[Factors influencing nurses' readiness to implementation of electronic health records]

Introduction: Personnel readiness is the major factor for implementation of Electronic Health Records [EHR]. On the other hand, nurses play an important role to the delivery of care. This study aimed to determine factors influencing nurses' readiness to implement EHR

Methods: This descriptive - cross sectional study was conducted on the nurses in the teaching hospital affiliated to Golestan University of Medical Sciences in 2013. The data was collected by a valid and reliable structured questionnaire. Data was analyzed using Descriptive statistics

Results: Data analysis indicated that the factor of perception and awareness of the characteristics and advantages of EHR [4.76 +/- 0.45] had the highest score, whereas the factor of ensuring the security and confidentiality in the EHR [4.21 +/- 0.81] and participation in the design and implementation phase of EHR [4.29 +/- 0.71] had the lowest score

Conclusion: The most obvious finding to emerge from this study is that most nurses believe that awareness of benefits and understanding of EHR concepts, increases their readiness to implement EHR. Thus, this issue should be considered by policy makers of information technologies

[Efficacy of defroxamine- deferiprone on cardiac function of patients with major thalassemia]

Background and Objective: Deferoxamin is the current "gold standard" chelator in comparison with new chelators. Combined therapy of Deferiprone and deferoxamin reduces the cardiac iron overload in patients with major talassemia. This study was done to evaluate the effect of defriprone-deferoxamine on heart function in patients with major thalassemia

Methods: In this historical cohort study, 8 patients with major beta thalassemia treated by subcutaneous deferoxamine were randomly selected and LVEF [the rate of blood that exited from heart in each beat] and serum ferritin were measeared. The patients were treated by deferiprone [50-100 mg/kg/day] compained with dferoxamine [30-50 mg/kg as 3 times in a week]. In the end of each year, LVEF and serum ferritin of patients were measured

Results: The ferritin level changed from 3243.12 in the first year to 2672.75 mg/kg at the end of third year. The mean of LVEF changed from 71.12% to 64.62 %. The correlation of serum ferritin and LVEF only at the end of third year was significant [P<0.05]

Conclusion: Combined therapy of deferiprone-deferoxamine during 3 years reduces ferritin and LVEF in patients with major thalassemia

[Effect of changing position and early ambulation on the bleeding, hematoma and urinary retention in patients with coronary angiography]

Coronary angiography is a routine and gold standard cardiac diagnostic procedure. Patients are restricted to bed rest after the procedure due to potential vascular complications using a femoral approach. Many patients are required to remain on bed rest for up to 24 hours after the procedure. The aim of this study was to assess the effect of changing position and early ambulation on the amount of bleeding, hematoma and urinary retention in patients with coronary angiography. In this clinical trial study 140 patients, which referred to coronary angiography center in Dezfoul-Iran, were randomly divided into four 35-individual groups. The patients in the control group were in supine position for 6 hours without movement. Position change was applied to the first interventional group based on a specific protocol, early discharge was applied to the second interventional group and both early discharge and position changes were applied to the third interventional group. The level of bleeding, hematoma and urinary retention were measured at zero, 1, 2, 4, 6 and 24 hours after angiography. The findings were collected using the individual data questionnaire and Kristin Swain's checklist in order to evaluate the level of bleeding and hematoma. There were no significant differences between the four groups in terms of occurrence of vascular hematoma and bleeding. The incidence of urinary retention was non significantly higher in the control group in compare to others. Changing position following angiography speed up patient discharge from hospital

[Causes of primary otalgia]

Otalgia is a complaint triggered from either ear disorders or adjacent structures due to common innervations between ear and adjust organs. This study was done to explore the causes of primary otalgia. This descriptive study was done on 770 patients with otalgia in Gorgan, Iran during 2009-10. After clinical examination age, gender, patient complaint and signs were recorded for each patient. 668 patients [86.8%] had primary otalgia including 39.9% left, 41.3% right and 18.8% bilaterally. 63.9% were female and 36.1% were males. External otitis was the most common causes of primary otalgia with 64.8%. Other causes consist of acute otitis media [14.5%], serumen [14.1%], chronic otitis media [5.8%], foreign body [4%] and trauma [3%], respectively. The most common cause of primary otalgia was external otitis

Diagnostic value of high resolution computed tomographic scan in active pulmonary tuberculosis

Since accurate and quick clinical and paraclinical diagnostic methods are not available, in some cases diagnosis of active pulmonary tuberculosis occurs after considerable time from the onset of disease. This study was designed to determine the diagnostic value of High Resolution Computed Tomographic [HRCT] scan in active pulmonary tuberculosis, in Gorgan, Golestan province, North of Iran. This diagnostic screening study was carried out on 135 [79 male and 56 female] hospitalized patients suspected with active pulmonary tuberculosis, and HRCT was used in their course of treatment as recommendation of their clinician. The patients were chosen from 5[th] Azar hosptial during 2009-10. Also it should be mentioned that patients were selected on avaliabity bases, and they were examined by smear, and sputum culture. The patients with negative smear and culture were set up as true healthy group [64 subjects]. The lung or small nuddles in HRCT was considered as proper position of lung involvument in active lung pulmonary. The HRCT findings between the case group [71 subjects] and healthy group were compared. According to HRCT findings, the sensitivity and specifity were determined for each patient. Data were analyzed using SPSS-16 and Chi-Square test. In this study, sensitivity, specificity, positive predictive value and negative predictive value of HRCT in active pulmonary tuberculosis were equal to 97.2%, 71.9%, 79.3% and 95.8% respectively. Involvement of upper and middle lobe of the right lung and upper lobe of the left lung were significantly higher than the control group [P<0.05]. This study showed that HRCT has high sensitivity and specificity in diagnosis of active pulmonary tuberculosis and can be used as a quick diagnostic way in active pulmonary tuberculosis, especially in patients with strong clinical suspicion and negative smear

Personality characteristics in migraine and tension headache in Gorgan, Iran [2007-08]

Headache is one the most common compliant of patients and has different causes and the migraine and tension headaches are common. Personality is characteristics forming an individual distinctive manner. This study aimed to determine the frequency and association of different types of personality characteristics in patients with migraine and tension headaches. This descriptive-analytic study was done on 160 [12 male and 148 female] subjects with chief complaint of headache whome referred to 5th Azar clinics of Gorgan, Iran during 2007-08. Subjects were selected by simple random sampling and were examined by either a neurologist or psychiatrist patient with diagnosis migraine either of or tension headache were included. Selected patients evaluated by short form of Minnesota Multiphasic Personality Inventory [MMPI]. Data were analyzed using SPSS-13 and Chi-Square test. The mean age was 11.18 +/- 33.29 in women and 34.33 +/- 13.7 in men. 96 patients [60%] had tension headache and 64 [41.2%] had migraine. In tension headache, depressed personality [43.8%] and hysterical personality [16.4%] were more common but in migraine headache, depressed personality [48.9%] and paranoid personality [20%] were common but this difference was not significant. This study showed that there is no relation between personality characteristics with tension headach and migraine

[Frequency of HBsAg in pregnant women in Gorgan, Iran]

The prevalence of hepatitis B infection is increasing worldwide. The main way to prevent hepatitis B transmission to newborns can be through accurate detection of HBsAg positive pregnant women and implementation of standard protocol for their infants. Therefore, this study carried out to determine the frequency of HBsAg in pregnant women in Gorgan, Iran. This cross sectional study was done on 1553 pregnant women whom attended to Dezyani hospital in Gorgan, North of Iran during 2008-09. Blood samples were taken and tested for HBsAg and HBeAg using ELISA method. HBsAg was found positive in 15 [1%] pregnant women. However, HBeAg were negative in all cases. Seven of these cases [46.7%] were not diagnosed before admission to the hospital for delivery and therefore had not received any immunoprophylaxis or HBIG treatment for their newborns. In contrary, six mothers and their newborns received immunoprophylaxis due to falsely diagnosed HBsAg seropositive. This study showed that the current protocols for dealing with HBsAg seropositivity and case finding among pregnant women in this region should be thoroughly revised. Furthermore, it is suggested that pregnant women during third trimester should be screened for HBsAg

[Coronary artery lesions and some of its related factors in more than 5000 patients in Kosar angiography center [Golestan province] from 2007 to 2009]

Coronary heart disease is the most common cause of death in Iran and most parts of the world. Major factors are involved in severity and extension of arterial obstruction. There have been different reports about location and severity of coronary artery lesions. This study determines factors related to the severity of coronary artery obstruction in the patients in Kosar Angiography Center. This was a descriptive analytical study and included 5444 patients. The characteristics of every patient were recorded in a check list. After measurement of blood pressure of the patients and recording history of hypertension, diabetes and drug consumption, data were introduced into a special software and then SPSS [16.00] software. Data analysis was performed by ANOVA, Kruskal-Wallis and Chi-square tests. p

[ prevalency of attempted suicide in Golestan province, north of Iran during 2003-07]

Suicide is one of the important causes of death worldwide particularly among 44-15 years. The aim of this study was to survey the prevalency of attempted suicide in Golestan province, North of Iran during 2003-07. This descriptive study conducted on 4977 suicide attempted subjects in Golestan province, North of Iran during 2003-07. Data were gathered through a filed questioners. Data was analyzed by SPSS-18 and Chi-Square test. Mean +/- SD of the subjects was 22.91 +/- 7.59 years. The female to male ratio was 1.62. 55.6% of subjects were single. The subjects resided in urban and rural area were 62% and 37.8%, respectively. 61.4% and 27.1% of subjects have finished and un-finished high-school studies. 2% and 0.9% from those attempted suicide were died and referred to specific centers, respectively for further medical follow-up. There was a positive correlation between suicide single status and low educated subjects with P=0.036 and P=0.001 respectively. The findings indicated that the prevalency of suicide were higher among single, female and those with lower education

[Coronary arteries angiography findings of subjects referring to Kosar angiography center in Golestan province, Iran [2008-09]]

Cardiovascular diseases is the first cause of mortality in developed and developing countries. This study was done to determine findings of coronary arteries angiography of subjects referring to Kosar angiography center in Golestan province, Iran. In this descriptive study 5444 patients whome referred to the Kosar angiography center in Golestan province, Northern Iran undervent in this study during 2008-09. Gender, age, ethnicity, body mass index [BMI], cigarette smoking, opium, hypertension and coronary arteries angiography findings were completed for each subjects. Coronary arteries angiography was performed on 5400 of subjects. Data was analyzed by using SPSS-13, ANOVA, Chi-Square and Kruskal-Wallis tests. In this study 52% of subjects were men. 72% of patients were Native Fars. 49.5% of subjects were found to be illiterate. While 92.6% of clients did not reported any history of smoking, 22.5% of subjects were addicted to different opium. The mean BMI was 27.48 and 38.2% of clients reported a history of hypertension. Coronary arteries angiography was performed on 5400 of subjects. Coronary arteries disorders were determined in 3142 of subjects [58.8% males, 41.2% females]. Left anterior descending, right coronary artery, circumflex and obtuse marginal were the most involved coronary arterial branches in positive angiograms, respectively.The most severe failure [47.7%] has been found in left anterior descending artery. Due to high incidence of coronary arteries disease in this region of Iran, it is suggested to design a project to investigate the preventive mearsures of cardiovascular disorders

[ correlation between age, gender and education with obesity in urban population of Golestan province]

Obesity is an undesirable outcome of changes in life style and behavior. This study aimed at determining the prevalence of obesity and its associated factors in population in Urban of Golestan province Iran to facilitate control of obesity related diseases. In this cross-sectional study, 2500 males and 2500 females residents of 17 different cities were selected, using cluster random sampling techniques. Anthropometric measures [height, weight] were obtained with standard methods and the data on social, demographics exercise, smoking and blood group were collected during interviews, using a specifically designed questionnaire. In assessment of obesity, a standard recommended WHO method, based on BMI distribution was used. Data was analyzed using SPSS version 11.5, and the logistic regression model was used to estimate the age adjusted odds ratio and its 95% confidence interval, P-value <0.05 being considered significant. Overall prevalences of obesity and overweight were 25.5% and 38.6% respectively [20.3%, 42.3% for men and 30.7% and 35% for women]. Mean BMI in, female and male subjects was 27.05 +/- 5.05, 27.63 +/- 5.54, and 26.48 +/- 4.44 respectively. In addition, WHR of all subjects was [0.92 +/- 0.1], [females] [0.91 +/- 0.9], males[0.93% +/- 0.11]. The pattern of obesity differed significantly with age in both genders. The results of logistic regression model showed that the odds ratio of obesity was greater, roughly 1.7 times in women, compared with men. The adjusted odds ratio decreased with increasing the levels of education and non smoking [P<0.0001]. The adjusted odds ratio showed no significant difference with occupation, race, blood group and or physical activity duration. The results of this study indicate an increased rate of obesity and overweight in an urban population, obesity in women being 10% higher than in men: Findings, showed that low levels of physical activity and education, gender, and smoking and aging were responsible for obesity

study on curative centers managers, knowledge and attitude levels about Hospital Informatics Systems

Researches showed the effective role of applying the hospital information systems [HIS] in upgrading quality of the curative care services, increasing satisfactions, and improving treatment economy. Due to the necessities of the HIS development and the important role of managers knowledge and attitudes, present study carried out to achieve the level of Golestan curative centers [province] managers knowledge and attitudes in 2006. Present study is a cross-sectional descriptive study, has been done on 73 people of the Golestan curative centers managers who agreed to participate in this study in the year 2006. A valid and reliable questionnaire have been sent for each manager. After completing the questionnaire, collected data analyzed by SPSS software. Our research findings showed that 59.3% of managers had average knowledge, and 95.1% had a positive attitude about the HIS. Maximum knowledge scores belonged to the medical records staffs, and minimum knowledge scores to operation theaters and hospital officers. Maximum level of the positive attitude found for laboratories staffs and minimum to finance and operation theaters department. Due to the average levels of Golestan curative centers managers knowledge and attitudes about HIS, to improve HIS usage at all different departments, to hold the training courses to improving the level of knowledge is necessary

[Seroepidemiology of celiac disease among blood donor in Golestan province]

Celiac is a digestive disease. In this disease, small bowel is damaged and the absorption of nutrients are adversely affected. These patients do not absorb gluten. There is probably a correlation between esophagus cancer and celiac. The aim of this research was to study the seroepidemiology celiac disease in this area with high prevalency of esophagus cancer. This research was a descriptive study, which was performed on blood donors in Golestan province during the year 2005-06. blood samples were taken from 2547 subjects. tTG-IgA determination were carried out using ElISA technique, the titre<4U/ml, 4-10U/ml and >10Um/l were considered to be as negative, weakly positive and positive respectively. EMA antibody assessment were carried out on all sample population with more than 4U/ml, using IFA method. 28 subjects [1.1%] had tTG-Ab positive test, out of this number 18 subjects [0.7%] were weakly positive and 10 persons [0.4%] were considered to be positive. EMA test were positive in 70% of subjects with tTG positive results. There was not any significant meaning between positive tTG test and ethnicity from weakly positive tTG, 15 subjects [83.3%] and 3 subjects [16.7%] were male and female respectively. The entire tTG positive were male subjects. In regard to high prevalency of esophagus cancer in the region and the relation of celiac disease with above cancer, it seems necessary to look more seriously at the celiac disease

[Epidemiological survey of suicide in Golestan province in the North of Iran [2003]]

Suicide is one of the most important causes of death in the world. The prevalence of suicide varies in different parts of Iran and the world. This study was done to determine the prevalence and types of suicide and its relation to gender, age and education in Golestan prevalence in North of Iran. This cross-sectional study was carried out on 1857 patients admitted to general hospitals in Golestan province during 2003. The data were collected through questionnaires filled by health workers and analyzed using SPSS software. The prevalence of suicide was 117.8, 88.5 and 147.4 per 10000 in general population, males and females respectively. The rate of suicide in 20-24 age groups was 285.8 per 10000. The highest rate of suicide was observed in spring. Thirty one percent of samples had high school education. 48 percent of suicide attempts were with drugs and opium. Considering the ethnicity, the rate of suicide was 177 among native Fars, 79.6 in Turkman and 270 in Sistani per 10000, respectively. This study has shown that the rate of suicide is higher in this province comparing to other studies in some parts of Iran and other countries

[Relationship between depression and associated demographic factors in patients on haemodialysis]

The scale of depression and the cost of prevention in some disease such as chronic renal failure is high. The present study was set up to determine the scale of depression among the haemodialysis patients. The present study a crosssectional research. The sample population was all of the haemodialysis patients in the Golestan province [129 patients with the age group 11-77 years]. The infromation gathered using, two questionairs included demographic characteristic and Beck depression inventory [BDI]. It showed that 37.2% of patients suffered from low to modrate depression and 31% from severe depression. Among different variable there was only significant correlation between depression and etiology of chronic renal failure [P<0.05]. This study showed that depression is a serious problem in haemodialysis patients and a threat for their health. It is suggested that periodic psychiatric clinical examination should be carried out to have early diagnosis and subsequent treatment of haemodialysis patients

[Relationship between quality of life and coping among hemodialysis patients in hospitals]

Background and Objective: hemodialysis patients quality of life is a significant subject. Style of coping or adjustment among hemodialysis patients is a complicated problem that affects the quality of life status. Responses domain to these problems are different from readjustment to suicide. The object of this study was to determine the relationship between quality of life and copings the problem, which were applied by hemodialysis patients

Materials and Methods: this is a descriptive analytical and correlational study. The study has been done in hospitals of Gorgan, Gonabad and Bandar Torkaman cities. The data were collected using a questionnaire with likert scale [From 1 to 5]. Sample population was 167 patients

Results: the results showed that 89 patients were male, 78 patients female, 25.74% between 35-44 years old and hemodialysis of duration of 114 patients was more than 4 years. The quality of life mean score and standard deviatior were respectively 89.58, 8.13. About 75.42% of patient's quality of life were moderate. The emotional and problem focused strategies were used in moderate way by the hemodialysis patients. Statistic tests between quality of life and emotional focused coping was significant [P<0.05]. In general there are relationship between quality of life and total coping [P<0.05]

Conclusion: according to study, we conclude that emotional focused coping and total coping influence the quality of life of hemodialysis patients. Therefore hemodialysis patients must be educated and supported, to cope with the problems

[ determination of hearing loss in Thalassemia major]

Background and Objective: major beta-Thalassemia is the most common form of anemia, which has a relatively high prevalency especially in the northern part of the country one of this disease side effect the hearing abnormality. This study has been carried out in Gorgan for the determination of the hearing level of beta-Thalassemic patients, and its relation with the level of serum Ferritin, the rate and the duration of blood transussion and dyspheral

Materials and Methods: in this study 95 patients with major beta-Thalassemia have been studied for the rate of hearing level. The variation parameter include age, gender, Ferritin level, the rate and duration of disferal consumption. Audiometry, tempanometry and physical examination carried out on all the patients. The findings from this research gathered and were analyzed using the SPSS statistical software

Results: 95 patients [190 ears] with age 3-29 year of old were gone under this study and only 72 ears had the threshold over 15 decibel, from this 43.9% were from sensorineural type of hearing. The 80% of ears's thempograms were type A. The results from this study showed that there is a meaningful statistical correlation between the hearing loss and serum Ferritin level. The rate of dyspheral consumption, in each time and its duration [P<0.05]

Conclusion: this study showed that high serum Ferritin level and the increased length of dyspheral consumption lead to the hearing loss in major beta-Thalassemia, therefore clinical examination of hearing interrally has to be carried out

[ incidence of peritonsillar abscess recurrence and their relation with the type of treatment]

Peritonsillar space infection can be occurred either as cellulitis or absecess formaiton. Antibiotic therapy, needle aspiration insicion, drainge and finally tonsillectomy are among the types of treatment which may be carried out in this disease. When torsillectomy was not done, the recurrence of peritonsillar abscess may be observed. The present study was set up to find out the recurrence rate of peritonsillar abscess with the type of treatment the patient is received. This study was done on 52 patients with peritonsillar space infection, 45 cases of these patients were presented with peritonsillar space abscess. The primary procedure such as recording personal demographic and pervious medical treatment on this patient was done. These patients were home visited by doing that, the rate of recurrence, re-hospitalization, the possible duration of recurrence and elective tonsillectomy were evaluated, these patients were also clinically examined. The gathered informations were analyzed by statistical software [SPSS]. From 45 peritonsillar space abscess, 8 cases [17.7%] were recognized as recurrence, from thsese numbers of patients 6 cases [13.3%] and 2 cases [4.4%] had once and twice recurrence respectively. The highest recurrence was seen among the patients with drug treatment. There was a meaningfull correlation between the method of treatment and the rate of recurrence incidence [P<0.05]. The highest rate of recurrence was among 20-29 years of age. The prevalancy of peritonsillar space abscess in women and men were 28.9% and 71.1% respectively. Winter and spring were the seasons with highest incidence. The rate recurrence of this abnormality among men and women were 15.6% and 23% respectively. It is recommended the patient with peritonsillar space abscess to have tonsillectomy especially later in adulthood, because of high incidence of recurrence. In cases where that abnormality is controlled by drug treatment alone, the tonsillectomy should be taken into consideration

[Anxiety level and its relationship with some variables in Mehrabad Airport control towers controllers]

The most common disorders in psychiatry are anxiety disorder. The onset is from adolescence through early adulthood. Some people due to various reasons are susceptible to these disorders, such as airport tower's controller. This study was done in order to determine anxiety level and its relationship with some variables such as age, length of empolyoment, gender, education, marital status, cigarette consumption, physical training and emplyoment satisfication. This was a cross secitonal-descriptive analytical study, which was performed on all of the controller personals [101 samples] during spring 2003, at Tehran Mehrabad airport, control towers controllers. They were studied by using an anxiety questionairs. The relationship between anxiety level was determined by eight independent variables. The findings from this study indicated the following results: undetectable minor anxiety [22.8%], mild intermediate anxiety [52.5%] and high-very high anxiety [24.8%]. According to the results from this study. The employment satisfaction could play an important role, in preventing the anxiety. In this sensitive job, the personal attention and concentration is of upmost importance, any factor that disrupts, this concentration should be prevented, otherwise unwanted accidents may happen. Therefore it is suggested that the responsible authorties select, the appropriate persons and provide them with a good and satisfactory job conditions to pave the way for the up grading the level of immunity in air flight