Socioeconomic status and catastrophic health expenditure evaluation in IR Iran: A comparative study in 2004 and 2011

Background: Health equity is a main principle of all healthcare systems in the world. Family Physician (FP) program, as a health sector reform (HSR) in Iran, was executed to reduce households’ health care cost and to achieve health equity in 2004. Meanwhile, catastrophic health expenditure is known as an accepted indicator in HSR evaluation. In this context, after determining and comparing socioeconomic status (SES) among different periods, we made an attempt to evaluate households’ health financial protection in different quintiles after implementation of FP program.  Methods: The current cross-sectional study was based on the data obtained from Household Income and Expenditure Survey in 2004 and 2011. The health expenditures, catastrophic health expenditure (CHE), and SES were determined by this data during these years. Descriptive analyses and comparisons using Chi-squared test were carried out via SPSS, version 20.  Results: A total of 1716 households were included in the survey during 2004 and 2011. The highest proportion of households was related to quintiles very poor and poor with respect to each year. Moreover, it was observed that SES in 2011 had the worse situation compared to that in 2004; this situation was worse in urban areas. In the present study, CHE is related to poorer quintiles, and in rural areas no household was faced with CHE in 2011.  Conclusions: Implementation of FP program in rural areas with more primary care has prevented hospitalization. This was considerable for poorer quintiles and has led to financial protection for rural households

Comparison of effect of ventolin and hypersaline 3 on recovery course of acute bronchiolitis in hajar hospital, shahrekord in 2013-2014

Background and Objective: Acute bronchiolitis is one of the most common reasons for inflammation, small airways obstruction, and lower respiratory tract infection in infancy. Owing that there has been no study on the efficacy of hypersaline 3% in the treatment of acute bronchiolitis in Iran, the present study was undertaken to deal with this issue. Materials and Methods: This double-blinded clinical trial was carried out in Hajar Hospital of Shahrekord in 2013-2014. 70 patients under 2 years of age with bronchiolitis were assigned to two groups of 35 each. The first group received nebulized Ventolin while the second group was given nebulized hypersaline 3% three times a day. Subsequent to these administrations, recovery duration was compared in both groups. Results: The mean and standard deviation of recovery duration in the Ventolin group was 4.14±0.9 days and in the hypersaline 3% group was 3.06±0.6 days. T-test and mean recovery duration was significantly lower in the hypersaline 3% group (P<0.001). Conclusion: Nebulizer hypersaline 3% had a better therapeutic effect than Ventolin in the treatment of acute bronchiolitis. Therefore, the use of this drug, rather than Ventolin, is recommended for the treatment of acute bronchiolitis in children under two years of age. © 2016, Zanjan University of Medical Sciences and Health Services. All right reserved

Effect of phenobarbital on nitric oxide level in term newborn infants with perinatal asphyxia

Perinatal asphyxia (PA) is very significant in perinatal medicine due to the involvement of the central nervous system. This study was conducted to investigate the biochemical, clinical, and paraclinical changes associated with phenobarbital administration in neonates with PA. Methods: In this prospective, case-control study, 30 neonates with PA in two groups of 15 each (case and control) were investigated. The case group received 20 mg/kg intravenous phenobarbital within six hours of birth, and the control group did not receive phenobarbital. Serum concentrations of nitric oxide (NO) were measured at enrollment and one week after birth in the two groups. Clinical, electroencephalography, and magnetic resonance imaging findings of the two groups were compared. Results: At enrollment, the two groups did not differ in clinical severity, seizure incidence, or NO concentration. After one week, NO concentration was significantly lower in the case group (p < 0.050), but there was no significant difference in other variables between the two groups. Conclusions: Early administration of phenobarbital in term neonates with PA could protect them against encephalopathy

Effect of Topical Application of the Cream Containing Magnesium 2% on Treatment of Diaper Dermatitis and Diaper Rash in Children A Clinical Trial Study

Introduction: Diaper dermatitis is referred to the inflammation in outer layers of the skin in the perineal area, lower abdomen, and inner thighs. The lesions are maculopapular and usually itchy, which could cause bacterial or candida infection, and predispose the infants to penis or vaginal and urinary infection and lead to discomfort, irritability, and restlessness. The drugs which have been so far administered for this disease (topical steroids) cause special complications for the sensitive skin in this area. Magnesium (Mg) is known for its anti-inflammatory and wound-healing properties. Aim: The aim of the present study was to study the effect of the cream containing Mg 2% on treatment of diaper dermatitis and diaper rash in children. Materials and Methods: In this clinical trial study, 64 children aged less than two years old with diaper dermatitis referring Paediatric Ward of Hajar Hospital were randomly assigned to two groups of 32. Group one was treated with the combined cream Mg 2% and Calendula and group two with Calendula cream alone. The duration of recovery was compared between the two groups. Results: The duration of recovery was significantly lower in the intervention group than the control group (p-value<0.001), but there was no significant difference in the lesions size and diapers' number between the two groups. Conclusion: Based on the finding of this study, Mg is effective on treatment of diaper dermatitis and could be used for treating diaper dermatitis and other types of dermatitis

Therapeutic effects of Ventolin versus hypertonic saline 3% for acute bronchiolitis in children.

BACKGROUND Complications of Ventolin as the most common drug used for bronchiolitis are widely known. The present study was conducted to determine the efficacy of hypertonic saline 3%, compared with Ventolin, for treatment of acute bronchiolitis in children. METHODS This double-blinded clinical trial study was conducted in Hajar Hospital, Shahrekord, Iran, from 2011 to 2012. A total of 70 patients under the age of two years with bronchiolitis were divided into two groups of 35 each. Ventolin nebulizer and hypertonic saline 3% nebulizer three times per day were administered in the first (Ventolin) and second (Hypersaline) group, respectively. The length of recovery was compared between the two groups. The data were analyzed by SPSS software (version 22) using chi-square, t-test, paired t-test, and Mann-Whitney. RESULTS The mean±SD length of recovery was 4.14±0.9 and 3.06±0.6 in the Ventolin and hypersaline groups, respectively. The mean duration of recovery was significantly lower in the hypersaline group (p<0.001). CONCLUSION Hypertonic saline 3% nebulizer has more pleasant therapeutic effects on acute bronchiolitis than Ventolin. Therefore, use of hypertonic saline 3% nebulizer is recommended for the treatment of acute bronchiolitis in children under two years old