[ situational analysis of human resources in Iranian hospitals affiliated with ministry of health in 2008]

Hospitals are known as one of the main health care providing organizations. Increasing expenditures is claimed to be one of the most serious problems in hospitals. In this context, economic analyzing is very essential for health system evidence based decision making. We aimed to collect and analyze the hospital resources and this article specially is going to clarify the human resources arrangement in hospitals affiliated with ministry of health. This is an Applied Cross Sectional study, which was performed on 139 hospitals in 2009. We were going to collect the data from all Iranian hospitals affiliated with MOHME. In this regard, an expert's panel defined some inclusion criteria and finally 139 out of 530 hospitals were selected. Nine online questionnaires were used to collect data. We categorized the hospitals on the basis of bed numbers, being educational or non educational and locating in poor or rich areas [A: below 50 beds, B: 51-150 beds, C:151-300 beds and D: above 300 beds]. We analyzed the data using SPSS software. In 139 hospitals, there were 23674 active beds and 48238 personnel [2.04 personnel per each bed]. Our data showed that 48.4 percent of personnel had an under-associate degree, 40% had bachelor degree and the rest had higher degrees. Nurses and midwives were 48.1 percents of all personnel. Average bed occupancy rate was 57.8% and the lowest bed occupancy rate was belonged to the under 50 bed hospitals [31.4%]. The ratio of clinical personnel in teaching hospitals [71.1%] was higher than the non-teachings [70.4%]. This ratio was higher in rich areas [71.2%] compared to the poor areas [68.7%]. The proportion of number of personnel per bed in teaching hospitals [2.09] was higher than non-teaching hospitals [1.9]. This proportion was lower in rich areas [2.02] than the poor areas [2.17]. The density of logistic personnel was higher [29.1]than the other personnel. The high density of logistic personnel is a sign of low efficiency in selected hospitals. Despite of increasing ratio of clinical personnel to total number of personnel, the ratio of medical personnel per beds was decreasing and this can be a sign of low quality and effectiveness. Big hospitals have a better bed occupancy rate compared to small ones

[Risk of seizure recurrence following an initial acute unprovoked seizure in children]

This study was aimed to assess the rate of recurrence after the first unprovoked seizure in children. In a prospective study, we recruited 145 children who presented with primary unprovoked seizure and were followed for at least 12 months after the first seizure. Seventy five children [51.7%] experienced subsequent seizures. The cumulative risk of seizure recurrence following the first seizure was 16.5%, 35%, 47% and 51.7% at 1, 6, 12, 24 months, respectively. The median time for repeated seizure was 5.4 months with 67% of recurrences occurring within the initial 6 months, 92% within 1 year and 100% before the end of two years. On multivariable analysis, risk factors for resumption of seizure comprised of abnormal electroencephalography [EEG] and age greater than ten years at the time of occurrence of the first seizure. On unvariable analysis, etiology of seizure, history of neonatal problems and lack of AED [Antiepileptic drugs] usage increased risk of recurrence. This study revealed that the risk of seizure recurrence in our patients was relatively high. Those with abnormal electroencephalography and age greater than ten years at the time of occurrence of the first seizure were at greater risk for recurrence of seizures