Demographic characteristics and prognostic factors in pediatric-type sarcomas; A 7 year single institutional experience and comprehensive review of the current literature

Background: due to limited clinical data in pediatric-type sarcomas [rhabdomyosarcoma, Ewing's sarcoma, PNET, and desmoplastic small round-cell tumor], the aim of this study was to evaluate the demographic characteristics and identifying prognostic factors for survival

Materials and Methods: we retrospectively reviewed 110 patients with pediatric-type sarcomas. Overall and disease free survival was analyzed with the Kaplan-Meier method and log rank test. To identify prognostic factors for overall and disease free survival, multivariate survival analyses using a Cox's proportional-hazard regression model was performed

Results: in this study mean age of patients were 20.30 years [SD=13.61; range, 1-83 years]. The survival data of 54 patients [49.1%] were obtained with median survival of 27 months. 3 and 5-year survival rate of these patients were 41.5% and 28.3% respectively. Recurrence of disease [P=0.006] and Ewing sarcoma subtype [P=0.018] were significantly associated with poor overall survival and location of the lesion in the upper extremities [P=0.007] and trunk [P=0.005] were significantly associated with a lower disease free survival

Conclusion: with multivariate analysis, the authors determined that recurrence of disease and Ewing's sarcoma subtype are poor prognostic factors for overall survival and site of origin for disease free survival among patients with pediatric-type sarcoma. In addition, gender, patient's age, and size of tumor had no significant impact on overall and disease free survival

Predictive factors of death in patients with tuberculosis: a nested case-control study

Tuberculosis is one of the main causes of death worldwide. This study aimed to determine predictive factors for death in patients with tuberculosis to set priorities for public heath interventions to reduce mortality in these patients. This nested case-control study was carried out in Mazandaran province of Islamic Republic of Iran among tuberculosis patients who were treated during 2002-2009. Each deceased patient was individually matched with a control patient according to sex, age, area of involvement and time of follow-up. Potential risk factors for death were evaluated using multivariate conditional logistic regression models. From 2206 patients 376 cases and 376 matched controls were selected. Only positive serology for HIV [OR = 19.1], history of kidney disease [OR = 6.81] and use of immunosuppressant drugs [OR = 3.96] significantly increased the risk of death in tuberculosis patients. These potentially modifiable risk factors could be taken into account in preventive interventions for tuberculosis patients in our country

[Epidemiological pattern of extra-pulmonary tuberculosis in Mazandaran Province, Iran [2001-11]]

Due to the increase of incidence of extrapulmonary tuberculosis in Iran, This study was conducted to determine the epidemiological pattern of extrapulmonary tuberculosis in the Mazandaran province, northern Iran. This descriptive-analytic study was carried out on medical record of 3313 tuberculosis patients in Mazandaran province, northern Iran during 2001-11. Age, gender, affected year, area and affected organ were gathered for each patient. 843 [25.4%] of subjects were diagnosed with extrapulmonary tuberculosis. The incidence of extrapulmonary tuberculosis increased by 4% for every unit increase in incidence year [P<0.05]. The mean age of patients with extrapulmonary tuberculosis was significantly less than patients with pulmonary tuberculosis [42.8 +/- 20.6 years vs. 48.7 +/- 21.2, P<0.05]. Extrapulmonary tuberculosis was significantly higher in women [P<0.05]. The chance of extrapulmonary tuberculosis in women was 1.7 times of men. Lymph node [33%] was the most common affected organ followed by pleura [18.9%] and bone [17.7%]. The trend of incidence of extrapulmonary tuberculosis was ascending during 2001 to 2011. The most affected organ in extra pulmonary tuberculosis was lymph nodes

[ rate of safety belt use and its associated factors in 15 to 44-years old of Kerman in 2012]

More than 50% of road fatalities occur in the 15 to 44-years old which are the young and active group of the society. One of the effective ways to reduce road accidents is using safety belts. In this study the rate of seat belt use and its associated factors have been estimated in the 15 to 44-years old of Kerman. This study was a cross-sectional descriptive and analytical study performed in 2012 and on 506, 15 to 44 years old people visiting the pre-marriage consulting center in Kerman. Sampling was done by convenient sampling. Data was analyzed by SPSS 16 and by using logistic regression. The rate of seat belt use was estimated to be% 54.4. People who owned private vehicles used safety belts more than non-owners [P <0.001]. Participants claimed that their own safety and preventing injury was the most important reason [59.1%] for using safety belts and forgetting due to mind occupation [33%] were the most important reasons for not using safety belts. Despite the high incidence of road accidents in Iran and despite years passed the first compulsory safety belt regulation, the rate of safety belt use among the society andespecially the youth [which are a high percent of the population] is still lower than other countries. These results emphasize the importance of implementing initiatives in this regard.

[Evaluation of illumination intensity and ultraviolet radiation at Kerman Medical University Libraries]

Adequate lighting in work environments can increase productivity and concentration and reduced fatigue. Light and illumination studies have been done mainly in industrial environments, and public or administrative environments were less under consideration. The aim of this study was to evaluate the ultraviolet radiation and illumination level at Kerman Medical Sciences University libraries. In this study, the total, natural and artificial amount of illumination was measured at two different times, at the center of the designated stations in 14 study halls and the height of 30 inches by Hagner [Model EC[1]] luxmeter. Also, ultraviolet radiation [UVB and UVA] was measured by Hanger [Model S4] equipped with UVB and UVA detectors. The results of ultraviolet radiation and illumination level measurements were compared with standard by Excel. The overall, natural and artificial illumination level, in 28.57%, 100% and 71.42% study halls was less than the National and IESNA standard [300 lux]. The School of Nursing has the highest amount of UVB and UVA radiation in both total and natural light measurements. The Shahid Bahonar Hospital, men's section had the highest amount of UVB and UVA radiation in artificial light measurements. Initiatives such as proper alignment of bulbs, periodic dusting and cleaning, regular replacing of burnt bulbs, using study desks with the appropriate level of brightness, placing lamps at appropriate heights, and using bulbs with less UV radiation can improve the lighting situation in libraries

shortcomings of the first series of long distance MPH education at Kerman University of Medical Sciences, from the academics viewpoint

The first series of long distant MPH [Master of Public Health] education in Iran started at Kerman University of Medical sciences by enrolling 30 students from February 2008. It seemed necessary to document the experience of this program, in order to use the results for tailoring and establishing similar long distance programs in other medical fields and universities. This study was a descriptive phenomenology qualitative study. All academics involved in the long distance education program were interviewed. Open and semi-structured questions were asked. The collected data was then coded and categorized to enable further analysis by using theme analysis. The final text was given to two participants for reading and commenting on the validity. Two main themes emerged from the data. The first was the concern of most of the academics about the quality of education; for example the academics thought the student have not learned as well as the face to face education students, their questions remain unanswered, problem solving is difficult and they procrastinate their reading material. The second theme was the problems of the academics themselves, such as the difficulty of teaching of the comprehensive and practical materials, the fact that preparing materials and communication through telephone and email is more time consuming and lack of a face-to-face contact hinders academics from getting instant feedback from their students. They also thought that academics should have been trained and that the infrastructure of long distance education, such as video-conferencing should have been established in advanced. Long distant education is still taking its first steps in Iran and in order to establish successful courses, appropriate planning is essential. Preparing the proper infra-structure, proper familiarization for students and academics before launching the course and continuous research and education-quality evaluation seems necessary

[Knowledge, attitude and application of evidence based medicine [EBM] among residents of Kerman medical sciences university]

Today evidence-based medicine [EBM] has been accepted as a new and reliable paradigm in medical sciences and considered to improve the quality of medical practice. The objective of this study was to assess the knowledge and attitudes of Kerman Medical University [KMU] residents about EBM and the rate of its application. This cross sectional study was conducted in November 2009. A valid and reliable questionnaire was completed by residents at KUM. Ninety four residents participated in the study in which 55.3% were male, the mean age was 32.7 years and the mean time from graduation as a General Physician was 5.6 years, 83.3% of respondents thought that EBM was beneficial in patient care but only 5.3% of them claimed they use EBM in more than half of their clinical work and 88.3% of the participants expressed interest in learning EBM. The information source for clinical decision making in 59.6% of the residents was the text book, 41.4% clinical judgment combined with text books and only 19.2% articles. The residents of KMU have limited knowledge about EBM and it is a necessity to schedule EBM education programs to increase the resident's knowledge and application

[Survey of noise exposure and permanent hearing loss among Shadris spinning factory workers of Yazd using Task Base Method [TBM]]

During last decades one the hazardous agents on workers health has been workplace noise. The aim of this study was to investigate the level of noise exposure in different jobs and noise induced permanent threshold shift in relation to noise level and work experience. This is a cross-sectional and descriptive study that performed among total workers. Dosimetry was done for determination of accurate noise exposure level during an eight-hour s shift for each job group. Audiometry was performed in a standard acoustic room by the audiologist. The obtained data was analyzed by means of SPSS software. Mean of age was 36.58 +/- 6.76 [19-52 years] and minimum, maximum and mean of work experience were 1, 18, 11.08 +/- 5.47 respectively. Mean of hearing loss was 15.38 +/- 8.63 in right ear and 16.31 +/- 9.51 in left ear and total hearing loss was 14.72 +/- 8.33. A significant relationship was also identified between noise intensity and work experience with hearing loss. Findings of this study indicated that there is a high prevalence of noise pollution in different parts of workplace. Considering the obtained results, that shows positive effect of noise and work experience on hearing loss, the necessity of improvement of control and protection measures is of prime importance