Prevalence of and risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries: systematic review and meta-analysis

Abstract Tuberculosis, in particular drug-resistant tuberculosis, is of global concern due to the high mortality and morbidity associated with it annually. The aim of this study was to determine the prevalence of and the risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries. Four databases (PubMed, BioMed Central, EMBASE, and Web of Science) were searched using key terms. Nineteen eligible articles were identified, of which 12 and seven were used for quantitative and qualitative analysis, respectively. The overall pooled estimate of the prevalence of multidrug-resistant tuberculosis, including both new and previously treated tuberculosis cases, in Iran, Iraq, Turkey and Pakistan was 16% (95% confidence interval [CI] 11-20). The patients with a previous tuberculosis treatment history (odds ratio [OR] = 6.45; 95% CI 5.12-7.79), those aged <45 years (OR = 1.57; 95% CI 1.12-2.03), and those who were males (OR = 1.83; 95% CI 1.19-2.48) had an increased pool risk of developing multidrug-resistant tuberculosis. The forest plot revealed that the pooled odds for the development of multidrug- resistant tuberculosis were 2.01 (95% CI 1.65-2.36). Poor adherence to treatment was one of the predictors of unsuccessful treatment outcomes. Multidrug-resistant tuberculosis is a great concern for public health programs in many countries globally, including those included in this review. The risk factors for the development of multidrug-resistant tuberculosis, specifically a previous tuberculosis treatment history, should be targeted through the implementation of specialized interventions.

Patient tracking in earthquake emergency response in Iran: A qualitative study / 世界急诊医学杂志（英文）

@#BACKGROUND:After a disaster, all victims have to be rapidly and accurately identified for locating, tracking and regulating them. The purpose of this study was to summarize people's experiences that how the patients were tracked in past earthquake disasters in Iran. METHODS:A qualitative study was carried out in 2015. This was an interview-based qualitative study using content analysis. The interviewed people included physicians, nurses, emergency medical technicians, disaster managers, Red Crescent Society' first responders and managers. Participants were identified using a snow ball sampling method. Interviews were audiotaped, transcribed, coded, and entered into MAXQDA (version 10) for coding and content analysis. RESULTS:Three main themes and seven categories including content (recoding data), function (identification of victims, identification of the deceased, informing the patients' relatives, patients' evacuation and transfer, and statistical reporting), technology (the state of using technology) were identified that showed the patient tracking status in past earthquakes in Iran. CONCLUSION:Participants believed that to identify and register the data related to patients or the dead, no consistent action plan was available. So developing a consistent patient tracking system could overcome this issue and improve patient safety.

[ comparative study of the athlete health records' minimum data set in selected countries and presenting a model for Iran]

The quality of health record depends on the quality of its content and proper documentation. Minimum data set makes a standard method for collecting key data elements that make them easy to understand and enable comparison. The aim of this study was to determine the minimum data set for Iranian athletes' health records. This study is an applied research of a descriptive - comparative type which was carried out in 2013. By using internal and external forms of documentation, a checklist was created that included data elements of athletes health record and was subjected to debate in Delphi method by experts in the field of sports medicine and health information management. From 97 elements which were subjected to discussion, 85 elements by more than 75 percent of the participants [as the main elements] and 12 elements by 50 to 75 percent of the participants [as the proposed elements] were agreed upon. In about 97 elements of the case, there was no significant difference between responses of alumni groups of sport pathology and sports medicine specialists with medical record, medical informatics and information management professionals. Minimum data set of Iranian athletes' health record with four information categories including demographic information, health history, assessment and treatment plan was presented. The proposed model is available for manual and electronic medical records

[The study of organizational factors affecting the application of information technology by middle managers in TUMS hospitals]

One of the most important reasons why organizations are distinguished from each other is the extent to which each applies information technology. Among the most important factors playing a role in the application of information technology are organizational factors such as organizational resources, organizational knowledge, processes, management structure, values and goals, all these elements affect the level of information technology acceptance and application. Therefore, this study aims to determine the degree to which the abovementioned elements can affect the application of information technology by middle managers of Tehran University of Medical Sciences [TUMS] teaching hospitals. This is a cross-sectional, descriptive-analytic study conducted in 2010. The subjects comprised 110 middle managers of TUMS teaching hospitals. The data-collection instrument was a questionnaire structured by the researchers, and its validity and reliability were confirmed prior to the study. The response rate was 80%. The participants consisted of 56 [62.9%] males and 33 [37.1%] females. The findings of the study showed that there was a statistically significant relationship between organizational resources, organizational knowledge, processes, management structure, values and goals on the one hand and the application of information technology in TUMS hospitals on the other [p<0.01]. The results show that organizational factors have a considerable impact on the application of information technology. Besides, managers and experts should consider the important aspects and effects of these organizational factors

[ systematic review of decision support systems: effects on health care]

Decision support systems[DSSs] refer to one of the types of information technology applications that can help clinicians to make right and timely decisions about patients. The aim of this study is to learn more about DSSs and their applications and effects on health care. In this systematic review, articles which were published between 2000 and 2012, which were available as full texts through databases and search engines - such as PubMED, EBSCO host research, Google scholar and Yahoo - and which were also of clinical-trial type were examined; besides, certain books in this area were used as primary sources. The findings show that DSSs were applied in five areas in health care, which had a significant effect on improving the process of care and the performance of providers. These areas are as follows: disease progress management [15.15%], care and treatment [27.27%], medication [27.27%], evaluation [27.27%], and preventation [12.12%]. In general, improvement can be seen in three areas: quality of care and patient safety, cost effectiveness, and provider's level of knowledge

[Information technology[IT]: a new revolution in urban health development]

Urban health is one of the challenges of the 21st century. Rapid growth and expanding urbanization have implications for health. In this regard, information technology can remove a large number of modern cities' problems. Therefore, the present article aims to study modern information technologies in the development of urban health. This is a review article based on library research and Internet searches on valid websites such as Science Direct, Magiran, Springer and advanced searches in Google. Some 164 domestic and foreign texts were studied on such topics as the application of ICT tools including cell phones and wireless tools, GIS, and RFID in the field of urban health in 2011. Finally, 30 sources were used. Information and communication technologies play an important role in improving people's health and enhancing the quality of their lives. Effective utilization of information and communication technologies requires the identification of opportunities and constraints, and the formulation of appropriate planning principles with regard to social and economic factors together with preparing the technological, communication and telecommunications, legal and administrative infrastructures

[Study of teleotolaryngology in ENT diseases]

With the increasing spread of technology, the use of telemedicine to treat diseases is increasing. Diseases of the ear, throat and nose, are among the most common illnesses, especially among children, which can be diagnosed and treated through tele-otolaryngology. This comparative study is conducted in the United Stated, Australia and England. The information needed for the present study was collected from print sources such as texts, journals, and articles found in such databases as Medline, Embase, CINAHL, Web of knowledge, Google Scholar, and Scopus. To this end, certain key words like Telemedicine, Telehealthotolaryngology, ENT, ear diseases, otology and Teleconsultation were used. The most common way to send information is through the standard otoscopy, video-otoscopy and videoconferencing equipment [Audio- Video Receiver]. The information needed for Telehealthotolaryngology includes demographic information [patient's name, identification number, date of receiving services] together with the data related to the diagnosis and treatment of the disease [disease history, radiology and scan results, eardrum images, laboratory results and previous consultation results]. For telehealthotolaryngology, suitable equipment is required to transmit audio-visual data properly so that ENT specialists and audiologists can benefit from it in their examination and treatment. The application of this method can help patients to economize on their treatment expenses and to follow their treatment in a better way

[Study of the genetic disorders of couples attending genetics clinic, Imam Khomeini hospital complex during 1995 to 2004]

Background and Aim: These days with the improvements in science and technology the number of individuals who suffer from genetic disorders should be drastically less. A crucial method for preventing these disorders, in the first place, is by genetic counseling. Educating the public in regards to how they can avoid producing affected children

Materials and Methods: In this retrospective cross-sectional study, all the files of the couples attending Genetics Clinic of the Imam Khomeini Hospital Complex, during 1995 to 2004 were studied. The data were collected using a reliable questionnaire and SPSS software was applied for data analysis

Results: The most important variable in this study was the relationship between the couples. The most frequent among the consanguineous marriages was the cross first cousins [45.3%], and the least frequency belonged to non-related marriages [6.4%]. The most frequent genetic diseases belonged to children who their parents were parallel first cousins [84.8%]

Conclusion: Due to the importance of genetic counseling in relation to reducing the frequency of the genetic disorders in society, educating the general public about compulsory genetic counseling before marriage, is the cheapest and the most effective approach in limiting the number of patients with genetic abnormalities

[ amount and causes deductions of bills in Tehran university of medical sciences hospitals]

Annually, large amounts of fees that paid by hospitals will not be reimbursed as deductions by health insurances and takes irreparable financial losses to hospitals. The purpose of this study was to determine the amount of deductions imposed on hospital bills of Tehran University of Medical Sciences and their causes related to documentation. The present research was a cross-sectional and descriptive study performed in year 2009 on educational hospitals of Tehran University of Medical Sciences. All deductions reports related to Medical Services and Social Insurance related to year 2008 was collected from Income Unit of hospitals. The amount of deduction of each hospital was extracted and organized in the form of comparative tables. Data was analysed by descriptive statistics and Excel application. Then, the amount, type and causes of annually deduction of each hospital was determined. Most deductions imposed on inpatient bills have been related to the tests, appliances, medicine, residency, surgeon commission, and anesthesia and for outpatient bills have been related to visit, tests and medicine which most of them have been created due to documentation deficiencies. Most of deductions are due to unfamiliarity of care staff with documentation requirements of insurance organizations. Therefore it is necessary to use a multi-aspect mechanism including education of documentation principles to staff, supervision on record control in the Medical Record Unit and establishment of a committee by university for related activities