Fungal infection in foot diabetic patients

Diabetic patients are more susceptible to cutaneous fungal infections. Cutaneous lesions and Foot infections are a frequent complication of patients with diabetes mellitus, accounting for up to 20% of diabetes-related hospital admissions. Foot ulcers and other foot problems are a major cause of morbidity and mortality in people with Diabetes mellitus. The higher blood sugar levels cause increasing the cutaneous fungal infections in these patients. More than 75% of diabetes mellitus (DM) patients are at risk for diabetic ulcers. About 15% of foot ulcers in diabetic patients lead to amputations. Although every 30 seconds one leg is amputated in the world due to DM, 80% of these cases are preventable. Poor controlled had significantly higher fungal infection in diabetic foot ulcers and require careful attention and management. The findings of various studies indicate that the prevalence of fungal infections in patients with diabetic foot ulcers is increasing and there are many drug resistance issues reported in this area, therefore more attention is important in diabetic centers about this neglected issue

A study of the problems between basic insurance organizations and teaching hospitals of Shiraz University of Medical Sciences as viewed by the staff of income hospitals and representative of the insurer’s organization in 2013

Introduction: In Iran health insurance is a significant tool in healthcare costs, financing health care and equal access to health services for people. Problems between hospitals and insurance organizations impose extra cost to the patient, leading to financial losses they will infringe upon the rights of patients. This study aimed to determine the issues between hospitals and basic insurance organizations and proposed practical solutions to solve problems in Shiraz University of Medical Sciences. Method:This research was a qualitative study (content analysis), which was conducted in 2013. The research population consisted of teaching hospitals of Shiraz University of Medical Sciences; Purposeful sampling was used and continued until data saturation. The representative of the insurers and staff of income hospitals were asked questions using a semi-structured interview. In this study, we used NVIVO for data analysis. Results: The results of this study showed that the most common problems between basic insurance organizations and teaching hospitals include the lack of prompt payment of hospital bills and imposing deduction on the hospitals. Conclusion: Based on the results of this study, it seems that cooperation between hospitals and insurance organizations could be improved by timely payment of hospital bills and codifying appropriate rules and regulations by basic insurance organizations and, on the other hand, with timely completion of bills and training of hospital staff by the hospital authorities

Executive and financial manager’s awareness of economic issues in private and public hospitals in Shiraz

Introduction: Managers, as the members of decision making team in hospitals, are required to understand economic issues In order to increase their knowledge, make better decisions making, and bring about economic growth in hospitals. Thus by measuring the managers’ level of economic knowledge and understanding their weaknesses at this field, we can take an important step in line with this transcendental target. Method: This was an analytical– descriptive study conducted in 2013. In this study, the views of 30 hospital executives and financial managers about various aspects of hospital economy including payment methods, techniques of economic evaluation, hospital income, and cost and subtractions were studied using questionnaires and interviews. SPSS 18 was used to analyze the collected data. P<0.05 was considered statistically significant. Results: None of the studied managers had a good level of knowledge and most managers (80.7%) had an undesirable level of knowledge, and few of them had a moderate level of knowledge. The administrators’ average knowledge of the ways to reduce the cost and increase the income of private hospitals was more than that of hospital administrators; as to the economic evaluation techniques and methods of payment, hospital administrators had more knowledge than managers of private hospitals. Conclusion: The managers’ low level of economic knowledge can be enhanced by more selective appointment of individuals for these sensitive positions and also increased by their participation in workshops and training courses

Microleakage of an Enhanced Resin-Modified Glass Ionomer Restorative Material in Primary Molars

Objectives: Resin composites, glass ionomers (GIs), or a combination of these materials have gradually replaced silver amalgam in pediatric dentistry. The purpose of this study was to compare the microleakage of Class II (box only) cavity restorations with ACTIVA Bioactive Restorative Glass, resin-modified GI (RMGI), and composite in primary molars. Materials and Methods: A total of 65 primary molars with at least one intact proximal surface were selected in this in-vitro study. After debridement of each tooth, Class II (box only) cavities were prepared. Based on the type of the restorative material and the application of etching and bonding adhesives, the samples were categorized into five groups: (1) composite; (2) RMGI (Fuji II LC)+conditioner; (3) RMGI (Fuji II LC); (4) enhanced RMGI (ACTIVA Bioactive Restorative Glass)+etching/bonding; and (5) ACTIVA Bioactive Restorative Glass. The restored teeth were thermocycled for 2000 cycles. After embedding in an acrylic resin, the degree of dye penetration at axial and gingival walls was assessed using a stereomicroscope. The data were statistically analyzed by analysis of variance (ANOVA) and Tukey’s test. Results: Resin-based composite (RBC) Z250 showed the least microleakage, while RMGI showed maximum microleakage at axial walls. The mean degree of microleakage at gingival margins was the lowest in RBC Z250 and ACTIVA+etching/bonding groups and the highest in RMGI+conditioner and RMGI groups. Conclusions: The microleakage of ACTIVA Bioactive Restorative material in the absence or presence of etching and bonding could be comparable to the microleakage of composite

Microleakage of an Enhanced Resin-Modified Glass Ionomer Restorative Material in Primary Molars

Objectives: Resin composites, glass ionomers (GIs), or a combination of these materials have gradually replaced silver amalgam in pediatric dentistry. The purpose of this study was to compare the microleakage of Class II (box only) cavity restorations with ACTIVA Bioactive Restorative Glass, resin-modified GI (RMGI), and composite in primary molars. Materials and Methods: A total of 65 primary molars with at least one intact proximal surface were selected in this in-vitro study. After debridement of each tooth, Class II (box only) cavities were prepared. Based on the type of the restorative material and the application of etching and bonding adhesives, the samples were categorized into five groups: (1) composite; (2) RMGI (Fuji II LC)+conditioner; (3) RMGI (Fuji II LC); (4) enhanced RMGI (ACTIVA Bioactive Restorative Glass)+etching/bonding; and (5) ACTIVA Bioactive Restorative Glass. The restored teeth were thermocycled for 2000 cycles. After embedding in an acrylic resin, the degree of dye penetration at axial and gingival walls was assessed using a stereomicroscope. The data were statistically analyzed by analysis of variance (ANOVA) and Tukey’s test. Results: Resin-based composite (RBC) Z250 showed the least microleakage, while RMGI showed maximum microleakage at axial walls. The mean degree of microleakage at gingival margins was the lowest in RBC Z250 and ACTIVA+etching/bonding groups and the highest in RMGI+conditioner and RMGI groups. Conclusions: The microleakage of ACTIVA Bioactive Restorative material in the absence or presence of etching and bonding could be comparable to the microleakage of composite

General self-efficacy and diabetes management self-efficacy of diabetic patients referred to diabetes clinic of Aq Qala, North of Iran

Background: Self-efficacy is one of the factors involved in successful self-care of diabetic patients. The aim of this study was to evaluate general self-efficacy and diabetes management self-efficacy and to determine their association with glycemic control in diabetic individuals, referred to the diabetes clinic of Aq Qala city, North of Iran. Methods: In this cross-sectional study, 251 type 2 diabetes mellitus patients were enrolled using census method. Data collection tools consisted of Sherer General Self-Efficacy Scale (SGSES) and Diabetes Management Self-Efficacy Scale (DMSES) with minor demographic adjustments and hemoglobin A1C test. Data were analyzed using descriptive statistics and analytical techniques include independent t-test, Spearman correlation coefficient and linear regression were applied for further data analysis. Results: The mean and standard deviation age of subjects was 56.17 ± 10.45 years. The mean level of HbA1C of studied subject was 8.35 ± 2.02. There was a negative correlation between age and general self-efficacy and diabetes self-efficacy while, there was a positive correlation between general self-efficacy and diabetes self-efficacy (P &lt; 0.001). Results of the regression analysis showed that duration of the disease was the only variable which had a significant effect on the level of hemoglobin A1C (P &lt; 0.001), so that for each year of having the disease, the level of hemoglobin A1C increased by 0.084 (CI 95 = 0.048-0.121). Conclusions: General self-efficacy and diabetes self-efficacy does not affect glycemic control in diabetic individuals. The duration of the disease is the only affecting variable on glycemic control by its worsening in diabetic individuals. Interventions are recommended to help glycemic control in individuals who are having this disease for longer periods. Moreover, further studies on the affecting factors on poor glycemic control of diabetic patients as well as the role of time variable, are recommended. © 2017 The Author(s)

Decisional balance and its relationship with stages of change in exercise behavior among employees of Gorgan: A cross-sectional study

Introduction: This study aimed to investigate the decisional balance for exercise and its relationship with stages of change in exercise behavior among employees in city of Gorgan, north of Iran. Material and Methods: This cross-sectional study was performed on 991 employees selected through random cluster sampling. Data were collected using the stages of change and decisional balance questionnaires. Results: a unit increase in the mean score of barriers decreased the possibility of moving to later stages by 49%, while a unit increase in the mean score of exercise benefits increased the possibility by 61%. There was a significant relationship between gender and stages of change (P<0.001) in a way that more female employees were in the early stages of exercise compared with males. Conclusions: The results of this study indicate that the disadvantages of exercise decrease through while subjects move toward later stages. Majority of the participant, specifically female employees, are in the early stages of exercise and are expected to have a sedentary lifestyle