Payesh
Year:2005 | Volume:4 | Issue:3|Papers Count:9

Objective(s): To study the views of medical students in Oroumieh Medical University on laboratory-based periodic health evaluation.Methods: In this cross-sectional study, we surveyed all externs and interns in Oroumieh Medical Universities School of medicine in the academic year 2004-2005. The subjects were asked about the frequency and indications of eighteen different check-up tests. A total knowledge score was also developed which showed the overall knowledge on these 18 tests.Results: Nearly all (98.5%) of the students recognized the importance of education in this field, though only 24.5% said they had received any relevant training. The mean of the overall knowledge score was 5.5 (SD=3.8), which was significantly higher in those who had received education (P=0.002).Conclusion: The mean knowledge score was rather low. The remarkable "unmet need" for education in this field also confirmed this considerable gap (24.5% vs. 98.5%). Systematic education of medical students in appropriate administration of periodic, laboratory-based health exams (check-up) seems that it should be mandatory.

Objective(s): Studies have shown that chronic hepatitis B infection could lead to an increased risk of poor outcomes like hepatocllular carcinoma and cirrhosis. This study aimed to estimate relative risk of mortality of chronic hepatitis B infection to no infected population and their life expectancy in Iran. Methods: Analysis is based on comparing prevalence of hepatitis B infection in general population and annual death. Prevalence of HBs Ag in all dead men and women was estimated as a weighted average of prevalence of HBs Ag in 3 liver related death (Cirrhosis, HCC and acute viral hepatic failure) and non hepatic death by relative frequency of them. According to total death and death due to HCC and cirrhosis, relative risk of mortality was estimated. Then with age specific mortality rate of general population, life table for community and HBV infected subjects with and without 0.5 percent annual chance of seroclearance of HBs Ag were calculated and loss of life expectancy due to HBV related death was estimated. Results: There was a paucity of evidence based epidemiologic data from Iran in these regards. In spite of this fact the relative risk of mortality due to HBV infection associated death was estimated to be 1.3 in males and 1.4 in females. By probabilistic sensitivity analysis of used parameters in acceptable range of values, the standard deviation of RR mortality was about 0.03. This excess mortality decreased 3 years of life expectancy at one-year-old to 1 year at age 80 in both sexes. Conclusion: Based on existing data and modeling, we estimated that chronic hepatitis B infection results in significantly increase mortality and decrease in life expectancy. This study should be validated by long-term prospective epidemiologic studies.

Objective(s): Thrombophlebitis from superficial catheters is one of the common and important problems in hospitals. The prevalence is between 2.3% - 30%. Risk factors include age>60, underlying disease, burns, infectious diseases, urgent catheterization, lower extremity catheterization and size. The aim of this study was to determine the phlebitis incidence and evaluation of some risk factors in semnan hospitals. Methods: We observed 300 patients who had catheters for at least 72 hrs. They were checked daily for symptoms of phlebitis such as erythema, pain or tenderness, warmness and swelling. We excluded patients who were discharged or had their catheters removed before completing 3 days of catheterization. A logistic regression model was used for data analysis. Results: In this study, 26% (95% CI: 21-31%) of patients developed thrombophlebitis. There were significant relationships between phlebitis and catheter size (OR=3.3), type of catheterization (OR=2.1), underlying infectious diseases (OR=6.2), diabetes mellitus (OR=7.8), Gender (OR=1.5) and burn (OR=4.0). The risk of phlebitis was greater in females and in cases where catheters were placed in emergency settings. Also, catheterization of lower limbs was associated with a greater risk of phlebitis. Conclusion: We detected a high prevalence of phlebitis in this study. Like the other studies, most risk factors had a significant relationship with the outcome variable. Diabetes was also an important risk factor in our study. There is a need for more education and better sanitary conditions in catheterized patients. It is suggested that were possible, one should avoid the use of catheters in diabetic patients.

Objective(s): The objective of this study was to measure anxiety and depression in women undergoing diagnostic or screening mammography in a specialized breast cancer clinic.Methods: Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). A consecutive sample of women was entered into the study and the HADS was administered at their first clinic visit, before the diagnosis was made.Results: In all 1147 women completed the questionnaire. The results indicated that 27% of women suffer from severe anxiety and 14% from severe depressive symptoms. However, the mammography results indicated that only 7% of the women had suspicious lesions. There was no significant association between mammography-based diagnosis and severe anxiety or sever depressive symptoms. In addition, the findings showed that those who were younger and had lower level of education were more likely to suffer from server anxiety. In contrast, old age and low education were associated with severe symptoms of depression.Conclusion: The results suggest that young and poorly educated elderly women need more attention when they are attending for mammography. The finding form present study also might contribute to improvements of the service is offered in order to reduce anxiety and depression.

Objective (s): To assess job satisfaction and related factors in general practitioners (GPs) in Tehran, Iran. Methods: This was a cross-sectional study carried out in Tehran between June and December 2003. Data were collected via a 16-item questionnaire. We divided the city of Tehran into 5 zones based on the size of the resident population: Central Zone (Districts 6, 7, 10, 11, 12), Northern Zone (Districts 1-3), Southern Zone (Districts 15-20), Eastern Zone (Districts 4, 8, 13, 14) and Western Zone (Districts 5, 9, 21, 22). A sample of 934 was drawn proportionately form these zones, taking into the account the number of private GP offices active at the time of the survey.  Results: The mean age of the participants was 39.5y (SD = 9y). Eighty-seven percent of the subjects were male, and 91% were married. Overall, in 11% of the subjects the job satisfaction level was "high" or "very high". 41% showed intermediate-level and 48% had low or very low satisfaction with their jobs. Job satisfaction was found to be significantly related to age category (P<0.002), working experience (P=0.003) and ownership of the office's premises (P<0.0001). No statistically significant relationships were detected between job satisfaction and gender, marital status, or spouse's education. Likewise, there was no significant relationship between job satisfaction and the particular zone where the clinic was located (North, South, …). Conclusion: This study showed that older, well-established physicians (who have a better financial and welfare status) were more satisfied with their jobs. Hence, there is need to provide the fast-growing population of young medical graduate with more equitable and attractive job opportunities in order to achieve greater job satisfaction and higher professional standards.

Objective(s): A cross-sectional study was conducted to evaluate the use of complementary medicine by cancer patients, in two comprehensive clinics, in Tehran, Iran.Methods: A specially designed questionnaire was completed for 625 breast cancer patients after informed consent was obtained. Results: The age of the participants ranged from 25 to 80 years, with a mean of 47.61 years (SD=±15.1). The majority was married (77%) and 219 (35%) reported that they used or were using complementary medicine. Users and non-users differed significantly in educational level. The most commonly used CM methods were prayer and spiritual healing (n=178, 81%), bio-energy therapy (9%) and homeopathy (6%). The main sources of information on complementary medicine were previous information (75%), and information obtained from relatives or friends (22%). Only 7% of users had received relevant information from their physicians. Two-Thirds of users stated that they preferred to receive CM treatment from their physicians.Conclusion: Our findings suggest that cancer patients frequently use complementary medicine after diagnosis and they would rather receive such treatment from their physicians. It seems that doctors should ask patients explicitly about their use of complementary medicine when they obtain medical history. They must also have greater knowledge of complementary medicine to offer better advice to their patients.

Objective(s): Spatial analysis of LBW using a geographic information system and determining the relationship between LBW and factors related to health and economic status, using a poison regression model. Methods: In each village, data were obtained on Total Births and cases of Low Birth Weight. Data were then combined with the information gathered from village maps. Relevant socioeconomic and health statistics were obtained from the Statistical Center of Iran. Results: Smoothed maps of LBW revealed a number of "hot spots". In the Poisson regression model the only statistical significant relationship was noted between LBW and General Fertility Rate. Conclusion: The geographic information system is a way to query specific places and through the use of this technology communities of concern could be identified.

Objective(s): Assessment of nutritional status in adolescent girls in the city of Sari, Mazandaran Province, Iran. Methods: The samples included 240 girls 14 to 18 years. Weight and height measurements were taken, and body mass index (BMI) was calculated and compared with standard charts issued by the US Centers for Diseases Control and prevention (CDC) in 2002. To assess nutrients intake, a food record questionnaire was used and results were compared with the recommended dietary allowances (RDA). Results: About 7.5% were underweight for their age and 3.8% had low BMI for their age. Using the same weight-for-age and BMI criteria, 7.5% and 13.3% were in risk of overweight and 3.8% and 3.3% were overweight respectively; 13.3% of girls had low height for age. There was also inadequate intake of such nutrients as riboflavin, vitamins C, B12, A and minerals like calcium and phosphor. 11.7% had severe food insecurity and 14.6% had excessive energy intake. Conclusion: We conclude that theses adolescents are in a phase of nutritional transition because malnutrition, overweight and inadequate intakes of some nutrients were observed.