Social factors influencing treatment interruption in Tuberculosis Patients: A qualitative stud

Background and Aims: Positive smear pulmonary Tuberculosis (TB) patients sometimes interrupt their treatment. They may consequently result in the prevalence of antibiotic resistant strains (MDR-TB) in the community. This study was aimed to explore social factors influencing the treatment interruption in these patients.Materials and Methods: Purposeful sampling method with maximum variance was employed in this qualitative research. Data gathering process were included unstructured in-depth interviews with totally 37 persons (26 patients, 5 their family members and 6 concerning therapy supervisors), patients’ medical records, as well as recorded information in both Tuberculosis register program and Tuberculosis registration office kept in health care centers. Concurrently with data gathering, they were analyzed through ongoing comparisons. Also the participants in the study informed consent was obtained. Results: Based on the findings of this study, social factors influencing treatment interruption in Tuberculosis patients were included six sub-categories: lack of social support, TB-related stigma, work issues, poverty, as well as imprisonment and drug abuse during the course of treatment. Conclusion: Results from this study demonstrated that family members and therapy supervisors need appropriate interventions in order to decrease social factors influencing treatment interruption in Tuberculosis patients. Key words: Social Factors, Tuberculosis Treatment Interruption, Qualitative Stud

An effective passive islanding detection algorithm for distributed generations

Different issues will be raised and highlighted by emerging distributed generations (DGs) into modern power systems in which the islanding detection is the most important. In the islanding situation, a part of the system which consists of at least one DG, passive grid, and local load, becomes fully separated from the main grid. Several detection methods of islanding have been proposed in recent researches based on measured electrical parameters of the system. However, islanding detection based on local measurements suffers from the non-detection zone (NDZ) and undesirable detection during grid-connected events. This paper proposes a passive islanding detection algorithm for all types of DGs by appropriate combining the measured frequency, voltage, current, and phase angle and their rate of changes at the point of common coupling (PCC). The proposed algorithm detects the islanding situation, even with the exact zero power mismatches. Proposed algorithm discriminates between the islanding situation and non-islanding disturbances, such as short circuit faults, capacitor faults, and load switching in a proper time and without mal-operation. In addition, the performance of the proposed algorithm has been evaluated under different scenarios by performing the algorithm on the IEEE 13-bus distribution system.fi=vertaisarvioitu|en=peerReviewed

Effect of Combination Therapy of Ceftazidime/Amikacin and Monotherapy with Imipenem on the Treatment of Fever and Neutropenia in Patients with Cancers

AIM: This study aimed to compare the effect of Imipenem monotherapy and combination therapy with Ceftazidime/Amikacin in febrile episodes in neutropenic cancer patients.MATERIALS AND METHODS: In this double-blind randomised trial, 122 adult patients with cancer, neutropenia and fever who were treated by chemotherapy were gathered by simple sampling method and were divided randomly to two equal Imipenem (IP) and Ceftazidime/Amikacin (CA) groups. 500 mg of Imipenem was administered every 6 hours IP group and 2 g of Ceftazidimeplus 15 mg/kg/day in 2 equally divided doses of Amikacin was administered in the CA group. The treatment was continued for 72 hours in both groups. Data were analysed with SPSS19.RESULTS: There was a significant difference between the mean temperatures of three days in each group (P < 0.001). There was no significant difference between the two groups regarding microbial response to antibiotics. There was no significant difference between 19 patients of IP and 13 patients of CA groups regarding bacteriologically documented infection (P = 0.3).CONCLUSION: Unmodified therapy by Imipenem is as effective as combinational therapy by Ceftazidime/Amikacin in clinically and bacteriologically documented infection

Prevalence of Upper Extremity Musculoskeletal Disorders in Dentists: Symptoms and Risk Factors

Aim. The purpose of the present research was to examine the factors that lead to musculoskeletal disorders in dentists by assessing their posture using RULA method. Materials and Methods. In this cross-sectional study, 130 dentists (84 male and 46 female) participated. The posture of the subjects during their normal workload was recorded by using the RULA method, and the range of musculoskeletal pains by using the Nordic Musculoskeletal Questionnaire (NMQ), and individual and professional data was assessed by a demographics questionnaire. All tests were performed at the P<0.05 level. Results. Assessment of the physical status of the subjects showed that 82.8% of subjects were at high risk of musculoskeletal disorders. The majority of musculoskeletal pains were in the neck (55.9%) and the shoulder (43.8%). Moreover, 68.9% of the subjects had experienced pain at least once over the last year. Significant relationships were observed between musculoskeletal pain and daily work hours P=0.07 and number of patients P=0.02, but the pain was not significantly associated with BMI and experience. Conclusion. The present findings showed that unsuitable posture of dentists during work has a considerable effect on musculoskeletal disorders. Therefore, further investigation is required to avoid the detrimental effects of wrong posture

Spinal vs General Anesthesia in patients undergoing urogenital surgery: A Randomized Clinical Trial

Background: This study aimed to evaluate the pain in the 24 hours after surgery, quality of life, and the outcome of surgery in patients undergoing urogenital surgery by spinal and general anesthesia. Materials and Methods: Women referring a candidate for urogenital surgery in Vali-e-Asr Hospital entered the study after their informed consent; in one of the two study groups: Spinal Anesthesia (SA) vs. General Anesthesia (GA). The pain scores around the clock were measured using the Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours postoperatively. Also, the two groups were compared regarding patient satisfaction at the time of ambulation. The surgery outcomes were measured using International Consultation on Incontinence Modular Questionnaires ICIQ. Data were entered and analyzed by SPSS software. Results: There was no significant relationship between parity, previous non-cesarean abdominal surgery, and urinary complications. However, there was a statistically significant difference between pain score in the two groups; while the postoperative days were not different in the two groups of anesthesia methods Conclusion: Considering the different influence of treatment methods for this disease, further research is needed to clarify, the results of anatomical, and anatomical outcomes after treatment for pelvic floor disorders in women

BERT for Long Documents: A Case Study of Automated ICD Coding

Transformer models have achieved great success across many NLP problems. However, previous studies in automated ICD coding concluded that these models fail to outperform some of the earlier solutions such as CNN-based models. In this paper we challenge this conclusion. We present a simple and scalable method to process long text with the existing transformer models such as BERT. We show that this method significantly improves the previous results reported for transformer models in ICD coding, and is able to outperform one of the prominent CNN-based methods

Prevalence, awareness, treatment, and control of hypertension based on ACC/AHA versus JNC7 guidelines in the PERSIAN cohort study

In this cross-sectional population-based study, we used the baseline data of the Prospective Epidemiologic Research Studies in IrAN cohort study collected in Iran from 2014 to 2020. The main outcomes were the prevalence of hypertension and proportion of awareness, treatment, and control based on the 2017 ACC/AHA guideline compared to the seventh report of the Joint National Committee (JNC7). Of the total of 163,770 participants, aged 35–70 years, 55.2% were female. The sex-age standardized prevalence of hypertension was 22.3% (95% CI 20.6, 24.1) based on the JNC7 guideline and 36.5% (31.1, 41.8) based on the ACC/AHA guideline. A total of 24,312 participants [14.1% (10.1, 18.1)] were newly diagnosed based on the ACC/AHA guideline. Compared to adults diagnosed with hypertension based on the JNC7 guideline, the newly diagnosed participants were mainly young literate males who had low levels of risk factors and were free from conventional comorbidities of hypertension. About 30.7% (25.9, 35.4) of them (4.3% of the entire population) were eligible for pharmacologic intervention based on the ACC/AHA guideline. Implementation of the new guideline may impose additional burden on health systems. However, early detection and management of elevated blood pressure may reduce the ultimate burden of hypertension in Iran

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe