Knowledge, attitude, and practice among staff associated with Human Papillomavirus vaccine of young children in Iran

@#Introduction: This study aimed to evaluate knowledge, attitudes, practice associated with Human Papillomavirus (HPV) Vaccine for Young Children among lecturers and health staffs of Shahid Beheshti University of Medical Sciences (SBMU). Method: This was a cross-sectional study with 220 adults from five different specialties, randomly selected. Data was collected using 45-item questionnaire on knowledge (12- item), attitude (18-item) and practice (15-item) (KAP) about HPV. The demographic questionnaire included information on age, gender, level of education, occupation, and marital status. Content validity was calculated by content validity ratio (CVR) and content validity index (CVI). Reliability was evaluated using test-retest and by Cronbach’s Alpha coefficient, internal consistency was calculated values >0.81 which considered as satisfactory. Results: The mean age of the studied population was 37.70± 8.07 (23-67) years. Of the 220 participants, 80 (36.4%) were males and 140 (63.6%) were females. In evaluating KAP in the men and women, the mean and standard deviation of knowledge were estimated at good level and one-way ANOVA analysis showed significant differences between women and men (p=0.019). There was no significant difference in men and women related to attitude (p=0.92) and practice (p=0.38). Conclusion: The KAP about HPV among participants was significantly higher at good levels compared to average levels. Women's knowledge was significantly higher than men. Attitude and practice could have been higher because there was consensus to the usage of vaccine among the specialists to prevent HPV.

Factors Associated with Health-Related Quality of Life in Tuberculosis Patients Referred to the National Research Institute of Tuberculosis and Lung Disease in Tehran / 결핵및호흡기질환

BACKGROUND: In tuberculosis (TB) patients, health-related quality of life (HRQoL) is significant in self-management, which in turn can be effective in therapeutic acceptance and prevention of treatment failure due to multi-drug resistant TB. This study was conducted to evaluate HRQoL and associated factors in TB patients referred to the National Research Institute of Tuberculosis and Lung Disease (NRITLD). METHODS: In this study, patients were selected from TB clinics of the NRITLD in Tehran. In addition to an Iranian version of the Short-Form Health Survey (SF-36), demographic and disease characteristic questionnaires were used for data collection. The data were then analyzed using SPSS software. RESULTS: Two hundred five TB patients, with the average age of 42.33+/-17.64 years, participated in this study. The HRQoL scores in different domains ranged from 14.68+/-11.60 for role limitations due to emotional problems to 46.99+/-13.25 for general health perceptions. The variables of sex, marital status, education, job status, place of residence, and cigarette smoking, influenced the HRQoL scores in different dimensions. CONCLUSION: According to the study findings are the important variables that influenced the HRQoL of TB patients. The consideration of its can improve the HRQoL of TB patients.

Burden of obstructive lung disease study in Tehran: research design and lung spirometry protocol

Chronic obstructive pulmonary diseases [COPD] are planned to rank fifth in burden of disease and third with respect to mortality by 2020. Carrying out research regarding different aspects of COPD is mentioned as important health priorities by academic institutions and governments. The burden of lung disease [BOLD] Initiative was designed a decade ago to develop robust models that can be used to estimate the prevalence and current and future economic burden of COPD. The goal of the present project is to describe the prevalence and determining the causes and risk factors of COPD in the population of Tehran city. This cross sectional study follows a stratified cluster sampling strategy with proportional allocation within strata. The target population is all noninstitutionalized inhabitants, aged 18-40 in one group and over 40 in another, who inhabit in Tehran city. The stratification of the sample according to the 22 municipal districts of Tehran is incorporated in the sampling process. Proportional to the number of households in the 22 districts, the appropriate number of clusters is weighted according to each district. For each cluster, a team of three members approaches the index household, which is specified through the aforementioned random selection of clusters, and continues the enumeration in 10 neighbor households in a systematic manner. As a study protocol, there are no specific results to present; our purpose is to share our design with the scientific body. We expect that findings from the BOLD study in Tehran will show the status of COPD and its causes in the community

Primary experience of telemedicine at shahid beheshti university of medical sciences

Telemedicine plays an important role in providing medical services over long distances, particularly in developing countries. For better management and planning, periodic assessment of this system seems necessary. This study was aimed to evaluate the first phase of teleconsultation project so as to use the findings for addressing the current practical problems and improving the system for future projects. After installing the equipment in Imam Khomeini Hospital of Firuzkuh and Zaeem Hospital of Pakdasht as the remote sites, teleconsultation project was started and patients at these hospitals requiring specialist opinion were enrolled in the study and consultation via teleconference by specialists at Masih Daneshvari Hospital as the central site was performed for them. A total of 22 patients [13 male] with mean age of 54.13 years [14 in Imam Khomeini Hospital] entered the study. Pulmonary medicine was the most frequently requested consultation [36.4%], followed by cardiology [27.3%]. Teleconsultation was resulted in recovery and discharge of 8 patients, yet 4 patients required emergency referral to a more equipped hospital. This study demonstrated that inadequate knowledge and unacceptability of telemedicine among physicians and medical staff and unavailability of necessary instrumentation in remote centers, and also lack of all the required specialties in central site, were setbacks in the uptake of teleconsultation system. Therefore, future projects should be conducted with enough funding and using the experience of this study to improve the quality and quantity of the consultations in order to perform a more meticulous assessment

Cigarette smoking, knowledge, attitude and prediction of smoking between male students, teachers and clergymen in Tehran, Iran, 2009

Students, clergymen and teachers as role models can be very important in encouragement or prevention of cigarette smoking in young people. The aim of this study was to compare prevalence of smoking in 3 male groups of teachers, clergymen and university students. Also, study their knowledge and attitude towards it and the prediction of their future consumption. In a cross sectional study in 2009 in Tehran, Iran, 1,271 male students, 549 clergymen and 551 teachers were randomly enrolled. Each participant completed the global adult tobacco survey questionnaire. Knowledge, attitude and prediction of smoking for the next 5 years were questioned in these 3 groups. Chi-squared test and logistic regression were used for analysis. P < 0.05 was considered significant. Prevalence of cigarette smoking was 31.1%, 21.9% and 27.2% among students, clergymen and teachers, respectively. Smoking in students was not associated with poor knowledge but were in teachers and clergymen. The odds ratio of smoking in students, clergymen and teachers was higher among those with having inappropriate attitude towards it [OR = 1.6, 6.1 and 4.5]. Those with poor knowledge had an inappropriate attitude and predicted higher chance of cigarette consumption in the next 5 years [P < 0.0001]. Inappropriate attitude in all 3 groups resulted in higher prediction of future smoking [P = 0.008]. This study revealed that the prevalence of smoking among male students and teachers was higher than general population and clergymen who equally smoked. Also, level of knowledge and attitude of students were lower than teachers and clergymen

Multidrug-resistant tubercular appendicitis: report of a case

Acute tubercular appendicitis has remained a rare disease despite frequent cases of tuberculosis. The following study reports a patient with multidrug-resistant [MDR] pulmonary tuberculosis that developed acute appendicitis. Histopathology of the appendix was compatible with tuberculosis. The patient had a good outcome after surgery and medical therapy

Global warming: knowledge and views of Iranian students

Study of students' knowledge about global warming can help authorities to have better imagination of this critical environmental problem. This research examines high school students' ideas about greenhouse effect and the results may be useful for the respective authorities to improve cultural and educational aspects of next generation. In this cross-sectional study, a 42 question questionnaire with mix of open and closed questions was used to evaluate high school students' view about the mechanism, consequences, causes and cures of global warming. To assess students' knowledge, cognitive score was also calculated. 1035 students were randomly selected from 19 educational districts of Tehran. Sampling method was multi stage. Only 5.1% of the students could explain greenhouse effect correctly and completely. 88.8% and 71.2% respectively believed "if the greenhouse effect gets bigger the Earth will get hotter" and "incidence of more skin cancers is a consequence of global warming". 69.6% and 68.8% respectively thought "the greenhouse effect is made worse by too much carbon dioxide" and "presence of ozone holes is a cause of greenhouse effect". 68.4% believed "not using cars so much is a cure for global warming". While a student's 'cognitive score' could range from -36 to +36, Students' mean cognitive score was equal to +1.64. Mean cognitive score of male students and grade 2 and 3 students was respectively higher than female ones [P<0.01] and grade 1 students [P<0.001] but there was no statistically significant difference between students of different regions [P>0.05]. In general, students' knowledge about global warming was not acceptable and there were some misconceptions in the students' mind, such as supposing ozone holes as a cause and more skin cancer as a consequence of global warming. The Findings of this survey indicate that, this important stratum of society have been received no sufficient and efficient education and sensitization on this matter

Air pollution: the knowledge and ideas of students in Tehran-Iran, and a comparison with other countries

Study of students' knowledge about air pollution can help authorities to have better imagination of this critical environmental problem. This research examines guidance school and high school students' ideas about air pollution and the results may be useful for the respective authorities to improve cultural and educational aspects of next generation. In this cross-sectional study, a closed questionnaire was used to examine knowledge and ideas of 2140 randomly selected school students of Tehran-Iran about composition of unpolluted air, air pollution and its causes and consequences. Cognitive scores were also calculated. Outcomes were compared with results of similar researches in Australia, Hong Kong and the United Kingdom. While a student's 'cognitive score' could range from -16 to +16, Iranian students' mean cognitive score was equal to +2.97. There was not significant statistical difference between girls and boys [P=0.32]. In response to question "most common gas in unpolluted air" nitrogen was mentioned by only 23.7%, While 45.1% of students mentioned oxygen. In general, student's knowledge was not acceptable and there were some misconceptions such as "supposing oxygen as the most prevalent gas in unpolluted air". The findings of this survey indicate that, this important stratum of society of Iran have been received no sufficient and efficient education and sensitization on this matter

Efficacy of harm reduction programs among patients of a smoking cessation clinic in Tehran, Iran

Background: Recently, harm reduction programs have been used to reduce mortality and morbidity among smokers. The main objective of this study was to evaluate the effect of harm reduction programs on the smoking patterns of subjects who presented to a smoking cessa-tion clinic in Tehran, Iran

Methods: This observational study was conducted between September 2008-September 2009 on 132 patients who were unable to quit smoking. Patients were enrolled by the first come first service method. During the study period, subjects were assigned to either group or individual visits every 15 days in conjunction with the use of nicotine gum. The main objective of this study was to evaluate at the third and sixth months of follow-up: the number of smoked cigarettes, level of expired carbon monoxide [CO], and numbers of nicotine gum used. Data were analyzed by the Wilcoxon rank, Fisher's exact, and Pearson's chi-square tests and SPSS version 17 software

Results: A total of 87.1% of the subjects were males. We noted decreases in the number of cigarettes smoked daily and the level of expired CO, whereas the amount of nicotine gum used significantly increased during the time interval between the first session and the third and sixth month follow-up visits [p<0.001 for all variables]. During the follow up sessions, 64.4% of subjects reduced the number of cigarettes they smoked daily by at least 50% and 12.9% of subjects quit smoking

Conclusion: Behavioral and pharmacological therapy in harm reduction programs result in a decrease in the number of cigarettes smoked daily and a reduction in the amount of expired CO. Therefore, these methods can be beneficial in achieving complete smoking cessation

Pattern of smoking and nicotine dependence in patients with psychiatric disorders

Smoking prevalence is high among psychiatric patients. This study aimed to evaluate the prevalence of smoking, related factors and nicotine dependence in patients suffering from psychiatric disorders. This analytical descriptive study was performed on patients who had been hospitalized for at least 2 days in Razi Hospital during 2010. Data were collected via an interview and the obtained information was recorded in a questionnaire. Fagerstrom test was also used. After determining the prevalence of smoking in these patients, the related factors and nicotine dependence were also evaluated using multiple logistic regression test and SPSS software. A total of 78.4% of men and 36.2% of women in this study were smokers and 64.4% had high nicotine dependence. Final logistic regression models showed that smoking was related with advanced age, male sexuality, hookah consumption, and depression. High nicotine dependence was correlated with hookah consumption and history of suicide attempt. Prevalence of smoking is higher among psychiatric patients compared to the public. Adequate intervention and strategies are necessary in these patients to promote smoking cessation

Balloon bronchoplasty: case series

Central airway stenosis may be a manifestation of benign or malignant lesions and can be a life threatening condition. There are different surgical and endoscopic modalities for treatment of these lesions. Balloon bronchoscopy is an interventional pulmonologic modality and can be performed under direct vision or fluoroscopic guidance. This technique can be used along with other interventional modalities for treatment of patients with tracheal stenosis. In this study we report balloon bronchoscopy as an interventional modality in a series of patients with tracheal stenosis and assess the outcome

Psychological problems and cigarette smoking in Tehran university students in 2010

The present study aimed at comparing psychological problems between smoker and non-smoker students and also males and females. A total of 22 faculty members of public and private universities in Tehran were selected through random sampling and 913 students from the same universities were selected through convenient sampling and enrolled in this study with a 2-step sampling method. Hopkins Symptom Checklist was used for data collection. Significant differences were detected between smoker and non-smoker students in Hopkins score, depression, anxiety and somatization. In addition, smoker women gained higher Hopkins scores, somatization, anxiety and interpersonal sensitivity scores compared to smoker males. Incidence of signs and symptoms of depression, anxiety and other psychological disorders was higher among smoker individuals. Therefore, smoking control strategies should further focus on this subject

Rapid detection of isoniazid resistance in mycobacterium tuberculosis by a single multiplex allele-specific polymerase chain reaction assay

Global surveillance has shown that drug resistant [DR] tuberculosis [TB] is widespread. Prompt detection of Mycobacterium tuberculosis drug resistance is essential for effective control of TB. The most frequent mutations associated with Isoniazid [INH] resistance in Mycobacterium are substitutions at codons 315 in the katG gene and the mabA-inhA promoter region [15]. This survey evaluated INH resistant-associated mutations in order to determine rapid detection of TB resistance. Through a descriptive cross-sectional study total of 96 sputum specimens were digested, examined microscopically for acid-fast bacilli and inoculated into L wenstein-Jensen slants. Thereafter, the susceptibility and identification tests were performed on culture positive specimens. Subsequently, the strains were subjected to multiplex allele-specific polymerase chain reaction [MAS-PCR] targeting in the codons 315 in the katG gene and the mabA-inhA promoter region. Distinct PCR banding patterns were observed for different mutation profiles. Drug susceptibility testing revealed that out of 96 available isolates, 30 [31.3%] were susceptible, 36 [37.5%] had multi-drug resistance [MDR-TB] and 30 [31.3%] showed mono-drug resistance. In comparison with the culture-based phenotypic drug susceptibility test, the sensitivity and specificity of MAS-PCR assay for drug resistance-related genetic mutations were 76.7% and 71.4%, respectively. The correlation between MAS-PCR and culture-based phenotypic drug susceptibility testing findings was 99. 4%. The profile of the isolates suggests a significant number of different DR strains with a high frequency of mutations at codon 315 of the katG gene. MAS-PCR provides a rapid, simple and cost-effective method for detecting MDR-TB

First insight into the drug resistance pattern of mycobacterium tuberculosis in Dohuk, Iraq: using spoligotyping and MIRU-VNTR to characterize multidrug resistant strains

The objectives of this study were to determine drug resistance pattern in new and previously treated tuberculosis [TB] patients, to assess function of TB control program, and to characterize multidrug resistant TB [MDR-TB] by molecular fingerprinting methods. Anti-micorbial susceptibility testing [AST] to the first line anti-TB drugs was performed on L?wenstein-Jensen [middlebrook 7H10] medium according to the proportion method. Molecular fingerprinting of all MDR strains was performed by spoligotyping and MIRU-VNTR. Mycobacterium tuberculosis strains were isolated from 53 Iraqi patients with pulmonary TB. Thirty eight patients [71.7%] tested cases, and 15 [28.3%] were previously treated. Four of the 38 new cases [10.5%] had resistant, of which 3 [7.9%] were MDR. Eight [53.3%] of the 15 previously treated patients had resistant strains, of which 7 [46.7%] were MDR. Spoligotyping of MDR strains showed CAS family [40%] as the predominant genotype. Using MIRU-VNTR typing, all isolates had a unique profile. MDR-TB prevalence is higher among previously treated patients than among the new cases. The many drug resistant strains, in absence of evidence of recent transmission and in combination with the many previously treated cases, highlight the need for an improved control program, coupled with a need to improve detection rate and early diagnosis of MDR-TB

effects of demographic factors and cigarette smoking status on drug treatment success rate in outpatient treatment and rehabilitation centers

This was an analytical historical cohort study based on an existing data base study conducted in different areas of Tehran. The present study determined the effect of demographic factors and cigarette smoking status on success rate of addiction treatment in outpatient treatment and rehabilitation clinics for substance abusers. We accomplished our study in outpatient clinics authorized by the "welfare organization," which included three governmental treatment centers and private centers among those located in 22 regions of Tehran. Data were collected using a checklist, which contained demographic characteristics, personal information and information about prevention, treatment and follow-up records of 1372 patients. Factors associated with addiction treatment success rate were reviewed using multiple logistic regression tests. Our study showed that addiction treatment was successful in only 258 cases [18.8%]. The final multiple regression model showed that single and married patients were 2.18 times [P=0.033] and 2.70 times more successful in quitting than divorced, or separated cases [P=0.005]. In addition, patients who lived in rental or mortgaged houses were 1.43 times more successful than homeowners [P=0.036]. More than 90% of participants in this study were daily smokers at the time of the study. Patients who did not have a history of smoking were 1.69 times more successful than ex-smokers [P=0.007]. Based on our study results only a few people were successful in addiction treatment; marital status, type of housing, residential status and smoking status were the most important factors associated with the outcome of addiction treatment