فهرست مطالب

Shiraz Emedical Journal - Volume:19 Issue: 9, 2018
  • Volume:19 Issue: 9, 2018
  • تاریخ انتشار: 1397/06/20
  • تعداد عناوین: 7
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  • Sahar Dalvand, Reza Ghanei Gheshlagh, Fereshteh Najafi, Hossein Zahednezhad, Kourosh Sayehmiri * Page 1
    Background
    Workplace violence is one of the major health concerns and managerial issues that, by creating insecurity at the workplace, would affect the performance of the health personnel and their professional relations. Due to the close contact with patients and their companions, nurses are more exposed to workplace violence. The aim of the present study was to determine the prevalence of workplace violence against Iranian nurses.
    Methods
    In the present systematic review and meta - analysis, 22 Iranian articles, which were published in Farsi and English until February 2017, were selected. National and international databases were searched using “nursing”, “aggression”, “physical violence”, “verbal violence”, and “workplace violence” keywords and their possible combinations. Data were analyzed using meta - analysis and random effects model. Heterogeneity between the studies was evaluated using I2 test.
    Results
    Analyzing the 22 selected articles with a sample size of 5639 showed that the general prevalence of verbal violence was 74% (95% CI: 66 - 83) and of physical violence was 28% (95% CI: 21 - 35). The prevalence of unreported workplace violence by the nurses was 48% (95% CI: 28 - 68).
    Conclusions
    The prevalence of verbal and physical violence against nurses is high and about half of the nurses do not report workplace violence to the hospitals’ authorities.
    Keywords: Workplace Violence_Meta - Analysis_Iran_Nurse_Prevalence
  • Masoomeh Eghtedari, Vahid Beigi *, Esmaeel Mostafavi Page 2
    Background
    Microbial keratitis in children can cause visual loss and amblyopia. In this study, epidemiological features of microbial keratitis in children was examined at a tertiary care center in Iran.
    Methods
    Sixty-three cases of microbial keratitis under the age of 15 admitted at Khalili hospital, Shiraz, Iran, during five years, were reviewed. Patients’ age, gender, residential area, ulcer size, causative organism, surgical, and medical treatment were investigated.
    Results
    Mean age of patients was 5.2 ± 4.8 years and 68.2% were under five years old. The prevalence of microbial keratitis was significantly higher in males than females (P = 0.003), especially in children coming from rural areas. Ulcers larger than 5 mm were observed more than smaller ones (P ≤ 0.0001) in hospitalized children. Ocular trauma was the most common risk factor (present in 56.9%), while in 22.4%, no risk factor was detected. The most causative microbial agent was Staphylococcus (42.8%). Fungus was detected in two cases and herpes simplex was suspected in eight cases. In 54% recovery was observed with medical therapy; mainly by combination of cefazolin-gentamicin and ceftazidime-vancomycin drops. Penetrating keratoplasty was needed in 16.9% and conjunctival flap in 14.7% of recalcitrant cases. Overall recovery from microbial keratitis was observed in 72% of cases, who showed complete healing of ulcer or significant decrease in size at the time of discharge from the hospital.
    Conclusions
    Pediatric microbial keratitis was more common under the age of five years old and trauma was the main predisposing factor. Staphylococcus was the main causative microorganism and recovery was observed with topical treatment in the majority of cases. Trauma prevention and timely treatment is recommended.
    Keywords: Keratitis, Corneal Ulcer, Ulcerative Keratitides, Pediatric
  • Shahla Chaichian, Jamileh Abolghasemi, Fatemeh Naji Omidi, Shahnaz Rimaz*, Zahra Najmi, Abolfazl Mehdizadehkashi, Bahram Moazzami Page 3
    Background
    Endometriosis is a common gynecologic problem in women of reproductive age around the globe. The aim of this study was to specify the factors influencing endometriosis in women of reproductive age using logistic regression and artificial neural network (ANN).
    Methods
    The data of this case-control study was obtained from the medical records in Rasoul-e-Akram hospital, Tehran. Patients, who underwent laparoscopy from 2007 to 2015 and were diagnosed with endometriosis, were selected as the case group (n = 250), and patients diagnosed without endometriosis served as controls (n = 250). To investigate the factors affecting the occurrence of endometriosis, ANN and logistic regression were used and for evaluating the efficiency of the two methods, the area under the ROC curve (AUC) was used. To analyze the data, SPSS (version 22) and R (version 3.2.1) software were used.
    Results
    The means of age in the cases (34.84 ± 0.62) and controls (33.75 ± 0.55) were significantly different (P value = 0.02). With multiple logistic regression, the number of live births and premenstrual spotting were found to be the factors associated with the occurrence of endometriosis. The most important variables entering ANN included BMI, menstrual duration, age, and premenstrual spotting.
    Conclusions
    The results showed that the fitted ANN with AUC of 0.94 could predict the likelihood of endometriosis better than logistic regression with AUC of 0.72. This suggests the superiority of ANN to the logistic regression and proposes ANN be used in further research on predicting the risk of endometriosis, instead of logistic regression. The most important factors affecting endometriosis in this model were BMI, menstrual duration, age, and premenstrual spotting that have to be considered in the clinical settings.
    Keywords: Endometriosis, Reproductive Age, Laparoscopy, Artificial Neural Network, Logistic Regression
  • Sakineh Gholamzadeh *, Seyedeh Sarah Sharifi, Ladan Zarshenas Page 4
    Background
    Age-related macular degeneration (AMD) and subsequent retinal detachment are one of the most common disorders in the elderly, which are treated with surgery. Performing eye surgery leads to psychological distress and affects the lives of the patients. The current study was an attempt to determine the predicting role of preoperative knowledge and self-efficacy in postoperative anxiety, depression, and vision-related quality of life among elderly patients with macular degeneration undergoing retinal surgery in Shiraz, Iran.
    Methods
    In this cross-sectional cohort study, 168 elderly patients with AMD who were candidates for retinal surgery were selected to be studied using purposive sampling. The study tools include the Persian version of HADS questionnaire, visual function index (VFQ-14), and self-efficacy and knowledge questionnaire, which were filled out by the elderly patients in three stages: before the surgery, after the surgery, and at follow-up. Partial correlation coefficient and General Linear Model analysis were used to achieve the objectives of the study.
    Results
    The results revealed that there was a significant relationship between preoperative self-efficacy and depression (P = 0.01) and vision-related quality of life (P = 0.05), as well as between preoperative knowledge and depression (P = 0.05) at follow-up (two months after the surgery). According to the general linear regression analysis, preoperative self-efficacy was identified as the predictor of depression and vision-related quality of life at follow-up. In addition, preoperative knowledge was recognized as the predictor of depression.
    Conclusions
    Based on the results, in designing training interventions, self-efficacy and knowledge need to be considered as the important predictors of patients’ psychological outcomes after the surgery.
    Keywords: Aging, Macular Degeneration, Depression, Anxiety, Vision-Related Quality of Life, Knowledge, Self-Efficacy
  • Fatemeh Gholizadeh, Pooneh Mokarram*, Sanaz Dastgheib, Zahra Rahpeima Page 5
    Background
    It is believed that diabetes has undesirable impacts on the function of the reproductive system in men like decreasing plasma testosterone levels and sperm count and making apoptosis in the testicular germ cells. There are some chemical drugs for improving the complications, but it has been proven that chemicals have many side effects in the patients. Hence, herbal medicines due to anti-oxidant properties, less cost, and fewer side effects can be beneficial substitutions for chemical drugs. Nowadays, Stevia rebaudiana Bertoni as a sweet plant has shown to be effective in ameliorating diabetic problems. This experimental study investigated the effects of stevia on suppressing oxidative stress in Streptozotocin-Nicotinamide (STZ-NA)-induced diabetic rats’ testes.
    Methods
    In the present study, adult Wistar rats were separated into three diabetic groups and two sham groups each containing 10 rats: 1. normal group receiving 1 mL of water; 2. diabetic control group receiving 1 mL of water; 3. and 4. diabetic groups treated with the aquatic extracts of stevia (400 mg/kg) and metformin (500 mg/kg), respectively (treated four weeks after confirming diabetes for 14 days); and 5. healthy group treated with the aquatic extract of stevia (400 mg/kg). Finally, after six weeks, the rats were anesthetized, blood samples were collected from the heart for evaluating serum glucose, and testis tissues were separated for measuring Malondialdehyde (MDA) level and Catalase (CAT) activity. Statistical analysis was carried out using one-way analysis of variance (ANOVA), followed by Tukey post hoc multiple-comparison test and data were presented as the mean±standard error of the mean (SEM).
    Results
    This study documented that stevia significantly declined serum glucose (P
    Conclusions
    The upshot of all, stevia, due to its antioxidant nature, could improve oxidative stress in the testis tissue of diabetic rats.
    Keywords: Diabetes Mellitus, Nicotinamide-Streptozotocin, Oxidative Stress, MDA, Catalase Activity, Testicular Tissue, Stevia
  • Farhad Motamedizadeh, Khalil Alimohammadzadeh*, Seyed Mojtaba Hosseini Page 6
    Objectives
    The aim of this study was to monitor and evaluate the program performance and management control system of tuberculosis in Sistan and Baluchestan Province by comparing the annual indicators over ten years.
    Methods
    This descriptive study was performed in the health departments of the province, using the records of tuberculosis patients during 2006 - 2016. Data were analyzed in SPSS version 23.
    Results
    The lowest rate of smear-positive pulmonary tuberculosis was reported in 2011 (27.23%). Based on the findings, the incidence of new cases of smear-positive pulmonary tuberculosis showed a downward trend during 2006 - 2016. The highest incidence of new smear-positive pulmonary cases was reported in 2006 (1.69%). According to the findings, to achieve a high success rate in tuberculosis management, revisions are needed in control programs and training workshops for healthcare personnel.
    Conclusions
    Tuberculosis can be eliminated through correct implementation of directly observed treatment, short-course (DOTS) strategy, implementation of educational and tuberculosis drug programs, and use of correct management policies.
    Keywords: Tuberculosis, Program Performance, Management Control System
  • Mahboubeh Firouzkouhi Moghaddam, Marzieh Assareh, Tayebeh Rakhshani *, Abbas Broomand Page 7