Payesh
Year:2006 | Volume:5 | Issue:4|Papers Count:10

Objective(s): To determine the role of mother's BMI on pregnancy outcomes.Methods: This was a cross-sectional study of 294 pregnant women aged 18-35 years, with term cephalic presentation, singleton attending to Barn maternity hospital for childbirth related to their BMI they were grouped as: underweight (BMI<19.8), normal (19.8<BMI<26) and overweight (BMI>26). Data were collected by a questionnaire and were analyzed descriptively.Results: The mean of first phase of delivery in underweight women was (7/73±5/77) minutes more than of over weight women (3/32±5/11) minutes. This difference was not statistically significant. The mean of third of delivery in normal weight was more than of under and overweight women, but not statistically significant.The mean of babies weight in over weight was more than of in under and normal weights, but the mean of APGAR Scores in over weights was low. The cesarean rate in over weights was 28.9%, in normals was 15.2% and in under weights was 4.5%. These differences were statistically significant. Conclusion: The findings suggest there is need to advise women to keep their weight normal before and during pregnancy to prevent adverse outcomes.

Objective (s): To determine the extent of clinical eye visits as an indicator for utilization of eye care services in Tehran population and to assess factors contributing to their visits.Methods: A random sample of 6497 individuals in Tehran was invited to take part in the study. All participants received complete eye exams and interview. At the interview, we collected information about demographic and socioeconomic status variables, past medical and eye history and history of eye visits. Results: In all 4565 people agreed to participate the study giving a response rate of 70.3%. Among all participants, 34.7 % had not seen either an ophthalmologist or optometrist sometime in the past (95% confidence interval [CI], 32.4 to 36.9) and 43.2% had not been seen by an eye care provider in the last 5 years (95% Cl, 40.8 to 45.6). Multivariate logistic regression revealed that men (OR=1.30), younger participants (OR=0.98) and the less educated (OR=0.93), and were more likely to have neglected eye care. Those with visual impairment had less negative history of previous eye visits (OR=0.41). Conclusion: A large proportion of the population requiring eye care is currently not utilizing existing eye care services. The results highlight high-risk groups.

Objective (s): Acute appendicitis happens in 7% of people during their lives, but there is no consensus about criteria for emergency appendectomy. This study was carried out to determine the appropriate combination of diagnostic tests and variables with high accuracy.Methods: All case records of patients attending the Imam teaching hospital for abdominal tenderness and suspected appendicitis during year 2001 to 2004 were reviewed. We collected data on all tests and post operating reports. Data were analyzed performing logistic regression analysis and Receiver Operating Characteristic (ROC) curve.Results: A total of 577 cases were studied. Considering Area Under the Curve (AUC) the best variables combination were percent of poly morpho nuclear (PMN %), sex and vomiting. This combination had a high accuracy for correct decision for appendectomy in suspected patients with abdominal tenderness (AUC=77.3 CI 95% = 70-84 %). Optimal cut-off point for white blood cell (WBC) count, PMN % and degree of fever, were 7.5 (1000 /mic.L), 65% and 37.7°C (oral temperature). Even with determining the best combination of conventional appendicitis diagnostic tests, there was not a good agreement with post operation pathology results (Kappa index =61%, SD=15%).Conclusion: To reduce the false positive diagnosis (inappropriate selection for appendectomy) and false negative (discharged patients who need emergency appendectomy), we recommend, at least in high-risk groups (Children, young women and senile patients), more diagnostic tests be performed.

Objective (s): To determine the protein-energy malnutrition prevalence and influencing factors among the rural school students of6-12 years in Shahrood, Iran.Methods: This was a cross-sectional study of protein-energy malnutrition among 890 school students using the cluster and random sampling methods. To determine the malnutrition prevalence status the anthropometric methods were used and compared with the NCHS (National Center for Health Statistics) standards. The nutritional status below -2SD was considered as an index of malnutrition and above or equal to -2SD as normal.Results: The findings showed that the prevalence of malnutrition in relation to W/A, HIA and W/H were 14.7%, 15.3%, and 11.6% respectively. It was noted that malnutrition among the boys was significantly more than the girls and that eating after breakfast was effective in wasting. In addition it was found that 11.6% of children need to be helped by nutritional interventions and 14.7% need urgent attention. Conclusion: The results revealed that the incidence of malnutrition was higher than the WHO (World Health Organization) standards. It was also revealed that children suffered with stunting, wasting and underweight. It seems that it is necessary to pay enough attention to children's nutritional status in rural settings.

Objective(s): This study examined patient satisfaction and related factors in the general hospitals affiliated to Hamedan Medical University Sciences.Methods: A sample of 400 patients was studied in 5 university hospitals in Hamedan. Participants were asked to fill in a "satisfaction" questionnaire under the supervision of a trained hospital nurse. The questionnaire consisted of 44 multiple choice and open-ended questions. To look at the factors that could affect patient satisfaction, 11 independent variables were examined: age, sex, marital status, education, employment, income, living conditions, admitted hospital and admitted ward, access to hospital and specific information on the disease.Results: The overall rate of satisfaction with hospital services was 72%. About 40.5% of patients did not know what kind of disease they had and for 44.7% access to hospital was difficult. In response to the question "would you recommend this hospital to others?" only 45.3% answered "yes". Moreover, 27.7% of the respondents reported some shortcomings such as: poor sanitation (34%), problems with general facilities such as poor food quality, and crowded rooms (30.6%), and lack of adequate medical equipment (13.7%). In the final analysis, the variables showing a significant relationship with in-patient satisfaction were education, income and access to hospital.Conclusion: In general patients were satisfied with hospitals, although they indicated areas that need to be improved. The results suggest that patients with lower socioeconomic status were more satisfied as compared to those with higher socioeconomic background.

Iran is among the most disaster-prone countries in the world. From 40 natural disasters identified in the world, 31 disasters took place in Iran.Various strategies that can mitigate the impacts of hazards can be adopted through strategic planning. This paper intends to provide suggestions that might help to reduce economic impacts of disasters.

Objective(s): To determine the most necessary skill required of effective quality management in medical sciences universities.Methods: This was a descriptive study. The study sample was consisted of 350 managers who precipitated in different management workshops (TQM, participative management, management of health plans). These workshops were approached in different provinces, especially in Hamedan, during year 2000 to 2004. To measure necessary skills, a designed questionnaire with 48 items was administered to measure basic skills and level of participation and team working.Results: The findings showed that more than 80% of necessary skills for effective quality management was leadership skills. 42.5% disagreed and only 29.3% agreed with the statement that managers are ready for participatory management. They believed that the lack of participatory culture and team working (50%); low motivation among personnel (48%), and weak reward and evaluation system are the most important factors contributing to ineffective quality management.Conclusion: Leadership skills are the most important skills for effective quality management.

Objective(s): To examine the correlation between prayer and spiritual well-being in patients with cancer undergoing chemotherapy attending cancer centers of Iran and Tehran Medical Sciences Universities during January to May 2006.Methods: This was a descriptive study. The Paloutzian & Ellison's spiritual well-being questionnaire (1989) and the prayer activity questionnaire (Poloma & Pendleton, 1991 and Meraviglia, 2002) were used for data collection. 360 patients with cancer undergoing chemotherapy were entered into the study.Results: The findings showed that the level of patients' spiritual wellbeing was high. The mean score of spiritual wellbeing was 98.35±14.36. The previous prayer experiences and attitudes toward prayer in 57.2% and 52.2% of patients were desirable respectively. Statistical analysis showed that prayer and spiritual wellbeing were strongly correlated.Conclusion: A strong and direct correlation exists between prayer and spiritual-wellbeing of patients with cancer. Healthcare providers can encourage patients diagnosed with life-threatening diseases to explore their spirituality as an effective resource for dealing with the physical and psychological responses to cancer.

Objective(s): To evaluate of knowledge and attitudes towards use of emergency contraception among health care providers in Tehran, Iran.Methods: This was cross- sectional study of216 healthcare personnel. Data were collected via a questioner.Results: The results indicated that there was association between gender, education, of knowledge (P=0.001), while association was not found between demographic variables and attitudes. Conclusion: The findings suggest that health care providers need more education about the use of emergency contraception.