The Prevalence of Risk Factors for the Development of Bacteraemia in Children

AIM: The objective of this study was to evaluate the frequency of risk factors for bacteremia in children less than 15 years of age was determined in Bahrami Hospital during 2013-2016. METHODS: This study conducted on 84 children aged 3 months’ to15 years old, who hospitalised in the pediatrics ward and the PICU in Bahrami Hospital from 2012 to 2016. Our study consisted of 46 boys (54.2%) and 38 girls. Moreover, 24.1% of subjects (20 patients) were entered in the study as young as three months old, followed by three months to three years (49.4 %; 41 subjects), and 3 to 15 years of age (26.5%; 22 individuals). RESULTS: The average hospitalization duration was determined to be 15.30 ± 8.75 days. Moreover, our results revealed that a history of blood transfusion in 11.2% of patients. On the other hand, 35.7% of cases were determined to be positive for blood cultures. The microorganisms reported from positive blood cultures include Enterobacter (81.48%), Escherichia coli (11.11%) and Klebsiella (3.70%). Also, 50% of patients were hospitalised in the internal ward, 12% received immunosuppressive drugs, and 96.4% of the patients had a history of vaccination. CONCLUSION: Pediatric severe sepsis remains a burdensome public health problem, with prevalence, morbidity, and mortality rates similar to those reported in critically ill adult populations. International clinical trials targeting children with severe sepsis are warranted

Urinary antigene and PCR can both be used to detect Legionella pneumophila in children's hospital-acquired pneumonia

Legionella pneumophila is the causative agent of more than 95% cases of severe Legionella pneumonia. Nosocomial pneumonias in different hospital wards is an important medical and pharmaceutical concern. This study aimed to detect Legionella with two methods: polymerase chain reaction [PCR] and detection of urine antigenic test [UAT] in patients suffering from nosocomial pneumonia admitted to pediatric intensive care unit [PICU] of children hospitals. This study was conducted in PICU wards of Rasool Akram and Bahrami children hospitals, Tehran, Iran during 2013 - 2014. In patients diagnosed with hospital-acquired pneumonia, intratracheal secretion samples for PCR and urine sample for urinary antigen test [UTA] were taken. Simultaneously, PCR and urinary antigen test were conducted using commercial kits. The results of urinary antigen test and PCR were analyzed by SPSS v.19 for statistical comparison. In this study, 96 patients aging 2.77 years on average with two age peaks of less than 1 year and 7-8 year were enrolled. More than half of the patients were under 1 year old. The most common underlying diseases were seizure, Acute Lymphoblastic Lymphoma, Down syndrome and metabolic syndromes. The positivity rate of Legionella urinary antigen test was 16.7% and positivity rate of PCR test was 19.8%. There were no significant associations between the results obtained by both assays with age, gender or underlying diseases. In conclusion, PCR is a better detection method for Legionella infection than urinary antigen test, but the difference between the two methods was not significant

Ant stings in military forces on three Persian islands of Abu-Musa, Greater Tunb and Lesser Tunb

Aims: Ants with the ability of biting and injecting venom to human body are called sting ants. This study was conducted to identify and determine the ant species and the prevalence of ant sting and related epidemiological factors in three Greater Tunb, Lesser Tunb and Abu-Musa islands, Iran. Methods: This descriptive cross-sectional study was performed during Jan-July 2010 in Greater Tunb, Lesser Tunb and Abu-Musa islands on 318 military individuals who were selected by random sampling method. The ant collection was done by active hand-catch method. The ant sting prevalence and related epidemiological factors were determined by questionnaire. Data were analyzed by descriptive statistical methods including Chi-square test, Mann-Whitney test and Spearman and Gamma correlation. Results: Sting ants in these islands were identified as Pachycondyla sennaarensis (Mayr, 1862) (Hymenoptera: Formicidae). The mean prevalence of ant stings was 70.1%. The seasonal incidence of sting in three islands had the same pattern and was more common in spring and summer. 84.4% of ant stings had occurred in limbs. The main symptoms caused by the ant stings include pain, severe itching and local inflammation and blisters in some cases. Conclusion: Although ant stings in these islands is not much dangerous and does not lead to anaphylactic shock and death, ant stings prevalence is very high and the pain, itching and burning would cause discomfort for soldiers and reduce their efficiency. Therefore, preventive measures and control of these ants should be considered

MHD forced convection of nanofluid flow in an open‑cell metal foam heatsink under LTNE conditions

In this paper, nanofluid forced convective heat transfer through an open-cell metal foam heatsink under a uniform heat flux, numerically has been investigated. A uniform magnetic field has been applied to the nanofluid flow. For the momentum equation, Darcy–Brinkman model and, for the energy equation, two-equation model under the condition of fully developed from the thermal and hydrodynamical standpoints have been used. In recent study, by utilizing a numerical method, an attempt was made to avoid a complete and complex CFD approach. To validate the results, the dimensionless parameters such as non-dimensional velocity and temperature, pressure gradient and Nusselt number have been compared with previous researches and a good agreement appeared. Eventually, the effects of different dimensionless parameters such as porosity, Hartman number, nanofluid volume fraction, Reynolds number, thermal conductivity ratio and pore density on the hydrodynamical and thermal characteristics of heatsink have been investigated. The outcomes show that the rise of pore density and Hartman number and the decline of the porosity will enhance the thermal performance; however, it also will reinforce the resistance to the flow through the porous media. Focusing on results illustrates that Nusselt number variation for increasing porosity from 0.85 to 0.95 at the minimum and maximum of the pore density are (ΔNu(ε))ω=10=−331.7 and (ΔNu(ε))ω=60=−367.8, and these values for friction factor are equal to (Δf(ε))ω=10=−22.3 and (Δf(ε))ω=60=−793, respectively. On the other hand, increasing Hartman number from 0 to 100 would change the Nusselt number and friction factor as (ΔNu(Ha))ω=10=9.4, (ΔNu(Ha))ω=60=0.2, (Δf(Ha))ω=10=213, and (Δf(Ha))ω=60=211, respectively. The amount of Hartman and Reynolds numbers effects on the heat transfer rate depends on the pore density. In other words, when the pore density becomes saturated, the effects of these parameters decrease. In addition, the use of nanofluid will improve the heatsink thermal performance

Social determinants of health during and after coronavirus: a qualitative study

Abstract Background Health has multiple dimensions influenced not only by individual factors but also by broader social, economic, cultural, and political structures. The widespread COVID-19 pandemic has multidimensional effects on people’s lives, which can have effects on individuals’ lifestyles after the COVID-19. This study aimed to speculate the social determinants of health during and after the COVID-19, which can lead to more effective planning for promoting community health. Methods The present study interviewed 21 experts in social and medical fields during four months. The sampling method was snowball. The interviews were semi-structured and administered in-person or electronic. All interviews were transcribed and analyzed according to the Brown and Clarke’s six-stage framework to extract themes. Results the participants were 13 males, eight experts in social field, all had PhD, 17 were academic members, and 10 were members of the Social Determinants of Health Research Center. The qualitative content analysis induced seven different social themes that affect the health which included: justice (3 Subcategories), integration (4 Subcategories), acceptance (4 Subcategories), participation (2 Subcategories), adaptation (3 Subcategories), flourishing (4 Subcategories), and cohesion (3 Subcategories). Conclusions According to the present study, a grand plan to cover all positive and negative social effects of COVID-19 should have at least seven different dimensions. However, the present models of effective social determinants in health do not have such comprehensiveness. Future studies may provide a proper model to be used in clinical and research fields

MHD enhanced nanofluid mediated heat transfer in porous metal for CPU cooling

In this study, impingement cooling of a porous metal CPU cooler saturated with nanofluid under the effects of magnetic field was modeled analytically. Darcy-Brinkman-Forchheimer model and viscous dissipation effect were considered to simulate fluid flow of nanofluid through the porous media under magnetic field. Proper similarity variables were proposed and the original partial differential governing equations were converted to nonlinear ordinary differential equations (ODEs), and the resulted ODEs were solved numerically. A system of water-alumina nanofluid flowing through a rectangular porous metal foam with top impinging jet (fan) and hot bottom wall (CPU surface) was modeled. The analytical solver was first validated against CFD and experimental data. Next, effects of different critical parameters including Darcy number (), Reynolds number (), aspect ratio (), Eckert number (), Hartmann number (), porosity (), and dimensionless distance from the axis of symmetry plane (), on fluid flow and heat transfer behaviors were investigated. Results indicate that the increase of can enhance heat transfer performance, while opposite trends are found for aspect ratio and Eckert number. However, the behavior of is more complex. At a low porosity, Nusselt number slightly decreases as increases, while an opposite behavior is observed at a high porosity. Overall, the use of a stronger magnetic field is beneficial to enhance the impingement cooling heat transfer with highly porous metal foam

تدوین کدهای اخلاق در آموزش مجازی

Background and Aim: Ethical codes are used as a practical guide to show the ethical behaviors of the owners of each profession in specific situations. Every organizational set has ethical codes appropriate to its professional structure, which is called professional ethics. Higher education is also a professional system, and professors and students must be aware of and adhere to the principles of professional ethics in e-learning. Adherence to the ethics of virtual education ensures the health of the teaching-learning process in the university and increases the commitment of professors to respond to the needs of students. Materials and Methods: This study was a developmental research that was conducted with the aim of extracting and compiling ethical codes in virtual education activities for professors and students by extracting the opinions of professors of Kermanshah University of Medical Sciences as a research community in four stages. The first stage in the research committee in medical school education was prepared with the presence of 20 professors of the initial draft of ethical codes, including 75 codes. In the second stage, the subject was categorized in 4 areas and 66 codes in the ethics committee of university education. Then, in the third stage, the proposed codes were sent to the faculties for the comments of all professors and officials in the field of education. Ethical Considerations: The purpose of the study was explained to the participants and individuals participated in the study voluntarily. Next, it was approved by the ethics committee of Kermanshah University of Medical Sciences and received a code of ethics. Findings: After conducting four stages of study and obtaining comprehensive opinions from professors, and officials in the field of education in different faculties and reviewing them in the work of the Department of Ethics in Virtual Education, codes in four general areas and 58 codes including: 25 Ethical codes of professors in virtual education, 11 ethical codes of electronic content production in virtual education, 10 ethical codes of students in virtual education and 12 ethical codes in electronic exam were compiled. Conclusion: The result of this study was to explain the ethical codes in virtual education for professors and students of medical universities.   Cite this article as: Khazaei MR, Izadi B, Almasi A, Sorosh A, Parvizifard AA, Foroghi AA, K Soltani M Boniani, Salari F, Farzaei MH. Devising Ethical Codes in Virtual Education. Faṣlnāmah-i akhlāq-i pizishkī, i.e., Quarterly Journal of Medical Ethics. 2021; 15(46): e31.زمینه و هدف: کدهای اخلاقی به عنوان راهنمای عملی برای نشان‌دادن رفتارهای اخلاقی صاحبان هر حرفه در موقعیت‌های خاص استفاده می‌شود. هر مجموعه سازمانی دارای کدهای اخلاقی متناسب با ساختار حرفه‌ای خود است که اخلاق حرفه‌ای نام دارد. آموزش عالی نیز نظامی حرفه‌ای است و اساتید و دانشجویان باید از اصول اخلاق حرفه‌ای در امر آموزش مجازی آگاهی داشته و به آن پایبند باشند. رعایت اخلاق آموزش مجازی تضمین‌کننده سلامت فرایند یاددهی ـ یادگیری شده و موجب افزایش تعهد پاسخگویی مدرسین نسبت به نیازهای دانشجویان می‌شود. مواد و روش‌‌ها: این مطالعه یک تحقیق کیفی است که با هدف استخراج و تدوین کدهای اخلاقی در فعالیت‌های آموزش مجازی برای مدرسین و دانشجویان با استخراج نظرات اساتید دانشگاه علوم پزشکی کرمانشاه با روش دلفی به عنوان جامعه پژوهش در چهار مرحله انجام گرفت. مرحله نخست در کمیته پژوهش در آموزش دانشکده پزشکی با حضور 20 نفر از مدرسین پیش‌نویس اولیه کدهای اخلاقی شامل 75 کد تهیه گردید؛ در مرحله دوم موضوع در کمیته اخلاق در آموزش دانشگاه طرح و کدها با نظر اعضا که متشکل از مدرسین باتجربه بود، در 4 حیطه و 66 کد دسته‌بندی شد؛ سپس در مرحله سوم کدهای پیشنهادی به دانشکده‌ها جهت اظهار نظر کلیه مدرسین و مسؤولین حوزه آموزشی ارسال گردید. ملاحظات اخلاقی: هدف از پژوهش برای مشارکت‌کنندگان توضیح داده شد و افراد به صورت اختیاری در مطالعه شرکت کردند، سپس در کمیته اخلاق دانشگاه علوم پزشکی کرمانشاه تأیید و کد اخلاق دریافت شد. یافته‌ها: بعد از اجرای چهار مرحله مطالعه و به دست‌آوردن نظرات جامع از اساتید و مسؤولین حوزه آموزشی در دانشکده‌های مختلف و بررسی آن‌ها در کارگروه تخصصی اخلاق در آموزش مجازی دانشگاه، کدها در چهار حیطه کلی و 58 کد، شامل 25 کد اخلاقی اساتید در آموزش مجازی، 11 کد اخلاقی تولید محتوای الکترونیک در آموزش مجازی، 10 کد اخلاقی دانشجویان در آموزش مجازی و 12 کد اخلاقی در آزمون الکترونیک تدوین گردید. نتیجه‌گیری: حاصل این مطالعه تبیین کدهای اخلاقی در آموزش مجازی برای اساتید و دانشجویان دانشگاه‌های علوم پزشکی بود

Evaluation of ERA5 Precipitation Accuracy Based on Various Time Scales over Iran during 2000–2018

In regional studies, reanalysis datasets can extend precipitation time series with insufficient observations. In the present study, the ERA5 precipitation dataset was compared to observational datasets from meteorological stations in nine different precipitation zones of Iran (0.125° × 0.125° grid box) for the period 2000–2018, and measurement criteria and skill detection criteria were applied to analyze the datasets. The results of the daily analysis revealed that the correlation between ERA5 and observed precipitation were larger than 0.5 at 90% of stations. Also, The daily standard relative bias indicated that precipitation was overestimated in zone 6. As detection criteria, the frequency bias index (FBI) and proportion correct (PC) showed that the ERA5 data could capture daily precipitation events. Correlation confidence comparisons between the ERA5 and observational time series at daily, monthly, and seasonal scales revealed that the correlation confidence was higher at monthly and seasonal scales. The standard relative bias results at monthly and seasonal scales followed the daily relative bias results, and most of the ERA5 underestimations during the summer belonged to zone 1 in the coastal area of the Caspian Sea with convective precipitation. In addition, some complex mountainous regions were associated with overestimated precipitation, especially in northwest Iran (zone 6) in different time scales