Assessment of related factors on delay in diagnosis of patients with smear-positive pulmonary tuberculosis

Background: Approximately, one third of the world population is infected with tuberculosis (TB) germs and is put at risk of tuberculosis. Pulmonary tuberculosis accounts for more than 80 percent of cases, mostly in adults with positive sputum smear. The mortality and morbidity of the disease are associated with delay in diagnosis. Delay in diagnosis can be related to the patients or the health care system. Methods: In this historical cohort study, all the patients with smear-positive pulmonary tuberculosis in Hamadan province from 21 March 2006 to 20 March 2012 were studied. Data on demographic characteristics, and clinical and treatment status of patients were extracted using patient registry software entitled TB Register. To determine the relationship between variables and the bacillus load, chi-square test was used. The logistic regression model was used to examine the co-effects of both variables on bacillus load of the patients at the time of the diagnosis. Data were analyzed using Stata11 software. Findings: From 440 patients with smear-positive pulmonary tuberculosis, 51 (221 patients) were men and 49 (219 patients) were women. 57 (251 people) were living in urban and others in rural areas. The grade of sputum smear at the time of diagnosis was associated with area of residence, age group, and gender, that all were statistically significant. Delay in diagnosis among women, was approximately 0.55 of men and those in urban areas were 67 higher than in rural areas, which were both statistically significant. Conclusion: Individual factors play important role in delayed diagnosis, regarding that men are diagnosed later than the women. Screening programs in the workplace are recommended. Sensitization of private physicians would be effective in early identification of patients in urban areas. © 2015 Isfahan University of Medical Sciences(IUMS). All rights reserved

Comparative study of dimensional accuracy in three dental implant impression techniques: Open tray, closed tray with impression coping, and snap cap

Aim: Several impression techniques have been proposed to result passive fitness between the prosthesis and osseointegrated implant. The aim of the study was to compare dimensional accuracy of three impression methods: Open tray, closed tray with impression coping, and closed tray with snap cap. Materials and methods: In this experimental study, a mandibular acrylic model was prepared with a milling machine to place three holes for dental implant analogs (Dio SM) with the dimension of 3.8 � 10 mm into the intended sites (one in midline and two others on the side at a distance of 10 mm) parallel with each other and perpendicular to the plane. Twenty-seven casts were prepared with impression material of polyvinyl siloxane (PVS) and dental stone type IV and divided into three groups. Implant situations were measured by coordinate measuring machine (CMM) and results were analyzed with Kruskal-Wallis and Mann-Whitney test to perform pairwise comparison among the groups. Results: The mean �R values for open tray, closed tray with impression coping, and closed tray with snap cap were respectively, 0.070 ± 0.088, 0.173 ± 0.205, and 0.142 ± 0.044.There were statistically significant differences between open tray and closed tray as well as open tray and snap cap methods (p < 0.05), but there was no statistically significant difference between closed tray and snap cap method (p = 0.1). Conclusion: Regarding the results, open tray impression technique had the highest dimensional accuracy compared with the other two methods. There were no statically significant differences between closed tray with snap cap and closed tray with impression coping technique. Clinical significance: Snap cap technique is less time consuming with similar dimensional accuracy in comparison with open tray impression technique. © 2018 Jaypee Brothers Medical Publishers (P) Ltd

The Effect of Training Premenstrual Coping Skills in Undergraduate Students in the School of Nursing and Midwifery, Hamadan-Iran

Background: The premenstrual Syndrome is a collection of physical, mental and emotional symptoms which influence the quality of individual’s life, so it is important to control and treat it. Objectives: The aim of this study was to investigate the effect of Training Premenstrual Coping Skills in Undergraduate Students in the School of Nursing and Midwifery, Hamadan-Iran. Methods: This is a quasi-experimental study including a before and after design on 140 students of Nursing and Midwifery in Hamadan-Iran, which was conducted in 2015. 80 Eligible individuals were selected by convenience sampling method and randomly assigned to intervention and control groups. The research tool which we used was a questionnaire related to stress and coping strategies before and it was completed before and two months after the intervention in two groups. The students were trained the coping skills in the intervention group over five weeks, for 60 to 90 minutes. Results: The average age between girls in intervention group is 21.71±3.21 and control group 21.94±3.16 is years old. Based on the results of Wilcoxon test average tension score’s comparison before Menstruation and also before and after intervention in each different statistical group is meaningful (p<0.01). Despite the reduction of tension score before Menstruation in the group of intervention difference, the comparison is not so meaningful (p=0.07). Conclusion: Training the Coping skills had no significant impact on reducing premenstrual stress, but contributes to improving people's coping skills. It is recommended to hold premenstrual stress coping skills training sessions with a longer time to achieve valuable result

O-C Study of 545 Lunar Occultations from 13 Double Stars

International audienceIn this article, we have studied the reports of lunar occultations by this project observation's teams (named APTO) in comparison with other observations of the objects. Thirteen binary stars were selected for this study. All the previous observations of these stars were also collected. Finally, an analysis of O-C of all reports were performed

Emotional Fuzzy Sliding-Mode Control for Unknown Nonlinear Systems

[[abstract]]The brain emotional learning model can be implemented with a simple hardware and processor; however, the learning model cannot model the qualitative aspects of human knowledge. To solve this problem, a fuzzy-based emotional learning model (FELM) with structure and parameter learning is proposed. The membership functions and fuzzy rules can be learned through the derived learning scheme. Further, an emotional fuzzy sliding-mode control (EFSMC) system, which does not need the plant model, is proposed for unknown nonlinear systems. The EFSMC system is applied to an inverted pendulum and a chaotic synchronization. The simulation results with the use of EFSMC system demonstrate the feasibility of FELM learning procedure. The main contributions of this paper are (1) the FELM varies its structure dynamically with a simple computation; (2) the parameter learning imitates the role of emotions in mammalians brain; (3) by combining the advantage of nonsingular terminal sliding-mode control, the EFSMC system provides very high precision and finite-time control performance; (4) the system analysis is given in the sense of the gradient descent method.[[notice]]補正完

Life Expectancy at Birth for People with Serious Mental Illness and Other Major Disorders from a Secondary Mental Health Care Case Register in London

Despite improving healthcare, the gap in mortality between people with serious mental illness (SMI) and general population persists, especially for younger age groups. The electronic database from a large and comprehensive secondary mental healthcare provider in London was utilized to assess the impact of SMI diagnoses on life expectancy at birth.People who were diagnosed with SMI (schizophrenia, schizoaffective disorder, bipolar disorder), substance use disorder, and depressive episode/disorder before the end of 2009 and under active review by the South London and Maudsley NHS Foundation Trust (SLAM) in southeast London during 2007-09 comprised the sample, retrieved by the SLAM Case Register Interactive Search (CRIS) system. We estimated life expectancy at birth for people with SMI and each diagnosis, from national mortality returns between 2007-09, using a life table method.A total of 31,719 eligible people, aged 15 years or older, with SMI were analyzed. Among them, 1,370 died during 2007-09. Compared to national figures, all disorders were associated with substantially lower life expectancy: 8.0 to 14.6 life years lost for men and 9.8 to 17.5 life years lost for women. Highest reductions were found for men with schizophrenia (14.6 years lost) and women with schizoaffective disorders (17.5 years lost).The impact of serious mental illness on life expectancy is marked and generally higher than similarly calculated impacts of well-recognised adverse exposures such as smoking, diabetes and obesity. Strategies to identify and prevent causes of premature death are urgently required

Is Symptomatic Long QT Syndrome Associated with Depression in Women and Men?

We examined whether long QT syndrome (LQTS) mutation carrier status or symptomatic LQTS are associated with depression, and whether there are sex differences in these potential relationships. The sample comprised 782 participants (252 men). Of the 369 genetically defined LQTS mutation carriers, 169 were symptomatic and 200 were asymptomatic. The control group consisted of 413 unaffected relatives. Depression was assessed using the Beck Depression Inventory-II (BDI-II). No association was found for LQTS mutation carrier status with depression. The multinomial logistic regression showed that LQTS mutation carrier men with arrhythmic events scored higher on depression compared with the control group, even when adjusting for age, beta-blockers, antidepressants, and social support (OR = 1.09, 95 % CI [1.02, 1.15], p = .007). The binary logistic regression comparing symptomatic and asymptomatic LQTS mutation carriers showed that symptomatic LQTS was associated with depression in men (OR = 1.10, 95 % CI [1.03, 1.19], p = .009). The results were unchanged when additionally adjusted for education. These findings suggest that symptomatic LQTS is associated with depression in men but not in women. Overall, however, depression is more frequent in women than men. Thus, regular screening for depression in LQTS mutation carriers and their unaffected family members can be important.Peer reviewe

Physical health behaviours and health locus of control in people with schizophrenia-spectrum disorder and bipolar disorder: a cross-sectional comparative study with people with non-psychotic mental illness

<p>Abstract</p> <p>Background</p> <p>People with mental illness experience high levels of morbidity and mortality from physical disease compared to the general population. Our primary aim was to compare how people with severe mental illness (SMI; i.e. schizophrenia-spectrum disorders and bipolar disorder) and non-psychotic mental illness perceive their: (i) global physical health, (ii) barriers to improving physical health, (iii) physical health with respect to important aspects of life and (iv) motivation to change modifiable high-risk behaviours associated with coronary heart disease. A secondary aim was to determine health locus of control in these two groups of participants.</p> <p>Methods</p> <p>People with SMI and non-psychotic mental illness were recruited from an out-patient adult mental health service in London. Cross-sectional comparison between the two groups was conducted by means of a self-completed questionnaire.</p> <p>Results</p> <p>A total of 146 people participated in the study, 52 with SMI and 94 with non-psychotic mental illness. There was no statistical difference between the two groups with respect to the perception of global physical health. However, physical health was considered to be a less important priority in life by people with SMI (OR 0.5, 95% CI 0.2-0.9, <it>p </it>= 0.029). There was no difference between the two groups in their desire to change high risk behaviours. People with SMI are more likely to have a health locus of control determined by powerful others (<it>p </it>< 0.001) and chance (<it>p </it>= 0.006).</p> <p>Conclusions</p> <p>People with SMI appear to give less priority to their physical health needs. Health promotion for people with SMI should aim to raise awareness of modifiable high-risk lifestyle factors. Findings related to locus of control may provide a theoretical focus for clinical intervention in order to promote a much needed behavioural change in this marginalised group of people.</p

Prevalence and determinants of unintended pregnancies amongst women attending antenatal clinics in Pakistan

Background: Unintended pregnancies are a global public health concern and contribute significantly to adverse maternal and neonatal health, social and economic outcomes and increase the risks of maternal deaths and neonatal mortality. In countries like Pakistan where data for the unintended pregnancies is scarce, studies are required to estimate its accurate prevalence and predictors using more specific tools such as the London Measure of Unplanned Pregnancies (LMUP). Methods: We conducted a hospital based cross sectional survey in two tertiary care hospitals in Pakistan. We used a pre tested structured questionnaire to collect the data on socio-demographic characteristics, reproductive history, awareness and past experience with contraceptives and unintended pregnancies using six item the LMUP. We used Univariate and multivariate analysis to explore the association between unintended pregnancies and predictor variables and presented the association as adjusted odds ratios. We also evaluated the psychometric properties of the Urdu version of the LMUP. Results: Amongst 3010 pregnant women, 1150 (38.2%) pregnancies were reported as unintended. In the multivariate analysis age \u3c 20 years (AOR 3.5 1.1-6.5), being illiterate (AOR 1.9 1.1-3.4), living in a rural setting (1.7 1.2-2.3), having a pregnancy interval of = \u3c 12 months (AOR 1.7 1.4-2.2), having a parity of \u3e2 (AOR 1.4 1.2-1.8), having no knowledge about contraceptive methods (AOR 3.0 1.7-5.4) and never use of contraceptive methods (AOR 2.3 1.4-5.1) remained significantly associated with unintended pregnancy. The Urdu version of the LMUP scale was found to be acceptable, valid and reliable with the Cronbach\u27s alpha of 0.85. Conclusions: This study explores a high prevalence of unintended pregnancies and important factors especially those related to family planning. Integrated national family program that provides contraceptive services especially the modern methods to women during pre-conception and post-partum would be beneficial in averting unintended pregnancies and their related adverse outcomes in Pakistan