Protection provided by hepatitis B vaccine in adult population of Chaharmahal and Bakhtiari province, Iran in 2013

Introduction: Hepatitis B vaccination has been integrated into National Expanded Program on Immunization in Iran since the year 1993 and young adult national vaccination project was done in 2008. So we have three subpopulations with vaccination coverage for hepatitis B and different antibody levels. Consisting of Subpopulation 1 born after 1993, subpopulation 2 born between 1989 and 1993 and receiving vaccination under adult national project, and subpopulation 3 born prior to the year 1989. Aim: The present study was conducted to investigate community protection by hepatitis B vaccine in adult population in an accessible population in Iran and compare vaccination coverage, HBs Ab level, and its effective titration among the three above-mentioned subpopulations. Materials and Methods: This cross-sectional study was done on a 3000-individual adult population from all seven counties of Chaharmahal and Bakhtiari province enrolled by clustering. After obtaining written consent and filling out a questionnaire of demographic data and history of hepatitis B vaccination by trained interviewers, necessary blood sample was taken and HBs Ab titration was checked. The data were analysed by chi-square in SPSS 19. The level of significance was considered as 0.05 and effective Ab titration as ≥ 10. Results: The mean age of the participants was 38.4±16.3 years. Of the participants 48.2% had effective titration. For vaccination coverage, 77.4% were unvaccinated, 20% completely vaccinated, and 2.6% incompletely vaccinated with a significant association with effective titration (p<0.001). Eighty six percent of the subpopulation 1 and 79% of the subpopulation 2 were completely vaccinated, with a significant difference in effective titration between them (p<0.001). Vaccination coverage was higher in men and the single but equal in cities and villages. The effective titration was significantly associated with being married and residence place (p=0.003). There was a significant association between effective titration and the time at vaccination (p<0.001). Conclusion: Protection provided by hepatitis B vaccine in adult population is relatively suitable especially in the youth population; however, catch-up programs of the groups exposed to risk are recommended. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved

Prevalence of asymptomatic bacteriuria and associated host factors in women with type 2 diabetes in shahre-kord, Iran; 2005

Objective(s): Asymptomatic bacteriuria (ASB) is common among diabetic women. The aim of this study was to determine the prevalence and risk factors for ASB in women with diabetes. Design: Prospective cross-sectional study Setting: Chahar-Mahal province, Iran Subjects and Methods: One hundred women with type 2 diabetes and 100 normal women (control) who had no abnormalities of the urinary tract were recruited. Demographic data and information regarding previous history of urinary tract infections (UTIs), duration of diabetes and presence of pyuria was collected. Baseline serum creatinine and fasting blood sugar levels (FBSL) were measured. Main outcome measure(s): Prevalence and risk factors for ASB in normal and type 2 diabetic women. Intervention: The prevalence of ASB and related risk factors in the two groups and the rate of ASB progressing to symptomatic UTI in a six-month period were evaluated. Results: The prevalence of ASB was 20 in diabetics and 4 in control group (p < 0.05). Pyuria was present in 80 of diabetics with ASB. Symptomatic UTI in previous year was the only risk factor for ASB (p < 0.05). During a follow-up of six months, 40 diabetics with ASB developed to symptomatic UTI. Conclusions: The prevalence of ASB is increased in women with diabetes. We recommend screening for detection and treatment of ASB in diabetic women

Rate of satisfaction and evaluation of medical students (interns and externs) from the quality of clinical education in the Shahre-kord university of medical sciences-2005

Introduction: Revolution of information in medical sciences as one of the important parts of knowledge has made the attention to medical education more critical. This study was performed to evaluate the satisfaction of Shahre-kord university medical students (interns and externs) from the quality of education in clinical courses. Materials and Methods: In this descriptive-analytical study, the rate of satisfaction of 77 medical students (interns and externs) from the quality of education in Shahre-kord university clinical courses was evaluated using a locally standardized questionnaire. The findings were classified as: high, moderate and low. Data were analyzed using SPSS software (version 11). Results: A total of 77 students completed the questionnaire. The high rate of satisfaction from the quality of education in different clinical clerkship periods was reported as follows: Internal medicine 25/7, surgery (general surgery and orthopedic) 27/4, pediatric medicine 17/5, gynecology 6/3, infectious disease 54/5, neurology 36/5, ENT 54/5, ophthalmology 47/5, poisoning 21/2, psychiatry 37/7, urology 6/3, health science 17/6. In addition, high rate of satisfaction from professional skills teaching was reported by 17.4 of the students. The most satisfaction rate in internal and pediatric courses was from morning reports and in surgery clerkship period, from outpatient clinic and theory courses. In gynecology period the lowest rate of satisfaction was reported from outpatient clinic and theory courses. High rate of satisfaction in minor clerkship periods was reported from ENT, infectious disease, psychiatry, and neurology periods respectively. Conclusions: In major clerkship periods, the students were unsatisfied from teaching rounds, outpatient clinic and theory courses. In contrast, high rate of satisfaction was belonged to morning report programs. Due to the low rate of satisfaction from gynecology, poisoning and urology courses and also un-satisfaction from CPR and labor management teaching, reviewing the educational programs by teaching managers is recommended

Frequency and severity of Post Traumatic Stress Disorder and efficacy of mental health intervention in children and young adults from a rural region in Chaharmahal and Bakhtyari Province, Safilan

چکیده: زمینه و هدف: بلایا و حوادث همه ساله منجر به ایجاد معلولیت، صدمات مالی و مرگ در بسیاری از افراد می گردد. تلفات انسانی پس از حوادث غیر مترقبه منجر به ایجاد آثار روانی مانند استرس، اضطراب و شکایات جسمی می گردد. اختلال فشار روانی آسیب زاد یا اختلال پس از ضربه (PTSD) از جمله این آثار است که در پی مواجهه با فشار آسیب زای شدید ایجاد می گردد. از جمله حوادث تأسف بار در ایران می توان به واقعه آتش سوزی مدرسه ابتدایی روستای سفیلان از توابع استان چهارمحال و بختیاری اشاره نمود. پژوهش اخیر با هدف بررسی فراوانی و شدت عوارض روانی ناشی از حادثه در کودکان و نوجوانان روستا و تأثیر مداخلات روانی در آنان انجام گرفت. روش بررسی: در یک مطالعه نیمه تجربی کلیه کودکان 15-5 ساله روستای سفیلان (41 نفر) که در هنگام حادثه در روستای سفیلان حضور داشتند انتخاب شدند. از طریق مصاحبه چهره به چهره با والدین کودکان پرسشنامه اطفال یول (Yoll) بلافاصله بعد از واقعه آتش سوزی تکمیل و سپس مداخلات بهداشت روان شامل تشکیل گروههای کاری، بازگویی روانشناختی، شناخت افکار اجتماعی و راهکارهای درمانی به مدت دو هفته و طی 4 جلسه صورت پذیرفت. مجدداً پنج ماه بعد از حادثه و مداخله بهداشت و روان پرسشنامه مذکور تکمیل و داده ها از طریق آزمون های آماری t زوجی، t مستقل و آنالیز واریانس یک طرفه تجزیه و تحلیل گردید. یافته ها: در سنجش نوبت اول میانگین نمره PTSD 03/15±14/61 و در نوبت دوم 6/9±19/48 بود (001/0

Hepatitis a seroprevalence and associated risk factors: A communitybased cross-sectional study in Shahrekord, Iran

Background: Recently, the epidemiology of hepatitis A virus (HAV) infection has been changing sue to lifestyle-related variations. To our knowledge, there are no published data about the seroepidemiology of this infection in Shahrekord, central Iran, by which decisions on the commissioning of a vaccination program could be made. Objectives: This study aimed to assess the seroprevalence of HAV immunoglobulin G (IgG) antibody at the Shahrekord Center of Chaharmahal and Bakhtiari province, southwest Iran. Patients and Methods: In this cross-sectional study, using the multistage cluster sampling method, a total of 501 serum samples from the same number of individuals over 15 years in both urban and rural areas of Shahrekord, during 2013 were tested for HAV IgG antibody using enzyme-linked immunosorbent assay (ELISA). The data were analyzed using the Pearson chi-square test. Logistic regression was also used to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Results: It was found that 455 out of 501 (90.8%) serum samples, including those of 211 (42.1%) men and 290 (57.9%) women, were positive for HAV IgG antibody. Education level, age, marital status, and ethnicity were associated with HAV seropositivity in the studied individuals (P < 0.05). Conclusions: The HAV seroprevalence of 90.8% in the studied region may be representative of a highly endemic region of HAV that does not require a vaccination program to be commissioned. © 2016, Infectious Diseases and Tropical Medicine Research Center

Effect of early clinical exposure on attitude and performance of first year medical students

زمینه و هدف: یکی از چالش های آموزش دانشجویان پزشکی ملموس نبودن مفهوم کلی ارتباط بین دروس علوم پایه و بالین بیمار است که علاوه بر اختلال در یادگیری بر انگیزه و توانایی های دانشجویان نیز تاثیر منفی دارد. برخورد زودرس با محیط بالینی به عنوان یکی از راهکارهای رفع این چالش مطرح شده است. لذا این مطالعه با هدف تعیین میزان تاثیر اجرای دوره های آموزشی برخورد زودرس با محیط بالینی در نگرش و عملکرد آموزشی دانشجویان سال اول پزشکی دانشگاه علوم پزشکی شهرکرد اجرا شد. روش بررسی: مطالعه حاضر به صورت مداخله ای بر روی 43 دانشجوی پزشکی سال اول دانشگاه علوم پزشکی شهرکرد در سال 1386 انجام گرفت. مداخله به صورت شرکت این دانشجویان در یک برنامه آموزشی خاص و تحت نظر راهنما، در محیط بیمارستانی در قالب گردش در بخش ها، اطاق عمل، اورژانس و درمانگاه و یک شب کشیک به عنوان ناظر در بیمارستان و اورژانس بود. نگرش دانشجویان بوسیله پرسشنامه معتبر و دارای اطمینان 82/0 قبل و بعد از مداخله اندازه گیری شد. جهت سنجش عملکرد آموزشی از مقایسه نمرات دروس اختصاصی و نتایج آزمون جامع علوم پایه با دانشجویان مشابه سال قبل استفاده گردید. داده ها با استفاده از آزمون های t زوجی و مجذور کای تجزیه و تحلیل گردید. یافته ها: مقایسه نمره نگرش قبل و بعد از مداخله نشانگر افزایش معنی دار در نگرش دانشجویان بود (01/0

Hepatitis B Seroprevalence and Risk Factors in Adult Population of Chaharmahal and Bakhtiari Province in 2013

Background: Hepatitis B virus is one of the important viral causes of liver inflammation with high worldwide prevalence and important hepatic and extra hepatic complications. Objectives: The aim of this study was to investigate the prevalence and risk factors of hepatitis B in Chaharmahal and Bakhtiari province, Iran. Patients and Methods: For this descriptive, analytical, population-based study, 3000 participants older than 15 years were enrolled according to the clustering method. After obtaining written informed consent and taking required blood samples, we gathered data on demographic status and probable transmission routes of disease using questionnaire between 2012 and 2013. The data was analyzed using SPSS software (descriptive parameters and chi-square). P value below 0.05 was considered as statistically significant. Results: The mean age of participants was 38.4 +/- 16.3. The seroprevalence rate of hepatitis B was found to be 1.3% (95% CI, 0.95%-1.81%). Prevalence of HBeAg among HBsAg positive participants was 2.5% (only 1 of 40). Seroprevalence was higher in male group (2.5 times higher than women), age group of over 55 years, farmers, and non-public occupations. Positive seroprevalence was associated with a history of renal disease, familial transmission, transfusion, surgery in hospital, circumcision, contact with hepatitis B infected individuals, imprisonment, intravenous (IV) drug abuse, and smoking (P < 0.05). Nevertheless, the highest odds ratio (OR) was obtained for history of renal disease (OR = 7.64: 3.01-18.4), followed by imprisonment (OR = 5.4: 1.86-15.7) and IV drug abuse (OR = 5.68: 1.3-24.7). Conclusions: Chaharmahal and Bakhtiari province could be categorized as a low endemic region for hepatitis B infection, with a seroprevalence similar to that in other provinces of western Iran. Vaccination seems to influence its decrease, especially in adolescents and youth. More surveillance and attention to risk factors are suggested to identify high-risk groups and to implement vaccination

A study on hepatitis B vaccination coverage and HbsAb effective titer in adults of Chaharmahal va Bakhtyari province, 2013

Background and aims: Hepatitis B virus is a major cause of liver inflammation with high worldwide prevalence and important complications. This study was performed to survey vaccination coverage and effective HBsAb titer in this province. Methods: In this descriptive analytic study, 3000 adults more than 15 years old were selected by cluster sampling. After receiving their written informed consent and gathering blood samples, some information about demographic status and their vaccination were gathered by questionnaire, and effective HBsAB titers were measured. Results: Mean age of individuals was 38.4±16.3. HBsAb titer mean was 70.88±162 (0-3799). 48.7% individuals had effective titration. Vaccination coverage was complete in 20% and incomplete in 2.6%. 77% individuals, who were related to effective titration, were unvaccinated (P≥0.001). 86% of individuals who were born after 1993-4 and 79% who were born from (1989-1992) had complete coverage with a significant difference in titration. (P≥0.001). Vaccination coverage was higher in male, unmarried persons, but it was equal in rural and urban area. Effective titration had a relationship with marriage status and residential area and it was higher in single and rural persons (P≥0.001). There was a significant relationship between time of the last vaccination reception and effective titration (P≥0.003), but there wasn't any relationship with other factors. Conclusion: It seems vaccination coverage and HBsAb titer in adolescent and young individuals is proper, but it is suggested to use of catch up program for high risk groups to increase vaccination coverage