[Effective determinants in household out of packet payments in health system of Iran, using two part regression model]

Introduction: Major part of health expenditure is paid directly by households in most of developing countries. This catastrophic expenditure is entailed on families. Assessing important determinants of Out Of Pocket Payment [OOP] is one of the key issues in health care finance

Methods: This study uses Iranian household income expenditure in 2005-2010 annually provided by statistical center of Iran using a two part model for assessing these factors. This was a cross sectional analytical study in which sampling was based on a multi-stage method. The sample size changed from 26882 to 38260 households

Result: The results showed that out of Pocket payments up to 74% increased during this period. High income households paid 2.5 times more than low income groups while probability of utilization for them was 17% more. Confidence of insurance indicates insurance systems succeeded in reducing only 15% of household insure expenditure whereas the probability of using health services increased only by 2%. Social demographic variables such as the number of the elderly, household size and urbanization increased OOP by 20%, 23% and 54%, respectively

Conclusion: During the study period, there was substantial inequality among different income groups. As if better off households had a higher chance of paying and using health care services. Moreover, the elderly, household dimension, urbanization and not having insurance coverage are the most important factors responsible for OOP. To reduce inequality, policy makers must provide the conditions to increase the role of social insurance in health finance and to make the services less expensive for the elderly

Is suicide predictable?

The current study aimed to test the hypothesis: Is suicide predictable? And try to classify the predictive factors in multiple suicide attempts. A cross-sectional study was administered to 223 multiple attempters, women who came to a medical poison centre after a suicide attempt. The participants were young, poor, and single. A Logistic Regression Analiysis was used to classify the predictive factors of suicide. Women who had multiple suicide attempts exhibited a significant tendency to attempt suicide again. They had a history for more than two years of multiple suicide attempts, from three to as many as 18 times, plus mental illnesses such as depression and substance abuse. They also had a positive history of mental illnesses. Results indicate that contributing factors for another suicide attempt include previous suicide attempts, mental illness [depression], or a positive history of mental illnesses in the family affecting them at a young age, and substance abuse

Cheap and easy modification of glassy carbon electrode for voltammetric determination of dopamine in the presence of ascorbic acid

Different methods have been proposed to modify glassy carbon electrode in order to determine dopamine [DA], as one of the most important neurotransmitters in central nervous systems of mammalian. These methods are time comsuming and in some cases expensive. In this work, a very simple and cheap pretreatment method is developed for the bare glassy carbon electrode [GCE] to determine DA in the presence of Ascorbic acid [AA]. Cyclic voltammetry as an electrochemical activation procedure was used for activation of glassy carbon electrode in order to separate diffrential pulse peaks of DA and AA. The effect of different parameters such as pH for supporting electrolyte, range of potential and the number of cycles were investigated. Finally, differential pulse voltammetry was used to determine DA in the presence of AA. On the activated electrode under optimum condition, anodic peak of AA shifted to negative potentials and peak current decreased, but the peak current of DA increased. The peak current was linearly proportional to the bulk concentration of DA in the range of 6.5x10-7-1.8x10-5 mol l-1. The limit of detection was 6.2x10-7 mol l-1. A simple and cheap method was developed for the activation of glassy carbon electrode. It was possible to determine DA in the presence of AA on the treated electrode. The proposed method was used to determine DA in pharmacutical samples

[Evaluating the validity of chest x-ray in diagnosis of congenital heart diseases and acquired valvular heart diseases]

One of the important diseases in the population is heart disease. Congenital heart disease complicated approximately one percent of all live births. Acute rheumatic fever involve the heart which can be fatal during the acute stage or lead to rheumatic heart disease, a chronic condition due to scarring and deformity of the heart valves. In this research have been investigated about the value of chest-X-Ray in 74 patient in the diagnosis of heart disease in patients of Modarres hospital during year of 1379 and decrypted radiographic appearances of heart disease through enlargement of cardiac chambers, vascularity of lung and final diagnosis of heart disease. Results of this research may be play a role in the planning for diagnosis of heart diseases and answer to this question that is it any role for CXR PA that is a simple and routine investigation for patients. The sensitivity and specificity of conventional radiology in the diagnosis of left to right shunt is 96.15 and 90.47 percent respectively and positively and negative predictive value is 86.2 and 97.43 percent respectively. In left a trial enlargement was 96.96 and 82.35 percent respectively and positive and negative predictive value is 84.2 and 96.55 percent respectively. In left ventricular enlargement was 73.3 and 82.5 percent respectively and positive and negative predictive value is 75.86 and85.5 percent respectively. In right a trial enlargement was 53.3 and 100 percent respectively and positively and positive and negative predictive value is-100 and 8735 percent respectively. In right ventricular enlargement is 86.95 and 72.72 percent respectively and positive and negative. The final diagnosis of heart predictive value is 89.95 and 72.72 percent respectively. Disease with conventional radiology consists of: 28.37 percent true definite diagnosis, 58.1 percent true differential diagnosis and 13.5 percent false diagnosis

Common environmental allergenic fungi causing respiratory allergy in North of Iran

The aim of this study was to isolate and identify airborne fungi from locations in Babol city, Babolkenar forest and a beach on the Caspian Sea [all in North part of Iran] in spring and summer. Of 126 samples collected, the most clinically important isolated fungi were Mucor spp. [18.6%] in the forest, Alternaria spp. [13.4%] at the beach; and Cladophialophora spp. [15.8%], Mucor spp. [11.7%] and Alternaria spp. [10.6%] in the urban areas. Non-sporulating fungal isolates were grouped in Mycelia sterilia. The concentration of air spora in the forest location was significantly greater than the other locations [p<0.05]. In this study, the highest quantities of isolated fungi were found in the summer. The results showed that Alternaria spp., Clodophialophora spp. and Mucor spp. were the most predominant fungi isolated in the different locations. Since some allergenic fungi have been shown to play a role in the appearance of clinical signs in allergic conditions, the results of this study can be used by physicians and veterinarians for the diagnosis and treatment of allergies

Mycological and histopathological findings of experimental disseminated candidiasis in dogs

Disseminated candidiasis is an opportunistic infection in immunosuppressed animals by Candida species. The purposes of this study were to determine the predominant candidal forms in different tissues and tissue reactions. Sixteen dogs were selected in this study. The treatment dogs were immunosuppressed by intravenous administration of cyclophosphamide and after 5 days, they were challenged with 1 _ 10[5] blastospores of C. albicans by intravenous injection. Both mycological and histopathological examinations were performed for detection of Candida in various tissues. The results showed that the highest counts of C. albicans were recovered from the lungs, followed by the kidneys, heart and liver on day 2 after challenge. The presence of yeast mixed with hyphal forms of C. albicans was confirmed in all tissues. In most tissues, the yeast cells of Candida were predominant, whereas hyphal forms, particularly true hyphae, were mostly found in the brain and eyes

Comparison of brain SPECT with 99mTc-MIBI and CT-Scan in discriminating of radiation necrosis and brain tumor recurrence

99mTc-MIBI has been proposed for use as an imaging agent for various tumors, including breast cancer, lung cancer, lymphomas, melanomas and brain neoplastic lesions. Brain tumors are very common and radiotherapy being major part of treatment following surgery. After radiotherapy, deteriorating clinical status can be due to either radiation necrosis or recurrent tumor. Computed tomography and magnetic resonance imaging offer imperfect discrimination of radiation necrosis and tumor recurrence. In this study, 26 patients with primary brain tumors and deterioration of clinical status after radiotherapy were evaluated. 99mTc-MIBI brain SPECT was performed 10 minutes and 3 hours after IV injection of 20 mCi 99mTc-MIBI. The images were obtained with ADAC dual head camera. Transverse, coronal and sagital views were reconstructed. Focal 99mTc-MIBI uptake was observed in 14 patients. Eight of these patients expired within 6 months. The CT scan was positive in 7 patients and the rest had equivocal or negative results. Of 12 patients with negative 99mTc-MIBI scan, only 2 patients died during the 6 months follow up. Six of these patients had positive, five had equivocal and one had negative CT scan. Patients with negative MIBI scan, radiation revealed higher survival rate. Focal uptake on 99mTc-MIBI scan is probably due to recurrent tumor, with lower 6 months survival rate. It can be concluded that brain SPECT scan with 99mTc-MIBI is a useful method for discriminating radiation necrosis from tumor recurrence in patients following brain radiotherapy