فهرست مطالب

Shiraz Emedical Journal - Volume:18 Issue:8, 2017
  • Volume:18 Issue:8, 2017
  • تاریخ انتشار: 1396/05/18
  • تعداد عناوین: 5
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  • Mohsen Moghaddami *, Mitra Amini Page 1
  • Sina Karamimagham, Maryam Poursadeghfard, Fariba Hemmati * Page 2
    Background
    Cranial ultrasound is considered as the method of choice for early evaluation of neonatal ventricular system. Since premature neonates are susceptible to intra-ventricular hemorrhage and hydrocephaly, it is essential to have normal values of parameters as reference ranges.
    Objectives
    To provide native information of ventricular sizes in normal premature infants in our area for screening policy.
    Methods
    This Multicenter prospective study was conducted on normal premature babies with a gestational age of 26 to 35 weeks, from February to September 2014, in the South of Iran. Patients were divided into 10 groups according to their weeks of gestational age and each group was separately studied during the first 3 days of life. Statistical package for the Social Sciences version 16.0 software package [SPSS Inc, Chicago, Illinois] was used for statistical analysis. Continuous variables were described by mean with standard deviations (SD) and categorical variables by numbers and percentage appropriately. A 95% confidence interval was supposed for all ventricular parameters (5, 50 and 95 percentile). Each parameter that was above the 95 percentile for GA or birth weight was considered abnormal. Comparison between groups was done by Pearson correlation and Mann-Whitney and Wilcoxon Signed Ranks tests as appropriate. P value ≤ 0.05 was regarded as statistically significant.
    Results
    177 premature neonates were evaluated. The mean of ventricular index was 11.7 mm ± 1.5 SD. The mean of anterior horn width and thalamo-occipital distance were 1.8 mm ± 0.7 SD and 15 mm ± 2.7 SD, respectively. Ventricular index was gradually increased as the gestational age and birth weight increased, however, there was no obvious relationship between these and 2 other dimensions. There was no significant difference in dimensions between boys and girls, and also between normal vaginal delivery and cesarean section.
    Conclusions
    This study provides native normal reference values for lateral ventricular size in preterm infants in Iran. It helps physicians better understand the normal and abnormal size of the lateral ventricle in preterm neonates and improves both early diagnostic and therapeutic approaches.
    Keywords: Cranial Ultrasound, Ventricular Index, Anterior Horn Width, Thalamo, Occipital Distance, Premature Neonate
  • Farhad Lotfi, Soraya Nouraei Motlagh, Ghadir Mahdavi, Khosro Keshavarz, Mohammad Hadian, Hassan Abolghasem Gorji * Page 3
    Background
    Research on the utilization of health services provides an opportunity to identify and determine the quantity and quality of factors, which can facilitate or debilitate access to services. Policymakers believe that factors affecting the use of health services should be quantified in order to allocate further resources to indicators, which can help reduce inequalities. This study aimed to investigate factors affecting the utilization of outpatient services and to determine the effect of health insurance on financial support for individuals.
    Methods
    The present study included all Iranian households, which had been recruited by the Statistical Center of Iran in 2012 - 2013. The data were analyzed in 2 logit models and divided into urban and rural areas.
    Results
    According to the results, basic and full insurance coverage was the main factor, influencing the utilization of outpatient health services. Furthermore, age composition of households affected their utilization of these services. More precisely, households with more members aged 65 years tended to use outpatient services more frequently. In addition, households with female heads and those from higher decile groups were more likely to use outpatient services. On the contrary, educational level and household size had negative effects on demand for outpatient health services.
    Conclusions
    Based on the results, there was a significant association between social and economic status and utilization of outpatient services. For decreasing the observed inequalities, policymakers should pay particular attention to households with low income and members aged 65 years and provide access to health services for these groups (eg, access to family physicians).
    Keywords: Utilization, Health Insurance, Outpatient Health Services
  • Fatemeh Rahimi, Ali Goli, Rita Rezaee* Page 4
    Background
    Hospitals are one of the most important health facilities in every society. Therefore, these facilities should be located in a rational manner. The present study aims to 1) select optimal locations for establishing new hospitals in Shiraz and 2) assess the location of the existing hospitals in Shiraz using the geographical information system (GIS).
    Methods
    At first, the hospital location allocation criteria were identified through reviewing the literature. Then, the criteria were entered into a questionnaire, which was completed by experts based on analytic hierarchy process (AHP). Afterwards, spatial raster layers of all the criteria were created in the Arc GIS 10.3 software. Then, in order to select optimal locations for hospitals, weights of the criteria were calculated based on AHP in Arc GIS and the weights were exerted on the relevant spatial created layers. Combination of the layers was presented on a map. After evaluating the 33 existing hospitals’ locations based on the map, the areas located in standard hospital service areas (1500 m) were erased from the map in order to exclude the served areas.
    Results
    The results revealed that ‘proximity to the main roads’ was the most important criterion amongst the whole applied criteria for selecting hospital location. This study also presented 15 land parcels, located in northern part of the city, as the best lands for constructing new hospitals. Besides, according the applied criteria in this study, none of the 33 existing hospitals were located in the appropriate locations.
    Conclusions
    Considering the obtained pattern of the existing hospitals’ locations, in most of the cases, the existing location is not good and the future hospitals must be located in more appropriate locations. The results of this study can be useful for health policymakers to select the most suitable locations for constructing new hospitals in future.
    Keywords: Geographical Information System, Hospital, Health, Location, Allocation, Site selection, Spatial, AHP
  • Iman Mashhadi, Zahra Kavousi, Payam Peymani, Shokrollah Salman Zadeh Ramhormozi, Khosro Keshavarz * Page 5
    Background
    Iran is one of the countries with a high incidence of venomous animal bites, especially scorpion stings and snake bites. As a result, paying inadequate attention to education and prevention programs can impose considerable economic and social costs on the country. Thus, this study aimed to determine the economic burden of snake bite and scorpion sting through identifying direct and indirect costs imposed on the patients in the country.
    Methods
    This was an applied, cross-sectional and analytical-descriptive study conducted in Ahvaz, Iran, in 2015. In order to collect data on direct medical costs, we used the data available in patients’ medical records and self-reports of specialists. Data on non-medical direct costs and indirect costs were collected through face-to-face or telephone interviews with the patients in the studied centers. Human capital approach was used to calculate indirect costs.
    Results
    The total annual costs estimated for the victims of scorpion sting and snake bite were 50,656,424 PPP$ and 11,317,416 PPP$, respectively. Of the mentioned costs, respectively, 90.6% and 75.1% were spent on direct costs and 9.4% and 24.9% on indirect costs.
    Conclusions
    The results of this study showed that scorpion sting and snake bites could impose a significant economic burden on payers, patients, and the community. Therefore, it is necessary to adopt proper preventive and medical measures to prevent the increase of the related economic burden.
    Keywords: Scorpion Sting, Snake Bite, Cost of Illness, Economic Burden