KNOWLEDGE AND HEALTH
Year:2007 | Volume:2 | Issue:3|Papers Count:11

Introduction: Mechanical ventilation has important role in improvement the patient’s ventilation and oxygenation that their respiratory condition is poor. Nevertheless it can accompany with innumerous unfavorable complications. ICU scoring systems have been offered for rapid and proper weaning patients from mechanical ventilation and outcomes prediction also Apache II scoring system has earned public acceptability. As regards the importance of weaning outcomes prediction, researcher investigated research: The role of Apache II scoring system in prediction outcomes from mechanical ventilation in patients have been hospitalized in Mashed Emam Reza, Ghaem and Shahidkamyab ICU wards.Methods and Materials: This prospective and descriptive study was done on 300 hospitalized patients in medical, surgical and trauma ICU wards in six months period.Information about the cases was recorded in questionnaire, information about the Knaus Apache II form (1985) that has been revised in 1999 include three sections: Acute physiology score, age adjustment and chronic health adjustment gathered in two times: The first admission 24 hours and complete weaning time.Results: The association of first admission 24 hours Apache II scores and outcomes (survivor and died) (t=2.86, P<0.005), complete weaning time Apache II score and outcomes (t=22.89, P<0.0001) , and difference between two stages Apache II score and outcomes (t = 25.78, P< 0.0001) confirmed also the results showed that Apache II score> 28 in first admission 24 hours has maximum sensitivity (71%) and specificity (69%) than another scores. In this research Apache II scoring system showed: sensitivity (81%), specificity (80%), positive indicative value (79%) and negative indicative value (82%).Conclusion: The results of research hopfully attracts education and research administrators and managers to proper and rapid weaning patients from mechanical ventilation according to better ICU scoring system there upon leading to rapid and safe discharge and low patients mortality in ICU.

Introduction: Medicine administeration is an important part of treatment and nursing care process and medication errors is a serious threat in health and patient safety and also in nursing profession. This study carried out to investigate the nurse’s view about factors affects medication errors in different care units of Imam Hossein hospital in Shahroud.Methods and Materials: This study is a descriptive analytic and cross-sectional study that has been done on 40 nurses who they work in different care units of Imam Hossein hospital in Shahrood. Subjects were selected in unrandomized sampling and their points of view about factors affect medication errors were measured by using a designed questionnaire. Data was analyzed by using descriptive and analytic statitic methods in SPSS software.Results: Upon to results, the majority of subjects mentioned that factors such as: Fatigue arised from overtime work (66.7%), deficiency number of nurses comparison number of patient (59%), psychological stress of nurse (48.7%), illegible physician order in patients file (42.5%) and lack of enough time (42.1%) are the most important factors that caused medication errors. Also, the majority of subjects mentioned that factors such as: Type of drug arrangement in drug shelf (47.4%), incorrect work devision in unit (46.2%), drug room environment (light, area, …) (46.2%) and type of prescription (intravascular, intramuscular,…) (36.1%) are the least important factors that caused medication errors. Subjects explained that factors such as: Morning shift (48.7%) and drug protocol (38.9%) were not effective in causing medication errors. There weren’t significant correlation between medication errors factors and demographic variables.Conclusion: Considering the results, for medication errors prevention in different care units, effective management and improvement motivation, knowledge potential and clinical skills in nurses about implementation of medication is recommended.

Introduction: Trichomonas virginals is a parasitic protozoan that is the cause of trichomoniasis, a sexually transmitted disease (STD) of worldwide importance. The disease encompasses a broad range of symptoms ranging from a state of severe inflammations and irritation with a frothy malodorous discharge and itching. Recent data have shown that the annual incidence of trichomoniasis is more than 170 million cases worldwide. The aim of this survey was to determine the association between demographic factors and the clinical manifestation of disease.Methods and Materials: For this cross sectional study 384 women referred to health centers were randomly selected. Initial data were gathered through a face to face interview and were completed by their results of the two methods of laboratory tests that had performed separately on each sample. Data were all collected and analyzed using suitable tests as c2 test.Results: The overall prevalence of trichomoniasis was 2.1% (of 384) by direct microscopy and 2.6% (of 384) by culture detection. There was no significant statistical difference between trichomoniasis and job (P>0.05). There was a significant statistical difference between trichomoniasis and delivery numbers (P=0.003). Conclusion: Results of the study showed that the prevalence of this disease was lower than the many other studies but higher than other studies. The different sensitivity and specify might be depended on their methods of laboratory tests besides demographic and cultural factors.

Introduction: Cement has long been known as a cause of both irritant and allergic contact dermatitis. However, there are little data relating to occupational skin diseases (OSD) in the Iranian construction industry. The aim of this study is to evaluate the epidemiology of cement dermatitis among terrazzo and cement manufactory workers.Methods and Materials: This is cross-sectional descriptive study. In this study 50 cement manufactory workers in Shahroud and 150 terrazzo workers in Lordegan were interviewed through questionnaire. Questionnaire includes demographic characteristics and questions about present dermatitis, background eczema, daily work hours, exposed chemical agents, using of gloves. Patients examined and patch tested by dermatologist. Data analyzed with SPSS software and c2, Mann Whitney and logistic regression statistical test.Results: The findings of the study showed that 8 workers (16%) in cement factories and 52 workers (34.7%) in Lordegan terrazzo enterprises had reported dermatitis at the time of review. Of which 15.5% in terrazzo workers had allergic contact dermatitis. In this study the prevalence of cement dermatitis increased with increasing age and there was significantly differences between dermatitis and background of dermatitis in terrazzo workers (P<0.05). Conclusion: Cement should be treated as hazardous materials, wearing of suitable gloves, early diagnosis and treatment of contact dermatitis and health education to workers is suggested.

Introduction: Intensive care unit ICU syndrome is a disorder, in which patients in an ICU or a similar setting experience anxiety, hallucination and become paranoid, severely disoriented in time and place, very agitated, or even violent, etc. The aim of this study was to assess knowledge, attitude and practice (KAP) of nurses with regards to prevention of ICU syndrome (Delirium).Methods and Materials: Subjects of this research were 56 nurses with including criteria of registration in nursing, university degree and at least one month experience of working in open heart surgery ICUs. The data was gathered from 3 clusters in university hospitals equipped with open heart surgery ICUs in Tehran. All subjects were asked to fill in a questionnaire. Moreover all subjects were observed in all shifts. During observation, two researchers observed each subject simultaneously to achieve higher accuracy of observations. Descriptive and analytic statistics were applied to analysis the data.Results: The finding of the study showed that more than 53% of the subjects had passed a continuing education course, but less than 46% of them never passed a training course on ICU. According to this research, subjects' work experience in ICUs had significant relation on their knowledge with regard to prevention of ICU psychosis. However, it has not significant relation to their attitude and skill.Conclusion: According to the results of the study, subjects have little chance to be familiar with the concepts and elements of ICU syndrome in their university program. The finding also indicated that many subjects in this study were not familiar with the important concepts such as sleep deprivation, sensory overload and sensory deprivation, etc. Ongoing progression in high-tech ICUs brings about continuing nursing education programs for all nurses. The results also showed that stress factor in ICU, such as high mortality, isolation, high workload etc. Gradually influences nurses’ attitude in ICU. So, it is strongly recommended to consider rotation of nurses in order not to impose high stress to ICU nurses.

Introduction: Osteoporosis is recognized as a major healthcare problem in elders. Data on prevalence and risk factors of osteoporosis in developing countries is sparse. In this study we aim to define the risk factors of osteoporosis in a selected group of postmenopausal women in Tehran.Methods and Materials: This is a case-control, interview based study that was conducted in a popular public hospital (Shariati) in Tehran during period 2002-2003. The sample sizes included 272 post menopausal women (136 case and 136 controls in the same age group). The case group was identified as osteoporotic patients based on WHO definition in spine and/or total femoral region interest using DEXA method and Lunar DPX machine. A self made questionnaire was used for data collection. It included some information on demographic, obstetrical and menstrual factors, medical and drug history, nutritional status, physical activity and life style. Risk factors for osteoporosis were calculated by adjusted odds ratios using multiple logistic regressions. Results: The significant (P<0.05) risk factors in present study population with their Odds Ratios (in parenthesis) were as follow: BMI<25 (4.2), duration of menopause > 5 years (2.4), Parity >3, lactation >3 years, steroid therapy (3.6), Bone and joint disorders (2.34) teeth problems (2.30), education < 12 schooling yrs (2.6) and red meat consumption ≥ 4 times/w (2.1).Regular consumption of milk ≥ 3/w (0.4), cheese ³ 30g/d (0.5), chicken (0.4), fish (0.3) and honey (0.42) appeared to be significant protective factors. Calcium supplementation (0.3), regular walking (0.4) and sunshine exposure (0.4) also reduced the risk significantly.Conclusion: Osteoporosis, in this study, appears to be associated with several risk factors. The association of environmental factors like diet, exercise and sunshine exposure with osteoporosis indicates need of more studies in this area and also the direction for elders’ health strategies for osteoporosis prevention in Iran.

Introduction: Accidents are second cause of disabilities and could lead to physical and psycological disorders and even death. The aims of this study were to evaluate the prevalence and causes of hospitalization in victims that admitted to emergency department of Imam Hossein hospital in Shahroud.Methods and Materials: This study is a descriptive analytic and cross-sectional research that has been done on 3027 victims of different accidents referred to emergency department of Imam Hossein hospital in Shahroud. Necessary data were obtained through questionnaire and archived file during one year in hospital. The data was analyzed by using descriptive and analytic statistic methods.Results: Upon to results, from all 3027 victims, 73.7% were male and 26.3% were female. Also, the majority of victims had 15-20 years old and the most of them were married. 42% of accidents were included traffic accidents and from 51.3% of accidents that their placed were determined, 83.4% of them were happened in street and in summer and in September and also in evenfall. In this study, significant correlation have seen between accident type and age, sex, accident place, season and month and accident time (P<0.05). Statistical tests didn’t revealed significant correlation between accident type and accident day (P>0.05).Conclusion: Accidents are preventable and require improving knowledge of people about importance of safety principles during driving and also increasing the safety factor in roads and streets. Effective heath and therapeutic planning in medical and emergency centers is essential for decreasing the rate of mortality from accidents.

Introduction: Reduction of low density lipoprotein cholesterol (LDL-C) in persons with coronary heart disease (CHD) is targeted. First step in treatment of lowering the LDL-C level is lifestyle modification including diet, weight reduction and exercise. At second step, the lipid lowering drug should be added. Although direct measurement of LDL-C from serum is most accurate, but it is not cost-effective, so laboratories usually use the Friedewald equation that suffers from several limitations such as hypertriglyceridemia and variability of lipoprotein composition. The authors compared and determined the correlation of LDL-C from enzymatic measurement with LDL-C from calculating.Methods and Materials: A total of 475 fasting serum samples (199 males and 276 females with mean age of 56.3 years) with TG less than 400 mg/ dl in Imam Hossein hospital (Shahroud) were analyzed. According to serum TG levels, samples divided in four groups (<100, 100-199, 200-299, 300-400). Authors calculated the LDL-C and then compared with direct measurement. Data analyzed with SPSS and table curve packages.Results: The comparison between direct and calculated methods showed that: 1) Concordance with the difference of 0±20 mg/dl is low. 2) Friedewald showed more accuracy compared with other calculated methods (51.2% versus 38.7% and 42.7%). 3) with the raising of TG, the accuracy declines and the overestimation increases. Correlation coefficient was 0.66.Conclusion: An overestimation of approximately 0±20 mg/dl was found in over 50% of samples comparison with direct LDL-C. Therefore; direct measurement of LDL-C in patients with CHD is recommented.