The Prevalence of Sharp Object Injuries and Consequences in the Hospital Staff of the Qom Province

سابقه و هدف: آسيب‌هاي ناشي از ابزار برنده به‌عنوان يکي از خطرات مشاغل بهداشتي- درماني شناخته مي‌شود که پيشگيري از آن‌ها در دستورالعمل‌هاي ايمني مشاغل آورده شده است. اين مطالعه با هدف بررسي همه‌گيري‌شناسي آسيب‌هاي ناشي از ابزار برنده و پيامدهاي حاصل از آن‌ها در کارکنان بيمارستان‌هاي استان قم انجام‌ شد. روش بررسي: اين تحقيق به شکل توصيفي- تحليلي گذشته‌نگر بر روي پرونده‌هاي سه سال اخير کارکنان انجام شد. تجزيه و تحليل آماري داده ‌هاي اين مطالعه به‌وسيله‌ي نرم‌افزار SPSS انجام شد و براي مقايسه گروه‌ها از آزمون‌هاي آماري کاي مربع (k2) و تي تست (T-test) و آزمون دقيق فيشر (Fisher Exact test) استفاده شد. لازم به ذکر است به تمامي بيماران اين اطمينان داده شد که اطلاعات محرمانه باقي خواهد ماند و در صورت انتشار، اسامي افراد ذکر نخواهد شد. يافته‌ها: مجموعاً 100 نفر(59 زن و 41 مرد) از کارکنان بهداشتي درماني بيمارستان‌هاي موردمطالعه که سابقه ثبت صدمات ناشي از اجسام برنده را در پرونده داشتند وارد مطالعه شدند. ميانگين سني افراد آسيب‌ديده 4/6±42 سال و فراواني افراد بالاتر از 30 سال بيش از افراد کمتر از 30 سال بود (05/P<0). بيشترين درصد آسيب‌ها مربوط به پرستاران (و پيراپزشکان) با 47% و کمترين ميزان مربوط به پزشکان با 15% موارد بود (05/P<0) که اغلب در نوبت شب (57%) و بخش‌هاي جراحي (21%) ، اورژانس و  تزريقات (20%) رخ داد. سرسوزن سرنگ (51%) و سوزن بخيه (42%) با اختلاف معني‌دار عامل بيشترين آسيب بودند . 28% از افراد منبع HBs Ag مثبت داشتند گرچه در پايش افراد آسيب‌ديده هيچ‌کدام از آزمايش‌ها مثبت نشدند. نتيجه‌گيري: ازآنجايي‌که وقوع جراحات با اجسام برنده به‌ويژه در نوبت شب ممکن است در انتقال عفونت‌هاي منتقله از خون نظير ويروس هپاتيت نقش داشته باشد؛ ضروري است اين آسيب‌ها يکي از مخاطرات مهم شغلي به‌ويژه براي کارکنان مراکز بهداشتي-درماني محسوب شده و به‌طور کامل موارد اين اتفاقات مراقبت شوند. How to cite this article: Nateghi Rostami M, Darzi F. The Prevalence of Sharp Object Injuries and Consequences in the Hospital Staff of the Qom Province. J Saf Promot Inj Prev. 2020; 8(2):58-64. Background and Objectives: Sharp injuries are known as one of the hazards of Health Care workers. This study was designed to determine the epidemiology of sharp injuries of  staffs in the  Qom province. Materials and Methods: This is a descriptive-analytical and retrospective study which is done on the sharp injuries patients files in the last three years in Qom province. Statistical analysis of data was performed by using SPSS software (Ver. 22).k2, t-test and Fisher’s exact tests were used to compare groups. Result: Totally 100 subjects (59 female and 49 men) who had a history of injuries accident were included from Qom provinces’ hospitals. The mean age of the subjects was 42±6.4 years and the frequency of those over 30 years was significantly higher than other age groups (P<0.05). The highest percentage of injuries was related to nurses and paramedics with 47% and the lowest rate to physicians (15%) (P<0.05); most of them were working at nights (57%) in surgery (21%) and emergency (20%) units. Syringe (51%) and suture (42%) needles were responsible for most of the injuries (P<0.05). Most of subjects were negative for viral infections tests, but 28% of them were HBs Ag positive. Other laboratory tests were also negative for the affected subjects. Conclusion: As sharp injuries especially in the night shifts might have a role in the transfer of blood burn infections including Hepatitis viruses, it is necessary to recognize sharp injuries as a major occupational hazard, especially for health care staff, and accidents should be included in surveillance programs. How to cite this article: Nateghi Rostami M, Darzi F. The Prevalence of Sharp Object Injuries and Consequences in the Hospital Staff of the Qom Province. J Saf Promot Inj Prev. 2020; 8(2):58-64.&nbsp

Optimization of Gamma-Aminobutyric Acid Production in Probiotics Extracted from Local Dairy Products in West Region of Iran using MRS broth and Whey Protein Media

Background and objective: Gamma-aminobutyric acid is a non-protein amino acid produced by lactic acid bacteria in fermented foods and includes unique functions in the human biological system. The aim of this study was optimization of culture media for gamma-aminobutyric acid production in probiotics extracted from local dairy products in west of Iran using two culture media of MRS broth and whey protein.Material and methods: The potential of gamma-aminobutyric acid production was assessed in Lactobacillus paracasei, Lactobacillus plantarum and Pediococos acidilactici, respectively extracted from doogh, yogurt and cheese using MRS broth and whey protein media and high performance liquid chromatography. To increase gamma-aminobutyric acid production, these media were optimized as pH (4-6), temperature (30-50°C), time (12-72 h) and glutamic acid concentration (25-250 mM).Results and conclusion: Results have shown that Lactobacillus plantarum extracted from doogh includes the highest potential of gamma-aminobutyric acid production (115.24 mg kg-1) under the following conditions of a culture temperature of 37°C, incubation time 60 h at pH 5 in MRS broth containing 50 mM of glutamic acid. After optimization of Lactobacillus plantarum media, gamma-aminobutyric acid production increased to 170.492 mg kg-1. The optimum conditions included a glutamic acid concentration of 250 mM, culture temperature at 37.27°C, pH=5.19 and an incubation time of 72 h. Based on the results, use of local isolated dairy products in west region of Iran and optimization of growth conditions increased the ability of gamma-aminobutyric acid production.Conflict of interest: The authors declare no conflict of interest

Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran):a pragmatic, cluster-randomised trial

Background: A fixed-dose combination therapy (polypill strategy) has been proposed as an approach to reduce the burden of cardiovascular disease, especially in low-income and middle-income countries (LMICs). The PolyIran study aimed to assess the effectiveness and safety of a four-component polypill including aspirin, atorvastatin, hydrochlorothiazide, and either enalapril or valsartan for primary and secondary prevention of cardiovascular disease. Methods: The PolyIran study was a two-group, pragmatic, cluster-randomised trial nested within the Golestan Cohort Study (GCS), a cohort study with 50 045 participants aged 40�75 years from the Golestan province in Iran. Clusters (villages) were randomly allocated (1:1) to either a package of non-pharmacological preventive interventions alone (minimal care group) or together with a once-daily polypill tablet (polypill group). Randomisation was stratified by three districts (Gonbad, Aq-Qala, and Kalaleh), with the village as the unit of randomisation. We used a balanced randomisation algorithm, considering block sizes of 20 and balancing for cluster size or natural log of the cluster size (depending on the skewness within strata). Randomisation was done at a fixed point in time (Jan 18, 2011) by statisticians at the University of Birmingham (Birmingham, UK), independent of the local study team. The non-pharmacological preventive interventions (including educational training about healthy lifestyle�eg, healthy diet with low salt, sugar, and fat content, exercise, weight control, and abstinence from smoking and opium) were delivered by the PolyIran field visit team at months 3 and 6, and then every 6 months thereafter. Two formulations of polypill tablet were used in this study. Participants were first prescribed polypill one (hydrochlorothiazide 12·5 mg, aspirin 81 mg, atorvastatin 20 mg, and enalapril 5 mg). Participants who developed cough during follow-up were switched by a trained study physician to polypill two, which included valsartan 40 mg instead of enalapril 5 mg. Participants were followed up for 60 months. The primary outcome�occurrence of major cardiovascular events (including hospitalisation for acute coronary syndrome, fatal myocardial infarction, sudden death, heart failure, coronary artery revascularisation procedures, and non-fatal and fatal stroke)�was centrally assessed by the GCS follow-up team, who were masked to allocation status. We did intention-to-treat analyses by including all participants who met eligibility criteria in the two study groups. The trial was registered with ClinicalTrials.gov, number NCT01271985. Findings: Between Feb 22, 2011, and April 15, 2013, we enrolled 6838 individuals into the study�3417 (in 116 clusters) in the minimal care group and 3421 (in 120 clusters) in the polypill group. 1761 (51·5) of 3421 participants in the polypill group were women, as were 1679 (49·1) of 3417 participants in the minimal care group. Median adherence to polypill tablets was 80·5 (IQR 48·5�92·2). During follow-up, 301 (8·8) of 3417 participants in the minimal care group had major cardiovascular events compared with 202 (5·9) of 3421 participants in the polypill group (adjusted hazard ratio HR 0·66, 95% CI 0·55�0·80). We found no statistically significant interaction with the presence (HR 0·61, 95% CI 0·49�0·75) or absence of pre-existing cardiovascular disease (0·80; 0·51�1·12; pinteraction=0·19). When restricted to participants in the polypill group with high adherence, the reduction in the risk of major cardiovascular events was even greater compared with the minimal care group (adjusted HR 0·43, 95% CI 0·33�0·55). The frequency of adverse events was similar between the two study groups. 21 intracranial haemorrhages were reported during the 5 years of follow-up�ten participants in the polypill group and 11 participants in the minimal care group. There were 13 physician-confirmed diagnoses of upper gastrointestinal bleeding in the polypill group and nine in the minimal care group. Interpretation: Use of polypill was effective in preventing major cardiovascular events. Medication adherence was high and adverse event numbers were low. The polypill strategy could be considered as an additional effective component in controlling cardiovascular diseases, especially in LMICs. Funding: Tehran University of Medical Sciences, Barakat Foundation, and Alborz Darou. © 2019 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved

Feasibility of Using Green Tea Powder as a Natural Antioxidant and Stevia as a Sweetener in Non-Fermented Layer Cake

Today there is an increasing demand for low-calorie and functional food products worldwide. Green tea powder (GTP) has antioxidant property due to its phenolic structure which makes it a good natural replacement for synthetic antioxidants. Stevia is a calorie-free product which can be substituted for sucrose in foods. The aim of this study was to investigate the feasibility of using GTP and stevia instead of flour and sugar, respectively, in the formulation of non-fermented layer cake. Methods: To do so, different concentrations of GTP (10, 20, 30% w/w) and stevia (40, 60, 80% w/w) were incorporated into the formulation of cake. Ten treatments were designed and the rheological properties of dough including farinograph and extensograph characteristics were measured. Three dough samples with superior rheological properties along with control sample were baked. The physicochemical and sensory properties of the selected samples were compared with those of control sample. Results: The layer cakes containing 10% GTP and 40%, 60%, and 80% stevia were selected as the superior treatments and their quality properties were compared with those of control sample. Increased concentration of stevia significantly reduced the specific volume and increased the firmness of the layer cake samples. There was no significant difference in total acceptance between the layer cakes containing GTP and stevia and control sample. Conclusion: The treatment containing 10% green tea powder and 80% stevia was selected as the superior treatment regarding the nutritional and quality properties

A hybrid quality function deployment and cybernetic analytic network process model for project manager selection

Identifying appropriate decision criteria and making optimal decisions in a structured way is a complex process. This paper presents an approach for doing this in the form of a hybrid Quality Function Deployment (QFD) and Cybernetic Analytic Network Process (CANP) model for project manager selection. This involves the use of QFD to translate the owner's project management expectations into selection criteria and the CANP to weight the expectations and selection criteria. The supermatrix approach then prioritises the candidates with respect to the overall decision-making goal. A case study is used to demonstrate the use of the model in selecting a renovation project manager. This involves the development of 18 selection criteria in response to the owner's three main expectations of time, cost and quality

The Effect of Sodium Nitrite Replacement with Lycopene Pigment in German Sausage and Evaluation of Its Physicochemical, Antimicrobial and Sensory Properties

Background: Meat products contain sodium nitrite. Consumer demand for natural preservatives instead of synthetic ones in foods has been growing in recent years because of their safety. Today, good quality meat products are produced worldwide, and in addition to desirable sensory properties, they are cheaper than fresh meat. Sausage with 40% red meat is one of these products which can partially meet the need for animal proteins. Methods: In this study, sodium nitrite was replaced by lycopene pigment at concentrations of 200, 400 and 600 ppm in 40% meat sausage. Physicochemical properties of sausage samples including moisture, protein, ash contents and pH value were measured according to National Standard. Microbial tests (Clostridium, mold, yeast and Clostridium perfringens count) were performed according to National Standards. The colorimetric lightness index (L*) of the sausage samples was measured. Sensory properties (smell and taste) were compared with control sample (40% meat sausage contain 120 ppm sodium nitrite) after 30 days of storage. Data were analyzed using Duncan's one-way analysis of variance at 95% confidence level through Minitab 16 software. Results: After 30 days of storage, no significant (P>0.05) difference was found in physicochemical properties, microbial tests, lightness index (L*), and sensory properties among the samples. Conclusions: Since no significant difference was observed in microbial load and sensory scores between sausage sample containing 600 ppm lycopene pigment and control sample, 600 ppm lycopene pigment can be used in sausage formulation

Comparison of clinical performance of antigen basedenzyme immunoassay (EIA) and major outer membrane protein (MOMP)-PCR for detection of genital Chlamydia trachomatis infection

Background: Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen worldwide. Early detection and treatment of C.trachomatis genital infection prevent serious reproductive complications. Objective: Performances of enzyme immunoassay (EIA) and major outer membrane protein (MOMP)-polymerase chain reaction (PCR) for diagnosis of genital C.trachomatis infection in women were compared. Materials and Methods: In this cross sectional study a total of 518 women volunteers were included (33.67±8.3 yrs) who had been referred to Gynecology clinics of Qom province, Iran, were included. Endocervical swab specimens were collected to detect lipopolysaccharide (LPS) antigen in EIA and to amplify MOMP gene of C.trachomatis in PCR. Results were confirmed using ompI nested-PCR. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) were calculated for performance of the tests. Odds ratios were determined using binary logistic regression analysis. Results: In total, 37 (7.14%) cases were positive by EIA and/or MOMP-PCR. All discrepant results were confirmed by nested-PCR. Sensitivity, specificity, PPV and NPV values of EIA were 59.46%, 100%, 100% and 96.98%, and those of MOMPPCR were 97.30%, 100%, 100%, 99.79%, respectively. Reproductive complications including 2.7% ectopic pregnancy, 5.4% stillbirth, 5.4% infertility, and 10.8% PROM were recorded. The risk of developing chlamydiosis was increased 4.8-fold in volunteers with cervicitis (p<0.05; OR 4.80; 95% CI 1.25-18.48). Conclusion: C.trachomatis infection should be regarded in women of reproductive ages especially those with cervicitis. Primary screening of women by using the low cost antigen-EIA is recommended; however, due to the low sensitivity of Ag-EIA, verification of the negative results by a DNA amplification method is needed