[ study on heat stress and its risk assessment in a steel factory]

A glance at different occupations and production processes showed that one of the important and popular occupational health problems in the workplace is improper climate conditions such as hot environments .In this condition the core body temperature may increase and cause some diseases, occupational accidents and reduction of efficiency. The purpose of this study is determination of heat stress and its risk assessment in a steel factory. In order to survey heat stress, a cross-sectional study was conducted in a steel factory in Ahwaz in the autumn season and WBGT index was used as a standard method for heat stress measurement. After measurement of WBGT index, the results were compared to ACGIH_TLV. In the second stage, for the assessment of probable heat hazard, psychometric conditions of work place along with some other parameters like work load, kind of occupation, distance between workplace and rest areas, water consumption and uses of personal protective devices were taken into account In this area, it was tried to determine the existence of improper probable heat condition with regard to priority and necessity for modifications. After measurement in production process, other workshops and administrative office, the data were compared to ACGIH standards .The results showed that the workplace had acceptable climate conditions from heat stress with 81.1%and there were no acceptable climate conditions with 18.9%which is above TLV. The workplaces heat risk assessment showed that their conditions with 14.3%, 49.3% and 36.4% were in level one to three respectively. Although the fall season in regions such as Khuzestan is cooler than summer, but employment in industries such as steel due to its exothermic process, a threat to the health of these kinds of workers. The heat conservation planning should not only be limited to the summer season. More research in the spring and even winter are recommended.

Comparison of pap smear quality with anatomical spatula method and the common method [spatula- cytobrush]: a single blind clinical trial

Cervical cancer is the third most common cancer in women in the world. Papanicolaou smear is known as a standard test for cervical cancer screening; however, the most important challenge is high rates of false negative results. The aim of this study was to compare the quality of smears obtained by anatomical spatula and spatula-cytobrush. The most important factor in false negative result is inappropriate tool of sampling. One hundred married women participated in this single blind clinical trial. All participants were interviewed; two samples were obtained from every participant: one with spatula-cytobrush and another one with anatomical spatula. All slides were encoded and were assessed by two pathologists. Then, data were analyzed by means of kappa coefficient. Cell adequacy was 96.1% in anatomical spatula method and 91.2% in spatula-cytobrush method [p= 0.016]. The rates for endocervical cells and metaplasia cells in anatomical spatula method were 70.6% and 24.5% respectively and these amounts were 69.6% and 24.5% respectively in the spatula-cytobrush method [p <0.001]. No one reported any pain and the amount of bleeding was 38.2% in both methods [P>0.05]. Regarding infection and inflammatory reactions there was no statistically significant difference between two methods [p>0.05]. Based on our findings in this study, results of sampling with anatomical spatula method were more acceptable and better than those with spatula-cytobrush sampling

Calculation of reproductive number using data from H1N1 patients in Fars province, Southern Iran

Effective reproductive number [Re] is an index which considers the proportion of susceptible people in a community. There are different methods for calculation of basic reproductive number. The aim of this study was to evaluate the reproductive number using data from H1N1 patients in Fars Province, southern Iran. According to the data obtained, 233 cases were confirmed between July 15[th] and December 3[rd], 2009 Two waves were observed during this period with a peak in October 21[st] in Fars Province. In the first wave, the highest amount of Ro was 3.22 and the lowest amount was 2.12 and in the second wave, the highest and lowest amounts of Ro were 3.42 and 2.42, respectively. Effective reproductive number could not be more than 1.54. Thus in order to maintain Ro below 1, using preventive measures like vaccination, only 70% of population should be immune. As 54.9% of Fars population were immune against H1N1 if only 15.1 of them take part in vaccination program, the disease will not reach an epidemic level

[Work schedule-related health problems in petrochemical industries workers]

Shift work is programmed in various schedules, each has its own advantages and disadvantages. The main purposes of this study were: a] to determine common shift schedules used in petrochemical industries, b] to compare shift work health-related problems among employees working in different shift schedules and c] to recommend appropriate shift schedule. This cross-sectional study was carried out at 14 petrochemical companies. Study population consisted of 987 shift workers. Data on demographic features, shift schedule and adverse effects of shift work were collected via anonymous questionnaire. Statistical analyses were performed using SPSS, version 11.5. Among 987 studied shift employees, 27% worked in 3M-3E-3N-3Res, 61% in 4M-4E-4N-4Res and 12% in 12-hour schedules. Health problems such as gastrointestinal, cardiovascular and musculoskeletal disorders among 4M-4E-4N-4Res schedule shift workers were significantly less prevalent than other schedules [P<0.05]. Furthermore, the results showed that the prevalence rates of health problems among 12-hour schedule shift workers were higher than 3M-3E-3N-3Res schedule workers. Since 12-hour schedule caused higher rates of gastrointestinal, cardiovascular and musculoskeletal disorders among shift workers as compared with 4M-4E-4N-4Res and 3M-3E-3N-3Res schedules, it should be avoided in shift system. Based on the results, 8-hour schedules with clockwise rapid rotation are recommended

Effect of pre-operative psycho-educational interventions on anxiety and pain in children undergoing tonsillectomy in Shiraz southern Iran

Excessive anxiety and stress can affect children's physical and psychological health, hinder their ability to cope with surgery, encourage their negative behavior in association with health care, and may also inhibit their post-operative recovery. This study was conducted to determine the effects of pre-operative psycho-educational interventions on post-operative anxiety and pain in children undergoing Day- Case tonsillectomy. A quasi-experimental pre-post test follow up control group design was used for 199 children aged 9 to 12 years old who were admitted for Day-Case tonsillectomy unit, along with their parents during a 12-month period. In a randomized method, 100 children were divided into the experimental group receiving psycho-educational interventions, and 99 children who were assigned to the control group receiving routine information preparation. The anxiety level of children was measured using children Speilberger State Anxiety Inventory [SSAI] and the post-operative pain level of the children was assessed by using the Visual Analogue Scale [VAS]. The children in the experimental group reported lower state anxiety scores in 4-time points of postoperative periods. There was no difference in children's post-operative pain between the two groups. The study provides empirical evidence in support of the effectiveness of using psycho-educational interventions for preparation of children for surgery

Influenza A [H1N1] virus pandemic in Fars Province: a report from southern Iran, July-December 2009

Influenza type A [H1N1] virus is considered as a major concern for health care system all over the world and imposes a considerable burden on the community. The aim of this study was to evaluate the pattern of the disease in order to help health administrators in making decision for preventive measures. 297 definite cases of influenza A [H1N1] diagnosed from 15 July to 3 December 2009 in Fars province, south of Iran, were included in this study. Diagnosis was confirmed performing Real time-PCR. The patients' information including age, gender, occupation, nationality, education, residency area and history of overseas or domestic travel, history of contact with other influenza patients, and symptoms were collected and analyzed. The mean age at the time of diagnosis was 24.4 +/- 15.8 years. 76 [25.6%] patients were admitted in the hospitals, of whom, 11 cases died due to related influenza complications with Case Fatality Ratio [CFR] of 4.4%. The most common reported symptoms were fever, cough and sore throat. There were two waves in the disease incidence, one about 1 month after emergence of the disease and another around 1 month after school openings. The first peak was observed mainly among adults with a history of foreign travel while the second peak was mainly observed among school students. The magnitude of the epidemic was much higher when the disease was transmitted between students at the beginning of the school year. Considering the high incidence of H1N1 flu among the students [41%], vaccination programs and preventive measures should target this age group

[Evaluation the impact of family physician care program on family planning in Sari from 2003 to 2007]

Iranian family physician care program as a new program has begun since 2005 to deliver a better service particularly in primary health care. The objective this survey was to evaluate the impact of this program on family planning in Sari city between 2003-2007. This survey was conducted among all women 15-49 years who married. Required data were collected from health files. The pattern of time trend evaluated and relevant indices compared before and after the family physician program. The application of condom, hormone injection, vasectomy and total modern contraceptives increased but employing the methods of tubectomy, IUD, OCR, Norplant and traditional method were descending. This variability for condom, tubectomy and traditional methods were statistically significant [p<0.05]. However for other methods were not statistically significant [p>0.05]. Difference of contraceptive using rates in pre and post of the application of program for condom, hormone injection, tubectomy and OCR were statistically significant [p<0.05] and for others were not statistically significant [p>0.05]. It seems relatively success of family physician program on family planning in Mazandaran province however more human resource should be allocated to family planning

[ comparison of the labor progression pattern with friedman's labor curve in nulliparous women, Fasa, Iran]

Labor refers to a chain of physiologic events that allows a fetus to undertake its journey from the uterus to the outside. Friedman [1954] described a sigmoid pattern for labor. This study was carried out to compare the pattern of labor progression in nullipara women of Fasa with the Friedman's labor curve. This cross-sectional study was conducted among 619 nulliparous women aged 18-35 who had term delivery and had no serious disease. In order to data analysis, we used one way ANOVA for comparing the means, and fixed effect of regression models in reverse method for curves drawings. In all of the subgroups, effacement rate increased by increasing the cervical dilatation. Mean of dilatation rate was significantly higher in induced group than the other groups. Duration of the active phase was longer in the group that had sedation than the other two groups. Means of the duration of active phase and second stage were significantly lower in our study than the durations in the Freidman's study [P<0.001] [3.87 hours vs. 4.9 hours; and 52 minutes vs. 57 minutes, respectively]. We did not observe the deceleration phase in our study. The pattern of labor progression differed from the Freidman's curve and had not sigmoid shape. The most important factor in latent phase was the time of admission to the labor ward

Estimation of survival and factors related to it in Esophageal Cancer using actuarial life-table mathod

Esophageal cancer is the 6th common cancer in Iran. Affected patients have a relatively short lifetime, as this cancer is usually diagnosed in advanced stages. This study was conducted to estimate survival and factors related to it in patients with esophageal cancer. All patients definitely diagnosed as esophageal cancer, registered in Fars Cancer Registry Center, were investigated. Required information was gathered from cancer registry forms and other resources. 1- to 5-year survival rates were estimated using life-table method. Wilcoxon test was used to compare survival rates between subgroups. All data were analyzed by SPSS software. Of 161cases, 61.5% were male. Mean age of patients was 64.6 +/- 13.10 years and 57.6 +/- 11.9 years in male and female, respectively. Overall survival rates at 1- to 5-years after diagnosis were: 58, 33, 18, 15 and 9 percent, respectively. Factors such as age at time of diagnosis, Presence of metastasis, histologic grade, type of first treatment, occupation in males, ethnicity and number of household showed to have a significant effect on prognosis. According to this study and similar studies carried out, screening and early detection of patients [in lower ages, and lower stages] is emphasized

[Quality of life and related factors in breast cancer patients under chemotherapy]

Today, the quality of life study has an important role in health care especially in chronic diseases, in clinical judgment and in medical resources supplying. Malignancies have a clinical and health importance in the world and Iran. Breast cancer has first order among women's malignancies. Now, survival rate for this cancer is long. However Breast cancer has several complications that affected patient's life. It is necessary that we studying the quality of life and related factors among this patients. We conducted a cross-sectional study on 119 breast cancer patients that admitted and treated in chemotherapy ward of Namazi hospital in Shiraz.We used QLQ-C30 and QLQ-BR23 to assessment quality of life in these patients. We used univariate nonparametric tests and multiple linear regression model to identify associations between dependent variables and the quality of life and it's different scales.All calculation performed by using SPSS.V.13. Mean age of patients was 48.27 +/- 11.42 with quality of life total score 64.92 +/- 24.28. Univariate analysis showed that occupation,duration of disease,grade of tumor, physical, emotional and cognitive functioning, also, symptoms such as fatigue,pain, nausea and vomiting, insomnia, constipation and financial difficulties, perspective were associated to quality of life. [P< 0.05]. But in multivariate analysis, only occupation, menopause status, dyspnea, grade of tumor and financial difficulties perspective were related to quality of life [p<0.05]. With this finding, It is recommended that financial supports, also early detection are necessary for improvement of quality of life in these patients

[Assessment of proportional hazard rate of cardiac disease in major beta thalassemia in Shiraz 2005-2006]

Thalassemia is the most common hereditary anemia in Iran and around the world that needs regular transfusion. Transfusion may lead iron overload in the body. Absence or irregular therapy chelation [Desferal usage] in these patients leads to various complications that the most important of them are cardiac diseases. The purpose of this study was to evaluate the hazard rate of cardiac disease and related factors using COX model. This descriptive analytical study carried out on eight-hundred and six thalassemic [406 males and 400 females] patients referring to Cooley's ward of dastgheib hospital of Shiraz were studied using a structured questionnaire through enumeration method. Age of occurrence, demographic information, age of onset and type of transfusion, and age of onset and method of chelation therapy were specified. Specialist physicians diagnosed the complications. Data were analyzed using descriptive and analytical [Proportional hazard rate and its confidence interval using COX model] statistics. In our subjects ages ranging were 1-43 years and means +/- SD was 15.34 +/- 6.82 years. The prevalence of cardiac diseases was 15.9% that it was estimate among female and male 17.8% and 14%, respectively [p>0.05]. the mean of age of onset of cardiac diseases was 16.93 +/- 5.43 years that it was estimate among female and male 16.41 +/- 4.8 and 17.58 +/- 6 years, respectively [p<0.05]. There was a significant association between proportional hazard rate of cardiac diseases of age of chelation therapy onset and educational level of parents [p<0.05]. Proportional hazard rate of this complication was not related to blood group, sex, chelating methods and type of transfused blood [p>0.05]. Early onset of blood transfusion with late onset of chelating increases the occurrence probability and early onset of cardiac disease complications. For prevention of these complications, it is recommended that onset of blood transfusion be according to onset of chelating. Educational level of parents and education to parents and patients very important. Progression of complications is prevented by regular survey and early diagnosis of complications and leads to high efficacy of patients

[Assessment of survival without cardiac disease of thalassemic patients of Shiraz, Iran, 2005]

Thalassemia is the most common hemolytic anemia in the world. Absence or irregular chelation therapy in these patients leads to cardiac complications such as heart failure, precarditis and arrhythmia. These complications are among the most common cause of death in thalassemic patients. The purpose of this study was investigation of survival without cardiac disease and effective factors in these patients. In a retrospective study [with enumeration method] the survival without cardiac disease was studied in 806 thalassemic patients [406 male and 400 female] referring to Cooley's ward of Dastgheib hospital in Shiraz using a data collection form. In addition to determination of age of cardiac disease incidence to survival analysis, demographic information and age at onset and type of transfusion and age at onset and method of chelation therapy also specified. Our data analyzed using descriptive and analytical [Kaplan-Meier and Log Rank test] statistic. The age range of the subjects was from 1 to 43 years [mean +/- SD: 15.34 years +/- 6.82]. The prevalence of cardiac disease was 15.9%. The mean age of onset of cardiac disease and mean age of patients with complications were 16.93 +/- 5.44 and 19.6 +/- 5.8 respectively and the estimated average years of survival with cardiac disease was 2.67 years. The median of survival without cardiac disease was 31.5 years and the estimated rates of survival without cardiac disease of 20 and 25 years were 75% and 69% respectively. There was a significant association between cumulative probability of occurrence of cardiac disease and age, education of parents and age of chelation therapy onset. Early onset of blood transfusion with late onset of chelating therapy increases the occurrence probability of cardiac disease. Educational level of parents and education of parents and patients about thalassemia and its complication would be very helpful in prevention of complications

Prevalence of helminth ova in soil samples from public places in Shiraz

To determine the prevalence of helminth eggs in public places and children's playgrounds, 112 soil samples were collected in 26 sites in Shiraz, southern Islamic Republic of Iran, during September 2002- September 2003. Toxocara cati ova were found in 7 [6.3%] samples, 2 had Ascaris ova, 3 had larvae morphologically similar to Strongyloides stercoralis. Coccidia oocysts were also observed in 4 samples. No contamination was observed during the dry season

Physical growth of 6-18 years old school children in relation to the national center for health statistics standard in Shiraz, Iran

Anthropometric indices were studied in 3534 [2.5% of the total population of school children in Shiraz, Iran] healthy 6-18 years old school children comprising 2037 boys and 1497 girls, in Shiraz, Iran. The school children were selected by proportional multi-stage cluster random sampling. National Center for Health Statistics [NCHS] reference population. The weight for age and height for age indices in the present study were less than those of NCHS. Median heights and weights of children in Shiraz lie approximately on the 25th centile of NCHS standard. These differences may reflect both nutritional and ethnic variations between children in the present study and NCHS data. Adolescent growth spurt occurred in girls around the age of 10 years. Peak Height Velocity [PHV] was 8.41 cm and 10 cm/year in boys and girls, respectively. The present study may be used as a source of reference for school children in Iran