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1.  Quantitative and Qualitative Evaluation of Bio-Aerosols in Surgery Rooms and Emergency Department of an Educational Hospital 
Bio-aerosols are a potential hazard in hospitals and are mostly produced by hospital staff, patients and visitors. Bio-aerosols are solid or liquid particles pending in the air and they consist of aerosols accompanying micro-organisms or organic compounds of micro-organisms such as endotoxin, metabolite, toxin and other parts of organism. Those are a potential hazard in hospitals and are mostly produced by hospital staff, patients and visitors.
This study aimed to determine the types and amount of bacterial contamination in operating rooms and emergency department of an educational hospital in Zahedan, South-East of Iran.
Materials and Methods:
In this study, 72 samples were collected from three operating rooms and three rooms in the emergency department of an educational hospital during 2012. On the first day of every month, a sample was taken from each room during the morning shift; active sampling was done on plates consisting of blood agar and brain-heart infusion agar (BHI) for 10 minutes in the axis of a one-story Anderson impactor (flow rate 28.1 litter per minutes) and SIBATA air pump SIP 32-L and samples were then placed in a 35°C Incubator. Bacterial colonies were counted; warm coloring and differential tests were done and the data were analyzed using Mann-Whitney U and Kruskal-Wallis tests.
Seventeen types of bacteria were detected including Staphylococcus, Micrococcus, Viridians, Pneumococcus, Escherichia coli, Streptococcus, Bacillus cereus, B. subtilis, Klebsiella, Pseudomonas, Diphtheroid, Citrobacter and Enterobacter. Quantitative bacterial results showed that the number of observed bacteria in the emergency department with an average of 103.88 ± 33.84 cfu/m³ was more than that of the surgery rooms with an average of 63.32 ± 32.94 cfu/m³. Furthermore, the highest average number of all counted colonies (106 ± 28.45 cfu/m³) was determined in autumn. In all samples, S. aureus and Micrococcus were the most detected bacteria.
The World Health Organization (WHO) has suggested relatively relaxed limits of 100 cfu/m3 for bacteria and 50 cfu/m3 for fungi in the hospital air. Therefore, quantitative and qualitative outcomes of this study demonstrate that contamination level and bacterial variety in surgery rooms and emergency departments is high and effective measures must be taken to control the possible health risks.
PMCID: PMC4295311  PMID: 25632321
Operating Room; Hospital; Bioaerosol, Bacteria, Fungi, Indoor
2.  Muscular adaptations to depth jump plyometric training: Comparison of sand vs. land surface 
The purpose of this study was to compare the effects of plyometric training on sand vs. land surface on muscular performance adaptations in men. Fourteen healthy men were randomly assigned to two training groups: a) Sand Depth Jump (SDJ; N = 7) and b) Land Depth Jump (LDJ; N = 7). Training was performed for 6 weeks and consisted of 5 × 20 repetitions of DJ training on 20-cm dry sand or 3-cm hard court surface twice weekly. Vertical Jump Test (VJT), Standing Long Jump Test (SLJT), 20-m and 40-m sprint, T-test (TT) and one repetition maximum leg press (1RMLP) were performed before and after training. Significant improvements in VJT [4 (ES = 0.63) vs. 5.4 (ES = 0.85) cm], SLJT [8.3 (ES = 0.3) vs. 12.7 (ES = 0.57) cm], and 1RMLP [23.5 (ES = 0.56) vs. 15.3 (ES = 0.49) kg] were seen for both the groups. Likewise, significant decreases were observed for both SDJ and LDJ groups in 20-m [0.3 (ES = 0.72) vs. 0.4 (ES = 1.98) s] and 40-m sprint times [0.2 (ES = 0.4) vs. 0.5 (ES = 0.71) s], and TT [0.5 (ES = 0.62) vs. 0.9 (ES = 0.57) s]. With regard to ES, it can be recommended that athletes used LDJ training for enhancing sprint and jump and SDJ training for improving agility and strength.
PMCID: PMC4168734  PMID: 25243078
jumping ability; performance; sand; stretch-shortening cycle
3.  Imatinib Therapy in Chronic Myelogenous Leukemia and Thyroid Function Tests 
Imatinib, a tyrosine kinase inhibitor which resulted in much improvement in the treatment of chronic myelogenous leukemia (CML), may adversely affect thyroid gland function. To date, assessment of thyroid function during imatinib therapy has limited to retrospective studies. The aim of this study was to evaluate the effects of imatinib on thyroid function in a prospective manner.
Materials and Methods
In this prospective study, 16 newly diagnosed adult subjects with positive Philadelphia chromosome in chronic phase of CML without any other apparent underlying diseases were enrolled. Free T3, Free T4, TSH, Anti TPO and Anti thyroglobulin antibodies were measured before and after 4 and 12 weeks of treatment.
Of the 16 patients, 9 were male (57.1%) and 7(42.9%) were female with a mean age of 29±5 years. There were statistically significant changes within reference ranges in serum concentrations of TSH (P=0.753 and 0.002), Free T3 (P=0.012 and 0.007) and Anti Thyroglobulin (P=0.221 and 0.041) 1 month before and 3 months after imatinib initiation, respectively. At the same time, there were no significant changes in serum Free T4 (P=0.196 and 0.650) and Anti TPO (P=0.807 and 0.600) concentrations.
This study showed some significant changes on thyroid function tests during imatinib therapy. However, all of them were within the normal range without any clinical abnormalities in the course of treatment. We recommend other studies with larger sample size and longer duration of follow-up.
PMCID: PMC4305377  PMID: 25642304
Imatinib mesylate; Chronic myelogenous leukemia; Thyroid function tests
4.  Mortality Risk Prediction by Application of Pediatric Risk of Mortality Scoring System in Pediatric Intensive Care Unit 
Iranian Journal of Pediatrics  2013;23(5):546-550.
The Pediatric Risk of Mortality (PRISM) score is one of the scores used by many pediatricians for prediction of the mortality risk in the pediatric intensive care unit (PICU). Herein, we intend to evaluate the efficacy of PRISM score in prediction of mortality rate in PICU.
In this cohort study, 221 children admitted during an 18-month period to PICU, were enrolled. PRISM score and mortality risk were calculated. Follow up was noted as death or discharge. Results were analyzed by Kaplan-Meier curve, ROC curve, Log Rank (Mantel-Cox), Logistic regression model using SPSS 15.
Totally, 57% of the patients were males. Forty seven patients died during the study period. The PRISM score was 0-10 in 71%, 11-20 in 20.4% and 21-30 in 8.6%. PRISM score showed an increase of mortality from 10.2% in 0-10 score patients to 73.8% in 21-30 score ones. The survival time significantly decreased as PRISM score increased (P≤0.001). A 7.2 fold mortality risk was present in patients with score 21-30 compared with score 0-10. ROC curve analysis for mortality according to PRISM score showed an under curve area of 80.3%.
PRISM score is a good predictor for evaluation of mortality risk in PICU.
PMCID: PMC4006504  PMID: 24800015
PRISM Score; Mortality; Pediatric Intensive Care Unit; Children
5.  Efficacy of applying self-assessment of larviciding operation, Chabahar, Iran 
Malaria Journal  2012;11:329.
Appropriate supervision, along with availability of an effective system for monitoring and evaluation, is a crucial requirement to guarantee sufficient coverage and quality of malaria vector control procedures. This study evaluated the efficacy of self-assessment practice as a possible innovative method towards achieving high coverage and excellent quality of larviciding operation in Iran.
The research was conducted on the randomly selected rural health centre of Kanmbel Soliman with 10 staff and 30 villages, in three main steps: (i) assessment of effectiveness of larviciding operations in the study areas before intervention through external assessment by a research team; (ii) self-assessment of larviciding operations (intervention) by staff every quarter for three rounds; and, (iii) determining the effectiveness of applying self-assessment of larviciding operations in the study areas. Two toolkits were used for self-assessment and external evaluation. The impact of self-assessment of larviciding operations was measured by two indicators: percentage of missed breeding habitats and cleaned breeding habitats among randomly selected breeding sites. Moreover, the correlation coefficients were measured between self-assessment measures and scores from external evaluation. The correlation coefficient and Mann Whitney test were used to analyse data.
Following the utilization of self-assessment, the percentage of missed breeding habitats decreased significantly from 14.23% to 1.91% (P <0.001). Additionally, the percentage of cleaned breeding habitats among randomly selected breeding sites increased from 66.89% to 95.28% (P <0.001). The external evaluation also showed significant effects of self-assessment in performance of vector control; the maximum effect of intervention were seen in an action plan for monitoring and evaluation of larviciding operations at field level, geographical reconnaissance for the registration of breeding habitats and worker skills related to larviciding.
Before intervention, the results of self-assessment practice were compatible with external evaluation in 76.3% of 139 reviewed reports of self-assessment. After intervention, the findings of self-assessment and external evaluation were similar in the vast majority of reviewed reports (95%).
The self-assessment tool seems to be valid and reliable in improving effectiveness of larviciding operations. Furthermore, the result of self-assessment is more compatible with external evaluation results if it would be applied frequently. Therefore, it can be used as an alternative assessment technique in the evaluation of larviciding operations in addition to traditional assessment methods.
PMCID: PMC3507720  PMID: 22985394
Malaria; Larviciding; Self-assessment; Action research; Monitoring; Evaluation
6.  The pattern of injury and poisoning in South East Iran 
Injury is a leading cause of morbidity and mortality worldwide, and even more so in low and middle-income countries (LMICs). Iran is a LMIC and lacks information regarding injury for program and policy purposes. This study aimed to describe the incidence and patterns of injury in one province in South Eastern Iran.
A hospital-based, retrospective case review using a routinely collected registry in all Emergency Departments in Sistan and Baluchistan province, Iran for 12 months in 2007–2008.
In total 18,155 injuries were recorded during the study period. The majority of injuries in South Eastern Iran were due to road traffic crashes. Individuals living in urban areas sustained more injuries compared to individuals from rural areas. Males typically experienced more injuries than females. Males were most likely to be injured in a street/alley or village whereas females were most likely to be injured in or around the home. In urban areas, road traffic related injuries were observed to affect older age groups more than younger age groups. Poisoning was most common in the youngest age group, 0 to 4 years.
This study provides data on incidence and patterns of injury in South Eastern Iran. Knowledge of injury burden, such as this paper, is likely to help policy makers and planners with health service planning and injury prevention.
PMCID: PMC3492065  PMID: 22958398
Iran; Injury; Road traffic crash; Urban/rural; Sex
7.  Baseline results of the first malaria indicator survey in Iran at the health facility level 
Malaria Journal  2011;10:319.
Malaria continues to be a global public health challenge, particularly in developing countries. Delivery of prompt and effective diagnosis and treatment of malaria cases, detection of malaria epidemics within one week of onset and control them in less than a month, regular disease monitoring and operational classification of malaria are among the major responsibilities of the national malaria programme. The study was conducted to determine these indicators at the different level of primary health care facilities in malaria-affected provinces of Iran
In this survey, data was collected from 223 health facilities including health centres, malaria posts, health houses and hospitals as well as the profile of all 5, 836 recorded malaria cases in these facilities during the year preceding the survey. Descriptive statistics (i.e. frequencies, percentages) were used to summarize the results and Chi square test was used to analyse data.
All but one percent of uncomplicated cases took appropriate and correctly-dosed of anti-malarial drugs in accordance to the national treatment guideline. A larger proportion of patients [85.8%; 95% CI: 84.8 - 86.8] were also given complete treatment including anti-relapse course, in line with national guidelines. About one third [35.0%; 95% CI: 33.6 - 36.4] of uncomplicated malaria cases were treated more than 48 hours after first symptoms onset. Correspondingly, half of severe malaria cases took recommended anti-malarial drugs for severe or complicated disease more than 48 hours of onset of first symptoms. The latter cases had given regular anti-malarial drugs promptly.
The majority of malaria epidemics [97%; 95% CI: 90.6 - 100] in study areas were detected within one week of onset, but only half of epidemics were controlled within four weeks of detection. Just half of target districts had at least one health facility/emergency site with adequate supply and equipment stocks. Nevertheless, only one-third of them [33% (95% CI: 0.00 - 67.8)] had updated inventory of malaria foci on quarterly basis.
To sum up, malaria case management still constitutes a public health problem in Iran. Additionally, data suggest scarcity in management and evaluation of malaria foci, detection and control of malaria epidemics as well as assignment of emergency sites across different regions of the country. Consequently, massive and substantial investments need to be made at the Ministry of Health to coordinate national malaria control programmes towards achieving determined goals and targets.
PMCID: PMC3213221  PMID: 22029447
8.  Baseline results of the first malaria indicator survey in Iran at household level 
Malaria Journal  2011;10:277.
Malaria is one of the leading causes of sickness and death in the developing world, causing more than a million deaths and around 250 million new cases annually worldwide. The aim of this comprehensive survey was to provide information on malaria indicators at household level in high-risk malaria areas in Iran.
In a cluster randomized cross-sectional survey data were collected from 5,456 households in both rural and urban areas of 20 malaria-affected districts of Iran. All the fieldwork was done by trained interviewers and a validated questionnaire. The questionnaire comprised baseline characteristics of the study population, the knowledge of people about different aspects of malaria (such as clinical symptoms, transmission and prevention) and their practice to prevent illness (such as using mosquito nets, spraying houses). The data were analysed and descriptive statistics (i.e. frequencies, percentages) were used to summarize the results.
The results of this survey showed that 20% (95% CI: 17.36 - 22.24) of households owned at least one mosquito net, whether treated or untreated. Consequently, the use of mosquito nets was considerably low among both children under age five [5.90% (95% CI: 5.14 - 6.66)] and pregnant women [5.70% (95% CI: 3.07 - 8.33)]. Moreover, less than 10% of households reported that the interior walls of their dwelling had been sprayed in the previous year [8.70% (95% CI: 6.09 - 11.31)]. Data also suggest that 63.8% of the participants recognized fever as a sign of malaria, 56.4% reported that mosquito bites cause malaria and about 35% of participants mentioned that the use of mosquito nets could prevent malaria.
Findings from this study indicate that low access to treated nets along with low understanding of the role of nets in malaria prevention are the main barriers to utilization of bed nets. Therefore, the use of insecticide-treated mosquito nets should be encouraged through health education on the importance of the use along with increasing access to it.
PMCID: PMC3184285  PMID: 21939505

Results 1-8 (8)