relationship of severe early childhood caries and body mass index in a group of 3- to 6-year-old children in Shiraz

Statement of Problem: Early childhood caries can cause pain, discomfort and also inability to have a healthy nutrition .Malnutrition can be characterized when there is a weight, height, and body mass index [BMI] deficiency

Purpose: The aim of this study was to evaluate the relationship between the severe early childhood caries [based on the dmft index] and BMI in pre-school children in Shiraz

Materials and Method: A descriptive analytical cross-sectional study was enrolled on 202 healthy preschool children with the age range of 3-6 years recruited from the kindergartens of different socio- economical parts of Shiraz, Iran. The Anthropometric measurements, weight and height were evaluated. The Z-scores were calculated employing WHO Anthro software [www.who.int/childgrowth/software/en/ index.html] to elucidate the subject's status on the age- and sex-specific growth chart. Every Child who has received two Z-scores under the normal value [< -2] was considered as abnormal. The relationship between dmft index and BMI was then investigated

Results: The mean of dmft was 4.13. From children with severe early childhood caries, 12.5%were under weight, 5% had height deficiency and 19.5% had BMI deficiency, however, there was no significant relationship between increasing dmft and the height, weight and BMI deficiency

Conclusion: There was not a linear correlation between severe early childhood caries and BMI, height, and weight deficiency. An incidence of 55% was yielded for severe early childhood caries which was an additional finding of this study

[Percentage of out-of-pocket payment for health services by people of Kurdistan in 2010]

In all countries a part of household income is spent on health-related costs. The amount and distribution of this financial contribution impose a significant burden of health problems to communities. The aim of this study was to determine the percentage of household's direct payments for health care services and health equipment in Kurdistan. This descriptive cross-sectional study included 1518 households living in urban and rural areas of Kurdistan, in winter of 1388, and they were divided into 150 clusters. Every cluster included 10 households. Data were collected by using a questionnaire consisted of two parts: household characteristics and household health expenses including; outpatient costs, the costs of hospitalization, medicines, medical equipment, nursing care, paramedical and medical diagnostic measures. The costs of outpatient health care services [visits, diagnosis, drug prescription and medical devices] and hospitalization were determined during four weeks for each member of the family or the total costs and expenses paid by the household were recorded in the questionnaire. Collected data were analyzed by using spss.16 software and mean, standard deviation and median were calculated. People contribution for prescription drugs was 43/3% and for other non-prescription drugs and consumer goods was 100%, for durable medical equipment 95/4%, for diagnostic measures especially in private offices, clinics or home 75/5%.Household contributions to the cost of medical services by GP, medical specialists, psychiatrists and dentists were 62/3%, 76/5%, 75/5% and 80/9 % respectively. 13/8% of the inpatient fees were paid by the patients. The mean cost of family health services in our study was 85380 +/-252012 with a median of 41050 Toman .The out-of-pocket payment by people was 55%. In general, considering the high percentage of people's contribution to health service costs, expansion of the roles of the insurance organizations to achieve the objectives of coverage of over 90% of population and increasing public and private sector contribution to more than 70 % in health services, is essential

[Nursing's position in health care delivery system in Iran]

Nursing is in the ideal position to meet the numerous challenges facing the health system. But in the health system of Iran, the status of nursing profession is not well explained and, little research has been done in this area. Therefore, this study aimed to clarify the role of nursing in health service delivery system in the country was conducted. In order to find studies and resources related to nursing in the health service delivery system, digital databases in the National Library of Medicine of Iran [Elsevier, Nursing index, Nursing consult, Proquest, Scopus, ...] and Google scholar and Persian databases including Irandoc, Iran Medex, Magiran, SID and Medlib was used. Search articles from 1970 to 2012 in English and Persian papers from 1370 to 1390. Using the key words health care system, nursing position and Iran separately and in combination was conducted. The results showed that the nursing profession in Iran does not have a significant importance. More nurses in hospitals, provided nursing care to patients in the secondary level of prevention. And their activities in other areas and other prevention levels in community settings, is very limited. Lack of knowledge about the abilities of nursing has caused low presence in community nursing centers. In Iran, like other developed countries the change in the health care system is necessary and followed by nursing positions will also change. Therefore, managers' effort to enhance and clarify the role of nursing in the health care system in Iran and, prepare nursing profession for servicing in the community seems to be necessary. Nursing system to meet the health needs of people and provide community service in various environments community such as schools, industries, health centers, etc., is suggested, nursing education programs should be reviewed

In vivo susceptibility of plasmodium vivax to chloroquine in Southeastern Iran

Plasmodium vivax is the predominant species causes of malaria with about 90% total annual reported malaria in Iran. This study conducted to determine the susceptibility of Plasmodium vivax isolates to chloroquine in Sistan and Balochistan Province, southeastern Iran. A total 270 subjects with symptomatic malaria and confirmed P. vivax infection completed the designed 28-day in vivo study. The thick and thin film blood smears were screened for malaria parasites by microscopy. The nested PCR was applied using the Plasmodium 18 subunit ribosomal ribonucleic [Ssr RNA] genes for detecting mixed infections and diagnosis of parasites in the samples with low parasite on days 0, 5, 6, 7, and 28. P. vivax was cleared in 15%, 50%, 95%, and 100% of patients on days 1, 2, 3, 4 respectively by microscopy assessment. Six patients were exhibited specific P. vivax band in nested PCR on day 5. No recurrence was observed on days 7, 14 and 28. Mean [ +/- standard deviation] parasite clearance time was 2.41 [ +/- 0.8] days. P. vivax is still susceptible to chloroquine in Southeastern Iran. This finding is compatible with results of neighboring countries Pakistan and Afghanistan

Shiraz hospitals [public and private] preparedness in dealing with disasters

Iran is a disaster-prone country and it can be considered as one of the most vulnerable countries for disasters in the world. Hospitals play an important role in disasters. This paper aims to study the preparedness of public and private hospitals in Shiraz dealing with disasters; to investigate and to identify problems and issues comparing current status with standards. In this cross-sectional study, 15 public and private hospitals were evaluated in Shiraz in 2010. The data was collected by using observation, interview and also a checklist including 10 fields and 220 questions. Then the collected data were analyzed by using SPSS. Totally, the results are as follows: the average disaster preparedness in the mentioned hospitals was 62/3%; evacuation, transport, traffic, communication and security fields were in the middle level; and emergency services, reception, training, logistics, human resources, commanding and management were in a good average level. Despite having an adequate preparation in the studied hospitals in Shiraz, appropriate measures should be taken to improve some fields such as evacuation, transport, traffic, communication, and security

Recurrence and survival effect in breast conserving surgery: what are the predictive and/or prognostic factors?

Breast conserving surgery [BCS] is a widely accepted form of operation in patients with early breast cancer. Recurrence remains one of the greatest concerns in breast conserving surgery. It can provoke serious anxiety in the patient and, when treated by mastectomy, negate the objective of conservation. In this study we investigated the prognostic value of demographic, clinical and pathological factors and biological markers in breast cancer patients treated with BCS. This study was performed on 258 patients who underwent BCS from 2002 to 2010. All of the surgeries were performed by a single surgical team. Recurrence and its risk factors were evaluated. The mean age of the patients at the time of diagnosis was 50. The overall 10 year survival was 81%, 5 year survival was 88% and recurrence rate after surgery was 9%. Lymphovascular Invasion [LVI] was observed in 41 [16%] patients and in 11 [48%] patients with recurrence. Our study confirmed that tumors with estrogen receptor negative and LVI had more recurrence rate but other demographic, clinical and pathological factors and biological markers [progesterone receptor, P53, HER-2] did not have any significant effect on recurrence. We recommend considering LVI and estrogen receptor assay as a prognostic factor in the patients treated with BCS

[Frequency of depression in 207 patients with copd in Qom city, 2008]

Depression is one of the common problems of patients with chronic obstructive pulmonary disease [COPD]. Depending on the severity of lung disease in patients and the kind of study, the prevalence of depression has been reported to lie between 10%-80%. Depression may not be diagnosed in routine examinations, so the patients may not receive appropriate treatment. Due to the lack of similar studies in Iran, the main purpose of this study was to determine the prevalence of depression in COPD patients in Qom. In this cross-sectional study, 207 known cases of COPD were evaluated for depression and its severity by using standardized tests of Beck depression screening. Other variables in the study such age, sex, educational level, marital status and smoking rates were taken into account. SPSS version 15 and Chi square test were utilized for data analysis [p<0/05]. Data analysis showed that 83.3% of patients suffer edfrom varying degrees of depression, of whom 12.9% had severe or very severe depression. Moreover, a significant relationship was found between depression and education level. Depression is one of the common problems in COPD patients reducing their quality of life. It can be treated by physicians which can lead to improved quality of life for these patients

[Requirements and areas associated with readiness assessment of electronic health records implementation]

With huge advances in information technology, in general, and health care services in particular during the past 20 years, various forms of electronic records have been introduced, designed or implemented. This study aimed to review the status of readiness assessment in the implementation process of electronic records with a detailed focus on required and associated areas and to provide a guideline for Electronic Health Records [EHR] directors and executers. Although making health records automatically has many advantages, in some cases, the creation of an electronic health records system seems a complicated task. Electronic health readiness assessment, performed prior to implementation, is considered as an essential process. Readiness assessment is a method used for assessing various aspects of an organization and evaluating the preparedness of each component in the organization. The benefits gained from assessment leads to correct decision making. The outcome can be used to identify deficiencies in the existing electronic health records and to provide solutions. Thus identifying factors and requirements of this assessment seems to be essential

Margin status influence on the outcome of patients treated with breast conserving surgery

Breast conserving surgery [BCS] followed by local radiotherapy is the standard treatment for early stage of breast cancer. Margin status may have an important impact on local recurrence and overall survival of patients treated with BCS, but this has not been defined adequately. In this study, we investigated the relationship between microscopic margins and outcome of BCS. Three hundred eighty four patients treated with BCS between 1999 and 2010 were included in our study. All surgeries were performed by a single surgical team. Margins were defined as close if surgical margins were less than 2 mm, as free if surgical margins were more than 2 mm and as positive if malignant cells were present in one of the tissue edges. Demographic, clinical, and pathological factors as well as biological markers, recurrence, and survival rates were compared between the close and the free margins groups. The mean age of patients at the time of diagnosis was 54.2 years. There were 34 [9%] recurrence cases and overall survival was 128.7 months and ten years survival rate was 81%. There was no significant difference between the close and the free margins groups in terms of demographic parameters, tumor characteristics, biological factors [estrogen and progesterone receptor status] and lymphovascular invasion. Also recurrence rate did not differ significantly between these two groups. Our study indicates that there is no significant difference between the patients with close and the free margins in terms of treatment results. There is no clear consensus in the surgeons' community over the definition of acceptable margin width in BCS, so additional studies are required to find the right answer

[Attitudes and knowledge of HIV positive persons and high risk behaviors groups in Golestan, Iran]

The epidemic of HIV has been become worldwide. Infected people with HIV which are most intravenous drug users [IDUs] and/or people who have unsafe sex are important source of transmission of infection to other persons in a community. Since there is little known about the knowledge and attitudes of HIV positives about HIV in Iran, therefore we decided to measure the level of knowledge and attitudes of this group in Golestan province in compare with individuals with risky behavior. This cross-sectional study was conducted on 54 HIV+ persons and 134 people with high risk behavior individuals in 2007 year. Our study showed that HIV- [High risk group] cases had higher education level [P=0.034]. Rate of jobless was higher in HIV+ persons [P<0.001]. HIV+ cases had lower income [P=0.037]. Both groups had moderate knowledge and poor attitude on HIV/AIDS. Level of attitude in HIV+ positive persons was lower than high risk group [P=0.05]. It is concluded that these susceptible persons and also infected individuals with HIV regardless of their socio-economic levels need more continuous education in structured programs

Gabapentin may relieve post-coronary artery bypass graft pain: a double blind randomized clinical trial

One of the most common complaints after coronary artery bypass graft [CABG] is postoperative pain. Gabapentin is an anticonvulsant and antineuralgic agent. To evaluate the analgesic effect of preemptive gabapentin on post-operative pain and morphine consumption after cardiac surgery. A double-blind randomized clinical trial was conducted on 60 male candidates for CABG. The patients were divided into two groups-the gabapentin [n=30] and the control group [n=30]. The test group received 800 mg gabapentin orally two hours before the surgery followed by 400 mg of the drug two hours post-extubation. The control group received placebo instead. Then severity of pain was recorded according to an 11-point visual analog pain scale. The amount of morphine consumed, its side effects and hemodynamic changes were also recorded during and at 2, 6, 12, 18 and 24 hours after extubation. The mean +/- SD cumulative morphine consumption at the first 24 hours after extubation in gabapentin group was 0.9 +/- 1.5 mg while it was 1.5 +/- 4 mg for the control group. Therefore, gabapentin group consumed 38% less than the control group [P=0.01]. The pain scores during rest and coughing at 2, 6, and 12 hours after extubation were also significantly lower in the gabapentin group compared with the control group [P=0.02]. The mean +/- SD mechanical ventilation time was 5.4 +/- 1.7 hours for gabapentin group and 1.6 +/- 4.4 hours for the control group [P=0.035]. The other variables including hemodynamic changes [HR, SBP and DBP], and incidence of nausea, vomiting and respiratory depression showed no significant difference between the studied groups within 24 hours after extubation. Oral pre-medication with gabapentin before CABG significantly reduces post-operative pain and morphine consumption in adult cardiac surgery

[Comparison of single cross-clamp versus multiple clamp technique in reducing the incidence of stroke for patients undergoing coronary artery bypasses grafting [CABG]]

Stroke and cognitive impairment after coronary artery bypass grafting [CABG] are associated with cerebral embolization. An important cause of embolism is manipulation of the ascending aorta. There are two distal and proximal anastomosis in CABG that can be done by single cross-clamp or by on cross-clamp and one side-biting clamp on ascending aorta. The later is done for reducing cardiac ischemia. Single clamp technique may be associated with lesser cerebral injury. The Aim of study is survey of surgical Complications of CABG. This study was carried out over 26 months [from oct 2006 until Jan 2009]. Patients referred for CABG to a private hospital [n=187] single clamp was used [group I], while patients referred to university hospital [n=187] were operated upon by conventional method of multiple clamps [group II]. The incidence of cerebral injury that was clinically patients referred diagnosed in both groups were analyzed. There were one left side hemiplegia and one mortality in group I and one left side hemiplegia and two cases of encephalopathy without any mortality in group II. The results of this study suggest that there is no benefit of single clamp over multiple clamp technique in terms of reduction in the incidence of stroke although there are some advantages of single clamp in causing less cognitive disorders

[Effect of hepatitis C and B infections on anemia in hemodialysis patients]

Hepatitis C [HCV] and B [HBV] infections are commonly seen in dialysis patients, but them long-term deleterious effects in these patients are unknown. We evaluated the effect of HCV and HBV infections on anemia in our hemodialysis population. A total of 90 chronic hemodialysis patients with anemia at kamkar and Hazrat Valiasr hemodialysis centers were included for the period 3 months, in 2008. Data classified according to the hepatitis-free, chronic hepatitis B and C groups. Nineteen HCV- positive and eleven HBV-positive patients were included for comparison analysis with 60 control patients. Erythropoietin was administered for 3 month. They were followed for 3 months and their hemoglobin and hematocrit were measured before administration of erythropoietin and the end of third month. For statistical analysis, T-test was employed. The mean rise of hemoglobin and hematocrit in hepatitis-free, HCV and HBV groups were 1.50 +/- 1.45 g/dL and 3.88% +/- 5.01%, 2.56 +/- 1.40 g/dL and 7.56% +/- 3.75%, 1.86 +/- 1.17 g/dL and 5.73% +/- 4.11%, respectively. The mean rise of hemoglobin and hematocrit in HCV group was significantly higher than hepatitis-free group and t test showed a significant statistical correlation. However the mean rise of hemoglobin and hematocrit in HBV group was higher than hepatitis-free group but t test didn't show a significant statistical correlation. We found that hepatitis C virus infection was associated with significant elevation in mean of hemoglobin and hematocrit than hepatitis-free group

Allelic dimorphism of the Plasmodium falciparum erythrocyte binding antigen-175 [EBA-175] gene in the southeast of Iran

The erythrocyte binding antigen 175 kDa [EBA-175] gene is located on chromosome 7. It encodes protein that binds to specific receptor glycophorin A on the erythrocyte surface during invasion. It has a dimorphic nature [FCR3 and CAMP]. This study was designed to determine the distribution of EBA-175 alleles of Plasmodium falciparum in the southeast of Iran. We used the nested PCR method with specific primers, which improves the two fragments of the EBA-175 gene. Sixty eight microscopically positive blood samples were collected from the infected falciparum malaria subjects in the southeast of Iran. In this study which marks the first one in Iran, CAMP strains [714 bp] and FCR-3 strains [795 bp] were found in 14 [37.8%] and 23 [62.2%] in the originally Iranian subjects and in 10 [32.3%] and 19 [61.3%] Pakistani infected migrants respectively. Two migrant cases [6.4%] had mix CAMP/FCR-3 infection. The two fragments of dimorphic EBA-175 gene were observed and the FCR-3 allele was more prevalent in Iran. There was no significant correlation between one of the EBA-175 alleles and the subject group in the mentioned region. This distributional pattern should be considered in designing to control P. falciparum malaria in the region

[ relationship between depression and religious attitudes in students of Qom university of medical sciences, Qom, Iran]

Depression is one of the main causes of debility all over the world. Its prevalence is reported to be 10% -64% in students. Various researches indicate that utilizing religious approaches play an efficient and effective role in treating mental disorders. The present study was conducted with the aim of determining the relationship between depression and religious attitudes in students of Qom University of Medical Sciences [QUMS], Qom, Iran. In this descriptive- analytical study, 250 students of QUMS were assessed by means of three questionnaires; a standard depression test questionnaire, and religious attitude questionnaire. The obtained data were analyzed using statistical procedures of Chi-Square, Mann-Whitney, Kruskal- Wallis test and Spearman Correlation Coefficient and P<0/05 was considered as the level of significance. The study showed that 44.8%of the subjects had no depression, 37.2% had minor depression, 14.8% were moderately depressed, and 0.8% were intensely depressed while 2.4% very intensely depressed. The study also showed that 82% of the cases had positive attitudes toward religious beliefs and 18% had negative ones. Moreover, results showed that there was a meaningful but negative relationship between depression and religious attitudes [P<0/02]. Regarding the positive effects of religious beliefs and practices on mental health, it is recommended to use this potential in community health planning especially when dealing with young adults

Evaluation of preoperative elevation of serum C-Reactive protein as an indicator for prognosis in Colorectal Cancer

The C-reactive protein [CRP] is a product synthesized in hepatocytes and has been reported to be up-regulated by such proinflammatory cytokines as interleukin-1 [IL-1], interleukin-6 [IL-6], and tumor necrosis factor [TNF]. The significance of a preoperative serum elevation in CRP as a predictive indicator for the malignant potential and prognosis in colorectal cancer has not been elucidated. Forty consecutive patients with colorectal cancer, whose local lesions were resected in our department, plus forty volunteer healthy persons, were selected. Any patient with inflammatory diseases such as infection or collagen disease was excluded from the current study. Then preoperative serum CRP level were measured, and also from the control group. The relationships between the serum elevation of CRP and both the clinicopathologic factors and prognosis of the patients was investigated. The rate of patients with elevated serum CRP level was significantly higher in colorectal cancer patients in comparison with the control group [55% versus 2.5%]. Furthermore the incidence of liver metastasis, peritoneal carcinomatosis, histopathologic lymph nodes metastasis, and tumor invasion in colorectal cancer patients with a preoperatively elevated serum CRP level were significantly more frequent than in those with a negative serum CRP level. The survival rates of colorectal cancer patients without a preoperative elevation of serum CRP proved to be significantly more favourable than what in colorectal cancer patients with such an elevation [94.4% versus 59.1%; P < 0.001]. A preoperative serum elevation of CRP was thus found to be an indicator of malignant potential of the tumor as well as a predictor for the prognosis of patients with colorectal cancer

[Patients satisfaction from general physicians and it's determinants in Qom [2005-2006]]

The present study was designed to evaluation of patients satisfaction and related factors from general practitioner in Qom. In a cross-sectional study sixty physicians were selected randomly by stratified sampling method. Twenty patients were selected for each physician that results in a sample of 1200 patients. Satisfaction questionnaire completed for each participants by interview. Data were analyzed with SPSS. The results revealed that the overall rate of satisfaction is 88%. The most of satisfaction rate was from physician communication. Dissatisfaction from visit time was more than other instances. We found a significant relationship between satisfaction and patient age, education, marriage, job, relationship and physician age, gender, record of service, clinic type and activity time. In general patients were satisfied from their physicians, but recommended that physicians pay attention to related factors in this research

Examining the factors effective on birth weight among babies of yazdprovince in 2007

Birth weight of a baby is the most important chance of its survivial, growth and development.With identifying and controlling risk factors which are mainly dependent on biological and social conditions,we can prevent birth of low weight babies. The main goal of this study was to examine the relationship between effective factors such as marital satisfaction, high blood pressure, age and occupation of mothers and baby's birth weight. In this study, among all the babies born in Yazd province hospitals in 1386 with parents residing in Yazd province, 941 babies were selected. Firstly, categorized sampling method [with respect to population ratio in each of the cities of Yazd province and season birth] was used. Secondly, cluster sampling method was used. A season day was selected randomly and all the data in that day and the rest of the days until reaching to a desired sample were recorded. The data were gathered by a researcher-designed questionaire and Enrich marital satisfaction scale. Data analysis was done by using "SPSS" software with logistic regression method. The results showed that pregnancy under the age of 19, extereme marital dissatisfaction, high blood pressure and being a working mother can meaningfully[p<0.05] increase the possibility of giving birth to a baby with low birth weight. Also it was cleared that baby's gender, season of birth, parents education, parents kinship before marriage have no meaningful effect on the possibility of baby's low birth weight. Regarding the negative effect of factors such as mother's blood pressure, extreme marital dissatisfaction like physical, emotional and sexual abuse, difficult job and job stress on birth weight, we suggest offering some training to couples at the time of marriage and pregnancy in order to prevent and avoid these factors

Study of the prevalence of hypertension in the urban population of Sabzevar, Iran

Background and Purpose: Hypertension is a common but asymptomatic disease which is easily traced and treated. However, if left untreated, deadly complications and hgih costs of treatement should be expected. This study was conducted to investigate the prevalence of hypertension in the urban population of Sabzevar, Iran

Methods and Materials: This descriptive cross-sectional study was conducted on the population of urban families supported by the health centers in Sabzevar, Iran. 596 cases [age 19 years or older] were selected by stratified sampling. In addition to filling out the study questionniare, the systolic and diastolic blood pressure of the cases were measured by the standard method using Alpk2 sphygmomanometer and Litman stethescope. The hypertension threshold was considered as 140/90. Frequency and percentages were used to describe the data, and chi-square was used for the analysis in SPSS

Results: The prevalence of the systolic and diastolic BP hypertensions were 21.5% and 25.8% respectively, and the prevalence was higher with women rather than men [p<0.0001]

As ascending trend in the systolic and diastolic hypertnesion was observed with the increase in the age. Also, the prvalence of systolic and diastolic hypertnesions were observed to be 69.5% and 54% in cases of 55 years or older

Conclusion: This study indicated that the prevalence of hypertension was high in Sabzevar, Iran