ELECTRONIC PHYSICIAN
Year:2015 | Volume:7 | Issue:7|Papers Count:18

Introduction: Clinical education is one of the most important components of the resource generation function of health systems, and it has a very important role in graduates' competency with respect to effective, practical education. This study aimed to assess the quality of clinical services in Kerman’s teaching hospitals located in southeastern Iran.Methods: This cross-sectional study was conducted in 2011 on 303 medical students at different levels of medical education at Kerman’s teaching hospitals. A modified SERVQUAL instrument was used to collect the data after its validity and reliability were checked. The data were analyzed by SPSS 18.0 using the paired t-test, Kruskal-Wallis, and post hoc tests, when appropriate.Results: In all five dimensions of quality, gaps were observed between students’ perceptions and expectations as follows: Assurance (mean=-1.18), Responsiveness (-1.56), Empathy (-1.4), Reliability (-1.27), and Tangibles (-1.21). There was a significant difference between the quality perceptions and expectations of the medical students (p<0.001). A significant difference was observed between three educational levels, including externships, internships, and assistantships regarding the dimensions of the quality gaps (p<0.001).Conclusion: The clinical services provided by teaching hospitals in the study did not meet the students' expectations at any of the three educational levels. As we precisely assessed the dimensions and items that had the higher quality gaps, it was apparent that, for most part, clinical education officials could improve the quality by designing interventions, which would not be very difficult to do.

Introduction: Medical students have a serious need to acquire communication skills with others. In many medical schools, special curriculums are developed to improve such skills. Effective training of communication skills requires expert curriculum design. The aim of this study was to explore the experiences and views of experts and stakeholders in order to design a suitable training program in communication skills for medical students.Methods: The content analysis approach was used in this qualitative study. Forty-three participants were selected from the faculty, nurses, physicians, residents, and medical students at Mashhad University of Medical Sciences using purposive sampling. The data were collected through focus group discussions and semi-structured interviews. To ensure the accuracy of the data, the criteria of credibility, transferability, dependability, and conformability were met. The data were analyzed by MAXQDA software using the Graneheim & Lundman model.Results: The findings of this study consisted of two main themes, i.e., “The vast nature of the present communication skills training" and “administrative requirements of the training program regarding communication skills.” The first theme included the educational needs of students, the problems associated with training people to have good communication skills, the importance of good communication skills in performing professional duties, communication skills and job requirements, the learning environment of communication skills, and the status of existing training programs for communication skills. Strategies and suitable methods for teaching communication skills and methods of evaluating the students in this regard also were obtained.Conclusion: The findings of this study were the elements required to design a proper and local model to teach communication skills to medical students through analyzing the concepts of effective communication. The results of this study can be useful for medical faculties in designing a proper program for teaching medical students how to communicate effectively with patients and colleagues.

Introduction: Infertility, as a global phenomenon and one of the most important issues of reproductive health, affects women more often than men, even when the infertility is due to a male factor. The purpose of this study was to explore the cognitive emotional experiences of women faced with male infertility.Methods: This qualitative study was conducted in 2014-2015 in Mashhad, Iran. The perceptions and experiences of healthy women whose husbands were diagnosed with primary male factor infertility were investigated using a qualitative content analysis approach. Participants were selected through purposeful sampling, and data collection was conducted using in-depth semistructured interviews. Data were analyzed using conventional content analysis with MAXqda software. Study rigor was verified via criteria proposed by Lincoln and Guba.Results: One main theme emerged through analysis entitled "cognitive emotional reactions confronting infertility diagnosis" with sub-themes of cognitive emotional reactions when confronted with male infertility diagnosis with subthemes of disbelief and denial, fear and apprehension, suffering and emotional distress, disappointment, frustration, confusion, and joy.Conclusion: The diagnosis of male infertility was associated with important emotional cognitive consequences for their female partners. Emotional support, providing new insights into how to treat the issue, and trying to shorten the process of diagnosis are necessary for these women. This kind of support could reduce the psychological effects of confrontation with the diagnosis of male infertility, including social insecurity for women.

Introduction: Chronic kidney disease (CKD) is an important health problem that gradually leads to end-stage renal disease (ESRD). In ESRD patients, death due to other diseases or some events, such as renal transplantation (known as competing risks), would change the probability of observing the event of interest. The aim of this study was to estimate the survival of ESRD patients using competing risk analyses.Methods: In this retrospective longitudinal study, 307 ESRD patients who were older than 20 were recruited from the dialysis and kidney transplant Centers in Kerman City, Iran, from2007 to 2011. To assess the impacts of the investigated factors on the outcome, a cause-specific hazard model and competing risk models were fitted.Also, the cumulative incidence (CI) approach and sensitivity analysis were implemented. All of the analyses were performed using Stata software, V.12.Results: The results of competing risk models showed that age and type of dialysis were associated with death (hazard ratio (HR)=1.03, p<0.001 and HR=1.65, p=0.011, respectively). In cause specific hazard model each year increase in age was associated with a 2% increase in the risk of death. Also, the types of dialysis were associated significantly with death (HR=1.93), and the effect of the type of dialysis was estimated as HR=1.51 (p=0.04) when we assumed that all patients who had experienced transplantation survived for the longest survival time.For those for whom receiving the transplantation was considered as death, the HR for the type of dialysis as well as the corresponding p-values were 1.82 and 0.001, respectively.Conclusion: Ignoring the competing risks of death due to ESRD, such as renal transplantation, in estimating the survival of these patients might lead to overestimation of the results.

Introduction: Road traffic accidents are among the most critical public health issues. Many people die on the roads each day and tens of millions sustain nonfatal injuries. The aim of this study is to describe the high-risk behaviors of motorcyclists in which police had to confiscate their motorcycles.Methods: This cross-sectional study was carried out on 240 motorcyclists in Iran from December 2010 to February 2011. A researcher-created questionnaire was used to collect data on self-reported high-risk behaviors, including passing the crossroads without considering the traffic light, refusing to wear a helmet, performing stunts in the street, and driving in the opposite direction. The collected data was descriptively analyzed.Results: The mean age of motorcyclists was 29.3 years (SD=8.26). Twenty-six percent (n=62) of the participants did not have a motorcycle driver’s license. The analysis of risk behaviors showed that 60.8% (n=146) of the motorcycle drivers usually passed crossroads without considering the traffic light and 20.8% (n=50) performed stunts in the street.Conclusions: This study indicates that the prevalence of high-risk behaviors among motorcyclists is significant.Health education interventions may inhibit these behaviors, thus reducing the risk of injuries.

Introduction: In recent decades, the development of medical and pharmaceutical science has led to a heavy financial burden on the government, insurance companies, and the general population. Due to the increasing the cost of pharmaceutical products in the Kermanshah Province, policy makers have tried to identify the factors that resulted in the increases. The aim of this study was to determine the main factors that affect the expenditures for pharmaceutical products by urban households in Kermanshah Province, Iran.Methods: This analytical-descriptive study was conducted using time series method. The study population was urban households of Kermanshah Province from 1991 to 2013. The explanatory variables of the log-log model were drug price index (LnDPI), the average income of urban households (LnINC), the number of physicians per 1, 000 people (LnPH), and the number of hospital beds per 1, 000 people (LnBE).The required data were acquired from the Statistical Center of the Ministry of Health and Medical Education. The unit root was evaluated by the Dickey-Fuller test. Stata v.11 software was used for the statistical analysis.Results: Coefficients of LnDPI and LnPH were 0.97 and 0.77, respectively, and they were statistically significant (p<0.05). Also, the coefficients of D. LnINC (first difference of LnINC) and LnBE were 0.34 and 1.8, respectively, and both of them were statistically insignificant (p>0.05).Conclusion: The results showed that drugs are non-elastic and essential for households. It should be noted that the health policy makers in Iran should conduct appropriate planning to ensure both the physical and financial accessibility to drugs by urban households. The development of basic and supplementary health insurance coverage, especially for poor populations and urban areas where there are patients with chronic diseases, can be a suitable solution to reduce barriers to acquiring the required drugs.

Introduction: The United Nations (UN) identified health as a basic human right, but, unfortunately, the evidence shows that people with disabilities (PWD) often have lower levels of health than the general population. This can be associated with problems in access to the services and programs. The aim of this study was to explore barriers of the health system to rehabilitation services for PWD in Iran.Methods: This was a qualitative study conducted on 21 participants using semi-structured, in-depth interviews and content analysis from June 2014 to July 2015. Data analysis was performed by MAXQDA version 10.Results: “Barriers” were the most prominent challenge of people with disabilities that needed access to rehabilitation services. These barriers were categorized into eight concepts of deficiency in the system that provides rehabilitation services, defect of education, deficiency in detecting and screening of people with disability, defect of stewardship in rehabilitation, ignoring socio-cultural factors, accessibility hardships, lack of identification, and financial hardships in rehabilitation.Conclusions: An efficient rehabilitation plan requires a common understanding, considering the long-term complications involved in addressing the barriers. Understanding the barriers of the health system to rehabilitation services requires comprehensive management that first should be familiar with all of PWD, providers, policy makers, and other beneficiaries. It also is necessary for policy makers to consider rehabilitation services as a main part of the health plan; especially, they must change their oversight of rehabilitation services and programs. Thus, policy makers should have need comprehensive management and recommended further research.

Introduction: Despite the importance of perceived barriers against self-care in diabetic patients, the role of this factor is rarely addressed in the improvement of self-care behaviors of Iranian patients. The lack of appropriate instruments that fit demographic properties of Iranian society is one reason. The aim of this study was to develop and validate the scale of perceived barriers to self-care in patients with type 2 diabetes mellitus.Methods: This cross-sectional study conducted on 400 patients with type 2 diabetes who were covered by the health centers in Isfahan (Iran) in 2015. A 22-item, researcher-made instrument was designed; the face and content validities of the instrument were examined through obtaining the opinions of an expert panel before administering the instrument in the study. Also, the exploratory factor analysis was used to investigate the instrument's validity. Cronbach's alpha was employed to measure its internal consistency (reliability). To examine the validity of the final scale, the mean scores of perceived barriers in patients with appropriate and inappropriate self-care behaviors were compared.Results: The research sample was comprised of 240 women (60%) and 160 men (40%). The mean value of the content validity index was 0.84. The results of factor analysis confirmed the validity of the 11 items and 3 factors of the developed scale. The factor loading ranged from 0.46 to 0.78. These three factors together explained 40.28% of the total variance. The overall reliability coefficient of the instrument was 0.79, ranging from 0.82 to 0.93 for three factors.Conclusion: According to the results, the developed scale was a valid and reliable instrument for examining the barriers perceived by the patients. The findings of this research can help health policy makers in planning to facilitate the self-care behaviors as the most vital factor in diabetes control.

Introduction: The neonatal mortality rate (NMR) is an essential index in the assessment of community health.With the rapid advancement of neonatal care, the causes of death in this group and the overall mortality rate have changed. For these reasons, the aim of this study was to determine the current NMR and its causes in Sabzevar City’s Neonatal Intensive Care Unit (NICU).Methods: This cross-sectional study was conducted in the NICU at Sabzevar Hospital from 2006 through 2013.Based on previous studies, the sample size was determined to be 365 neonates who were admitted to the NICU and died before they were discharged. The study tool was a researcher-developed checklist related to deceased neonates in the NICU. The checklist was confirmed based on the validity of its content and its inter-rater reliability. We used chi-squared, the Mann-Whitney U test, and the Spearman correlation to analyze the data.Results: The NMR in Sabzevar’s NICU was 6.44 per 1000 during the seven-year period; this rate included the following cases per 1000 live births: very early mortality (2.16), early mortality (3.33), and late mortality (0.96).Among 58, 270 live births, 3, 667 of the neonates were admitted to the NICU during the seven-year period, which was equivalent to 62.93 admissions per 1000 live births. Of the 3, 667 neonates admitted to the NICU, 375 (10.23%) died before they were discharged. The most recurrent diagnoses were respiratory distress syndrome (46%), followed by sepsis (12%). The one-sample chi-squared test as a goodness-of-fit test (95% CI) showed that the mortality rates were significantly different based on gender (p=0.004), birth weight (p<0.001), gestational age (p<0.001), different causes of death (p<0.001), and different years of death (2006 -2013) (p<0.001).There also was a significant difference between the duration of survival (very early mortality, early mortality, and late mortality) (p<0.001).Conclusion: Neonatal mortality in the present study was comparable with that reported in similar studies in Iran and in other countries. The strong association between the mortality rate in the NICU with premature birth and low birth weight indicates the necessity of prenatal care aimed at preventing pre-term labor. Comprehensive programs from antenatal care and care at and after birth are recommended, including the investigation of the risks for neonatal death and offering preventive strategies.

Introduction: Employee satisfaction is considered to be an important component in the promotion of service quality and increased efficiency and effectiveness in the reform plan for a healthcare system. Neglecting this issue could result in a lack of success in achieving the healthcare system’s objectives. The healthcare reform plan is being implemented to achieve the objectives of the healthcare system. Thus, given the key role of hospital employees in implementing the reform plan, the aim of this study was to determine the levels of hospital employees' satisfaction with their jobs.Methods: This was a qualitative study in 2015 that included thematic analysis, and 138 employees of the Kosar, Rajaii, and Ghods Hospitals participated. Data were collected using semi-structured interviews, and the data were analyzed using content analysis.Results: After analyzing the data collected by interviewing the employees, 132 codes were identified. The codes were classified into five general concepts including opinions about 1) the reform plan and its administrative barriers, 2) changes in visits, 3) changes in working conditions, 4) changes in salaries and 5) General satisfaction of personnel.Conclusion: Increasing workloads, stagnant salaries, and the shortage of personnel were the main factors that reduced the satisfaction of the hospitals’ employees with the administration of the healthcare reform plan.

Introduction: Pelvic masses are among most the common causes of patient admission into gynecology clinics and one of the most common reasons for referral to gynecologic oncology departments due to the risk of uterine or ovarian malignancies. The aim of this study is to compare the four indices of the risk of malignancy index (RMI 1-4), as a combination of menstrual status, radiological findings, and serum CA125 concentration, for discrimination of benign from malignant pelvic masses.Methods: This retrospective descriptive and analytic study was conducted on 200 patients with pelvic mass, post-surgery, and who were referred to the oncology department in Shahid Sadoughi hospital of Yazd (Iran) between June 2007 and September 2011. Data regarding demographics, pathology reports, paraclinical and clinical tests were analyzed. The four RMI indices were separately used for determination of benign vs.malignant masses using the optimized cutoff points, ROC curve, sensitivity, specificity, predictive value of positive and negative, and accuracy. Finally, p value for each index was calculated, and a final discrimination power was measured by using SPSS version 17 software.Results: The calculated p values in the four RMI indices in ultrasound findings indicated statistical significance, and the RMI 2 showed the highest level of accuracy or diagnostic performance. RMI 2 had a cutoff point of 90, an under-chart area 86.7, 79.36% sensitivity, 78.95% specificity, 58.44%, positive predictive value, 90.08% negative predictive value, and 78.93% accuracy, and a p value of 0.004. However, this relationship was found not to be meaningful using CT scan images.Conclusions: Using RMI 2 for differentiation of malignant from benign pelvic masses is a reliable method with ultrasound findings.

Introduction: Computerized tomography of the urinary tract (CT-UT) has been established as the diagnostic procedure of choice for urinary stones. This study aimed to evaluate its role in predicting the outcome of percutaneous nephrolithotomy (PCNL) in terms of stone free rate and residual fragments.Method: This prospective cohort study was conducted on 34 patients in the Urology Department of Theodor Bilharz Research Institute from January 2013 to March 2014. The patients who had large and/or multiple renal stones, including staghorn stones, in 19 renal units scheduled for PCNL were included in this study. All had a pre-operative CT-UT to determine the stones’ characteristics and renal anatomy. CT-UT, together with a kidney-Ureter-Bladder (KUB) film, was taken on the first post-operative day. The data were analyzed by SPSS version 17 using independent-samples t-test and the chi-squared test.Results: CT-UT showed a statistical significant sensitivity in detecting residual fragments over standard KUB, yet this significance was lost when corrected to significant residual. Stone size and density were independent factors for the presence of residual stones.Conclusion: CT-UT post PCNL was sensitive to detect residual fragments, yet it showed no superiority over standard KUB in detecting significant residual.

Introduction: Occupational injuries as a workforce’s health problem are very important in large-scale workplaces. Analysis and modeling the health-threatening factors are good ways to promote the workforce’s health and a fundamental step in developing health programs. The purpose of this study was ANN modeling of the severity of occupational injuries to determine the health-threatening factors and to introduce a model to predict the severity of occupational injuries.Methods: This analytical chain study was conducted in 10 large construction industries during a 10-year period (2005-2014). Nine hundred sixty occupational injuries were analyzed and modeled based on feature weighting by the rough set theory and artificial neural networks (ANNs). Two analytical software programs, i.e., RSES and MATLAB 2014 were used in the study.Results: The severity of occupational injuries was calculated as 557.47 ± 397.87 days. The findings of both models showed that the injuries' severity as a health problem resulted in various factors, including individual, organizational, health and safety (H& S) training, and risk management factors, which could be considered as causal and predictive factors of accident severity rate (ASR).Conclusion: The results indicated that ANNs were a reliable tool that can be used to analyze and model the severity of occupational injuries as one of the important health problems in large-scale workplaces. Additionally, the combination of rough set and ANNs is a good and proper chain approach to modeling the factors that threaten the health of workforces and other H& S problems.

Introduction: Camel milk is the closest to a human mother’s milk. Camel milk is different from other milks, however, having low sugar and cholesterol, high minerals (sodium, potassium, iron, copper, zinc and magnesium, and vitamin C). The milk is considered have medicinal characteristics as well. This systematic review is aimed at determining and reporting nutritional values and medicinal characteristics of camel milk in children.Methods: The search strategy of the current review is “ (camel AND milk) AND (autism OR food allergy OR milk allergy OR children OR diarrhea.” The search was conducted via PubMed, Scopus, and Google scholar.Also two Persian scientific databases (SID and Iranmedex) and international congresses were investigated. Fulltext papers and abstracts on the topic of camel milk, evaluating nutritional value and medicinal properties, were included in this systematic review.Results: Out of the 472 records found in the resources, 35 related studies were included in the final analysis. The result showed that camel milk is highly nutritious and is safe for consumption by children.Conclusion: It seems that many researchers did not follow a specific guideline for reporting and confirming the therapeutic properties of camel milk in children, but there is evidence denoting the importance, trials, and investigations of its usability and benefits. Camel milk as a supplemental treatment seems less invasive and costly than specialist care, medications, alternative treatments, and behavioral interventions. Based on our findings, camel milk is safer for children, effective in the treatment of autism, improves general well-being, promotes body natural defenses, is a good nutritional source, and can helps the daily nutritional needs of humans.

Introduction: Fungal contamination in hospitals has been a major health concern, especially in immunosuppressed patients. Construction programs increase the risk of fungal contaminations in hospitals. This study aimed to monitor and compare fungal contamination in two hospitals in Bandar Abbas, Iran, one of which was undergoing construction. Furthermore, the study determined the seasonal variations in the prevalence of fungi identified in the two hospitals.Methods: This study was conducted during April-December 2014 on 146 soil samples collected from the Shahid Mohammadi Hospital that was under construction and the Shariati Hospital that was not involved in any construction program. The soil samples were collected in the morning from the dust on the ground. Statistical analysis was performed using the chi-squared test.Results: Among the fungal cultures, 83.56% were found to be positive. We identified 122 fungal isolates, representing 16 genera, 13 of the genera were isolated from Shahid Mohammadi Hospital and 14 were isolated from Shariati Hospital.Aspergillus was the dominant fungus in both hospitals. In Shariati Hospital, 100% of Aspergiluss nigerwere isolated in the summer. In the spring, Mocur was dominant in both hospitals, and, in the winter, Rhizopus spp. was the dominant fungus in Shahid Mohammadi Hospital (55.5%); however, this fungus was dominant in spring in Shariati Hospital (66.7%). In Shariati Hospital, Scopulariopsis, Drechslera, Penicillium spp., and Yeasts were present only in the fall, whereas yeast was the dominant fungus in summer (100%) in Shahid Mohammadi Hospital. There were not significant differences between two hospitals, with the exception of Fusarium spp., which was more frequent in Shariati Hospital, where no renovation was taking place (p=0.008).Conclusion: Our results indicated that specific ecological niches existed in the two general hospitals in Bandar Abbas. Special attention should be paid to environmental control programs. It is recommended that soil exposure be considered in patients’ histories in addition to the current focus on infections related to food and water.

Background: Oral and saliva conditions of patients undergoing chemotherapy is often affected by the medication they receive. Up to now, no appropriate medication that possesses the positive effects of chemotherapy without presenting oral complications has been introduced.Objective: The aim of this study was to assess the clinical effects of CPP-ACPF paste on the oral and salivary status of patients undergoing chemotherapy.Methods: From October 2013 to April 2014, 20 patients in chemotherapy treatment plans and who met the inclusion criteria enrolled in this randomized parallel single-blind controlled clinical trial in Shohada-e-Tajrish Hospital in Tehran, Iran. Patients were divided into two groups: 1) patients received their daily medication of cancer therapy center (group 1, control); 2) patients applied CPP-ACPF Crème (MI paste plus, GC USA) twice a day as instructed (group 2). The baseline status of oral conditions of patients (mucositis, dry mouth, infection, diminished tasting sense, difficulty in food intake, burning sensation of mucosa, saliva and dental plaque pH, rest and stimulated saliva, buffering capacity of saliva) were recorded and reevaluated after 21 and 42 days. The data were analyzed with a Mann-Whitney U-test.Results: A total of 20 patients were allocated randomly to groups 1 and 2. The Mann-Whitney U-test showed that application of CPP-ACPF paste twice daily did not cause any significant difference in oral complication of the subject group compared with the control group (p>0.05). Among salivary signs, resting and stimulated saliva rates and saliva buffering capacity had significantly altered in the CPP-ACPF group in day 21 and 42 in comparison with those of the control group (p<0.05).Conclusion: Application of CPP-ACPF paste before and during chemotherapy can improve the salivary status of patients undergoing this treatment.Trial registration: The trial is registered at the U.S. National Institutes of Health (https: //www.clinicaltrials.gov) with the identification number NCT01737307.Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

Introduction: Cervical cancer is the second most common cancer among women worldwide. The sensitivity of conventional Pap smear in detecting cervical lesions before cervical cancer is 51%, which means the false negative value is 49%. The aim of this study was to compare two methods for screening for cervical cancer in patients with secondary immunodeficiency, i.e., the conventional Pap smear and colposcopy.Methods: This cross-sectional study was conducted on 101 immunodeficient patients who were referred to the Gynecologic Clinic at Shahid Sadughi Hospital in Yazd from March 2011 to August 2012. All patients underwent the Pap test, a colposcopy, and a cervical biopsy, with the latter being considered as the gold-standard test.Results: The most frequency of immunodeficiency was noted among patients with rheumatoid arthritis (53.3%), and this was followed by patients who were undergoing chemotherapy (30.7%), patients with lupus erythematosus (12.9%), and patients with AIDS (3%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Pap smear were18.2, 98.5, 85.5, 71.3, and 72.2%, respectively. The respective values for colposcopy were 66.7, 98.94, 80, 97.9, and 97%, respectively.Conclusion: In this study the accuracy, sensitivity, specificity, and negative predictive values of colposcopy were higher than those for the Pap smear in detecting high-grade, cervical, pre-malignant lesions (cervical intraepithelial neoplasia: CIN≥ 2). Therefore, an annual colposcopy is advised for secondary immunodeficient patients instead of a Pap smear.

Introduction: A considerable segment of the elderly population in Iran is illiterate, and it seems the existing neuropsychological screening tests are not very useful for detecting dementia in illiterate participants. The purpose of this study was to develop and validate a tool called Persian test of Elderly for Assessment of Cognition and Executive function (PEACE) for detecting dementia in both illiterate and literate participants.Methods: First, in order to design some of the cognitive aspects of the PEACE assay, we considered other prevalent neuropsychological instruments, such as the General Practitioner assessment of Cognition (GPCOG), Functional Assessment Staging (FAST), Mini Mental State Examination (MMSE), and Wechsler Memory scale.The other domains of PEACE were designed according to our clinical proficiencies and the culture of the society.In the next step, the participants were classified into three distinct groups, i.e., the control group (n=33), the Mild Cognitive Impairment (MCI) group (n=30), and the Alzheimer’s group (n=38). All of the participants in each group were divided according to their educational level, i.e., illiterate, semi-literate, and literate.Results: We developed PEACE consisting of 14 items, each of which represents a specific cognitive function, with a maximum score of 91. The 14 items are Orientation, Praxis, Attention and Concentration, Attention and Calculation, Memory, Similarity, Thinking, General Information, Language, Judgment, Gnosis, Planning (Sequencing), Problem Solving, and Animal Naming. PEACE scores are highly correlated with those of the MMSE (r=0.78). The optimal cut-off point of PEACE chosen for diagnosis of Alzheimer’s disease was 67.5 (sensitivity: 75.8%, specificity: 97.4%). The PEACE scores showed a significant difference between Participants with Alzheimer’s disease and the control group (p=0.0000) and the MCI group (p=0.003). In addition, there was no significant difference between illiterate and literate participants in the Alzheimer’s group. However, the PEACE scores differed significantly (p=0.0000) between illiterate and literate participants in the control group.Conclusion: The PEACE addresses the limitations of existing tests and is appropriate for use in countries that have high rates of illiteracy. It is a valid screening mechanism for the detection of dementia in both illiterate and literate participants.