On-admission versus in-hospital thromboembolism due to COVID-19 infection. What is the particular characteristic of those with early thrombotic events?

Introduction: Increasing evidence has declared a hypercoagulable state in the coronavirus 2019 infection (COVID-19), while the etiology has remained a question. For the first time, the current study has aimed to compare the contributors of thromboembolism among those whose primary manifestations of COVID-19 were thrombosis vs the patients with a thrombotic event during the period of hospitalization.Material and methods: This case-control study has been conducted on 267 COVID-19 patients, including 59, 48, and 160 ones with an on-admission, in-hospital, and without a thrombotic event, respectively. The events were defined as deep vein thrombosis (DVT), ischemic cerebrovascular accidents (CVA), pulmonary thromboembolism (PTE), or acute myocardial infarction (AMI). The demographic, physical examination, clinical and laboratory assessments of the groups were compared.Results: The DVT (OR: 5.18; 95% CI: 1.01–26.7), AMI (OR: 11.1; 95% CI: 2.36–52.3), and arterial thrombosis (OR: 5.93; 95% CI: 0.63–55.8) were significantly associated with an on-admission thrombosis compared to those who presented in-hospital events. Lower levels of oxygen saturation were the only significant predictor index inversely associated with on-admission thrombosis compared to those with an event during the hospital admission period.Conclusion: PTE development was the most common in-hospital thrombotic event, whereas other thromboembolism types were remarkably more often among cases with on-admission events. Oxygen saturation was the only predictor of premature thrombosis that was inversely associated with outpatient events

A survey on the users' satisfaction with the hospital information systems (HISs) based on DeLone and McLean's model in the medical-teaching hospitals in Isfahan city

Background and purpose: The user's satisfaction with information system in fact denotes the extent the user is satisfied with the system's achievement in fulfilling his/her information requirements. This study tries to explore the users' satisfaction with hospital information systems (HISs) based on DeLone and McLean's model focusing on the medical-teaching hospitals of Isfahan city. Methodology: This study which was applied and descriptive-analytical in nature was carried out in the medical-teaching hospitals of Isfahan city in 2009. Research population consisted of the system users from which a sample was selected using random sampling method. The size of the sample was 228. Data collection instrument was a self-developed questionnaire produced based on the satisfaction criterion in the DeLone and McLean's model. Its content validity was assessed based on the opinions given by the computer sciences professionals with its estimated Cronbach's alpha found to be 92.2. The data were analyzed using SPSS software. Findings: As the findings of the study showed, the differences among the mean scores obtained for the satisfaction with different kinds of HISs in use in the hospitals were statistically significant (p value≤0.05). Generally, Kowsar System (old version) and Pouya Samaneh Diva system gained the highest and lowest mean scores for the criterion in question, respectively. The overall mean score for the satisfaction was 54.6 for different types of systems and 55.6 among the hospitals. Conclusion: Given the findings of the study, it can be argued that based on the used model, the level of users' satisfaction with the systems in question was relatively good. However, to achieve the total optimum condition, when designing the system, the factors affecting the enhancement of the users' satisfaction and the type of hospital activity and specialty must be given special consideration. © AVICENA 2014

HIV Modes of Transmission in Sudan in 2014

Background: In Sudan, where studies on HIV dynamics are few, model projections provide an additional source of information for policy-makers to identify data collection priorities and develop prevention programs. In this study, we aimed to estimate the distribution of new HIV infections by mode of exposure and to identify populations who are disproportionately contributing to the total number of new infections in Sudan. Methods: We applied the modes of transmission (MoT) mathematical model in Sudan to estimate the distribution of new HIV infections among the 15-49 age group for 2014, based on the main routes of exposure to HIV. Data for the MoT model were collected through a systematic review of peer-reviewed articles, grey literature, interviews with key participants and focus groups. We used the MoT uncertainty module to represent uncertainty in model projections and created one general model for the whole nation and 5 sub-models for each region (Northern, Central, Eastern, Kurdufan, and Khartoum regions). We also examined how different service coverages could change HIV incidence rates and distributions in Sudan.Results: The model estimated that about 6000 new HIV infections occurred in Sudan in 2014 (95% CI: 4651-7432). Men who had sex with men (MSM) (30.52%), female sex workers (FSW) (16.37%), and FSW’s clients accounted (19.43%) for most of the new HIV cases. FSW accounted for the highest incidence rate in the Central, Kurdufan, and Khartoum regions; and FSW’s clients had the highest incidence rate in the Eastern and Northern regions. The annual incidence rate of HIV in the total adult population was estimated at 330 per 1 000 000 populations. The incidence rate was at its highest in the Eastern region (980 annual infections per 1 000 000 populations). Conclusion: Although the national HIV incidence rate estimate was relatively low compared to that observed in some sub-Saharan African countries with generalized epidemics, a more severe epidemic existed within certain regions and key populations. HIV burden was mostly concentrated among MSM, FSW, and FSW’s clients both nationally and regionally. Thus, the authorities should pay more attention to key populations and Eastern and Northern regions when developing prevention programs. The findings of this study can improve HIV prevention programs in Sudan

Explanation of the Status of Nosocomial Surveillance System in Iran: A Qualitative Study

Introduction: The national nosocomial surveillance system has been newly developed in Iran; therefore, it is necessary to investigate its different aspects in order to improve the quality of this system. Thus, the aim of this study was the explanation of the status of the nosocomial surveillance system in Iran. Method: This qualitative study was conducted through qualitative content analysis. The study participants were selected through purposeful sampling method. Data collection was carried out through 17 in-depth interviews and 3 focus group discussions with relevant stakeholders. Data were analyzed using content analysis method. In order to assess the accuracy and validity of the study, validity, confidentiality, and confirmability criteria were evaluated. Results: Through the analysis of interviews, 9 main themes (planning and policy making, human resources, infection control committee, quality and quantity of resources, protocols, software, surveillance, coordination and education) and 42 subsidiary themes concerning the status of the national nosocomial surveillance system were extracted. According to the participants’ opinions, the planning and algorithm of the program are acceptable. However, some issues exist in components such as applicability, priority, comprehensiveness of the definitions, attitude and behavior of the human resources, and ambiguity of the roles and responsibilities. Conclusion: This qualitative study showed that numerous factors influence the improvement of the nosocomial surveillance system. The interviews indicated that its design pattern is acceptable. Nevertheless, some of its components are not executed uniformly in all domestic hospitals. Keywords: Surveillance, Nosocomial, Qualitative study, Hospita

Detection of bacterial agents causing prostate infection by culture and molecular methods from biopsy specimens

Background and Objectives: Prostatitis affects about 16% of men in their lifetime and sometimes leading to prostate cancer. Bacterial infections are the most common causes of prostatitis. Diagnosis of the causative agents of bacterial prostate infections plays an essential role in timely treating and preventing secondary complications. This study isolated bacterial infectious agents in patients’ surgical prostate and evaluated them by routine and molecular microbiological methods. Materials and Methods: In this cross-sectional study, 72 prostate biopsy specimens were collected from the Orology Departmen of hospitals of Qazvin University of Medical Sciences. All samples were cultured in aerobic and anaerobic conditions. Antibiotic susceptibility test by Kirby-Bauer standard method was performed for all isolated bacteria. In addition, all isolated bacteria were identified using 16S rDNA PCR and sanger sequencing methods. Also, TaqMan real-time PCR was applied to detect Ureaplasm aurealyticum, Mycoplasma hominins, and Mycoplasma genitalium. Results: In conventional culture method, out of 18 positive samples, 15 samples (83.3%) were Gram-negative bacteria and 3 samples (16.6%) were Gram-positive bacteria, containing Escherichia coli (55.5%), Klebsiella pneumoniae (11.1%), Enterobacter cloacae (5.5%), Pseudomonas aeruginosa (11.1%), Staphylococcus aureus (11.1%), and Enterococcus faecalis (5.5%). The results of molecular identification methods were the same as conventional culture results. Also, four patients were Ureaplasm aurealyticum, and three patients were positive for Mycoplasma hominis. Conclusion: Most bacteria isolated from prostate specimens belonged to the Enterobacteriaceae family, especially Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae. Staphylococcus aureus and Enterococcus faecalis were cocci isolated in the specimens too. Also, Ureaplasma urealyticum, and Mycoplasma hominis were identified in prostatitis. Keywords: Prostatitis; Pathogens; Enterobacteriaceae; 16s rDNA; Real-time polymerase chain reactio