---

Background & Objective: in recent years antibiotic resistance of Pseudomonas aeruginosa is increased as a causetive factor in hospital contamination. This study was done to determine the prevalence and antibiotics susceptibility of Pseudomonas aeruginosa isolated from inanimate objects in Taleghani hospital.

 

Materials & Methods: This descriptive study was done on inanimate objects in different wards of Taleghani hospital during 2006. Sampling was performed by sterile gauze pad for dry surfaces and swab for wet surfaces. To differentiate and identify P.aeruginosa, various culture media such as Brain Heart Infusion Agar, Citrimide Agar and Triple Sugar Iron Agar were used. Antibiotic sensitivity of the isolated strains was determined by Kirby-Bauer Method using Muller-hinton Agar medium. Moreover, antiseptic sensitivity of the strains to Decosept and Povidone-Iodine as the main antiseptic agents was identified by determining Minimal Bactericidal Concentration and Minimal Inhibitory Concentration using Nutrient Agar and Nutrient Broth media.

 

Results: Fifty-five of the total 292 samples were positive for P.aeruginosa. Based on the ratio of the number of positive samples to the total samples, Thalassemia ward (38.5%) was the most infected ward and taps (61.1%) was the most infected sampling place. None of the samples from room atmosphere and intensive care equipments were positive for P.aeruginosa. 20% of the samples were resistant to ceftazidime and 32.7% were resistant to piperacillin, also 10.9% of samples were resistance to both ceftazidime and piperacillin.

 

Conclusion: This study showed that contamination with P.aeruginosa and antibiotic resistance of the isolated bacteria are the main problems in Taleghani hospital.

---

Background & Objective: Hepatitis B virus (HBV) infection is one of the most important health problems all over the world. This study was conducted to determine the co-infection of hepatitis C virus (HCV), hepatitis D virus (HDV) in HBV infected patients in Golestan province of Iran. Materials & Methods: This population based cross sectional study was done in 2004. 139 HBsAg positive cases were assessed for co-infection with HCV and HDV. Serologic tests were done by ELISA method using available kits. Data were analyzed by SPSS-12 and STATA8 software. P-values of less than 0.05 were considered as significant. Results: Sixty eight (48.9%) of 139 cases were males and 71 (51.1%) were females. The mean (±SD) of participant's age was 41.89 (±11.3) years (range: 25-64 years). Anti-HCV and Anti-HDV antibodies were positive in 17 (12.3%) and 8 (5.8%) cases, respectively. Females were more infected with HCV and HDV than males. But the differences were not significant. Conclusion: The prevalence of co-infection with HCV and HDV in HBV infected cases is relatively high and notable in Golestan province of Iran. Because of negative effects of these co-infections in clinical outcome of the disease, it is recommended to assess possible HCV and HDV infection in individuals with HBV infection. This may result in more efficient management of the disease.

---

Background and Objective: Esophageal and gastric cancers are among the most common and fatal cancers. These are diagnosed at the latest phase and the prognosis is too poor. Due to the importance and high incidence rate of the upper gastrointestinal cancers in Golestan province, this study was conducted to explore the overall survival rate of these patients in rural area of this region. Materials and Methods: In this descriptive cross-sectional study, a total of 121 pathologically confirmed esophageal or gastric cancers, with rural place of residence, were retrieved from the cancer registry at the health department in Gorgan. After conducting interview with patients or their relatives, analysis of their sociodemographic and clinicopathologic features was performed. The median survival rate was compared regarding age groups and gender using Kaplan-Meier statistical test. Results: Male to female ratio in esophageal and gastric group were 1.2 to 1 and 3.8 to 1, respectively. Short-term survival rates were 54.76% and 26.2% for esophageal cancer and 66.6% and 37.5% for gastric cancer. Collected information regarding patients’ sociodemographic and clinicophathologic factors did not have significant association with patients’ survival in both esophageal and gastric cancers. The mean survival rate in patient with gastric and esophageal cancers according to age and gender was not significant. Conclusion: This study showed that the overall short-term survival rates for upper gastrointestinal cancers are very low in Golestan province. Therefore the need for intervention the need and allocating more diagnosis and therapeutic resources for upper gastrointestinal cancers are required.

---

Background and Objective: Occult hepatitis B infection is a form of hepatitis in which despite of absence of detectable HBsAg, HBV-DNA is present in peripheral blood of patients. The mechanisms which are responsible for progression of OBI yet to be clarified but some investigators believed that the genetics and immunological parameters may are different in resistant individuals and patients. Cytokine network system could be leading alteration in viral immune response. The aim of this study was to investigate the relation between polymorphisms +874 region of IFN-Gama with occult hepatitis B infection. Materials and Methods: In this study, the plasma samples of 3700 blood donors were tested for HBsAg and anti-HBs by ELISA. The HBsAg negative and anti-HBc positive samples were selected and screened for HBV-DNA by PCR. HBV-DNA positive samples assigned as occult hepatitis B infection cases and ARMS-PCR technique were performed to examine the present polymorphisms in +874 region of IFN-Gama genes of patients with occult hepatitis B infection. Results: 352 (9.51%) out of 3700 blood samples were negative for HBsAg and positive for anti-HBc antibody. HBV-DNA was detected in 57 (16.1%) of HBsAg negative and anti-HBc positive samples. Our results showed that there was not any significant difference between patients and control group in polymorphisms in +874 region of IFN-Gama genes. Conclusion: This study showed that there is not any significant difference between polymorphisms in +874 region with IFN-Gama occult hepatitis B infection.

---

Background and Objective: There are some reports about probable association between acute leukemia and special blood groups. Frequency of ABO and RH blood group is different in each population. This study was done to determine frequency of ABO and Rh blood groups in patient with acute leukemia and healthy population.

Materials and Methods: This case - control study was done on 214 patients (132 males, 82 females) that suffering from acute leukemia as case group and 117026 individuals healthy population who were voluntary blood donors as controls in Mashhad, Iran during 2001-07. Age, sex, ABO blood group and RH blood group were collected from hospital files for each cases. Furthermore the results of ABO and RH blood groups of controls were collected. Data were analyzed with Chi-Square, fisher test and Odd’s ratio.

Results: The frequency of A, B, AB, O and RH blood groups in cases were 23.8%, 32.8%, 7.0%, 36.4% and 90.7%, respectively. The frequency of A, B, AB, O and RH blood groups in controls were 29.8%, 27.4%, 8.9%, 33.9% and 88.3%, respectively. Odds Ratio test didn’t show association of ABO and RH blood groups with acute leukemia. Odds Ratio test showed association of B blood group with acute leukemia in females (OR=0.571, 95%CI: 0.358-.0908, P=0.021).

Conclusion: This study showed although there was not any association between ABO and RH blood groups and acute leukemia but probably females with B blood group are more susciptible toward acute lymphoblastic leukemia.

---

Background and Objective: Budget reforming and distribution of source is considered as one of economic bases of health and treatment. In the ministry of health, performance based budgeting has been performed since 2000. This study was done to identify barriers of operational treatment budget in Islamic Republic of Iran, ministry of health and medical education. Materials and Methods: In this descriptive study, data were gathered by questionairs to identify the barriers in six parts including: human resource, financial management system, financial information system organization structure, performance measurement system and legal necessities during 2007. The questionnaire were distributed among 80 executive staffs whome were responsible to perform operational budgeting plan. Data were analyzed using SPSS-16, fisher's exact test, Karl Pearson, Spearman correlation coefficient tests and Entropy criterion. Results: Disorder in commitment accontity statistical aconite system (0.1464), financial information system, weakening of quantity and proper index (0.1442) for estimating performance program performance measurement system were identified as major barriers. In organizational structure, assignment of authorities and responsiblies for managers and expert were identified as the most priorities (0.1447) of weakness of exact cost controlling system (0.1450) allocated the most rating in the financial management system. Staff resistance (01449) was with high rating in human resource dimension. weakness of rules and internal guidelines for establishment of mentioned budgeting the highest rate in legal barriers. Conclusion: This study indicated that there is corrolation between financial information, performance measurement, financial management systems, organizational structure human resource with barriers of budgeting establishment.

---

Background and Objective: Proprioceptive, vestibular and visual senses control human movements. This study was carried out to compare the posture of head and shoulder in blind, deaf and ordinary pupiles. Materials and Methods: This descriptive and analytic study was done on 16 blind, 30 deaf and 60 ordinary pupiles in Ardabil city, Noth-west of Iran. Sagital and frontal planes Photos for each child was used for determination of head and shoulder deviation. Results: Forward head in blind group significantly was lower than deaf and ordinary pupiles (P<0.05). Rounded shoulder in blind and deaf pupiles significantly was lower than ordinary pupiles (P<0.05). Uneven shoulders in deaf pupiles significantly was lower than ordinary and blind children (P<0.05). Lateral flexion of the head in blind and deaf pupiles significantly was higher than ordinary children (P<0.05). Conclusion: There is a relationship between sensory impairment and postural problems paticularly in blindness Pupils.

---

Background and Objective: A high percentage of patients with multiple traumas sustained at least from an orthopedic problem. One of the high frequent lesions was femoral shaft fracture. The aim of this study was to determine the amount of bleeding and the need for blood transfusion in femoral shaft fractures and risk factors.

Methods: This descriptive, retrospective study was done on 84 patients with femoral shaft fractures whom were operated in Imam Khomeini Hospital in, Sari, in northern Iran during 2012-15. Age, sex, comorbidities, type of fracture, hospitalization period, pre and post-operative hemoglobin and blood unit's loss were recorded for each patient.

Results: In 43 patients (51.19%) plate and in 41 patients (48.80%) intramedullary naling were used for treatment of fractures.13 (15.47%), 33 (39.28%) and 37(44.04%) of patients were received one, two and three blood units, respectively. There was no significant relationship between energy intensity and age. There was significant relationship between the intensity and the type of fracture (P<0.05). A significant correlation existed between blood unit transfusion with sex, fracture type, hemoglobin before surgery and fracture energy intensity (P<0.05).

Conclusion: Based on the results of this study, it is recommended for hip fracture at least 3 units of blood should be reserved.

---

Background and Objective: Trauma is the third cause of death and the main cause of disability in Iran. Children are more susceptible to trauma due to physiological conditions and the growth process. This study was done to evaluate the epidemiolog of pediatric trauma in Hamedan, Iran during 2016-2017.

Methods: This descriptive-analytical study was done on 482 traumatic children (330 boys, 152 girls) at the age of 0 to 14 years whom referred to Besat Hospital in Hamedan, Iran during April 2016 to March 2017. Age, gender, season, type of troma and the outcome of trouma were recorded for each subject.

Results: The highest rate of trauma was observed between the ages of 7-14 years old (40.5%). The rate of trauma was significantly higher in boys than the girls (P<0.05). The most rate of trauma occured in summer (36.9%). The most common, place, cause, type, region of traumas were home (44%), falling down (53%), fracture (35%), and region (41%) respectively. Regarding the subsequence of discharge of subjects, 10 deaths and 42 disabilities after trauma were observed.

Conclusion: Regarding the most common type and place of accidents, providing safety at home and knowledge of parents are nesscery for preventing of pediatric teruma in Iran.

---

Background and Objective: There are few studies that highlighted the effectiveness of exercise on unstable surfaces in eldely subjects. This study was done to evaluate the effect of training on stable and unstable surfaces on walking kinematic and timed-up-and go (TUG) test variables in elderly wemon.
Methods: In this quasi-experimental study, 75 elderly women were non-randomly assigned to exercises and control groups. Cadence, step length, stride length, step width, walking speed, and TUG were measured. Gait kinematics (cadence, stride length, walking speed, step width) was recorded by an image recording camera. Gait kinematics variables were measured. The average of three repetitions was recorded for analysis for each subject.
Results: Exercise training had a significant effect on the step length, stride length, step width, walking speed, and time of TUG (P<0.05). Although, there was a significant difference in gait kinematics after exercise training, training on foam with (9cm height) created the highest mean difference in TUG, cadence, step length, and training on sand resulted in the greatest mean difference in step length and walking speed variables.
Conclusion: Training on stable and unstable surfaces improves walking kinematic and TUG time variables in elderly wemon.

 

---

Background and Objective: Balance in intellectual disability individuals is very important due to the weakness in performing balance tasks. This study was performed to determine the effect of six weeks of vestibular stimulation exercises on the balance of children with mild intellectual disability.
Methods: In this clinical trial study, 30 intellectual disability boys were randomly divided into control and experimental groups. Subjects in experimental group were receiving vestibular stimulation training for six weeks. No intervention was performed on the subjects in the control group. A single leg test was used to screen the subjects with a balance of weakness. To assessment the static, dynamic and functional Balance, the Bruninks Oseretsky test was used and a Timed Up and Go (TUG) was used, respectively.
Results: After the end of the training period, static balance, dynamic balance and functional balance was significantly increased in experimental group compared to controls (P<0.05).
Conclusion: Six weeks of vestibular stimulation exercises have a positive effect on static, dynamic and functional balance in intellectual disability boys.

---

Background and Objective: brucellosis is one of the most common zoonosis diseases. Brucellosis is a systemic disease and affected several organs and tissue in human. This study was performed to determine the knowledge, attitude and practice about brucellosis control among livestock farmers.
Methods: This descriptive-analytic study, was performed on 300 rural literate livestock farmers in BuinZahra, Qazvin Iran during 2019. The knowledge, attitude, and practice, the related factors and demographic characteristics such as age, education level and family count were evaluated by structured six-part questionnaire including 30 questions.
Results: The mean age of the subjects was 41.3±16.4 years. Although 90.7% had heard of brucellosis, only 14% had previous trained. There was a positive attitude about the use of methods to reduce the risk of infection in the family and the seriousness of the issue of animal brucellosis in 19% and 64% of cases, respectively. About 94.7% were attended to veterinarian in suspected cases and 96.7% examined the new animals. 97% were uses of new cheese and milk but the milk was boiled by 89.3%. The mean knowledge was 5.3 ranging from 0 to 8 points in them. There was a statistically significant difference in the knowledge score of individuals according to the information source (P<0.05). Knowledge score and number of household members had positive correlation (r=0.135, P=0.019).
Conclusion: There is medium-level knowledge about brucellosis in livestock farmers. The attitude and some actions (such as dealing with infected livestock) needed to be improved. The probable reason is the high cost of behavior modification in some areas, which has provided the gap between knowledge, attitude and behavior in this area.

---

Background and Objective: Loneliness is one of the problems experienced by the aging population, and the lack of social communication plays a major role in the emergence of loneliness. This study was conducted to determine the effects of telenursing on the loneliness of the elderly.
Methods: This field trial was conducted on 100 elderly people over 60 years of age who were selected by convenience sampling from the clients of Gonabad (Iran) community health centers during 2017. The elderly participants were randomly assigned to 2 groups of 50 people, intervention and control. Then, the demographic information questionnaire, the Informant Questionnaire for Cognitive Decline in the Elderly, and Dehshiri et al.'s Loneliness Scale were completed. The intervention group received face-to-face training by the researcher for 2 hours. There was no intervention for the control group, and the elderly received routine care from the family health unit. After the face-to-face meeting, phone calls were made by the researcher to the intervention group for 12 weeks. One month after the end of the intervention, the questionnaires were completed again by the two groups and evaluated and compared.
Results: The mean (standard deviation) score of loneliness was 60.82±21.07 and 57.48±18.76 before the intervention in the intervention and control groups, respectively, and this value after the intervention was 35.06±14.20 and 61.40±18.72, respectively, in the intervention and control groups. After the intervention, a statistically significant difference was found in terms of a reduction in the loneliness score of the elderly in the intervention group compared to the control group (P<0.05).
Conclusion: This study showed that telenursing was effective in reducing the loneliness of the elderly.