Effective factors of treatment outcome in smear positive tuberculosis patients in Golestan province-Iran [2014]

Background and Objective: Tuberculosis [TB] is the main cause of death in the world. Half of the patient eventually will die during first 5-year of infection if they do not receive suitable treatment. According to WHO's report, treatment success in Iran is lower than the regional and global mean. This study was conducted to identify the effective factors of treatment failure among tuberculosis patient in golestan province- Iran

Methods: This cross- sectional study was conducted on 331 new smear positive tuberculosis patients that detected in TB laboratory in in golestan province-north of Iran during 2014. Inclusion criteria included weight more than 30kg, age greater than 13 years, diabetes, immune deficiency, liver or kidney diseases. Patients were treated according to a protocol for a period of two months on the DOTS strategy. The criterion of treatment outcome was sputum smear at the end of the second month of treatment. The effect of gender, medication regiment, age, weight, smoking, addiction and severity of smear basilli load on treatment outcome was assessed

Results: 50.8% and 49.2% of patients were treated with combination and separate medicinal regiments, respectively. The conversion rate of smear positive was 67.7% at the end of the second months. According to multivariate logistic regression, the age of the patient [95% CI: 0.96-0.99, OR: 0.98, P=0.017], addiction [95% CI: 1.26-4.54, OR: 2.4, P=0.008], ethnicity [95% CI: 1.86-7.02, OR: 3.62, P=0.0001] and diagnostic smear bacilli load [P=0.0001] were the important effective variables

Conclusion: The success of two months treatment was fairly low and the important factors on treatment success during the intensive phase were patient age, smoking, addiction and diagnostic smear bacilli load

Birth weight and risk of childhood acute leukaemia

Studies of risk factors for acute leukaemia are inconclusive. This case-control study was done In West Azerbaijan province, Islamic Republic of Iran, to determine the relationship between birth weight and acute leukaemia in children aged under 15 years. For every patient 2 age- and sex-matched controls were selected from hospital and community populations. Of 130 cases diagnosed over the period 2003-2009/108 [83.1%] had lymphoblastic and 22 [16.9%] myloblastic type. Significantly more of them were male than female [55.4% versus 44.6%]. In a multivariate logistic regression model variables significantly associated with acute leukaemia were: birth weight [OR = 2.25], birth order [OR = 2.25], birth place [OR= 7.93], history of chickenpox [OR - 0.46] and mothers' education [OR = 3.23]. The risk of acute leukaemia increased significantly with increasmg birth weight in the total group and among girls, but not among boy

[ effect of implementing orem's self-care model on the self- esteem of elderlies resident of nursing home in Urmia]

Regarding the increase in the elderly population, using nursing theories especially Orem self-care model can be effective in self- esteem improvement. This study aimed at evaluating the effect of implementing Orem self-care model on the self- esteem of the elderly resident in the nursing homes in Urmia. In this quasi-experimental study, 50 elderly people who have inclusion criteria were selected through available sampling and were randomly divided into two groups of control [25] and intervention [25]. Self- esteem was evaluated via Rosenberg self-esteem questionnaire before and one month after implementing the selfcare program. Data were analyzed via SPSS software v. 16, using descriptive and inferential statistical testes. Results showed that in the control group, need level in 48% of the elderly was low, in 44% moderate and in 8% high. In the intervention group this level was reported low in 44%, moderate in 52% and high in4% of the subjects. Chi-square test did not show a significant difference between the two groups regarding level of needs [P=0.76]. In the intervention group, the mean score of self-esteem before the intervention was 25.70 which increased to 27.96 after the intervention. The difference between the means scores of self-esteem in the two groups was significant [P=0/015]. Implementing orem's self-care model had a positive influence on improving self- esteem of the elderly people. Therefore, nurses and other eldercare providers are suggested to reinforce self-care spirit in these patients, according to the nursing theories and health care programs, to improve self- esteem in the elderly resident in nursing homes.

[ prediction's trend of graft survival in renal transplantation with chronic allograft dysfunction]

Clinically chronic allograft dysfunction [CAD] is characterized by a progressive decline in glomerular filtration rate [GFR] over time, the pattern of disease progression determined by the five-stage model. In this paper, we used Erlang and hypo-exponential distributions as phase- type distributions to describe hazard of kidney failure at over time in RTR with Cad. In a single-center retrospective study, 214 patients with RTR with Cad were investigated at the Emam hospital of Urmia University of medical sciences from 1997 to 2005. Kidney function at each visit assessed with GFR and categorized based on NKF and KCOQI staging system. The estimated hazard rates of disease progression from stage 1 to 2, 0.0378; from stage 2 to 3, 0.04; from stage 3 to 4, 0.0458; and from stage 4 to 5; 0.0541 were respectively based on each expected month. This estimates yield a mean waiting time of disease progression from stage 1 to kidney failure or dialysis 91.63 month. The 18th, 58th, 118th and 155th months of death-censored graft survival were 0.99, 0.75, 0.25 and 0.10 respectively. The findings of this study are compatible with hyperfiltration theory in chronic kidney disease and give us more detailed information about the dynamic process of disease which would help to manage it effictevliy

Association between the socio-economic indicators and infant mortality rate [IMR] in Iran

Infant mortality is one of the main indexes in the assessment of a society's access to the primary health care services. Many factors are involved in this regard. The present study aimed at determining the structural association between socio-economic variables and the rate of infant mortality rate. The required data and information were collected from the multiple indicator cluster surveys [MICS,1998], reports of the Statistical Centre of Iran [SCI] from the population indices in 2003, the project of Incomes and Costs of the Iranian Families [2002] and the National Health Survey on Iran [NHS- 1999]. In this study dependent variable was IMR and independent variable was demographic and socioeconomic factors. The data were analyzed by Path Analysis method. According to the standardized coefficients, the illiteracy rate of the women aged 15-46 years is one of the main factors that, not directly but indirectly awareness, attitude and performance of the women, increases IMR by as much as 0.8, partly about 0.3 due to the lack of access to the health services such as urbanity and the percentage of caesarean. In addition, the index of consumption costs has direct and decreasing effect of about 0.353 on the infant mortality rate. Reduction in women's illiteracy rate, increase of the families, welfare and the present of access to high quality services are the most important factors that decrease IMR