[ relationship between risk factors and primary symptoms of acute coronary syndrome in below and above 65 years old]

Acute coronary syndrome is health threatening and a major cause of mortality among elderly people. Recognizing factors associated with symptoms of acute coronary syndrome are important in the reduction of consequences of delayed diagnosis of symptoms. This study proposes to determine factors associated with early symptoms among elderly people with ACS. In this cross sectional study, data collecting instrument included a checklist of early symptoms of acute coronary syndrome. The early symptoms of 446 patients with diagnosis of ACS were assessed in eight hospitals in Tehran-Iran, 2006. Symptoms were categorized as typical and atypical. Correlation between demographic and risk factors with age group and early symptoms were assessed using the chi-square test. Multivariate logistic regression analyses were conducted to determine factors related to early symptoms acute coronary syndrome. Elderly patients and younger ones showed a statistically significant difference in chest symptoms, arm pain, jaw or neck pain and dyspnea [P<0.001]. Palpitation was the most common reported symptom in patients over 65 years [38.19%] and younger than 65 years [37.08%]. Multivariate logistic regression showed that elderly patients with a history of hypertension [P=0.002, OR=0.43], smoking [P= 0.019, OR=0.51], and obesity [P=0.011, OR=0.69] had less chance to experience the early symptoms compared to younger patients, respectively. Obesity, hypertension and smoking are risk factors which lower the initial symptoms of acute coronary syndrome in the elderly .Nurses and physicians should pay a careful attention to history taking of the elderly suspected to acute coronary syndrome.

Effectiveness of training classes for food-handlers and food operators on improving their knowledge and practice of personal hygiene in the workplace at health training centers in Shiraz, Fars province

Pervious studies have shown that food-handlers personal hygiene plays a major role in food contamination and food poisoning prevention. By law, all food handlers must attend training courses specified for these professions in order to satisfy practical amendment of food, drink, cosmetics and health materials. In this study we evaluated the effect and outcome of a personal hygiene training course offered by health training centers in the city of Shiraz in 2006. In this study 58 subjects were evaluated. The data collection methods were observation and questionnaires. Fifteen questions in the abstraction tool were based upon the practical amendment of food, drink, cosmetics and health materials in Article 13 and related role regulations. Analytical methods of statistical implementation were conducted by SPSS package. Analytical results indicated 96.4% of the subjects were directly involved in food preparation. Results revealed that knowledge of the subjects' personal hygiene was significantly better before and after training session. However, no difference was observed on practice comparing before and after training. Evaluation of the effect and outcome of the personal hygiene training course, offered by health training centers in Shiraz, Fars province, before and after the training session, did not have the desired improvement in personal hygiene during food preparation. Therefore, changes are necessary in practical implementation of personal hygiene and food preparation as well as enforcement of health laws found in Article 13. In addition, training session materials at health training centers need to include more information regarding consequences of diseases caused by poor hygiene and food preparation to improve outcomes and to protect the public from food related diseases