Knowledge of Mothers in Management of Diarrhea in Under-Five Children, in Kashan, Iran

Background: Diarrhea has been considered as a major cause of mortality in children aged less than five years old. Most of these deaths are due to dehydration and mis management or delayed management of the disease. Most of the diarrhea episodes are treated in the home by mothers. Therefore the mothers’ knowledge in management of diarrhea is likely related to its mortality and morbidity. Objectives: This study designed to evaluate the knowledge of the mothers with children under five years old about diarrhea and its management and to identify the relation of the knowledge content with some demographic characteristics. Materials and Methods: In this cross-sectional study, 430 mothers who had at least one child aged below five years old were selected by cluster sampling. The mothers were asked to complete the 22 items questionnaire designed to evaluate their knowledge of diarrhea. Some demographic characteristics such as age, number of children, education of the mother and her spouse and the source of knowledge also were recorded. Subsequently, the data analyzed using descriptive statistics and chi-square test. Results: Most of the mothers were 25-30 years old (43.8%). Slightly more than half (55.6%) had just one child. The health center, educational programs and the personal reading were the main sources of the knowledge about the treatment (43.7%). Twenty eight point eight percent of the mothers had a good knowledge in diarrhea diagnosis and its treatment, while the 46.5% had medium and 24.7% suffered low knowledge. The knowledge of the mothers had significant relationship with the age of the mother, education of the father, number of children, occupation of the mother, and the source of the knowledge. Conclusions: The mothers studied in this research had inadequate knowledge about diagnosis and treatment of diarrhea. The educational programs must be an essential part of the health centers programs

Correlation of End-Tidal Carbon Dioxide with Arterial Carbon Dioxide in Mechanically Ventilated Patients

Background:: Patients undergone mechanical ventilation need rapid and reliable evaluation of their respiratory status. Monitoring of End-tidal carbon dioxide (ETCO2) as a surrogate, noninvasive measurement of arterial carbon dioxide (PaCO2) is one of the methods used for this purpose in intubated patients. Objectives:: The aim of the present trial was to study the relationship between end-tidal CO2 tensions with PaCO2 measurements in mechanically ventilated patients. Materials and Methods:: End-tidal carbon dioxide levels were recorded at the time of arterial blood gas sampling. Patients who were undergoing one of the mechanical ventilation methods such as: synchronized mandatory mechanical ventilation (SIMV), continuous positive airway pressure (CPAP) and T-Tube were enrolled in this study. The difference between ETCO2 and PaCO2 was tested with a paired t-test. The correlation of end-tidal carbon dioxide to (ETCO2) CO2 was obtained in all patients. Results:: A total of 219 arterial blood gases were obtained from 87 patients (mean age, 71.7 ± 15.1 years). Statistical analysis demonstrated a good correlation between the mean of ETCO2 and PaCO2 in each of the modes of SIMV, CPAP and T-Tube; SIMV (42.5 ± 17.3 and 45.8 ± 17.1; r = 0.893, P < 0.0001), CPAP (37 ± 9.7 and 39.4 ± 10.1; r = 0.841, P < 0.0001) and T-Tube (36.1 ± 9.9 and 39.4 ± 11; r = 0.923, P < 0.0001), respectively. Conclusions:: End-tidal CO2 measurement provides an accurate estimation of PaCO2 in mechanically ventilated patients. Its use may reduce the need for invasive monitoring and/or repeated arterial blood gas analyses

Evaluation of Emotional Intelligence and Job Satisfaction in Employees of Kashan Hospitals

Background: Job satisfaction and emotional intelligence are two important variables in organizational behavioral studies, and are key factors in promoting the efficiency of organizations. Objectives: The present study was conducted in order to determine the job satisfaction and emotional intelligence of employees of Kashan hospitals in 2011. Materials and Methods: This cross-sectional study was performed on 121 employees of Kashan hospitals who were selected using random stratified method. In this study, Bar-on emotional intelligence and job satisfaction questionnaires were used. The data were analyzed using statistical methods such as odds ratio, Chi-square and Fisher's exact test. Results: The majority of employees (76%) had moderate emotional intelligence while 88.2% of them had moderate job satisfaction. In this study, there were no significant relations between emotional intelligence and variables such as sex, education, and marital and job status (P > 0.05) but significant relations were found between the age and emotional intelligence (P = 0.01). Furthermore, there was no significant relation between job satisfaction and demographic variables. Moreover, no significant relation was found between the emotional intelligence and job satisfaction (P > 0.05). Conclusions: As the majority of the staff had average level of job satisfaction and emotional intelligence and others were lower than average, it seems necessary for authorities to explore the reasons for job dissatisfaction to prevent job burnout, depression and developing a sense of helplessness in the staff. It is also recommended to hold educational workshops for the staff especially who are younger than 40 years to promote their emotional intelligence

The frequency of osteoporosis in hip fracture following minor trauma and the resulting mortality rate and direct treatment costs in patients over 45 years old in Kashan Naghavi hospital during 2005-2007

Background & Aims: Osteoporosis is the most common metabolic bone disease. In the recent decades due to the increase of population age, the prevalence of osteoporosis has been increased. The most important complication of osteoporosis is bone fracture, especially in the hip. The aim of this study was to evaluate the prevalence of osteoporosis, its mortality rate and direct treatment costs in patients over 45 years old referred to Kashan Naghavi hospital following hip fracture during 2005-2007. Methods: This cross-sectional study was done on 119 patients with hip fracture following minor trauma admitted during one year to Naghavi hospital in Kashan Iran. Demographic findings, types of fracture, costs of hospitalization, treatment and prosthesis were recorded in a questionnaire. BMD of lumbar spine & neck of femur was done with Osteocore II instrument by DXA method. Data analysis was done by SPSS 14. Results: Mean age of patients was 71/6±9/35 years. From all, 72/3 were female and 27/7 was male and 67/8 had fracture of neck of femur and 23/2 had intertrocanter fracture. In whole, 65 had osteoporosis. In 51.3, it was in lumbar and in 23.5 it was in femur. Mean hospitalization period was 7.92±3.66 days. Mortality rate was 17/2. Mean cost of hospitalization and treatment was 277 and mean cost of prosthesis for each person was 1670. Conclusion: Osteoporosis is a predisposing factor for hip fracture in old patients after minor trauma. Since Hip fracture places a high cost burden on the healthcare system, wise programming for prevention of hip fracture seems to be highly necessary

Registry Data Coordinator (RDC): A proper accessible strategy for improving Road Traffic Injury (RTI) Hospital Based Trauma Registry Systems in developing countries and low income countries

Abstract Introduction: Evidence suggested that a significant level of trauma mortality can be prevented using registry system. Aim: This study aimed to improve Kashan Hospital Based Trauma Registry System (KHBTRS) for Road Traffic Injury (RTI). Material and methods: After conducting focus group discussion absence of minimum data set (MDS) and poor data collection process (DCP) were identified as main problems for KHBTRS- RTI. Proposed MDS were surveyed by 20 experts of trauma research center of throughout the Iran. Then approved MDS applied for trauma registry system data base in form of SQL. DCP were reform from prospective data collection (review of medical record) to concurrent (through the interview) approach. Results: Most of participants for MDS approval belonged to clinical group 13(65%). 146 MDS in eighteen main categories were proposed for RTI. The maximum score for each MDS main categories were attributed to body parts injured 220 (100%) and patient vital signs 139 (99.29%) respectively. Pilot testing of KHBTRS- RTI database of 50 (50%) riders indicated fully completeness 50 (100%) for concurrent approach. It was concluded that based on experts’ viewpoints MDS relating to injury nature and place of occurrence have more priority in comparisons to MDS relating to causes of injury. It may attribute to health care providers focus on clinical care and treatment. Conclusion: It was concluded that based on experts’ viewpoints MDS relating to injury nature and place of occurrence have more priority in comparisons to MDS relating to RTI prevention; it may attribute to health care providers focus on clinical care and treatment. To develop injury interventions based on given data, recruitment of professionals as registry data coordinator with specific job description to collect and advocacy of injury external causes data seems imperative. Keywords: data collection, registries, trauma, road traffic accident, data completeness, World Health Organizatio

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Serum total IgE levels and total eosinophil counts: Relationship with treatment response in patients with acute asthma Relação dos níveis séricos de IgE total e das contagens de eosinófilos com a resposta ao tratamento em pacientes com asma aguda

Objective: To determine whether serum total IgE levels and total eosinophil counts have any relationship with the response to routine pharmacological treatment in patients with acute asthma. Methods: A cross-sectional study involving 162 patients with acute asthma. Serum total IgE levels, peripheral blood cell counts and eosinophil counts were determined. The treatment was adjusted for each patient according to the severity of asthma. Spirometry was performed at baseline and two weeks after the treatment. The patients were divided into two groups: high IgE (�100 IU/mL) and low IgE (&lt;100 IU/mL). We compared the two groups in terms of the relationships between baseline values and final values (percentage change) for the following parameters: FEV1, FVC, FEF25-75, peripheral white blood cell counts and eosinophil counts. Results: There were no significant differences between the groups regarding the percentage changes of the studied parameters. Nor were there significant differences between the groups regarding FEV1, FVC, FEF25-75 ( of the predicted values) at baseline. Conclusions: On the basis of these findings, we conclude that serum total IgE levels, peripheral white blood cell counts and eosinophil counts cannot predict the response to the pharmacological treatment of patients with acute asthma

Results of clinical and sonographic estimation of fetal weight

Background: Accurate estimated fetal weight (EFW) has importance in the management of labor and delivery. Estimated fetal weight was done in two sonographic and clinical ways (Palpation of abdomen). Many studies have been conducted for comparing clinical and sonographic EFW. With regard to contraindications and absence of studies in this area, this research was conducted on women admitted due to termination of pregnancy in Shabih Khani Maternity Hospital in 1383 Materials and Methods: This research as a cross-sectional study was done on 100 women with gestational 37/42-week ages admitted for termination of pregnancy. Excluded criteria consists of premature rupture of membrane, placenta abruption- placenta previa , preeclampsia, fetal abnormality , amniotic fluid disorder Clinical estimation in labor was performed by senior resident or obstetrician and sonographic estimation was performed by sonographists. The actual birth weight was determined by electronic scales and recorded in the chart immediately after delivery. Accuracy of birth weight estimation was determined by calculating the percentage error, and the proportion of estimates within 10% of the actual birth weight. Then processing of information performed by chi-square, fisher exact test and relative risk was determined Results : study on 100 pregnant woman showed mean age was 22.5 ± 4.5 and mean gestational age was . 39.2 ± 0.9 and mean birth weight was 3513 ± 370.3 .Birth weight in %10 of new born was less than 3000 gr and %12 of birth weight was more than 4000 gr . In total pregnant women clinical estimation in (83 women) 83% and sonographic estimation in (67 women) 67% was acceptable in which statically were important (P= 0.009).In birth weight less than 3000 gr sonographic estimate better than clinical estimate p<0, 03 Conclusion: regarding that most of fetus is reneged between 3000-4000 gr. accuracy of clinical estimation is often more than sonographic estimation so that we can perform EFW by simple weight and without cost. But in cases such as low birth weight that sonographic estimation of weight as direct diagnosis are defined and in obese women due to difficulty of clinical estimation , we suggest sonographic estimation to use

Molecular characterization and antibiotic susceptibility pattern of methicillin-resistant S. aureus (MRSA) in Tertiary care hospital, Kashan (Urdu Source)

Background and Objective: Methicillin resistant Staphylococcus aureus (MRSA), which is the most common cause of nosocomial infection, has been a major cause of morbidity and mortality around the world. This study was carried out to find out the resistance pattern and staphylococcal cassette chromosome mec (SCCmec) typing among MRSA. Materials and Methods: This descriptive work was done on 87 Methicillin resistant taphylococcus aureus isolates which were collected from the patients with infections in a teaching hospital in Kashan, Iran, during the period of 2009. The isolates were tested for antibiotic resistance by the disc-diffusion method, covering 10 antimicrobials. The genotypes of SCCmec subtypes were determined by multiplex PCR. Results: Amomg 87 MRSA isolated tested; the highest resistance was shown against erythromycin, clindamycin, sulfamethoxazole-trimethoprim, and tetracycline respectively. By contrast, the highest sensitivity was shown to amikacin. All of the isolates were resistant to Beta-lactams. All of the isolates were resistant to at least three classes of antibiotics, and all of the isolates were sensitive to vancomycin. Three (3.4) MRSA strains were SCCmec type I, 12 (13.8) were type II, 8 (9.2) were type IV-b, 4 (4.6) were type IV-d, and 3 (3.4) were typeV. Overall, 57 (65.5) MRSA strains could not be typed. Conclusion: The rising trend of multi-resistance to antibiotics poses an alarming threat to treatment of MRSA infections. Our findings show that clinical isolates of MRSA in our hospital carrying various kinds of staphylococcal cassette chromosome mec (SCCmec) types. SCCmec typse II and IV were the predominant strain of MRSA identified

Self-confidence among male high school students in Kashan, 1996-97

History and Objectives: Due to the importance of self-confidence on the carrier, social, family and psychological well being of adolescents, due to the lack of information on the self-confidence among adolescents, the present study was undertaken in order to determine the rate of self-confidence among male high school students in 1996-1997 school year. Materials and Methods: A descriptive study on 400 cases was performed. Self-confidence was assessed on the basis of Eyseneck method and divided into 3 high (Score higher than 21), fair (Score between 14-21) and low self esteem (Lower than 14). In addition, personal records including birth ranks in the family, family size and age were recorded. The prevalence of low self-esteem in the samples with 95 confidence of interval was obtained. Results: Low self-confidence was observed among 21.5 whereas 71.3 individuals had fair self-confidence and 7.3 had high self-confidence. High self-confidence was observed with family size of 5 or higher and among older children in a given family. Conclusion: Since low self-confidence is prevalent among adolescents in Kashan, further analytical research is required to find the underlying causes of low self-confidence