Epidemiology of Animal Bites and Factors Associated With Delays in Initiating Post-exposure Prophylaxis for Rabies Prevention Among Animal Bite Cases: A Population-based Study / 예방의학회지

OBJECTIVES: One way to prevent deaths due to rabies is the timely utilization of post-exposure prophylaxis (PEP). Therefore, in addition to an understanding of the epidemiological distribution of animal bites, it is necessary to explore the factors leading to delays in PEP initiation. METHODS: This cross-sectional study was conducted in Iran in 2011, and included 7097 cases of animal bites recorded at the Rabies Treatment Center of the Shiraz University of Medical Sciences using the census method. Logistic regression was used to identify factors associated with delays in PEP. RESULTS: Among the patients studied, 5387 (75.9%) were males. The prevalence of animal bites in Fars province was 154.4 per 100 000 people. Dogs were the most frequent source of exposure (67.1%), and the most common bitten part of the body was the hands (45.5%). A delay in the initiation of PEP was found among 6.8% of the studied subjects. This delay was more likely in housewives (odds ratio [OR], 4.66; 95% confidence interval [CI], 2.12 to 10.23) and less likely in people with deep wounds (OR, 0.65; 95% CI, 0.43 to 0.97). CONCLUSIONS: Although all animal bite victims received complete PEP, in some cases, there were delays. Further, the type of animal involved, the depth of the bite, and the patient’s occupation were the major factors associated with a delay in the initiation of PEP for rabies prevention.

The impact of disease characteristics on multiple sclerosis patients' quality of life / 한국역학회지

OBJECTIVES: The aim of this study was to assess the quality of life (QoL) of patients with multiple sclerosis (MS), and to investigate the effects of characteristics of MS such as disease course, severity, and relapses on patients' QoL.METHODS: This was a cross-sectional study, in which 171 patients were enrolled. Health-related QoL was assessed using the Persian version of the Multiple Sclerosis Quality of Life-54 questionnaire. To measure patients' disability status, we used the Expanded Disability Status Scale. Other variables included in the study were disease course and relapses of the disease.RESULTS: The average scores for patients' physical and mental QoL were 60.9±22.3 and 59.5±21.4, respectively. In a bivariate analysis, disease course, severity of the disease, and relapses were significantly associated with the physical and mental health composite scores. In a hierarchal regression analysis, disease course, severity of the disease, and relapses were responsible for 38 and 16% of the variance in physical and mental QoL, respectively. It was also observed that relapses were a strong predictor of both physical and mental QoL.CONCLUSIONS: Our results showed that disease characteristics significantly affected both dimensions of QoL. It is therefore suggested that health care providers should be aware of these characteristics of MS to more successfully improve MS patients' QoL.

The impact of disease characteristics on multiple sclerosis patients' quality of life / 한국역학회지

OBJECTIVES: The aim of this study was to assess the quality of life (QoL) of patients with multiple sclerosis (MS), and to investigate the effects of characteristics of MS such as disease course, severity, and relapses on patients' QoL. METHODS: This was a cross-sectional study, in which 171 patients were enrolled. Health-related QoL was assessed using the Persian version of the Multiple Sclerosis Quality of Life-54 questionnaire. To measure patients' disability status, we used the Expanded Disability Status Scale. Other variables included in the study were disease course and relapses of the disease. RESULTS: The average scores for patients' physical and mental QoL were 60.9±22.3 and 59.5±21.4, respectively. In a bivariate analysis, disease course, severity of the disease, and relapses were significantly associated with the physical and mental health composite scores. In a hierarchal regression analysis, disease course, severity of the disease, and relapses were responsible for 38 and 16% of the variance in physical and mental QoL, respectively. It was also observed that relapses were a strong predictor of both physical and mental QoL. CONCLUSIONS: Our results showed that disease characteristics significantly affected both dimensions of QoL. It is therefore suggested that health care providers should be aware of these characteristics of MS to more successfully improve MS patients' QoL.

Decomposition of health inequality determinants in Shiraz, South-west Iran

Background: Despite the enhancement in health outcomes worldwide, health inequity and inequality is one of the most relevant topics both for health policy and public health. This research was designed to decompose the health inequality of people living in Shiraz, south-west Iran

Methods: Data were obtained from a multistage-sample survey conducted in Shiraz from April to May 2012, to find determinants of health related quality of life [HRQoL]. General health [GH] and mental health [MH] were used as health status. As a measure of socioeconomic inequality, a concentration index of GH and MH was used and decomposed into its determinants

Results: The overall concentration indices of MH and GH in Shiraz were 0.023 [95% CI: 0.015, 0.031] and 0.016 [95% CI: 0.009, 0.022], respectively. Decomposition of the concentration indices indicated that income made the largest contribution [39.92% for GH and 39.82% for MH] to income-related health inequality. Education [about 25% for GH and 34% for MH], insurance [about 14% for GH and 11% for MH], and occupation [about 12% for GH and 11% for MH] also proved important contributors to the health inequality in Shiraz

Conclusions: There exist MH and GH inequalities in Shiraz. Apart from insurance, most of the health inequalities in Shiraz can be explained through factors beyond the health sector. Hence, implementing redistributive policies and education expansion programs as well as providing an insurance scheme and secure career conditions could decrease these unethical health inequalities

Optimization the number of nurses in the emergency department using linear programming technique

Introduction: Aim of current study is determination of optimal number of nurses in the emergency department of Shiraz Ali Asghar Hospital

Method: Current study is an applied study and belongs to operational research [OR] studies. The population has been studied in this research, includes records of referred patients to the emergency department of hospital in 2008. Sampling was performed in the forms of stratified [monthly] and simple for all of the records and each of months respectively. Required data collection was performed from statistics notebook and also patient's records using data collection forms. After average determination of entering patients in a day at eight period in three hours, determining the type of provided services and also the period of offering nursing services [with using time information]determine optimum number of required nurses in different periods of hospital with using of linear programming technique by lingo 8 software

Results: The minimum number of nurses needed in emergency department of Ali Asghar hospital regarding to desired services to the patients were obtained 1 and 3 nurses for each shift and a day respectively

Conclusion: According to the results the used number of nurses in the emergency department was more than optimum number. It seems that, obtained number of nurses from quantitative methods such as linear programming technique is much less than the calculated number experimentally by the directors of nursing

Comparison of the patient satisfaction from inpatient and outpatient fissurectomy in Motahari clinic and Shahid Faghihi hospital, Shiraz, Iran

Introduction: Satisfaction of the patients is considered as an important index in evaluating the performance of the hospitals and is highly effective in developing and improving the quality of the provided services .so, the present study aims to compare the satisfaction of the patients suffering from anal fissure from inpatient and outpatient treatments

Method: This cross-sectional study was conducted on 212 subjects who were selected through systematic sampling from the patients with anal fissure referring to Motahari clinic and Shahid Faghihi hospital. In order to compare the patient satisfaction in two inpatient and outpatient groups, 21-item questionnaire was designed in order to assess the patient satisfaction. Independent t-test and chi-square test were used to analyze this data

Results: satisfaction of the inpatients was significantly more than that of the outpatients [P<0.001]. The inpatients' waiting time for operation was significantly longer than that of the outpatients [P=0.029]. In comparison to the inpatients, the outpatients were more satisfied with the explanations provided regarding food diets after the operation [P=0.004]. Of course, outpatients had felt more stress during the operation compared to the inpatients [P=0.002]. Concerning the treatment environment, the outpatients were more satisfied than the inpatients [P<0.001]; however, the inpatients were more satisfied with the treatment services [P>0.001], quality, and other services compared to the outpatients [P=0.041]

Conclusion: According to the advantages that mentioned, outpatient operations can be a better choice for small surgeries; of course, health planners should pay more attention to its importance and necessity and provide more equipments and welfare facilities in treatment centers