±42.28 mg/dl, the blood triglyceride was 183.28±79.34 mg/dl, the LDL was 84.89±26.35, and the HDL 29±14.51, the mean oxLDL was 1482.5±6031.85 ng/ml.
Conclusion: The results of this study indicate that dyslipidemia in patients with acute myeloid leukemia has not been evident. Concerning oxLDL, an oxidative stress factor involved in acute myeloid leukemia requires further investigation and studies.
Maria Zahiri , Khalil Pourkhalili , Sadegh Darvishi , Hossein Heydari , Zahra Akbari,
Volume 77, Issue 10 (January 2020)
Volume 77, Issue 10 (January 2020)
Abstract
Background: Aphanizomenon flos-aquae (AFA) is a type of blue-green algae and contains a source of biological compounds. These microalgae have many beneficial health effects. Recently, fucoidan, known sulfated polysaccharide component of AFA algae, has been claimed to stimulate stem-cell mobilization in animal models. Stem cells play an essential role in tissue repair process. In this study, we use excisional full thickness wound model to investigate the effectiveness of trademark AFA extract on skin wound repair process.
Methods: In this experimental study, 21 adult male Wistar rats (weighing 200-250 g) were used and under general anesthesia (intraperitoneally with a ketamine/xylazine solution), two round excisional wounds were created under sterile conditions by a 6 mm punch on the dorsum (paravertebral area) of all rats. Animals were randomly assigned into 3 groups. In groups 1 and 2 (SE-200, SE-400), StemEnhance© (StemTech Health Sciences Inc. British Columbia, Canada) were given respectively 200 or 400 mg/kg by oral gavage once daily and in group 3 (Sham), distilled water (DW) was given to all subjects. Post-wounding gavage of StemEnhance or DW started from 1st day and continued to 7th day. The wound surface area was monitored daily by digital camera and assessed by Image Tool™ software, version 3.5 (UTHSCSA, San Antonio, TX, USA). At 9th day post-wounding animals were sacrificed and repaired tissues were harvested by and assessed by a 8 mm punch. Repaired skin areas were processed for hematoxylin and eosin (H&E). Histopathological parameters of healing including inflammatory cell infiltration, angiogenesis, and fibroblast count were assessed by pathologist. Our study was conducted in the Physiology Department of Medical School, Bushehr University of Medical Sciences, Iran, from October 2016 to March 2016.
Results: Macroscopic imaging of wound area revealed that there was statistically significant difference in wound area reduction between SE-200 group and sham group on day 6 post wounding (P=0.032). Moreover, histological findings showed that the number of neutrophils, macrophages, fibroblasts, and microvessel density decreased in both StemEnhace-treated groups. There were no significant differences between two treatment groups.
Conclusion: According to the obtained results it seems that the extract of Aphanizomenon flos-aquae algae positively affects wound healing process by ameliorating inflammatory response in early healing phases.
Methods: In this experimental study, 21 adult male Wistar rats (weighing 200-250 g) were used and under general anesthesia (intraperitoneally with a ketamine/xylazine solution), two round excisional wounds were created under sterile conditions by a 6 mm punch on the dorsum (paravertebral area) of all rats. Animals were randomly assigned into 3 groups. In groups 1 and 2 (SE-200, SE-400), StemEnhance© (StemTech Health Sciences Inc. British Columbia, Canada) were given respectively 200 or 400 mg/kg by oral gavage once daily and in group 3 (Sham), distilled water (DW) was given to all subjects. Post-wounding gavage of StemEnhance or DW started from 1st day and continued to 7th day. The wound surface area was monitored daily by digital camera and assessed by Image Tool™ software, version 3.5 (UTHSCSA, San Antonio, TX, USA). At 9th day post-wounding animals were sacrificed and repaired tissues were harvested by and assessed by a 8 mm punch. Repaired skin areas were processed for hematoxylin and eosin (H&E). Histopathological parameters of healing including inflammatory cell infiltration, angiogenesis, and fibroblast count were assessed by pathologist. Our study was conducted in the Physiology Department of Medical School, Bushehr University of Medical Sciences, Iran, from October 2016 to March 2016.
Results: Macroscopic imaging of wound area revealed that there was statistically significant difference in wound area reduction between SE-200 group and sham group on day 6 post wounding (P=0.032). Moreover, histological findings showed that the number of neutrophils, macrophages, fibroblasts, and microvessel density decreased in both StemEnhace-treated groups. There were no significant differences between two treatment groups.
Conclusion: According to the obtained results it seems that the extract of Aphanizomenon flos-aquae algae positively affects wound healing process by ameliorating inflammatory response in early healing phases.
Hasan Alinezhad, Reza Vazirinezhad , Ahmadreza Sayadi, Zeinab Hajaliakbari, Mahdi Alinezhad,
Volume 78, Issue 10 (January 2021)
Volume 78, Issue 10 (January 2021)
Abstract
Background: One of the most important duties of a family physician is primary health care. The family doctor plan is one of the developmental measures to provide easy and low-cost access for patients to health care centers. The family doctor and her team are fully responsible for the health of the individuals and families covered. Therefore, this study was conducted to assess the satisfaction of rural areas of Rafsanjan city with the family physician plan.
Methods: This study is a descriptive-analytical study that was conducted in rural areas of Rafsanjan from October to December 2018. The study population consisted of twelve randomly selected villages in Rafsanjan. The required sample size was examined according to the size of the statistical population of 480 people. In this study, to collect the required data, a researcher-made checklist was used, which was prepared by reviewing the texts of the questions. The sampling method was cluster random. To check the validity of the checklist, the opinions of 10 health education experts were used. To check the reliability, the checklist was provided to 20 villagers and the reliability was determined using Cronbach's alpha method of 82%. The mean was used to describe the data and inferential statistics t-test and ANOVA were used to analyze the data and analyzed by SPSS.
Methods: This study is a descriptive-analytical study that was conducted in rural areas of Rafsanjan from October to December 2018. The study population consisted of twelve randomly selected villages in Rafsanjan. The required sample size was examined according to the size of the statistical population of 480 people. In this study, to collect the required data, a researcher-made checklist was used, which was prepared by reviewing the texts of the questions. The sampling method was cluster random. To check the validity of the checklist, the opinions of 10 health education experts were used. To check the reliability, the checklist was provided to 20 villagers and the reliability was determined using Cronbach's alpha method of 82%. The mean was used to describe the data and inferential statistics t-test and ANOVA were used to analyze the data and analyzed by SPSS.
|
Results: The average satisfaction of villagers with the family physician program was relatively good. The Highest satisfaction is with diploma education and income below 1 million 2.21% and the lowest satisfaction score is 21-30 years old and income over three million 2.16%.
Conclusion: Satisfaction with the implementation of the family physician program in rural areas indicated that the health system reform processes were successful and to increase this satisfaction, we must improve the level of service and improve the quality of family physician services day by day because the health system with effective health care is an important element of family physicians. |
Negar Heidari , Paria Heidari, Nader Salari, Hakimeh Akbari, Masoud Mohammadi,
Volume 79, Issue 12 (March 2022)
Volume 79, Issue 12 (March 2022)
Abstract
|
Background: Parkinson's disease is one of the chronic neurological diseases. It is the second most common neurodegenerative disease after Alzheimer's, affecting 7.5 million people worldwide and its rate is expected to increase by 20% by 2020. three symptoms of tremor, muscle stiffness and movement disorders are among the main diagnostic symptoms of the disease. The prevalence of Parkinson's worldwide varies between 18 and 418 cases per 100,000 people per year. It is generally estimated that the prevalence of this disease in the general population is 0.3%. A systematic review study was performed to determine the factors associated with Parkinson's disease. Methods: This study was a systematic review that was conducted by searching national and international databases until February 2020. Initially, all articles which had mentioned Parkinson-related factors were collected and accepted by researchers based on studies. Entry and exit criteria were met. Exclusion criteria included irrelevant items, duplication of studies, unclear procedure, and lack of access to the full text of the study. To reduce bias, articles were evaluated independently by two researchers, and the quality of articles was assessed using the STROBE checklist. All final articles submitted to the systematic review process were prepared by a template checklist. Checklists included article title, first author’s name, year of publication, place of study, risk factors, protective factors, and ineffective factors or the ones which their effects have not yet been determined, and the average age. Results: In these studies, the following risk factors were reported: family history, agricultural occupation, literacy, stress, well water consumption, aging, environmental factors, genetic factors, pesticide exposure, and alcohol abuse. On the other hand, factors such as smoking and oilseeds, high levels of B-complex vitamins, female estrogen hormones, and selenium have been reported to protect against Parkinson's disease. Conclusion: Considering the results of the present study and although there is no definitive treatment for this disease, protective factors and risk factors should be seriously considered by health policymakers for preventive measures. |
Reihaneh Pirjani, Ali Akbari Sari, Mahbobeh Shirazi, Amin Nakhostin Ansari, Maryam Rabiei, Amene Abiri,
Volume 80, Issue 3 (June 2022)
Volume 80, Issue 3 (June 2022)
Abstract
Background: Streptococcus beta group (GBS: Group B Streptococcus) is a gram-positive coccus that colonizes in the rectovaginal area. About 4.6% to 31.3% of women of childbearing age carry GBS infection. GBS colonization is a risk factor for subsequent infections in pregnant women that can be transmitted to the fetus through vertical transfer and aspiration of infected amniotic fluid. 2% of cases lead to an invasive infection in the baby. In most countries, treatment is done according to the CDC (Centers for Disease Control and Prevention) protocol which is based on culture results. According to studies conducted in our country, treatment is based on risk factors. Therefore, during this study, we decided to compare the results of treatment based on risk factors and treatment based on culture results and other maternal and neonatal complications in these two groups.
Methods: This case-control study was performed on 98 pregnant women aged 35 to 37 weeks who were referred to the perinatal clinic of Arash Hospital from April 2018 to the end of March 2020 and also 200 pregnant women with a GBS risk factor. Samples of rectovaginal discharge of 98 pregnant women were sent to a selected laboratory for culturing. In this group, treatment was performed based on the culture result. The control samples included 200 pregnant mothers who were treated based on risk factors without culture. Then the two groups were compared in terms of pregnancy outcomes.
Methods: This case-control study was performed on 98 pregnant women aged 35 to 37 weeks who were referred to the perinatal clinic of Arash Hospital from April 2018 to the end of March 2020 and also 200 pregnant women with a GBS risk factor. Samples of rectovaginal discharge of 98 pregnant women were sent to a selected laboratory for culturing. In this group, treatment was performed based on the culture result. The control samples included 200 pregnant mothers who were treated based on risk factors without culture. Then the two groups were compared in terms of pregnancy outcomes.
|
Results: Out of 98 subjects, 24 (24.5%) had positive rectovaginal culture. Individuals treated with antibiotics based on positive culture results did not show a significant difference in terms of observed pregnancy outcomes compared with the control group.
Conclusion: The prevalence of GBS colonization was significantly higher in patients with a history of vaginal discharge than in those without a history. Due to the small number of studies conducted in Iran, it is recommended to conduct studies with a larger sample size in order to explain a more appropriate protocol in terms of effectiveness and economics. |
Masoumeh Asgharpour, Khadijeh Ezoji, Roghayeh Akbari, Kayvan Latifi , Shahram Seyfi,
Volume 80, Issue 5 (August 2022)
Volume 80, Issue 5 (August 2022)
Abstract
Background: Information on the coronavirus infection 2019 (COVID-19) which can clinically range from asymptomatic infection to severe pneumonia, in transplant recipients is still low. Infections are a major cause of death in kidney transplant recipients, and kidney transplant recipients, like other organ recipients, appear to be more vulnerable to a variety of infections due to comorbidities and immunosuppressive drugs that predispose them to infection.
Case presentation: In this study, we reviewed 10 transplant recipients with a mean age of 50.3±11.25 years who were admitted to Ayatollah Rouhani Hospital in Babol due to COVID-19 From April 2019 to September 2019. Four patients were female and six ones were male. Fever (100%) and cough (60%) were the most common symptoms in patients. All patients used standard immunosuppressive drugs (tacrolimus, corticosteroids, mycophenolate, and cyclosporine). The mean level of oxygen saturation at the time of admission in these patients was 87.9±11.3 and in two patients with death outcomes of 57% and 95%, it was at the beginning of hospitalization. The mean leukocytes of patients at the beginning of hospitalization was10470±5784.08 per ml and the mean lymphocytes of these patients were 1081.5±516.05. In the studied patients, the mean of previous years of transplantation was 8/05±7.13 and two patients died 20 years and 5 years after their kidney transplantation. Two patients (20%), aged 57 and 50 years, died from progressive respiratory symptoms and the other eight patients recovered and were discharged from the hospital.
We reported COVID-19 infection in ten kidney transplant recipients with different clinical outcomes and periods, which may be a reference for the management of COVID-19 in such patients.
Conclusion: It seems that more information is needed to better understand the effect of anti-transplant immunosuppressive therapy on the outcome of COVID-19 infection in kidney transplant recipients. Long-term follow-up studies and more cases are needed to clarify the diagnosis, outcome, and treatment options for COVID-19 in these patients.
Case presentation: In this study, we reviewed 10 transplant recipients with a mean age of 50.3±11.25 years who were admitted to Ayatollah Rouhani Hospital in Babol due to COVID-19 From April 2019 to September 2019. Four patients were female and six ones were male. Fever (100%) and cough (60%) were the most common symptoms in patients. All patients used standard immunosuppressive drugs (tacrolimus, corticosteroids, mycophenolate, and cyclosporine). The mean level of oxygen saturation at the time of admission in these patients was 87.9±11.3 and in two patients with death outcomes of 57% and 95%, it was at the beginning of hospitalization. The mean leukocytes of patients at the beginning of hospitalization was10470±5784.08 per ml and the mean lymphocytes of these patients were 1081.5±516.05. In the studied patients, the mean of previous years of transplantation was 8/05±7.13 and two patients died 20 years and 5 years after their kidney transplantation. Two patients (20%), aged 57 and 50 years, died from progressive respiratory symptoms and the other eight patients recovered and were discharged from the hospital.
We reported COVID-19 infection in ten kidney transplant recipients with different clinical outcomes and periods, which may be a reference for the management of COVID-19 in such patients.
Conclusion: It seems that more information is needed to better understand the effect of anti-transplant immunosuppressive therapy on the outcome of COVID-19 infection in kidney transplant recipients. Long-term follow-up studies and more cases are needed to clarify the diagnosis, outcome, and treatment options for COVID-19 in these patients.
Ahmad Tahmasebi-Ghorrabi , Zahra Heydarifard, Behrouz Nemati, Majid Davari, Alireza Delavari, Hamideh Salimzadeh , Ali Akbari Sari ,
Volume 81, Issue 9 (December 2023)
Volume 81, Issue 9 (December 2023)
Abstract
Background: Screening is a cost-effective method for prevention, early detection of the disease and reducing the burden of the third deadliest cancer in the world, i.e. colorectal cancer. This study aimed to analyze the cost-effectiveness of colonoscopy screening compared to sigmoidoscopy for colorectal cancer in high-risk individuals in Iran.
Methods: This economic evaluation study was conducted using the cost-effectiveness method between July 2016 and February 2017. Evaluation of the effectiveness of screening methods was done using a systematic review. Cost evaluation was also done using the costs obtained from the tariff approved by the Iranian Ministry of Health in 2015 for colonoscopy and sigmoidoscopy. Finally, the combined model of decision tree and Markov was used to evaluate the cost effectiveness. Incremental Cost Effectiveness Ratio (ICER) formula was used for cost effectiveness analysis considering the final outcome of 5-year survival of high-risk individuals. Excel and TreeAge software were used for data analysis.
Methods: This economic evaluation study was conducted using the cost-effectiveness method between July 2016 and February 2017. Evaluation of the effectiveness of screening methods was done using a systematic review. Cost evaluation was also done using the costs obtained from the tariff approved by the Iranian Ministry of Health in 2015 for colonoscopy and sigmoidoscopy. Finally, the combined model of decision tree and Markov was used to evaluate the cost effectiveness. Incremental Cost Effectiveness Ratio (ICER) formula was used for cost effectiveness analysis considering the final outcome of 5-year survival of high-risk individuals. Excel and TreeAge software were used for data analysis.
|
Results: The effectiveness of sigmoidoscopy and colonoscopy in increasing 5-year survival is 11 and 15.7%, respectively, and colonoscopy screening is 4.7% more than sigmoidoscopy. The cost of colonoscopy and sigmoidoscopy screening was calculated as 1000 and 19920 billion Rials, respectively. Based on cost-effectiveness analysis, the cost of treating patients in the case of screening with colonoscopy and sigmoidoscopy is lower than without screening. The ICER ratio of colonoscopy and sigmoidoscopy compared to no screening was -4/441/389/160 and -4/757/954/940 Rials respectively, and colonoscopy compared to sigmoidoscopy was -3/699/785/880 Rials, respectively. Finally, the use of colonoscopy leads to spending 3/699/785/880 Rials less in exchange for obtaining 4722 additional survivals with the prevention of colorectal cancer compared to sigmoidoscopy.
Conclusion: Screening by colonoscopy and sigmoidoscopy methods are effective in reducing the incidence and death of colorectal cancer compared to no screening. Screening by colonoscopy is a dominant option for the high-risk population in Iran. Colonoscopy screening is more cost effective compared to sigmoidoscopy. However, decisions about colorectal cancer screening and screening methods depend on local resources and personal preferences. |
Shokoufeh Akbari, Monireh Rahimkhani, Reza Mirnejad,
Volume 81, Issue 10 (January 2024)
Volume 81, Issue 10 (January 2024)
Abstract
Background: Today, Methicillin-Resistant Staphylococcus Aureus (MRSA) has become one of the public health concerns due to its resistance to antimicrobial drugs, and this problem makes treating patients with infections caused by this bacterium difficult. Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) strains are pervasive in both community and hospital settings, primarily attributable to Staphylococcus aureus' capacity to colonize areas like the nose or skin. In this study, with the aim of comparing phenotypic (disc diffusion method) and genotypic (PCR) methods, to detect methicillin-resistant Staphylococcus aureus isolated from patients of hospitals under supervision of Tehran university of medical sciences, and also detection of nor A, that is the one of the most important genes in efflux pump cluster genes.
Methods: The present research was a cross- sectional study that was conducted from February 2022 to September 2023. In this research, 43 isolated strains of Staphylococcus aureus from wound discharge and blood samples, were collected from different departments of Tehran hospitals and had submitted to the research laboratory of the school of allied medical sciences in Tehran university of medical sciences. After identifying the strains, the resistance of the isolates to 14 types of antibiotics was checked by disk diffusion method.
| Results: Staphylococcus aureus diagnostic tests including gram staining on colonies, catalase, coagulase, DNase tests were performed and it was found that all strains were Staphylococcus aureus. In the next step, all samples were resistant to Cloxacillin by disc diffusion method, and the presence of mec A gene in them was confirmed by PCR method, thus the presence of MRSA strains was confirmed from the genotypic point of view. Of the 43 Staphylococcus aureus strains, 26 samples were identified as having the nor A gene by PCR and electrophoresis. Conclusion: The results of the present research have shown that the prevalence of Staphylococcus aureus bacteria in hospital samples is significant and resistance to methicillin and ciprofloxacin has increased in the strains of this bacteria. |
Related Websites
Site Keywords
Cardiology, Anatomy, Biology, Epidemiology, Immunology, Neuroscience, Physical therapy, Physiology, Dermatology, Endocrinology and metabolicSite Statistics
- Registered users: 7803 users
- Online users: 0 users
- Guest users: 276 users
- All visits: 16302919 visits
- Visits in 24 Hours: 12333 visits
- Total articles: 11352 articles
- Published articles: 4954 articles
© 2025 , Tehran University of Medical Sciences, CC BY-NC 4.0
Designed & Developed by : Yektaweb