ABSTRACT
Background: Although diabetes control and prevention program has been initiated in Tehran, Iran and five other large cities in the country since 2010, patients' satisfaction with the services provided by this program has not been evaluated yet. The aim of this study was to determine the patient satisfaction with this program in Tehran
Methods: This cross-sectional study, were conducted in 15 primary health care centers in Tehran, Iran in 2013. We enrolled 386 people aged older than 30 yr referred to primary health care centers. A questionnaire was used to evaluate the degree of patients' satisfaction with the services [the questionnaire included six domains: access to services, continuity of care, the humanness of staff, provision of health education materials, effectiveness of services, comprehensiveness of care]. The chi-square test, independent t test and one-way ANOVA were used for data analysis
Results: Overall, 239 patients [62%] were female. The mean age [SD] of the patients was 51 +/- 11 yr. Overall, 263 patients [68%] were highly satisfied with providing services. The highest levels of patients' satisfaction were in the domains of continuity of care, the humanness of staff, and effectiveness of services. The lowest level of satisfaction was in the domain of provision of health education materials
Conclusions: Diabetes control and prevention program seems to be a suitable program in health care centers in Tehran, however, it is necessary to make further plans to improve the level of training materials provided to patients and comprehensiveness of care
ABSTRACT
Oxidative stress in teratozoospermic semen samples caused poor assisted reproductive techniques [ART] outcomes. Among antioxidants, ascorbic acid is a naturally occurring free radical scavenger and as such its presence assists various other mechanisms in decreasing numerous disruptive free radical processes. The main goal of this study was to evaluate potential protective effects of ascorbic acid supplementation during in vitro culture of teratozoospermic specimens. Teratozoospermic semen samples that collected from 15 volunteers were processed, centrifuged and incubated at 37°C until sperm swimmed-up. Supernatant was divided into four groups and incubated at 37°C for one hour under different experimental conditions: Control, 10 micro m A23187, 600 micro m ascorbic acid and 10 micro m A23187+600 micro m ascorbic acid. After incubation sperm motility, viability, acrosome reaction, DNA damage and malondialdehyde levels were evaluated. Our results indicated that after one hour incubation, ascorbic acid significantly reduced malondialdehyde level in ascorbic acid group [1.4 +/- 0.11 nmol/ml] compared to control group [1.58 +/- 0.13 nmol/ml] [p<0.001]. At the end of incubation, progressive motility and viability in ascorbic acid group [64.5 +/- 8.8% and 80.3 +/- 6.4%, respectively] were significantly [p<0.05 and p<0.001, respectively] higher than the control group [54.5 +/- 6.8% and 70.9 +/- 7.3%, respectively]. A23187 significantly [p<0.0001] increased acrosome reaction in A23187 group [37.3 +/- 5.6%] compared to control group [8.5 +/- 3.2%] and this effect of A23187 attenuated by ascorbic acid in ascorbic acid+A23187 group [17.2 +/- 4.4%]. DNA fragmentation in ascorbic acid group [20 +/- 4.1%] was significantly [p<0.001] lower than controls [28.9 +/- 4.6%]. In vitro ascorbic acid supplementation during teratozoospermic semen processing for ART could protect teratozoospermic specimens against oxidative stress, and it could improve ART outcome
ABSTRACT
This was a prospective cross-sectional study of consecutive transported patients by emergency medical service [EMS] to a referral hospital. The goal of this study was the evaluation of emergency medical technician intermediate prediction about their transported patients disposition in Emergency Department of Imam Khomeini Hospital. 2950 patients were transported to this hospital, Questionnaires were submitted in 300 of consecutive patient transports and completed data were obtained and available upon arrival at hospital for 267 of these cases. Emergency medical technicians intermediate [EMT-I] were asked to predict whether the transported patient would require admission to the hospital, and if so, what will be their prediction of patient actual disposition. Their predictions were compared with emergency specialist physicians. EMT-I predicted that 208 [78%] transports would lead to admission to the hospital, after actual disposition, 232 [%87] patients became admitted. The sensitivity of predicting any admission was 65%, with positive predictive value [PPV] of 39% and specificity of 86% with negative predictive value [NPV] of 94%. The sensitivity of predicting trauma patients [56.2% of total patients] was 55% with PPV of 38%, specificity of 86% and for Non-trauma patients' sensitivity was 80% with PPV of 40% and specificity of 82%. EMT-I in our emergency medical system have very limited ability in prediction of admission and disposition in transported patients and their prediction were better in Non-trauma patients. So in our EMS, the pre-hospital diversion and necessity of transporting policies should not be based on EMS personnel disposition
Subject(s)
Humans , Emergency Service, Hospital , Transportation of Patients , Prospective Studies , Cross-Sectional StudiesABSTRACT
Soccer is a contact sport in which the players are frequently faced with the risk of injury. It has been shown that the force exerted on the head during heading can be as much as 500-1200 Newton [N]. The main objective of this study was to determine whether there was any relationship between the force exerted on the head and several biomechanical and anthropometrical parameters related to heading free kicks. A total of 16 semi-professional soccer players with at least 5 years experience participated in this study. The mean age, height, and weight of the study participants were 21.36 +/- 5.67, 178 +/- 5.99 cm, and 70.55 +/- 8.55 kg, respectively. To measure the force exerted on the heads of the players, a pressure gauge was installed on their foreheads. Each participant was asked to defend the ball using the heading technique three times. A camera with a sampling frequency of 150 frames per second was used to record the moment of impact between the ball and head during each heading event. For each participant and replicate, the ball and head velocity [m/s] as well as the angular body changes [degrees] were calculated using MATLAB and AutoCAD softwares, respectively. Descriptive statistics, including means and standard deviations were used to describe the data. Pearson correlation coefficient [alpha = 0.05] was used to examine potential relationships between the variables of interest. Significant correlations existed between the force exerted on the head during heading, participant age, body mass, body fat percentage, and head perimeter [P < 0.05]. The study revealed the significance of anthropometric variables related to heading, such as age and head perimeter. Therefore, it was concluded that these variables should be considered when teaching and practicing the heading technique with players of different ages and anthropometric sizes
Subject(s)
Humans , Biomechanical Phenomena , Anthropometry , SoccerABSTRACT
Gastro-oesophageal reflux disease [GERD] and dyspepsia are common digestive disorders that inflict serious harm, burden and economic consequences on individuals worldwide. The aim of this study was to estimate the direct and indirect economic burden of GERD and dyspepsia in the whole population of Tehran, the capital of Iran. The study was performed on a total of 18,180 adult subjects [age > 18 years] taken as a random sample in Tehran province, Iran [2006-2007]. A valid and reliable questionnaire was used to enquire about the symptoms of GERD, dyspepsia and the frequency of the utilization of health services including physician visits, hospitalisations and productivity loss due to GERD/dyspepsia symptoms in the preceding 6 months. GERD was found in 518 [41.9% males] patients and dyspepsia in 404 patients [38.9% males]. Further 1007 subjects had both GERD and dyspepsia. The total direct costs of disease per patient for GERD, dyspepsia and their overlap were PPP$97.70, PPP$108.10 and PPP$101.30, respectively [PPP, purchasing power parity dollars]. The total indirect cost of disease per patient was PPP$13.7, PPP$12.1 and PPP$32.7, for GERD, dyspepsia and their overlap, respectively. According to our results, hospitalisation and physician visits were the main cost of disease that could be minimized by revision of the insurance business in Iran