Payesh
Year:2004 | Volume:3 | Issue:4|Papers Count:10

Objective(s): To assess the burden of suicidal behaviors in Ilam, Iran. Methods: This was a cross-sectional study. 606 cases of attempted completed suicide were reviewed. Burden calculation was done using the Disability Adjusted Life Years (DALY) index. Results: There was a total loss of 4891 DALY's lost in the Ilam population, equivalent to the crude rate of 9.7 per 1000. Women bore 64 percent of the total burden. The 20-29y and 10-19y age groups accounted for most of the total disease load (41 and 33 percent respectively). Unfortunately, suicidal burns represent 73 percent of total burden of suicidal behaviors. Conclusion: We found a higher disease load in women while in the other studies such as WHO's Global Burden of Disease study (2000) it is the men who bear the greatest burden of suicidal behavior.

Objective(s): This survey investigates factors affecting Health House services utilization in Damavand, a small city in Tehran Province. Methods: This cross-sectional study was carried out on 400 people aged above 30 years who lived in the catchment area of different Health Houses (primary health care or PHC clinics) in Damavand in 2003-4. Fourteen out of the 27 existing Health Houses were selected at random. Systematic samples proportional to size of the target population were drawn in every village. Subjects completed questionnaires at their homes. Data analysis included chi-square and logistic regression and was performed using the SPSS package. Results: 49.5% of men and 77.1 % of women have reported that they were using Health House facilities from September 2002 to March 2004, while 24.5% of men and 20.3% of women did not. 26% of men and 2.6% of women have never used these services. The factors for non-utilization were: male sex, type of occupation, higher education, time spent getting to the Health House more than 20 minutes, waiting times above 20 minutes inside the Health House, providers' unfriendly behavior, lack of consultation regarding different services, physical environment of Health Houses, inappropriate service timing (P<0.001 for all), poor communication (P<0.04), long latent periods for hypertension-related disability, (P<0.02) and a refusal to admit the detrimental effects of HTN on life expectancy (P<0.01). Conclusion: Appropriate interventions addressing the above factors could improve service utilization.

Objective(s): To identify factors influencing the severity of injuries in motor vehicle crashes. Methods: The source of data was The National Trauma Study -Teheran (1999-2000), performed in six major hospitals in Tehran. We looked at demographic and pre-hospital data on 564 car passengers injured in nonfatal traffic accidents. We used the Injury Severity Score (ISS) to determine the severity of injuries. Results: Most cases of trauma involved the extremities and the bony pelvis. Injuries were more severe in passengers of pick-up trucks compared to those injured in crashes involving two passenger cars. Also, those traveling in pick-up trucks were more likely to be injured in the head and neck (P<0.05). There were significant differences in the severity of injuries between urban and rural accidents. Conclusion: Higher severity of injuries in accidents involving pick-up trucks shows the need for more in depth studies about safety of pick-up trucks in Iran. For better monitoring and evaluation of injuries, the use of standard forms to gather data on all traffic accidents is needed.

Objective(s): To study the knowledge, attitude, and practice of complementary medicine. Methods: This was a descriptive study of a random sample of 4123 adults aged 15 years and over in Tehran, Iran. Data were collected in face -to- face interviews and participants were asked to indicate whether they knew about complementary and alternative medicine and whether they were used or using CAM. Results: The survey showed that 83.2% of the respondents were familiar with some form of complementary medicine. Herbal medication was the most popular CAM modality; therefore, excluding herbal medication, 58.6% of studied population knew some form of complementary medicine. The best known forms of CAM in the Tehran population were: herbal medication (75.6%), acupuncture (43.6%), hypnosis (39.2%), energy therapy (28.1%), yoga (22.1%), meditation (5.3%) and homeopathy (4.1%). 42.2% of studied population had used some form of complementary medicine. Herbal medication was again the most popular, but apart from herbal medication, 9.6% of the study population had used some form of complementary medicine. The most prevalent CAM modalities were: herbal medication (38.4%), energy therapy (3.4%), yoga (3%), acupuncture (2.7%), meditation (5.3%), hypnosis (1.2%), and homeopathy (0.4%). Conclusion: Public knowledge and demand for complementary medicine seems to be high. With growing demand, CAM deserves greater attention from health planners, policy makers, and a more scientific approach from the academic community. In the absence of hard evidence, we should not be influenced by those who either blindly promote or stubbornly reject complementary and alternative medicine. Appropriate legislation by the Ministry of Health might help to ensure certain minimum standards such as proper regulation, standardized record-keeping and effective communication. Patients also need to be protected against unqualified, substandard practice, inappropriate treatments or unethical research activities (this would also facilitate ongoing medical assessment of CAM). The future of CAM should (and hopefully will) be determined by unbiased scientific evaluation. 

Objective(s): To study the sexual behavior during pregnancy and factors that affecting it. Methods: 120 pregnant women were selected by convenience sampling from those attending AL-Zahra Medical Center in Tabriz, Iran. Data were collected by means of a questionnaire covering personal and social characteristics, parity and gynecologic history. It contained 15 questions on factors influencing sexual behavior, 5 questions related to the variations in the nature of sexual intercourse during the first, second and third trimesters of pregnancy (libido, number of sexual contacts, love-making positions and feelings of inconvenience during and after coitus). The data were analyzed using the SPSS-10 program. Results: The findings showed that 10.7% of women in the first trimester, 15.2% in the second and 20.6% in the third trimester had experienced dyspareunia. 18.5% of women in the first trimester, 18.3% in the second trimester, and 33.2% in the third trimester had complaints of stomachache and backache during intercourse. 17.7% of women in the first trimester, 24.3% in the second trimester, and 23% in the third trimester suffered from stomachache and backache after intercourse. The results of chi-square tests showed a significant association between parity and the following set of symptoms: feelings of guilt, dyspareunia (P=0.004), fear of preterm labor and dyspareunia (P=0.04), parity and postcoital stomachache and backache (P=0.01), dyspareunia and postcoital vaginal irritation (P=0.03) in the first trimester. Conclusion: The results suggest a real need for sex education among couples. It seems that most of sexual problems are preventable through education.

Objective(s): To determine the prevalence of amputations due to electrical burns among inpatients at Shahid Motahari Hospital, Tehran. This hospital is the main referral center for burns in Iran. Methods: In this descriptive study, we investigated all inpatients suffering from electrical burns over a period of 3 years (April 1998 to April 2001). There were a total of 106 cases, and we recorded data on age, sex, burn voltage, width and depth of burn, amputation, fasciotomy, debridement, eschartomy, graft and any associated trauma. Results: The prevalence of amputation was 18.9%. Thirty percent of amputations were in females and 10% in children under the age of 10. The rate of electrical burns in Iranian children and woman was higher than other countries. The rate of amputation due to electrical burns with low voltage (< 1000 volts) was 55%. The 19-29y age group accounted for most cases (35%). One third of the cases had Burned Surface Area (BSA) of 30-39% while 75% had 3rd-degree burns. In only 10% of burns fasciatomy had been performed and 80% had at least one debridement before amputation. Also 45% of them had associated trauma, mostly limb fractures. Conclusion: With regard to the study findings, the necessity of public educations in prevention of electrical burns should be insisted, especially because of the higher rate of electrical burns occurring in homes in comparison with other countries. According to the importance of scharotomy and fasciatomy in prevention of irreversible vascular and neural ischemia and because only few patients receive such remedies, the necessity of education and performing these two simple surgical procedures by emergency physicians is essential.

Objective(s): To determine the microbiological quality of water used in Tehran food industries. Methods: 50 food factories were randomly selected. Free residual chlorine (as an indicator of effective disinfections), Total and Thermotolearant Coliforms (as indicators of contamination) were the main parameters measured in up to 300 water samples taken from water supply systems. The examination of water was performed according to the standard methods described by the American Public Health Association (APHA). Results: The result indicated that 94% of factories had private water supply systems. 92% were used underground water resources. Only 36% of factories disinfected water before use; in most samples, concentrations of free residual cholrine were not in the optimal range. 47.7% and 10.4% of sample were contaminated; with mean total coliform 3 per 10ml and mean thermotolearant coliforms counts of 8.6/l00ml respectively. Conclusion: In general, the management of water quality control (specially microbiological aspect) in Tehran food industries is poor and there is a real need for improvement. 

Objective(s): To develop a nationwide medical classification system in Iran. Methods: This comparative cross-sectional study was done in 2003-2004. It attempted to evaluate and modify the English classification system and produce a suitable model for Iran in the year 2003-4. We used library resources, websites and E-mail communication with domestic and overseas specialists. The model takes into account the economic, cultural and geographical peculiarities. This model used Delphi techniques and questionnaires properly evaluated in terms of their validity and reliability. The final model was set up after statistical analysis. Results: In this research, we actually evaluated the international English classification system. We also created a model for Iran, based on five major axes. It seems that to optimize the infrastructure in all these axes, the current national classification system should undergo extensive revision. Conclusion: Multi-axis format, expandability, broader scope, local coding guidelines, necessary modifiers, standardized terminology and chapter organization based on the types of procedures or interventions, could be considered as advantages of our model compared to the current classification system.