مجله دانشگاه علوم پزشکی رفسنجان
سال چهاردهم شماره 7 (پیاپی 78، مهر 1394)

Needle stick and sharps injuries (NSIs) have been recognized as one of the occupational hazards among health care workers. Many infections including blood-borne viruses such as Human Immunodeficieny Virus (HIV), hepatitis B and C can be transmitted by exposure to infected blood or other body fluid via accidental inoculation injury. The aim of current study was to determine prevalence of NSSIs and related factors in health care workers of Besat hospital of Sanandaj, 2014. This cross-sectional study, with sample size of 249 persons, was carried out during June and August in 2014 in Besat hospital of Sanandaj. Participants including nurses auxiliary nurse, midwives and service staff. Descriptive methods and logistic regression were used for summarie of data and assessing the associations between variables and occupational exposure, respectively. The prevalence of occupational exposure in this hospital personnel was 79.92 %. Multivariate logistic regression analysis showed that men more than women and those with experience (years of services) of 10 to 15 years were significantly more likely to needlestick. 61.36% of the participants also had correct knowledge about occupational exposures and how to deal with it. The findings showed that the occurrence of NSIs in this hospital was high. We concluded that prevention of NSI as an integral part of prevention programs in the work places is essential, and training of health care workers regarding safety practices indispensably needs to be an ongoing activity.

Adolescence is one of the most sensitive periods in every one’s life in which the psychological disorders of mothers play a significant role in its emotional development state. The purpose of this study was to investigate the relationship of mother’s psychological distress with depression, anxiety and stress in adolescents. In this descriptive study, 200 girls and boys studying in high schools of Ardabil in academic year of 2013-2014 and their mothers (n=200) were selected by multistage cluster random sampling, and the adolescents responded to Depression, Anxiety and Stress Scale (DASS-42) and the mothers responded to Depression, Anxiety and Stress Scale (DASS-21). Data were analyzed by Pearson’s correlation coefficient test and multiple linear regression analysis. Results showed that there is a positive significant correlation among the mother’s psychological distress (depression, anxiety and stress) with their adolescents’ depression, anxiety and stress disorders (p<0.001), and the most correlation coefficient was referred to the relationship between mother anxiety and adolescent anxiety (r=0.46). Linear regression analysis results also showed that the model of predicting adolescents depression, anxiety and stress based on the mothers’ psychological distress is significant (p<0.001) and 16% of the variance of adolescents depression, 25% of their anxiety and 20% of their stress can be explained by mothers’ psychological distress. These results support of the relationship between mothers’ psychological distress and their adolescent’s depression, anxiety and stress. Thus, attention to mothers’ psychological conditions can be important in order to prevent the psychological disorders in adolescents.

Increased methadone prescription in narcotics withdrawal protocols in recent years resulted in a high number of accidental methadone poisoning, especially in children. The aim of the study was to determine the frequency of methadone poisoning and its probable causes in children aged less than 15 years. In this cross-sectional study, 97 children with methadone poisoning admitted to emergency medical services of Ali-Ebne-Abitaleb hospital in Rafsanjan were investigated. Data were collected through medical examination and interview and analyzed by descriptive and analytical statistical methods including correlation coefficient, Chi-Square and comparison of means tests. Out of total 97 poisoned children, 57 (58.8%) and 40 (41.2%) cases were male and female, respectively. 7 (7.2%) of these children, 67 (69.1%) children's fathers and 16 (16.5%) of the children's mothers were opiate-dependent. Seventy-one (73%) cases had been poisoned accidentally. Average time interval to referring to hospital was 3.14±2.24 hours and average used naloxone was 16.3±12.7 ampoules. The maximum amount of referring was observed in autumn season and afternoon shifts. Twenty (20.6%) and 53 (54.6%) poisoned children had severe and moderate risk signs, respectively, and 24 (24.7%) cases were asymptomatic. The frequency and severity of methadone poisoning had a statistically significant association (p<0.05) with variables including child addiction, child's birth rank, mother addiction, mother age, mother educational level, and family economic status. Season, mother conditions, children addiction and birth rank, family economic status and habitat are the most important factors in the incidence of methadone poisoning.

Breast cancer is the most common cancer among females. Early detection by screening programs is a useful approach to controlling the disease. The purpose of this study was to assess the health beliefs in breast self-examination, mammography and clinical breast examination among females referring to Bonab health centers. It was a cross- sectional study. The participants were recruited from 5 health centers of Bonan by Convenience sampling (n=250). Data was collected by Champion’s Health Belief Model Scale and analyzed using SPSS-PC (v.13). The results showed that 76.8% of the participants believed in the benefits of mammography and 66.4% of them the clinical examination. About 65.2% of participants had poor health beliefs about efficacy of Breast Self-Examination. 94% of participants believed that mammography reduce the risk of death due to breast cancer. Despite good health beliefs in some fields, rates of breast cancer screening are low, therefore it is recommended to know the factors that play a role in increasing the acceptance of breast cancer screening methods and used them to encourage women to have screening.

Acquired Immunodeficiency Syndrome (AIDS) as a major health challenge has close relationship with high-risk behaviour. Patterns and changes in risk behaviour associated with HIV are important factors in creating a community-level HIV epidemic. The current study examined the prevalence and patterns of risky behaviour before and after the diagnosis of HIV-positive individuals. In this cross-sectional study, 130 HIV-positive people were selected through census method in Rafsanjan health center 1 (n = 55) and Kerman behavioral diseases center (n = 75) in 2012. The patients were interviewed thrugh of checklist made by resercher by a psychiatrist and necessary information was collected before and after the diagnosis of HIV infection. Data were analyzed using chi-square, Fisher's exact, and McNemar's tests. The mean age of patients was 40.12 ± 8.20 years and most of them were male. Before HIV diagnosis, the frequencies of injecting drugs, the use of collaborative injection tools and unprotected sexual behavior were 61.5%, 43.1% and 40%, respectively. According to findings, the probable cause of the high-risk behavior for HIV infection in this study was similar to the national pattern. Risky behavior had significant changes in different directions after diagnosis.

The incidence of antibiotic resistance, in addition to threatening the lives of people, is also due to treatment costs in the healthcare system are enormous. The aim of this study was to determine isolated bacterial from of clinical samples from patients with nosocomial infections and antibiotic resistance patterns in Imam Reza hospital in Bojnurd. This cross-sectional study was performed in 2013, all patients with nosocomial infections were selected. After the separation, identification and confirmation of species, antibiotic resistance was evaluated according to CLSI guideline. The collected data were analyzed by SPSS version 18 and presented with descriptive statistics. One hundred and twenty-six patients with nosocomial infection were detected during the study, the most common isolated microorganism was Escherichia. coli (20.63%), followed by coagulase-negative Staphylococcus(13.50%), Candida (11.90%), coagulase- positive Staphylococcus (11.11%), Enterobacter (9.52%), Klebsiella (7.94%), Citrobacter (5.56%), Pseudomonas aeruginosa (4.76%), Acinetobacter (3.97%), Gram-positive Bacillus and Enterococcus (3.97%) and Gram-negative Coco bacilli(3.17%). Organisms isolated from samples showed variety resistance to different antibiotics. The highest resistance rate (100%) was observed in Acinetobacter, to Ciprofloxacin, Amikacin and Gentamicin. The present study showed the considerable antibiotic resistance in clinical isolated samples collected from studied hospitals, that requires more doctor's attention, infection control professionals in various sectors, especially the intensive care unit of the hospital for antibiotic prescribing.

Methadone maintenance therapy is a comprehensive treatment plan in which methadone is used as a substitution long therapy in people with Opioid dependent. The aim of the present study is to translate and determine the validity and reliability of Abstinence Orientation Scale (AOS) in Iran. This cross-sectional study was carried out in Rafsanjan in 2013. The AOS was developed by Caplehorn et al. The back-translation method has applied in order to translate the original Scale from English into Farsi. Validity was checked using Impact Score (IS), Content Validity Ratio (CVR) and Content Validity Index (CVI). Reliability was checked using cronbach's Alpha coefficient. The IS for all questions was above 1.5. The CVR for all questions was above 0.62 and the CVI for all questions was above 0.79 and the whole were acceptable. The cronbach's Alpha coefficient was also equal 0.62 which was slightly less than the acceptable level (i.e. equal or more than 0.7). For the first time, in the present study the AOS was translated into Farsi and its validity and reliability were reported as to be rather satisfactory.

Internal evaluation is an important aspect in the improvement of the quality of education. This study aimed to internally evaluate the strength and weakness points of the anesthesiology department in order to improve the quality of the educational programs. This cross-sectional study was conducted in the anesthesiology department of the paramedical faculty of Rafsanjan University of Medical sciences in 2013. Questionnaires were prepared on the basis of seven factors includeing Goals and objectives, Management and organization, Education and Curriculum, Faculty members, Students, The learning and teaching procedures and Equipment. The statistical populations included faculties (6 persons), students, (128 persons), operating room supervisors (3 persons) and administrator group that were selected through census method. Data were analyzed with descriptive statistical methods and categorized using Gourman scale. Out of the seven studied factors, the goals and missions with average score of 3.68 were considered to be desirable and the students factor with score of 2.5 was undesirable. The other factors received relatively desirable scores. On the whole the quality of the anesthesiology department with the overall score of 2.53 is considered desirable. Satisfying ratewas based on the rating of Gourman scale. Based on the results of this evaluation the quality of the anesthesiology department from the perspective of students and the faculty members were satisfactory. Considering the undesirable score of the students factor, it is recommended that curriculum developers and program designers should pay more attention to encouraging students participation, holding educational workshops and familiarizing the students with new evaluation methods.