Payesh
Year:2003 | Volume:2 | Issue:2|Papers Count:8

Objective(s): Several cases of Crimean-Congo Hemorrhagic Fever, which is an arboviral disease, have been reported since summer 1999 from different parts of Iran. The main objective of this study was to determine the prevalence of the infection within Zahedan and Zabol, two districts of the Sistan and Baluchestan province in Iran.Material & Methods: In this seroprevalence study 300 subjects sampled through "probability proportional to size cluster sampling" method from the general population of the Zabol and Zahedan districts. For every subject in the sample a questionnaire was completed and a blood sample was taken. The following variables were measured through questionnaire: age, sex, living environment (rural versus urban), education, job, history of tick bite, history of contact with domestic animals, history of slaughtering, presence of places for keeping livestock at house and history of keeping of livestock in house.Results: All but just 3 of 300 samples were consent for blood sampling and just 7 out of the 297 serum samples were found to be ELISA positive. In other words the calculated seroprevalence was 0.024 (95%Cl= 0.003-0.044). History of keeping of domestic animals in house seemed to have significant relationship with seropositivity (P=0.018).Conclusion: This pilot study showed that the prevalence of Crimean-Congo Hemorrhagic Fever in the study population is much lower than expected.

Objective(s): To determine the effect of an educational intervention about mental health on teachers' knowledge, attitude and practice. Material & Methods: 64 teachers in 24 governmental elementary schools in Khorramabad city in Lorestan province of Iran, I.R. during the academic years: 2001-2 were selected, through two step cluster randomized sampling. Of these 57 agreed to participate in the study. A 3-day workshop administered for teachers in case group. Research data were collected using self-administered questionnaires before and after workshop, and at the end of the project. Data were analyzed using SPSS software.Results: At pretest, most teachers in both groups had a weak knowledge about common mental disorders in children. The findings showed significant improvements in teachers' knowledge and attitude scores in intervention group after workshop. No significant changes were observed in comparison group. Teachers in case group identified and referred 106 students. Psychologists confirmed psychiatric disorders in 79 of the referred cases. During the same period only 2 students have been referred by control group. Conclusion: The findings suggest that trained teachers have significant capabilities for participating in School-Based Mental Health Services. In addition this might imply that schools are currently the best place for helping children who need mental health services. The results indicated a better knowledge, attitudes and practice among females and those with higher education.

Objective(s): To study the impact mother and child care, quality delivered during pregnancy and infancy, on the infant mortality in Bojnourd City, (North East of Iran), and to suggest appropriate strategies for improving the quality of care in order to reduce infant mortality. Material & Methods: This was a case- control study. The study population were infants whose parents were resident of Bojnourd for at least three continuos years. The cases were 150 infants who had passed away during the year 2000 (From 21 March 2000 to 20 March 2001). Controls were 450 infants selected from the rest of the study population. Data were collected through questionnaires, interviews with parents, extracted of medical records in health centers, birth and death certificates and delivery facilities. Results: The results of this study indicate that both quality characteristied and all of the service delivery measured were significantly associated with infant mortality (P=0.001). On the other hand, quality characteristied of services, both individually and collectively, were significantly associated with infant mortality (P=0.0001). Conclusion: The results of this study further emphasizes the existence of problems in the quality of maternal and child care and its effect on infant mortality. This indicates that there is need for continuos monitoring and evaluation of the system in the region.

Objective(s): This study aimed to investigate research barriers as perceived by academic staff of the Iran University of Medical Sciences. Material & Methods: This was a cross-sectional study of 60 academic staff of two faculties of the Iran University of Medical Sciences: school of Management & Medical Information Sciences and school of Nursing & Mid wifery. Data were collected using a self-design questionnaire. Results: %75 of faculty members were women and %25 were men. %22 had M.D. or Ph.D. and others had M.Sc. The results indicated that only about half of the respondents had experties in writing a proposal, conducting a research, analyzing data and writing a scientific paper. The most important barriers as indicated by the respondents were: typing, printing, using internet and access to library. Conclusion: The findings indicate that there is need to improve research abilities among academic staff. Also there is need to provide initial research facilities to encourage academic staff to do more research.

Objective(s): The aim of this study was to determine the quality of spiritual rehabilitation in hospitalized elderly patients in mental wards in the affiliated hospitals of Tehran University of Medical Sciences. Material & Methods: This was a descriptive study of 54 elderly patients in mental wards in Tehran, Iran. Data were collected using a check list regulated in three sections derived from the QualPacs. Results: The results in relation to respect to the religious believes and practices of the elderlies was found to be 34 percent and this mostly was evaluated to be in average level (45%). Providing facilities for worship was found to be 41% and most elderlies evaluated this as good (%53). In addition 62% indicated that they have receiving help for worship and most evaluated this help as good (%57). Finally the findings showed that most elderly patients indicated that in general spiritual rehabilitation care they had received was good (%50) or excellent (6%). Conclusion: The findings suggest that spiritual rehabilitation care for elderlies was acceptable but it is too far from a high level care.

Objective(s): To determine the quality and quantity of input and process of clinical education in Iran University of Medical Sciences.Material & Methods: Through a descriptive analytic study, 3 questionnaires were used to gather data. Results: The result indicated that the proportion of clinical students to teachers, in each teaching round was (9.23) and the proportion of students to teaching bed, patient. medical personnel, books in selected hospitals was (2.5), (1.9), (1.3), (25.5) respectively. The highest total mean score in scientific mastery and educational administration domain was related to internal medicine ( X̄=3.32, X=2.95) respectively and in communication and consultation was related to obstetrics and gynecologic group ( X̄=3.04).Conclusion: Promoting quality of clinical education is related to changing attitudes and introducing new educational methods, evaluation and also active and effective presence of teachers in clinical fields.

Objective(s): To assess the in influence of maternal request on the elective cesarean section rate and related factors in maternity hospitals in Tehran.Material & Metods: This was a cross-sectional study using data from 824 pregnant women via a two-step random sampling. A standardized form was completed for each mother, collecting past and present obstetric history and demographic characteristics.Results: 66.5% of mothers delivered by cesarean section and 33.5% vaginally. 72% of cesareans were elective and of these 22% were performed because of maternal request and 71% of mothers who requested cesarean had no explanations for their request. Also 65% of doctors suggested cesarean for their patients without any true medical indications. The majority of elective cesarean section on maternal request were performed in private hospitals (86% in private VS. 14% in state hospitals, P<0.0001. The level of education employment status and first pregnancy were significantly related to the request for performing elective cesarean section.Conclusion: To decrease the frequency of unnecessary cesarean section and their unwanted complications, there is need to increase women's awareness. Also performing painless normal vaginal delivery might help to decrease cesarean section rate.

Objective(s): To examine survival rate in Iranian breast cancer patients. Material & Methods: One hundred and sixty- seven breast cancer patients diagnosed at 1997 were entered into the study and followed up for five years.Results: The mean age of patients at diagnosis was 47.2 (SD=13.5) ranging from 24 to 81 years. In all 39 patients were lost in the follow- up period. This led to analysis of data for the 128 remaining patients. Of these at five years 79 patients were alive and 49 patients were dead. Most patients (61%) presented with advanced disease (stage III, n=42 and stage IV, n=36). The remaining 39% had stag I (n=10) or stage II (n=40) breast cancer. Using the life table analysis the overall 5-year survival rate was found to be 62% (SEM=0.04) In addition, after adjustment for age at diagnosis, initial treatment (mastectomy, breast conserving surgery, and neo-adjuvant therapy), and disease stage, using The Cox(s) regression model, it was found that receiving neo-adjuvant therapy as initial treatment was an independent predictor of poorer survival (Hazard ratio= 4.56, 95%CI=2.20 to 9.044, P<0.0001). The other variables (older age and late stage disease) although showing a higher hazard rate were not significant.Conclusion: The study findings suggest that overall survival rate in Iranian breast cancer patients stands between western and eastern European countries and needs to be improved. It seems that early detection and better management using standard guidelines could contribute considerably to improved survival in women who are experiencing breast cancer.