Effect of a participatory intervention to reduce the number of unnecessary cesarean sections performed in Shahrekord, Iran

چکیده: زمینه و هدف: در سال های اخیر در کل جهان و از جمله ایران روند رو به رشد سزارین به چشم می خورد. در شهرکرد در سال 1380 سزارین 49 زایمان ها را به خود اختصاص داده است. در دنیا رویکرد جدیدی جهت کمک گرفتن از نیروهای مردمی در حل مشکلات سلامتی بوجود آمده است. در این تحقیق نقش مشارکت گروههای مردمی در کاهش میزان سزارین مورد بررسی قرار گرفته است. روش بررسی: در یک مطالعه میدانی (فیلد تریال) 171 زن باردار که سابقه قبلی سزارین نداشتند و کمتر از 3 بار زایمان داشته اند از زنان باردار به صورت تصادفی انتخاب شدند. ساختار یک گروه مردمی متشکل از پزشکان، ماماها، پرستاران علاقمند، زنان خانه دار، معلمین، رابطین بهداشتی، پرسنل بهداشت خانواده، خانم های فروشنده و نمایندگانی از سازمان های غیر دولتی فعال شهر شکل گرفت. این گروه، زنان باردار انتخاب شده را از طریق آموزش ترغیب به انجام زایمان طبیعی نمود. رضایت زنان باردار از آموزش ها و فراوانی سزارین قبل و بعد از مداخلات جمع آوری و با استفاده از آزمون های آماری t زوجی و مک نمار تجزیه و تحلیل گردید. یافته ها: در این مطالعه 70 زنان باردار از آموزش های ارائه شده راضی بودندو فراوانی سزارین از63 قبل از اجرای طرح به 52 بعد از انجام مداخلات کاهش داشت (05/0

Study of clean (Class I) surgical wound infections in Shahrekord and Borujen hospitals, 2000

از نظر تاریخی زخم های جراحی به زخم های تمیز، تمیز-آلوده و آلوده تقسیم بندی می شوند. عفونت زخم های جراحی دومین نوع عفونت های شایع اکتسابی بیمارستانی هستند که حداقل 17 این موارد را شامل می گردند. میزان عفونت در صورت تجویز آنتی بیوتیک پروفیلاکسی برای زخم های تمیز، تمیز-آلوده و آلوده بترتیب در حدود 0.8، 1.3 و 10.2 در هر یکصد بیمار گزارش گردیده است. برای ارزیابی وضعیت عفونت های بیمارستانی و نیز تخمین میزان عفونت زخم های جراحی توصیه شده است که زخم های تمیز مورد پایش قرار گیرند. لذا با در نظر گرفتن این حقیقت، بررسی حاضر با هدف تعیین میزان شیوع عفونت های زخم های تمیز، جداسازی و شناسایی گونه های شایع باکتریایی و بررسی الگوی حساسیت عوامل عفونت زا به آنتی بیوتیک ها انجام شد. همچنین رابطه عفونت با عواملی همچون سن، نوع عمل و طول مدت جراحی مورد بررسی قرار گرفت. 845 زخم جراحی تمیز یا کلاس I در طی 9 ماه از بهمن 1378 تا آبان ماه 1379 مورد برسی قرار گرفتند. میزان بروز عفونت برای زخم های جراحی تمیز 4.9 بدست آمد. از سوی دیگر، میزان عفونت در اعمال جراحی که بیش از نیم ساعت بطول انجامیده بود بیشتر از اعمال انجام شده در مدت زمان کوتاه تر بود. استافیلوکوک اپیدرمیدیس با 73 شایع ترین عامل ایجاد کننده عفونت و پس از آن استافیلوکوک آرئوس با 17 و سپس انتروباکتر ائروژینوزا با 4.9 رتبه های بعدی را حائز گردیدند. سویه های استافیلوکوک اپیدرمیدیس و استافیلوکوک آرئوس جدا شده همگی به پنی سیلین و آمپی سیلین مقاوم بودند. باتوجه به شیوع بالای عفونت زخم های تمیز که حاکی از جدی بودن عفونت های بیمارستانی دربیمارستان های مورد مطالعه می باشد نیاز به استقرار یک برنامه سازمان یافته و موثر کنترل عفونت احساس می شود که به نوبه خود می تواند متشکل از یک سیستم فعال پایش عفونت در بیمارستان ها و اقدامات کنترلی شدید برای حذف خطرات شناخته شده باشد

Epidemiology of injured patients attending emergency wards in Kerman/ Iran 2002-03

Background: Injury is a major public health problem in Iran. The essential part of an injury control program is injury surveillance. This study was conducted to clarify the type of injuries and to explore the demographic characteristics of injured individuals in Kerman. Methods: This cross sectional study was conducted in emergency wards of three major hospitals of Kerman from August 2002 through July 2003. Data were collected by trained interviewers on arrival of patients attending the emergency wards every fourth day via a questionnaire. The questionnaire had three parts: demographic characteristics, type of injury, and baseline characteristics of accidents. Results: The age range of the injured patients (61%) was 15 - 39 years male to female ratio was 2/3. The educational level of the majority was less than high school (70%). Traffic accident was the most common cause of injury (36.6%, CI= 35.1% 38.1%). Falling down (9.83%, CI= 8.9% 10.7%) and physical fighting were the second and third causes of injury, respectively. Friday and Thursday had the highest proportion of accidents (15. 5% and 15. 1% respectively). A total of 27% of subjects admitted in hospitals, after initial evaluation in emergency wards. Conclusion: Adolescence is a major risk factor for injuries in Kerman. Road accident is also the most common cause of injury therefore more educational emphasis should be paid to prevention measures of traffic accident

Identification of the land use changes on river flooding bed, affective on reservoir water quality (Case study: headwater of Kardeh reservoir)

The effects of magnetic water were examined in terms of leaf area, special leaf area, and some of the physiographic indicators such as relative water capacity and foliar chlorophyll content (SPAD) in three species endemic to arid environments namely Nitraria, Haloxylon, and Atriplex. In addition to the factors mentioned, acidity (pH) and electrical conductivity (EC) were also measured. This research was conducted in a completely randomized block design with three replications. Data analysis was carried out via the analysis of variance using MSTAT software. The aim of this study was to investigate the effect of magnetic water on water use efficiency, rehabilitation of land, and the propagation of vegetation cover in arid areas, along with the introduction of a new Water Magnifier Device. The results showed that species irrigated with magnetic water, had better performance in terms of the growth indices. Leaf development was increased by 121.74, leaf area by 108.97 mm2, special leaf area by 3803.74 mm2.gr, RWC by 9.81%, and SPAD by 15.79. Water magnetization process also reduced pH to 5.0 and EC to 3.0 µmhos.cm-1

A Hierarchical Classification Method for Breast Tumor Detection

Introduction Breast cancer is the second cause of mortality among women. Early detection of it can enhance the chance of survival. Screening systems such as mammography cannot perfectly differentiate between patients and healthy individuals. Computer-aided diagnosis can help physicians make a more accurate diagnosis. Materials and Methods Regarding the importance of separating normal and abnormal cases in screening systems, a hierarchical classification system is defined in this paper. The proposed system is including two Adaptive Boosting (AdaBoost) classifiers, the first classifier separates the candidate images into two groups of normal and abnormal. The second classifier is applied on the abnormal group of the previous stage and divides them into benign and malignant categories. The proposed algorithm is evaluated by applying it on publicly available  Mammographic Image Analysis Society (MIAS) dataset. 288 images of the database are used, including 208  normal and 80 abnormal images. 47 images of the abnormal images showed benign lesion and 33 of them had malignant lesion.  Results Applying the proposed algorithm on MIAS database indicates its advantage compared to previous methods. A major improvement occurred in the first classification stage. Specificity, sensitivity, and accuracy of the first classifier are obtained as 100%, 95.83%, and 97.91%, respectively. These values are calculated as 75% in the second stage   Conclusion A hierarchical classification method for breast cancer detection is developed in this paper. Regarding the importance of separating normal and abnormal cases in screening systems, the first classifier is devoted to separate normal and tumorous cases. Experimental results on available database shown that the performance of this step is adequately high (100% specificity). The second layer is designed to detect tumor type.  The accuracy in the second layer is obtained 75%

Determining the efficiency of ZSM-5 zeolite impregnated with nanoparticles of titanium dioxide in the photocatalytic removal of styrene vapors

Introduction: Styrene monomer is a volatile organic compound that has many applications particularly in plastic, rubber and paint industries. According to the harmful effects of these compounds on human and environment, reducing and controling of them seem necessary. Therefore, in this study removal of styrene was investigated using photocatalytic process of titanium dioxide nanoparticles stabilized on ZSM-5. Methods: After stabilization of titanium dioxide nanoparticles on ZSM-5 zeolite, BET, SEM and XRD analysis were used to determine the characteristics of nanoparticles. Experiments were conducted at ambient temperature in laboratory scale. Concentration of produced styrene in the experiments was 50 and 300 ppm, and input flow rate was 1 l/min. Results: images and spectra obtained through XRD and SEM-EDAX showed that  nano-catalysts are well- stabilized. The results showed that by increasing of input concentration of styrene from 50 to 300 ppm, photocatalytic removal efficiency are reduced. Also, adsorption capacity of the catalyst bed in concentrations of 50 and 300 ppm was calculated 16.3 and19.4 mg/gr of adsorbent respectively. Conclusion: The results show that the use of hybrid bed can increase the removal efficiency of contaminants. And due to low cost of application of these systems compared to conventional methods, it is recommended that more comprehensive studies to be done regarding the optimization of the parameters affecting the process of photocatalytic removal