Psychological distress among Bam earthquake survivors in Iran: a population-based study

BACKGROUND: An earthquake measuring 6.3 on the Richter scale struck the city of Bam in Iran on the 26th of December 2003 at 5.26 A.M. It was devastating, and left over 40,000 dead and around 30,000 injured. The profound tragedy of thousands killed has caused emotional and psychological trauma for tens of thousands of people who have survived. A study was carried out to assess psychological distress among Bam earthquake survivors and factors associated with severe mental health in those who survived the tragedy. METHODS: This was a population-based study measuring psychological distress among the survivors of Bam earthquake in Iran. Using a multi-stage stratified sampling method a random sample of individuals aged 15 years and over living in Bam were interviewed. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12). RESULTS: In all 916 survivors were interviewed. The mean age of the respondents was 32.9 years (SD = 12.4), mostly were males (53%), married (66%) and had secondary school education (50%). Forty-one percent reported they lost 3 to 5 members of their family in the earthquake. In addition the findings showed that 58% of the respondents suffered from severe mental health as measured by the GHQ-12 and this was three times higher than reported psychological distress among the general population. There were significant differences between sub-groups of the study sample with regard to their psychological distress. The results of the logistic regression analysis also indicated that female gender; lower education, unemployment, and loss of family members were associated with severe psychological distress among earthquake victims. CONCLUSION: The study findings indicated that the amount of psychological distress among earthquake survivors was high and there is an urgent need to deliver mental health care to disaster victims in local medical settings and to reduce negative health impacts of the earthquake adequate psychological counseling is needed for those who survived the tragedy

Disaster Preparedness: Knowledge, Attitude, and Practice of Hospital Staff

Background: A disaster, as a serious disruption in the functioning of society, may cause extensive damage. Following a disaster, the demand for healthcare increases, and people rush to healthcare centers. In such situations, health staff and medical services play an important role. As a result, people’s knowledge, attitude, and practice toward disaster preparedness in the workplace play an important role in accident prevention. Materials and Methods: This cross-sectional analytical descriptive study was conducted to evaluate the level of knowledge, attitude, and practice of hospital staff to prepare for disasters in 2020. A total number of 350 hospital staff working at Shiraz University of Medical Sciences were selected using the cluster sampling method. A researcher-made questionnaire was used to collect the data and SPSS software, version 21 was used to analyze the data. Results: The mean scores for knowledge, attitude, and practice regarding disaster preparedness were 9.44±1.53, 39.26±4.8, and 7.26±3.66, respectively. In addition, 74.5%, 89.5%, and 29.2% of participants showed good knowledge, attitude, and practice, respectively. There was a significant relationship between knowledge and attitude (r=254, P<0.001), knowledge and practice (r=205, P<0.001), and attitude and practice (r=161, P=0.004).  Conclusion: Results revealed a good level of knowledge and attitude and a moderate level of practice in hospital staff in terms of disaster preparedness. It seems necessary to hold both theoretical and practical training programs as well as operational maneuvers with an emphasis on repetition in appropriate intervals

Comparison of VATS and thoracotomy in the treatment of empyema thoracis in children: A retrospective observational study: VATS and thoracotomy in empyema of children

Introduction: The use of minimally invasive surgical techniques, such as VATS, has impacted the management of intrathoracic diseases, including empyema thoracis (ET). While VATS is superior to thoracotomy in various thoracic diseases, no specific intervention has been proven superior for ET, and its superiority in the pediatric population is not well-established. A retrospective study was conducted to compare outcomes between VATS and thoracotomy in managing ET. Methods: This is a retrospective observational study of 80 patients who underwent surgery for empyema thoracis. The patients were divided into two groups: VATS and thoracotomy. The outcomes measured were length of stay, admission days after surgery, need for segmentectomy, wound infection, pneumothorax, retained hemothorax, emphysema, redo surgery, and mortality rate. Results: There were 42 patients in the thoracotomy group and 38 patients in the VATS group. The two groups did not differ significantly in terms of age, gender, involved side, etiology, and stage of the disease. The length of stay and admission days after surgery were slightly longer in the thoracotomy group than the VATS group, but the difference was not statistically significant. The incidence of wound infection, pneumothorax, retained hemothorax, and emphysema was significantly higher in the thoracotomy group than the VATS group. However, there was no significant difference between the two groups in terms of redo surgery and mortality rate. Conclusion: VATS is associated with fewer complications, including wound infection, pneumothorax, retained hemothorax, and emphysema. Therefore, VATS should be considered as a safe surgical intervention for empyema thoracis

Prognostic Impact of Adjuvant Radiotherapy in Breast Cancer Patients with One to Three Positive Axillary Lymph Nodes

Background: Radiotherapy, as an adjuvant treatment, plays a well-known role in prevention of locoregional recurrence in breast cancer patients. This study aims to investigate the impact of radiotherapy in patients with N1 disease. Methods: In this retrospective study, we reviewed the characteristics and treatment outcomes of 316 patients with a biopsy proven diagnosis of breast carcinoma and 1-3 positive axillary lymph nodes. The patients received treatment between 1995 and 2014. The patients had a median follow-up of 60 (range: 6-182) months. Results: This study was conducted on 316 patients with a median age of 48 (range: 26-86) years. Among patients, 215 underwent modified radical mastectomy and 101 had breast-conserving surgery before adjuvant treatment. Indeed, 259 patients received radiotherapy (radiation group) and 57 did not (control group). There was locoregional recurrence in one control group patient and two patients in the radiation group. Multivariate analysis results indicated hormone receptor status as an independent prognostic factor for the 5-year disease-free survival rate. Estrogen and progesterone receptor negativity (HR = 1.80, 95% CI: 1.02-3.19, P=0.043) also had a negative influence on the 5-year disease-free survival rate. However, radiotherapy had no significant effect on disease-free survival (P=0.446) and overall survival (P=0.058) rates. Conclusion: The results showed that adjuvant radiotherapy had no prognostic impacts on locoregional and distant disease control in breast cancer patients with N1 disease