Assessment of unhealthy days of urban marginal inhabitants and effective factors in Mashhad, Iran

Background: The concept of the quality of life (HRQOL) related to health and its determinants contain aspects of quality of life that clearly affect people’s physical or mental health. One of the newest ways to assess the health and also the quality of life-related to health is the self-assessed health of the individual. The aim of the present study was assessment of unhealthy days, self-reported health status, and its influencing factors on residents of the marginalpart of Mashhad, Iran. Methods: In the current cross-sectional study, 580 citizens of the marginal regions and slum areas of Mashhad city were enrolled through cluster sampling method using governmental health care services divisions. The Persian version of the questionnaire CDC HRQOL-4 was used to measure the unhealthy days. Data was analyzed using SPSS, version 11.5, running ANOVA, chi-square, and t-tests. P-value of less than 0.05 was considered as statistically significant. Results: In the present study, 359 persons (61%) were women and the mean age of participants was 32.6±11.51 years. The means of unhealthy days, physically unhealthy days, mentally unhealthy days, and days with dysfunction were found to be 7.2, 2.8, 4.1, and 1.7 days, respectively. The unhealthiest days (physical and mental) were seen in unemployed people and the best to excellent health days were seen in housewives. Conclusion: Unhealthy days and days with dysfunction were reported higher in slum inhabitants, especially female, low literacy, and housewife participants. Providing the education and employment facilities for people who live in marginal city areas might decrease the unhealthy days.Keywords: Unhealthy days; Health; Urban Marginal Inhabitants; Mashha

The Prevalence of Hyperamylasemia and Its Relationship With Mortality in COVID-19 Patients

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The Economic Burden of depression in psychiatric disorders

Background: Psychiatric disorders are very common, but their economic costs are not calculated transparently, while they are associated with significant economic consequences. The aim of this study was to investigate the direct and indirect costs of psychiatric disorders in 2017. Method: The present cross-sectional study was performed on all psychiatric patients admitted to hospitals in Ibn-e-Sina and Hejazi hospitals of Mashhad. According to the International book of ICD10, the medical records of psychiatric patients admitted with Code of Mental and Behavioral Disorders (F32-F33.9) were first identified and their costs of hospitalized was extracted and investigated from the Hospital Information system. The Top-Down Approach was used to estimate the costs. Descriptive statistics were used to analyze the data. Result: During the study period, 6896 patients were discharged, of which 1915 (28%) had mood disorders and among the mood patients, 300 (16%) had depression. The highest treatment cost for psychiatric patients is paid by insurance (93%). The average length of stay in the hospital was 23.6 days, and the average cost of each patient was $ 1020. The greatest cost of depression patients is related to hoteling (62%) and doctor's visit (24%). Conclusion: Depression is a common and costly disease and should be prevented by designing effective intervention

Evaluation of an arterial blood sampling device and its function in accelerating and facilitating blood sampling

Background: Arterial blood sampling is among the basic standards in critically ill patients. The aim of this study was to examine an inventive sampling device in facilitating arterial blood sampling in comparison to the conventional method using an insulin syringe.Methods and materials: This randomized interventional clinical trial was performed on 100 patients admitted to Qaem and Imam Reza Hospitals in Mashhad in 2016 for whom two arterial blood gas (ABG) samples were indicated. The patients were randomly selected by the visiting operator on a daily basis. The operator visited the hospital on certain days and took two samples from the selected patients.Results: The patients' mean age was 45.31±16.15 years. In the insulin syringe group, venous blood gas sampling was in 24% and arterial sample in 76%. In the designed device group, same figures were 12.1% and 87.9%, respectively. Sampling score (p=0.01), unsuccessful attempts with and without needle removal from the skin (p=0.01), and need for vertical and horizontal needle displacement for sampling (p=0.01) were significantly differed between the two groups. Localized swelling score and its size, localized bruising, palpable arterial spasm and the spasm duration was significantly less for the inventive device (p<0.05). Satisfaction score of patients and operator were significantly higher in the device group (p=0.01).Conclusion: The study device had desirable function in facilitating and accelerating arterial blood sampling. Its application can be further approved by future studies.Keywords: Arterial blood sampling, Facilitated sampling, Accelerated sampling, Intensive Care Uni

Intelligent Blood Glucose Control in Diabetic Patients by Designing and Simulating an Artificial Pancreas With a Predictive Sliding Mode Control Method

Background: Diabetes mellitus (DM) is a common chronic disease with various complications. About 10% of the world’s population suffers from this disease. For smart control of the blood glucose in DM patients, an artificial pancreas was designed and simulated by a predictive sliding mode controller considering the time delay of insulin effect. Methods: In this method, one of the time-delay glucose-insulin models was first selected. Then, using the predictive sliding mode control model, the stability of the blood glucose and insulin concentration was considered as the target. The performance and efficiency of the design were then verified by simulating the parameters of the proposed model in MATLAB software. Results: Using the proposed method, despite considering a 25-minute delay from insulin injection to its effect, the glucose and insulin concentrations reached stability in 60 and 50 minutes, respectively. Conclusion: The results of this study indicate that the combined controller of the predictive sliding mode model control can control blood glucose more effectively than previous controllers and therefore can help reduce disease complications, improve patients’ quality of life, and reduce costs and individual and health systems

National Nosocomial Infection Surveillance System–based study in north eastern of Iran

among about 10% of hospitalized patients. HAIs increase mortality and morbidity and prolonged hospital stay not to mention considerable costs they impose on the health care system. The present study was conducted in order to evaluate the prevalence of HAIs based on National Nosocomial Infection Surveillance System in hospitals of Mashhad, Iran.  Methods: The current prevalence study of HAI was carried out in 26 hospitals using a protocol updated yearly in Mashhad, Iran. The Centers for Disease Control and Prevention–National Nosocomial Infections Surveillance were used to define four HAIs. All patients admitted to the hospitals during a one-year period (March 1, 2015-February 30, 2016) were recruited in the study. Data was extracted using Iranian nosocomial infection surveillance software.  Results: The overall prevalence rate of HAI in our study was 0.8% among the hospitals with the most frequent HAIs found to be pneumonia (25%), followed by urinary tract infections (20%), and blood stream infections (19%). The highest prevalence rate was observed in 15- to 65-year old patients with more than 50% related to surgical site infection. Also, the most frequently isolated micro-organism was acinetobacter. In addition, the highest seasonal prevalence was seen in winter with pneumonia as the most frequent infection. A total of 4988 pathogens were isolated with 30.33% of clinical confirmation and 69.66% of positive culture.  Conclusion: These findings emphasize the need for appropriate measures for prevention, screening, labeling, and isolation precautions for infected patients

پروفایل سرشت های عاطفی به عنوان یک عامل زمینه ساز برای پسوریازیس پلاک مزمن

مقدمه: اگرچه رابطه نزدیکی بین پسوریازیس و مسائل روانی از جمله سرشت عاطفی وجود دارد، اما مطالعات کمی به این ارتباط پرداخته اند. این مطالعه با هدف بررسی پروفایل سرشت عاطفی در بیماران مبتلا به پسوریازیس پلاکی مزمن انجام شد.روش‌ کار: این مطالعه مقطعی در سال 98-1397 در کلینیک سرپایی پوست بیمارستان امام رضا (ع) مشهد انجام شد. در مطالعه حاضر، 40 بیمار پسوریازیس و 40 داوطلب سالم همسان از نظر جنس و سن شرکت کردند. ابزارهای تحقیق شامل پرسشنامه  ممفیس، پیزا، پاریس و سن دیگو  (TEMPS-A)، پرسشنامه اضطراب بک (BAI) و پرسشنامه افسردگی بک II (BDI-II)  بود. برای مقایسه متغیرهای اسمی و طبقه‌ای از آزمون‌های تی، من-ویتنی و مجذور خی استفاده شد. برای ارزیابی همبستگی ها از آزمون های اسپیرمن و پیرسون استفاده شد.یافته‌ها: در مجموع، 36 نفر از 80 بیمار (45%) مرد بودند. خلق و خوی افسرده، سیکلوتایمیک و مضطرب در گروه پسوریازیس به طور معنی‌داری برجسته‌تر بود (001/0 P<)، در حالی که نمره هیپرتایمیک در گروه شاهد به‌طور قابل‌توجهی بالاتر بود (023/0=P). بین شدت بیماری (نمره PASI) و سرشت عاطفی مختلف ارتباط معنی داری وجود نداشت. مدت درگیری پسوریازیس با تمام سرشت های عاطفی همبستگی منفی متوسطی داشت (05/0 P<) به جز سرشت هیپرتایمیک. شیوع اضطراب (80 درصد در مقابل 30 درصد، 40=n؛ 001/0 P<) و افسردگی (60 درصد در مقابل 5/32 درصد، 40=n؛ 009/0= P) در بیماران پسوریازیس به طور معنی‌داری بیشتر از گروه شاهد بود.نتیجه گیری: به نظر می رسد سرشت سیکلوتایمیک، افسرده و مضطرب و همچنین اضطراب و افسردگی در بیماران پسوریازیس به طور قابل توجهی شیوع بیشتری داشته باشد. با این حال، این ها با شدت بیماری همبستگی نداشتند

Evaluation of the ability of emergency medicine residents in teaching and supervising emergency medicine interns

Background: Approximately 25% of the residents’ time in each shift is allocated to educating lower-level assistants and interns. Assistants have played a major role in interns’ education. Aim: To assess the teaching abilities of emergency medicine assistants in the training and monitoring of medical interns and undergraduate students. Methods: This cross-sectional study was performed in 2015 at the emergency center of Imam Reza hospital in Mashhad University of Medical Sciences. We employed a researcher-made questionnaire to search the capability of emergency medicine residents to assess the teaching capabilities of emergency medicine residents to interns. This questionnaire was completed by 106 interns. The Validity of the questionnaire was confirmed by three specialist experts and reliability of the questionnaire was confirmed by Cronbach's alpha (0.94). This questionnaire consists of 24 questions in six areas. The analysis was performed by descriptive statistics using SPSS 16. Result: The study showed that the least favorable score was related to “residents get feedback on each shift” and the highest score was given to “a friendly relationship with the Interns and residents”. Conclusion: Considering the key role of residents in the education and training of future healthcare specialists, training interventions and allocating sufficient time to the proper education of different members of healthcare teams and medical students could largely contribute to the development of clinical training systems

Epidemiological and cost analysis of burned patients in Iran

Introduction: Considering the financial support provided by insurance and the government for burn patients in Iran, and recognizing the substantial economic impact associated with their treatment, there is a pressing need to delve into the epidemiology of these patients and analyze the related costs. This study aims to explore the epidemiological aspects and hospitalization costs of burn patients specifically within the burn ward of Imam Reza 68-bed Hospital in Mashhad, a regional center of referral in the eastern part of the country. Methods: Data had extracted from the electronic data collection system, which is used on a daily basis in the hospital. We included patients with a primary or secondary diagnosis of burns, code T20.0-T32.9 and T95 according to the International Classification of Diseases ICD-10. Ultimately, 1151 patients were included in the study. We analyzed 1151 burn cases in terms of patients’ age at the time of the event, gender, type of burn (Chemical, scalds, flame, electrical and contact burns), anatomical location of the burn (head and neck, upper limb, lower limb, multiple regions and part unspecified), burn etiology, burn degree (I, II, III), total burn surface area (%TBSA), Inpatient ward, expenditure ($), burn mortality rate and length of hospitalization. The age group was divided into seven groups by the 10 years intervals. Statistical analysis of the data was performed using SPSS-16 and Excel software. Results: 1151 patients were included in the study. High-risk groups are pediatric up to nine (0–9) years. According to age, we found that most cases were children, respectively, 25$9,365 ± $8,100 in pediatrics and$11,179 ± $10,180 in adults Conclusions: Most cases of death were related to burn in multiple areas of the body and then trunk burn (30% and 19%, respectively) and no death was observed in patients with hand and wrist burn. Burns can be incredibly severe and life-threatening, especially when they affect multiple areas of the body, such as the trunk and any burn injury is still a serious matter. It's important to prioritize fire safety and take precautions to prevent such accidents from happening

The Epidemiology of Burn Injuries in North East of Iran (2010-2015)

Introduction: Burns have impacts include medical, psychological, economic and social that involve patients and health care system. Epidemiologic factors of burns vary in different societies. While the effects of some burn variables on mortality rate, in similar circumstances, are expected to be universal. The present study was carried out to analyze the epidemiology, mortality, and current etiological factors of burn injuries. Materials and Methods: This cross-sectional study was conducted during a period of 6 years (from 2010 to 2015). Data were obtained by analysis of the medical records of patients hospitalized in the Imam Reza Burn Center in Mashhad, Iran. The data were recorded by the nurses and staffs in the burn ward. Results: In our study, 1334 in-hospital burn patients were recorded. The mean age was 27 ± 5.67 years. The most common Mechanism of burn was flame. The multivariable logistic regression modeling revealed, the most important risk factor of patient mortality were length of stay (LOS) (OR=1.009(95% CI: 1.001-1.018), age OR=0.9(95% CI: 0.96-0.97), sex OR=0.4(95% CI: 0.3-0.5), percentage of burn regarding body surface (BBS) OR=0.9(95% CI: 0.93-0.94),degree of burns OR=0.9(95% CI: 0.89-0.98). Conclusion: The results of our study revealed a high incidence of burns among >20 years old. Implement prevention programs should be designed for focusing chiefly on the domestic environment and the kinds of risks to which children are exposed in their everyday routine and parents, should also be educated about how to supply entertainment that would keep children away from risks