Ventilator-associated Pneumonia: A Study of Patients admitted in Internal Intensive Care Unit of Ali Asghar Hospital, Shiraz

Introduction: Ventilator-associated pneumonia is defined as a pneumonia occurring in patients within 48 hours or more after intubation with an endotracheal tube or tracheostomy tube and which not present before. The main objective of this study was to determine prevalence, predisposing factors and outcomes for ventilator associated pneumonia in an internal intensive care unit in a tertiary hospital. Material and Methods: In this retrospective review, all adult intensive care unit admitted patients at Ali Asghar Hospital with clinically and radiologically suspected ventilator-associated pneumonia between March 2009 and May 2010 were considered. The following data were recorded for each patient: demographic data, culture densities, chest radiological findings, pathogen(s), age, white blood cell count (WBC), presence of comorbid diseases, duration of hospital stay prior to diagnosis, and hospital survival. Data was assessed with SPSS software version 15 compatible for windows. Results: There were 49 patients in this study and most of the patients (69.3%) were males. Most of the patients (65.3%) were in more than 60 years age group of whom males were dominant. The most common risk factor was smoking, nasogastric tube, prolong duration of hospitalization, hospital admissions more than 2 times, prolong duration of intensive care unit admission, decreased level of consciousness and prolong ventilator support. The most common organism isolated was acinetobacter. Most of the patients were died (59.1%) of whom most were males. Discussion and conclusion: This study demonstrated that ventilator associated pneumonia is an important nosocomial infection among patients receiving mechanical ventilation in a community hospital and it is associated with greater hospital mortality rates and longer lengths of stay in the intensive care unit and hospital. Prevention is better than cure. Ventilator associated pneumonia is a well preventable disease and a proper approach decreases the hospital stay, cost, morbidity and mortality

The effect of fasting on emotional intelligence in clergies in Shahrekord seminary

زمینه و هدف: اصطلاح هوش هیجانی به منظور بیان کیفیت و درک احساسات افراد، همدردی و توانایی اداره ی مطلوب خلق و خو بکار برده می شود. از آنجا که اثرات مفید روزه داری در ماه رمضان بر ابعاد روانی انسان هر روز بیش از پیش مشخص می شود، هدف از این مطالعه تعیین تأثیرات روزه داری بر میزان هوش هیجانی و مولفه های آن می باشد. روش بررسی: مطالعه حاضر در زمره تحقیقات کوهورت خود کنترلی از نوع آینده نگر است که در ماه رمضان 1389 با شرکت 32 نفر از طلاب مرد روزه دار حوزه علمیه شهرستان شهرکرد و به روش داوطلبانه در دسترس انجام گرفت. مقادیر هوش هیجانی با 15 خرده مقیاس توسط پرسشنامه بار-ان (Bar-On) در 3 مرحله (یک هفته قبل، پایان و یک ماه پس از ماه رمضان) اندازه گیری و با استفاده از آزمون آماری آنالیز واریانس سنجش تکرار شده، تحلیل مقایسه های چندگانه انجام گردید. یافته ها: مطابق نتایج میانگین هوش هیجانی در 3 مرحله متفاوت (001/0>P) و بیشترین مقدار آن در مرحله دوم (پایان ماه رمضان) مشاهده گردید (51/8 ± 59/125) .به جز در مورد خرده مقیاس استقلال در سایر مولفه ها، تفاوت معنی‌داری بین 3 مرحله انجام آزمون وجود داشت (05/0>P) و مولفه های خودشناسی، کنترل تکانش، مسئولیت پذیری و همدلی در مرحله دوم افزایش یافتند. نتیجه گیری: بر اساس نتایج این مطالعه روزه داری می‌تواند یکی از عوامل تأثیر گذار در میزان هوش هیجانی در روزه داران باشد ولی با این حال نتیجه گیری دقیق در باره ی رابطه بین روزه داری و هوش هیجانی و شناخت و آگاهی از فرآیندهای زیربنایی تأثیرگذار بر این رابطه مستلزم انجام تحقیقات بیشتر اس

The relationship of religious attitude with self-control andself-discrepancy in students

Background and Aim: Spiritual attitude is one of the factors affecting mental health of students. The purpose of this study was to determine the relationship of religious attitudes with self-control and self-discrepancy (S-D) in students of Shahrekord University of Medical Sciences (SKUMS) in 2017. Methods: In this cross-sectional study, 328 students of the SKUMS were studied. The participants completed Tangney Self-control Survey, Higgins Self-discrepancy Questionnaire, a religious attitude questionnaire, and a checklist of demographic information. For data analysis, in addition to descriptive statistics, independent t-test, Pearson correlation coefficient, and one-way ANOVA were used. Stata software was used to analyze the data. Results: The mean values of religious attitude, self-control, and self-discrepancy were higher in women in comparison with men (P< 0.05). There was a significant difference between self-control religious beliefs, actual-self minus actual-self (S-D2), and self-discrepancy in terms of total monthly income of all family members (P< 0.05). Academic discipline was significantly associated with religious attitude, ideal-self minus actual-self (S-D1), S-D2, and S-D (P< 0.05), but self-control difference was not significant (P= 0.84). There was a linear relationship, significant correlation of religious attitude with the mean values of self-control, required self, actual-self, idea-self, self-discrepancy, and S-D1 and S-D2 (P< 0.05). Conclusion: According to the results of this study, religious attitude was associated with self-control, self-discrepancy, and their dimensions. Keywords: Religious attitude, Self-control, Self-discrepancy, Studen

Standardization of a trauma symptoms checklist for children

Background: The aim of this study was to standardize and assign validity and reliability of the Trauma Symptom Checklist for Children (TSCC-A). Methods: Normative data for the TSCC-A were based on 3042 students participating in a prevalence child abuse study in 19 different locations of Tehran and 140 participants who had been refered to the run-away children centers in Tehran. After the TSCC was validated on run-away and abused children, it was made available to researchers doing larger studies on a normative group. Results: Reliability analysis of the TSCC-A scales in the normative sample demonstrated high internal consistency. The evidence for its validations (convergent, discriminant and construct validity) showed that they were significantly acceptable. Conclusion: This paper presents data demonstrating the psychometric reliability and validity of the TSCC-A scales in the Iranian student population. We suggest to include the TSCC-A in a battery of relevant standardized tests

The Frequency of Alcohol Use in Iranian Urban Population: The Results of a National Network Scale Up Survey

Background: In Islamic countries alcohol consumption is considered as against religious values. Therefore, estimation of frequency of alcohol consumptions using direct methods is prone to different biases. In this study, we indirectly estimated the frequency of alcohol use in Iran, in network of a representative sample using network scale up (NSU) method. Methods: In a national survey, about 400 participants aged above 18 at each province, around 12 000 in total, were recruited. In a gender-match face to face interview, respondents were asked about the number of those who used alcohol (even one episode) in previous year in their active social network, classified by age and gender. The results were corrected for the level of visibility of alcohol consumption. Results: The relative frequency of alcohol use at least once in previous year, among general population aged above 15, was estimated at 2.31% (95% CI: 2.12%, 2.53%). The relative frequency among males was about 8 times higher than females (4.13% versus 0.56%). The relative frequency among those aged 18 to 30 was 3 times higher than those aged above 30 (3.97% versus 1.36%). The relative frequency among male aged 18 to 30 was about 7%. Conclusion: It seems that the NSU is a feasible method to monitor the relative frequency of alcohol use in Iran, and possibly in countries with similar culture. Alcohol use was lower than non-Muslim countries, however, its relative frequency, in particular in young males, was noticeable

National population size estimation of illicit drug users through the network scale-up method in 2013 in Iran

Background: For a better understanding of the current situation of drug use in Iran, we utilized the network scale-up approach to estimate the prevalence of illicit drug use in the entire country. Methods: We implemented a self-administered, street-based questionnaire to 7535 passersby from the general public over 18 years of age by street based random walk quota sampling (based on gender, age and socio-economic status) from 31 provinces in Iran. The sample size in each province was approximately 400, ranging from 200 to 1000. In each province 75% of sample was recruited from the capital and the remaining 25% was recruited from one of the large cities of that province through stratified sampling. The questionnaire comprised questions on demographic information as well as questions to measure the total network size of participants as well as the network size in each of seven drug use groups including Opium, Shire (combination of Opium residue and pure opium), Crystal Methamphetamine, heroin/crack (which in Iranian context is a cocaine-free drug that mostly contains heroin, codeine, morphine and caffeine with or without other drugs), Hashish, Methamphetamine/LSD/ ecstasy, and injecting drugs. The estimated size for each group was adjusted for transmission and barrier ratios. Results: The most common type of illicit drug used was opium with the prevalence of 1500 per 100,000 population followed by shire (660), crystal methamphetamine (590), hashish (470), heroin/crack (350), methamphetamine, LSD and ecstasy (300) and injecting drugs (280). All types of substances were more common among men than women. The use of opium, shire and injecting drugs was more common in individuals over 30 whereas the use of stimulants and hashish was largest among individuals between 18 and 30 years of age. Conclusion: It seems that younger individuals and women are more desired to use new synthetic drugs such as crystal methamphetamine. Extending the preventive programs especially in youth as like as scaling up harm reduction services would be the main priorities in prevention and control of substance use in Iran. Because of poor service coverage and high stigma in women, more targeted programs in this affected population are needed

Lichen planus and Hepatitis C: a case-control study

BACKGROUND: The association of lichen planus with hepatitis C (HCV) has been widely reported in the literature. However, there are wide geographical variations in the reported prevalence of HCV infection in patients with lichen planus. This study was conducted to determine the frequency of hepatitis C in Iranian patients with lichen planus at Razi hospital, Tehran. METHODS: During the years 1997 and 1998, 146 cases of lichen planus, 78 (53.1%) women and 69 (46.9%) men were diagnosed. They were diagnosed on the basis of the usual clinical features and, if necessary, typical histological findings. The patients were screened for the presence of anti-HCV antibodies by third generation ELISA and liver function tests. We used the results from screening of blood donors for anti HCV (carried out by Iranian Blood Transfusion Organization) for comparison as the control group. RESULTS: Anti-HCV antibodies were detected in seven cases (4.8%). This was significantly higher than that of the blood donors' antibodies (p < 0.001). The odds ratio was 50.37(21.45–112.24). A statistically significant association was demonstrated between erosive lichen planus and HCV infection. Liver function tests were not significantly different between HCV infected and non-infected patients. CONCLUSION: HCV apears to have an etiologic role for lichen planus in Iranian patients. On the other hand, liver function tests are not good screening means for HCV infection

Identification of unique neoantigen qualities in long-term survivors of pancreatic cancer

Pancreatic ductal adenocarcinoma is a lethal cancer with fewer than 7% of patients surviving past 5 years. T-cell immunity has been linked to the exceptional outcome of the few long-term survivors1,2, yet the relevant antigens remain unknown. Here we use genetic, immunohistochemical and transcriptional immunoprofiling, computational biophysics, and functional assays to identify T-cell antigens in long-term survivors of pancreatic cancer. Using whole-exome sequencing and in silico neoantigen prediction, we found that tumours with both the highest neoantigen number and the most abundant CD8+ T-cell infiltrates, but neither alone, stratified patients with the longest survival. Investigating the specific neoantigen qualities promoting T-cell activation in long-term survivors, we discovered that these individuals were enriched in neoantigen qualities defined by a fitness model, and neoantigens in the tumour antigen MUC16 (also known as CA125). A neoantigen quality fitness model conferring greater immunogenicity to neoantigens with differential presentation and homology to infectious disease-derived peptides identified long-term survivors in two independent datasets, whereas a neoantigen quantity model ascribing greater immunogenicity to increasing neoantigen number alone did not. We detected intratumoural and lasting circulating T-cell reactivity to both high-quality and MUC16 neoantigens in long-term survivors of pancreatic cancer, including clones with specificity to both high-quality neoantigens and predicted cross-reactive microbial epitopes, consistent with neoantigen molecular mimicry. Notably, we observed selective loss of high-quality and MUC16 neoantigenic clones on metastatic progression, suggesting neoantigen immunoediting. Our results identify neoantigens with unique qualities as T-cell targets in pancreatic ductal adenocarcinoma. More broadly, we identify neoantigen quality as a biomarker for immunogenic tumours that may guide the application of immunotherapies

Development of country-wide strategies to reduce the alcohol abuse

Background: Evidence shows that in Iran alcohol abuse rate may be of concern, especially among the youth. The mental and social health and addiction Department of the Ministry of Health and Medical Education has designed a plan to prevent, treat, and rehabilitate the patients abusing alcohol in a time period of 2011-2015. Methods: In a 6-month period, three guiding committees of experts in the field of alcohol abuse reviewed the literature. The meetings of the steering committee were held in order to collect the comments of the policy-makers in recognition of the problem, orientation, and administration procedures for the suggested strategies. The first input was discussed in the committee meeting. In the orientation phase, intervention strategies were suggested whose base was the evaluation of the previous international guidelines. In the final phase, the suggested strategies and challenges and their possible solutions were criticized. Finally, using these strategies, appropriate interventions were defined. Results: Preventing alcohol supply, school- and community-based prevention efforts, monitoring and vigilance were defined as primary prevention. While secondary and tertiary prevention are defined to be the treating and rehabilitating services for the alcohol abusers. Conclusions: We hope by using this strategy we will be able to control alcohol abuse in our country. The first step to reach this aim is done by breaking the taboo of giving alcohol-related information and news using media and educational programs especially to the young population

The Impact of Social Structures on Deviant Behaviors: The Study of 402 High Risk Street Drug Users in Iran

This study is a sociological analysis of the three dimensions of social structure including institutional, relational, and embodied structures that have an impact on the individuals’ deviant behaviors in the society. The authors used a mix method to analyze the qualitative and quantitative data of 402 high risk abandoned substance users in 2008 in Tehran, capital city of Iran. The leading reasons of substance use were categorized into four fundamental themes as follows: stress, deviant social networks, and low social capital and weak social support sources. In addition, the epidemiology model of regression analysis provides a brief explanation to assess the association between the demographical and etiological variables, and the drug users’ deviant behaviors. In sum, substance use is discussed as a deviant behavior pattern which stems from a comorbidity of weak social structures