[Ventilator - associated pneumonia in intensive care units and physician - nurse relationship role]

Introduction: Ventilator-associated pneumonia is one of important factors of morbidity and mortality in critical care units, associated with hospitalization day's and increased cost of treatment. Thus prevention through identifying related factors must be highly recommended

Objective: This study is conducted by the aim of determining the nurses understanding of physician-nurse relationship with Ventilator - associated pneumonia reports in critical care units of Guilan University of Medical Sciences

Methods: This cross-sectional -analytic study conducted by selecting 101 nurses from 7 critical care units of Guilan province with determined characters by census method. Data were gathered by a 3-part tool consisting demographic data and ventilator associated pneumonia recording data for 3 months before sampling and standard Practice Environment Scale of the Nurses Work Index [physician-nurse relationship] by interview. Mean of reported pneumonia frequency classified in 3 groups of none, 1-5 cases and more than 5 cases. Mean of physician-nurse relationship classified in 2 groups of desirable and undesirable. Data were analyzed using descriptive statistics and analytic tests [chi-square]

Results: The findings showed that majority of samples [62/7%] 1-5 were related to ventilator associated pneumonia. This variable had significant relation with years of employments in samples [p=0.004]. Mean score of 72.5 percent of samples in physician-nurse relationship was in favorable level with no significant relationship with personal variables except the nurses` employment status [p=0.035]. Finally, X[2] statistical test showed significant relationship between favorable perceived physician - nurse communication and lower Ventilator-associated pneumonia [p=0.01]

Conclusion: Significant relation between ventilator associated pneumonia and physician-nurse communication in this survey indicated that possibility of prevention of pneumonia by improving nurse-physicians relationship and collaboration quality

Hepatitis C virus infection among multi-transfused patients and personnel in haemodialysis units in central Islamic Republic of Iran

A cross-sectional study was made of the prevalence of HCV and associated risk factors in 382 multi-transfused patients and haemodialysis staff in Yadz province in 2006. Of those tested for anti-HCV antibodies, 50.6% of patients with inherited bleeding disorders, 11.8% with thalassaemia and 5.0% undergoing haemodialysis were seropositive. First transfusion before 1996 [when blood donor screening started] was the common risk factor associated with HCV infection. Only 1/52 haemodialysis staff members was HCV infected [an intravenous drug user]. Infection control measures were poor in all centres. In patients with inherited bleeding disorders genotype 1 [65.0%] was the predominant followed by genotype 3 [35.0%]. The results provide evidence that blood donor screening and use of virus-inactivated factor concentrates have lowered the risk of HCV infection among multi-transfused patients

[Effects of brewer's yeast on blood pressure and serum lipoproteins in type-2 diabetes mellitus patients]

The increasing trend of prevalence of diabetes mellitus, a diet-related chronic disease has prompted research to find ways to control it. Brewer's yeast may have a potential role because its glucose tolerance factor [GTF] may have beneficial effects on insulin receptors in diabetic patients. This study was conducted to investigate the effects of brewer's yeast supplementation on serum lipoproteins and blood pressure in patients with type-2 diabetes mellitus [T2DM] patients. In a randomized double-blind controlled clinical trial 84 adults [21 men and 63 women, 46.3 +/- 6.1 years old] with T2DM were recruited and divided randomly into 2 groups of 42 subjects each, one receiving brewer's yeast [six 300-mg capsules/day, total 1800 mg] and one [control group] receiving a placebo [6 capsules/day] for 12 weeks. Body weight, height, body mass index [BMI], food consumption [based on 24-hour food recall], fasting serum lipids and lipoproteins [total cholesterol, triglyceride, LDL-c and HDL-c], and systolic and diastolic blood pressure were measured before and after the intervention. Data analysis was performed using the Statistical Package for Social Sciences [SPSS-Ver 18.0], the statistical tests being the independent t-test, paired t-test, Kolmogorov-Smirnov test, and analysis of covariance. Brewer's yeast supplementation brought about statistically significant reductions in diastolic and systolic blood pressures [5.7 +/- 0.6 mm Hg, p=0.001 and 4.1 +/- 1.5 mm Hg, p=0.007, respectively] after 12 weeks. Changes in LDL-c, HDL-c, triglycerides and total cholesterol were no-significant. Further analysis of the data showed significant differences between the brewer's yeast and control groups with regard to diastolic [p<0.03] and systolic [p<0.05] blood pressure at the end of the period. Dietary supplementation with brewer's yeast can reduce systolic and diastolic blood pressure in type-2 diabetes mellitus patients

Effect of post operative bleaching on marginal leakage of composite restorations

Today, the esthetic dentistry is considered as an important part of dental treatments. Regarding the increasing number of patients' demand to remove tooth discolorations, need for bleaching treatment is on rise. The effect of bleaching on microleakage of composite restorations is regarded as the main factor of composite failure. This aim of this research was to investigate the effect of pre- and post-operative bleaching on microleakage of class 5 composite restorations. This experimental study was performed on 15, carries free eruptive human third molar divided into 3 groups of 5 members each and marked as 1] case group [pre-operative bleaching group], 2] case group [postoperative bleaching group], and 3] control group [no bleaching group]. In group 1, samples were exposed to 20% carbamide peroxide-containing gel 2 hours a day for 7 days and kept in artificial saliva between the bleaching processes. After 14 days and while the bleaching were finished, class 5 cavities prepared in buccal and lingual surfaces of teeth [dimensions: 4*2*2 mm] where the gingival margin of all cavities were 1mm under the CEJ. Later, all cavities were filled with composite [Z 250/3M]. In group 2, class 5 cavities were prepared, filled with composite in a similar way and exposed to bleaching process as for group 1. In group 3, only class 5 cavities prepared and repaired without bleaching. Soon after, Samples were termocycled [500 times, at 4 and 55 °C]. The process of dye penetration was carried out by placing the samples in a solution containing 1% methylene blue for 24 hours. The teeth were later sectioned and the rate of microleakage evaluated using a stereomicroscope [magnification 40x]. The data were analyzed by Mann Whitney test. The rate of microleakage in class 5 restorations exposed to bleaching [either before or after restoration] increased at both occlusal and gingival margins. The degree of microleakage at occlusal margin was lower than gingival margin in all groups. The rate of microleakage in both occlusal and gingival margins showed a significant difference, statistically [p<0.006; p<0.014] however, no significant difference at occlusal and gingival margins of case group was observed [p=0.684; p=0.264]. Bleaching process increases the rate of microleakage following composite restoration

[ study on acute stress, post-traumatic stress disorder and quality of life in injured accident survivors admitted to Rasht Porsina hospital during 2009-10]

There is limited information on health-related quality of life [HRQOL] of injured accident survivors. The aim of the present study was to assess acute stress, post traumatic stress disorder and health-related quality of life in injured accident survivors. Eighty-eight patients admitted to the orthopaedics and trauma surgery department of Rasht Porsina Hospital were enrolled to this descriptive study. SRSPTSD [post-traumatic stress] and SF-36 [short-form of health-related quality of life] questionnaires were completed and assessed one week and two months after the accident. Acute stress of the first week of the accident was found to be an independent predictor of post-traumatic stress of two months later. Regression analysis showed a statistically significant relationship between position of the survivor as a driver and score of post-traumatic stress disorder two months post-accident [P=0.024]. The results also showed a statistically significant improvement in physical function [P=0.005], lack of improvement in role limitations due to physical injury [P=0.02], no improvement in mental function including mental health [P=0.001], role limitations due to emotional problems [P=0.01] and vitality [P=0.001]. There is a significant relationship between PTSD and quality of life of the injured survivors. The return of injured accident survivors to pre-injury HRQOL may depend not only on optimal medical care but also on awareness and timely interventions regarding PTSS

Housewives' obesity determinant factors in Iran; national survey - stepwise approach to surveillance

Women suffer more from obesity than men in Iran do. In this study, we compared obesity risk and its contributors regarding the job categories as housewives [HWs] or employees to deeply explore the risk of obesity in housewives in Iran. Based on WHO stepwise approach, in 2005, 33472 women aged 15 to 65 years old [excluding all men] were examined for the major risk factors for non-communicable diseases. Obesity was determined by Body Mass Index>30kgm[-2] in adults [>20 years] and by girl BMI percentiles according to WHO 2007 Growth Reference 5-19 years in adolescents. We modeled obesity by logistic regression and entered all the known/potential predictors, including job categories. The participation rate was more than 99%. The weighted prevalence of overweight and obesity in HWs were 34.5% and 24.5% respectively. Employed women were about 4% and 10% less overweight and obese than the HWs, respectively [P< 0.01]. HWs vs. employed women had the adjusted OR 1.39 [CI95%, 1.18-1.63] for obesity. Older women, with higher educational level and socioeconomic status, lower physical activities and those living in urban areas were at risk of obesity. In comparison to HWs, working as an Official Clerk [OR=0.66] associated with a decrease in odds of obesity significantly, while others did not. Being as HW is an independent significant factor for obesity in women. Preventive health care programs to reduce risk of obesity in women should be applied, considering their occupation for achieving more effectiveness

[Implementation of standards in emergency departments in hospitals of Rasht]

In emergency departments [ED] like all other sectors in health system quality improvement is necessary. For achieving this goal implementing standards rules is important. This study is going to evaluate standard implementation in ED of Rasht [a city]. This is a descriptive and cross-sectional study. Samples were emergency departments of selected hospitals. Data was gathered with a checklist which was prepared by researcher and analyzed by descriptive statistics. 79.6% of evaluated EDs had appropriate situation. Mean achieved scores by hospitals were: manpower 71.4%, physical structure 78.5%, facilities and equipments 81.05%, processes and activities 88.47% and personnel educations 54.28%. All EDs achieved unacceptable scores in manpower education. This is contrary to curvet M.O.H strategies for improving qualities of EDs. Special attention and resource allocation should be considered for improving the job training and personnel educations. In service education recruiters well trained personnel providing appropriate equipments and spaces and periodical evaluations are necessary strategies for quality improvements in EDs

comparative study on the job description of medical record professional in selected countries and submit a model

Organization, given that is a dynamic, flexible social phenomenon, which constantly changes. Therefore, categorizing plan of jobs would not be a stable phenomenon. Therefore, because the content of job alters with technical advances, it had better to examine specially at the time of an annual assessment, the job description. In addition, the chief of medical records unit should, as possible as, predicate future changes. The present paper is a practical descriptive-analogical research, so that the researcher comprised available job descriptions structures of [Health Information Management Associations] by checklist fully. Then, the draft was designed based on that analogy, put on the table to be criticized by medical records experts, finally, the last proposal designee would be offered. Job descriptions written by American Health Information Management enjoy the structure consists of job title, direct supervisor, main goal, responsibilities and competency. While Australian Health Information Association presents job descriptions comprising job code and class, unit name and supervisors as well as competency, and necessity conditions, and even times of work and rest. This association maintains to record performance indexes at the form of job description. Job description form, in Canadian Health Information Management Association is presented as assessment form of staffs, stating responsibility schedules and separated from job specification form. During double-stage screening of final draft, the researcher came to result that the job description form must include five dimensions as job title, its goal, its responsibilities, performance indexes, and job specification. The authorities believe that these features has the importance of 88%, 82%, 88%, 87%, 91%, respectively

[Prevalence of hepatitis B virus [HBV] infection among Iranian prisoners during 2001-2005]

To determine the prevalence of Hepatitis B Virus [HBV] infection, as a blood borne viral infection, among prisoners and its associated factors in Iran. In this cross sectional study, 5317 inmates, who had stayed in prison for at least 3 months, were tested in 7 provinces from 2001 to 2005. The degree of contamination with HBV and its association with age and drug abuse were evaluated. The frequency of contamination with HBV ranged from 1% to 15% in different prisons. Overall frequency was 6.7% [95% CI: 6.1%-7.4%]. The crude and adjusted association between HBV infection and age was studied. While adjusted for prisons. The result showed no significant association between age and HBV infection [P = 0.88] based on Mantel Heanszel test. However, there was a significant association between HBV infection and drug abuse in two out of seven prisons [where the data was available]. The frequency of contamination with HBV infection is relatively high [more than twice] in prisons comparing to the general population [6.7% VS 2.8%]. Planning regular screening, preventive practices such as vaccination against HBV in prisoners as well as easy access to therapeutic facilities are highly recommended

[Study of constraining factors of research from the viewpoint of faculty members in Guilan University of Medical Sciences]

Introduction: Science, research, culture and politics are interdependent. Advent of developments in each of these fields cannot be realized without establishment of the coordinated developments in other fields in a sustainable way. Research is one the key ares in the area of national security. Quality and quantity of scientific products are the most important indicators for national development in the country. At present, there is a great gap between the scientific products of Iran and many other countries in the world. Despite the increased rate of research credits as well as the increased number of investigators in our country, there is no appropriate increase in number of research projects approved by Iranian universities of medical sciences and in number of internationally published articles. Thus, we attempted to investigate the deterrent factors and the constraints for research among the main elements of universities [faculty members]

Objective: This study was carried out to determine the deterrent factors for implementing the research projects from viewpoint of faculty members in Guilan University of Medical Sciences in 2003

Materials and Methods: Present study was carried out in a descriptive method by using a questionnaires developed by Fonk et. al and its validity and reliability was established. The questionnaire was given directly to all faculty members of Guilan University of Medical Sciences [N=28] and finally, 186 people answered. Data were analyzed by statistical software of SPSS and inferential statistics

Results: Examination of results showed that administrative and organizational factors in view of faculty members were the most important deterrent factors for research. The majority of faculty members [76.9%] as assistant- Professor believed that authorities and managers didn't pay attention to the results of applied research while the majority of faculty members as educators [87.6%] believed that there was no strong motivation for research

Conclusion: Research limitations can be eliminated by effective leadership and management in the field of research in universities and by establishment of research facilities and possibilities such as establishing research consultation nucleus and shortened period of time for assessment and improvement of research projects and by reduction of teaching hours and educational duties and by establishing opportunities in the areas of research and by enabling research areas by faculty members

Inhibitory effect of ascorbic acid on development of dependency to heroin in rats

There are several line of evidences that dopamine release from dopaminergic neurons of VTA increases during heroin administration and ascorbic acid [AA] regulates this dopamine release. The main object of present study was, to determine the effect of 3 different doses of AA on dependence to heroin. Male wistar rats were implanted with silastic catheters into the right jugular vein. After recovery animals are studied in 3 groups [control, heroin and AA] through IV self administration [SA] method by two lever [active and passive] for 2h every day until 15 days. During the first 5 days animals were hungry since 12h before SA, While during the remaining 10 days were not. The latter group [AA] composed of 3 subgroups [a, b, c] that got different doses [100, 300, 700 mg/kg. IP] of AA 30 minutes before SA, respectively. AA injection decreased active lever pressing and the effects of doses applied in this study were almost the same. Number of lever pressing in all groups was as follows [mean +/- SEM]: Lever Group salin Heroin Ascorbate a Ascorbate b Ascorbate c Passive 1.97 +/- 0.18 6.48 +/- 0.39 6.03 +/- 0.34 5.65 +/- 0.35 5.11 +/- 0.31 Active 11.13 +/- 0.62 41.48 +/- 1.82 25.68 +/- 1.07 25.24 +/- 1.05 23.89 +/- 0.94 Injection of AA prevented the reinforcing effect of heroin and developing dependence to it. There was no significant difference between different doses of AA in this issue