SADRA MEDICAL SCIENCES JOURNAL
Year:2015 | Volume:3 | Issue:2|Papers Count:7

Background: Mediastinal widening is a serious complication in patients with chest trauma. The gold standard method for diagnosis of this condition is chest Computed Tomography (CT) scan which is not applicable in many cases due to the high dose of radiation, high-cost, and emergency conditions. One of the most practicable and cost-effective diagnostic methods is supine Chest X-Ray (CXR). This study aimed to assess the diagnostic value of supine chest radiography for mediastinal widening by comparing the mediastinal width in supine CXR and chest CT scan (gold standard method) in patients with blunt chest trauma.Methods: In this prospective non-interventional study, multi-detector chest CT scan was performed for patients with blunt chest trauma who had abnormal supine CXR or suspicious clinical findings. Mediastinal width was compared in CXR and CT scan in each patient for determination of accuracy of supine CXR in diagnosis of mediastinal widening.Results: The sensitivity, specificity, positive predictive value, and negative predictive value of supine chest radiography were 16.6%, 97.5%, 57.1%, and 85.5%, respectively.Conclusion: Considering the high positive predictive value of supine CXR, it can be concluded that normal supine CXR could be highly suggestive of exclusion of mediastinal widening. CT scan remains the gold standard diagnostic method in patients with high clinical suspicion of mediastinal widening.

Background: After years passing from establishing accrual accounting system instead of cash form in the units affiliated to the Ministry of Health, Treatment, and Medical Education, studies are necessary to be conducted for categorizing the accomplishments of this change. This qualitative study aimed to analyze the views of middle and high level managers of Iran’s universities of medical sciences regarding the accomplishments of establishing accrual accounting.Method: This qualitative study which was performed through thematic analysis aimed to assess the views of the financial and development managers of the universities of medical sciences selected through purposive sampling. Data saturation point was achieved after performance of 24 semi-structured and deep interviews. The data were analyzed by 5-step framework analysis and main and subthemes were extracted using Atlas Ti software, version 6.Results: The results were categorized into 12 main themes, namely the effects of establishment of accrual accounting on the directory board, managers, staffs, processes, violations, resources, audit presence, recognition of costs and revenues, unit autonomy, internal control, referral system, and out-section effects.Conclusion: It seems that establishing the first phase of health financial management reform in Iranian health sector was accompanied by great achievements. In spite of some differences among various units according to their own circumstances, continuation of these changes can be optimistically helpful.

Background: Identification of common infections and their effective factors among transplant recipients plays a major role in prevention and control of these disorders. This study aimed to survey post-transplant early infections and their major risk factors.Methods: This prospective study was performed on 582 transplanted patients in Namazi transplant center from 2011 to 2013. These patients were followed up regarding the incidence of any kind of infection through Para clinical experiments for 6 months after transplantation. The patients who referred with clinical symptoms were followed, as well. The data were analyzed using the SPSS statistical software, version 19.Results: In this study, 140 patients experienced 194 types of infections during 6 months, 106 of whom had 133 kinds of infections which were mostly bacterial within the first month. Besides, 50 patients experienced 61 types of infections between the first and the sixth month. Bacterial infections comprised most of the cases within the first 6 months after transplantation. Among the risk factors, length of hospital stay (P=0.048 and OR=1.018) and MELD score (P=0.044 and OR=1.035) were significantly associated with post-transplant infections.Conclusion: The study findings showed that MELD score and length of hospital stay were significantly related to increase in the incidence of post-transplant early infections. Besides, most of these infections occurred within the first month after transplantation due to treatment processes and hospital infections. After the first month, opportunistic infections were common among the patients. By knowing these common infections and their risk factors, we can increase the readiness of the transplantation team for preventing and controlling these infections.

Introduction: Inappropriate usage of technology, particularly Internet, can affect individuals’ physical and mental health and behavior. Therefore, this study aimed to examine mental health of female Internet-addict or non-addict high school students in Dezful in 2014.Methods: This causal-comparative, cross-sectional study was conducted on all female high school students in Dezful in the academic year 2013-2014. In this study, 250 students were selected through multistage random sampling. After collecting the questionnaires, 216 questionnaires were selected for analysis. The study data were collected using Goldberg’s General Health Questionnaire (GHQ-28) and Young's Internet Addiction Questionnaire (IAT). The data were entered into the SPSS statistical software (v.18) and were analyzed using descriptive statistics, multivariate analysis of variance (MANOVA), and Scheffe post hoc test.Results: The results showed that 28.8% and 3.8% of the students were addicted to Internet moderately and severely, respectively. In addition, 7.5% of the participants were prone to Internet addiction. A significant relationship was found between Internet addiction and physical symptoms (F=3.32, P=0.02) and anxiety (F=6.28, P=0.0001). Besides, the results of MANOVA revealed a significant difference between the Internet addicts and non-addicts regarding mental health (F=6.11, P=0.03) and Internet-addicts had lower mental health levels.Conclusion: According to the results, mental health was at risk among the girls with different degrees of Internet addiction and they were susceptible to social dysfunction, anxiety, and depression. Thus, the authorities are recommended to pay special attention to this group of population.

Background: Hospitalization of neonates, as a stressful event and a hard emotional crisis, interferes with performance of parental roles and endangers mothers’ physical and mental health. Muslim mothers tend to say prayers, adhere to holy profits, and recite the holy Quran in such conditions. The present study aimed to assess the experience of holy Quran recitation in mothers of preterm infants admitted to Neonatal Intensive Care Unit (NICU).Methods: In this qualitative study, seven mothers with premature infants admitted to NICU of Shiraz University of Medical Sciences were selected through purposeful sampling. The participants’ experiences of holy Quran recitation were assessed through semi-structured interviews. Then, the data were analyzed using inductive content analysis.Results: Data analysis resulted in emergence of three major categories and eight subcategories. The first category was comprehensive advocacy which included three subcategories, namely faith in having a supporter, psychotherapy of Quran, and physical treatment of mothers and infants. The second category was being spiritual whose subcategories were incomparable pleasant experience, surrounding to Divine will, and a stronger than ever return to God. Finally, the third category was ability in life management and the subcategories were self- awareness, carrying out duties, and having control over the situation.Conclusion: Mothers select holy Quran recitation in difficult and stressful situation of NICU. Their experience of reciting the holy Quran included elimination of psychological and physical needs of themselves and their newborns. The mothers believed that recitation of the holy Quran supported them and their children, empowered them to play their roles and have control over the situation, and directed their lives towards spirituality. Thus, Quran recitation is recommended to be facilitated and systematically considered as one of the most powerful ways to meet the mothers’ needs in NICUs.

Background: Domestic violence against women is a major health problem in the world that involves various aspects of maternal and fetal health. Attention to and dealing with this problem require information about its types, severity, and frequency. Therefore, the present meta-analysis aimed to determine the prevalence of domestic violence and its components among Iranian pregnant women.Methods: The present meta-analysis was done using random effect model. In order to selecting studies on the prevalence of domestic violence, the researchers searched SID, Iranmedex, Magiran, Medlib, Pubmed, ISI, and Scopus databases from 2001 to 2013, extracting 64 articles. After reviewing the studies based on the inclusion criteria, 22 articles were selected and analyzed using random effect model and Comprehensive Meta-Analysis (CMA) software. Besides, heterogeneity among the studies was determined using Q, Ƭ2, and I2 indices.Results: The overall prevalence of domestic violence in Iranian pregnant women was 48% (95% CI: 38-58). In addition, the prevalence rates of physical, psychosocial, and sexual violence were 17% (95% CI: 12-32), 41% (95% CI: 33-50), and 21% (95% CI: 16-23), respectively. Moreover, the indices related to heterogeneity were statistically significant (I2≥90).Conclusion: In this study, the prevalence of domestic violence during pregnancy was higher compared to other regions. Due to its damaging effects, families and authorities should pay specific attention to this issue. Also, considering the high prevalence of domestic violence among pregnant women, healthcare centers are recommend to screen pregnant women in this regard so as to diminish its negative outcomes.

Family plays an important role in the health of its members. Health policymakers should move towards family-centered approaches in provision of healthcare services since nearly 70-90% of health care are provided by family and its members. The present study aimed to review the activities of the family and its members in production of health and health-related services. This review study was performed by reviewing the related articles in reliable databases. The study findings showed that families need three categories of facilities, namely values, resources, and activities, to have appropriate health products. In addition, the health services provided by families were classified into seven groups. In conclusion, enabling family members, especially mothers who perform most health care, can have a great impact on the health of the family and its members.