Soheila Khazaei
Abstract
This article briefly describes effective factors, the process to access health services, the success of the national and international indices, problems - challenges, concerns and worries about the health of children and system services. Then study the root causes and then paid attention to global and ...
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This article briefly describes effective factors, the process to access health services, the success of the national and international indices, problems - challenges, concerns and worries about the health of children and system services. Then study the root causes and then paid attention to global and national experience to provide solutions in the form of national sector reform program.Material& Methods: Research in statistical reports from confirmed sites about Iran children health situation analysis Research in several findings of Iran statistical investigation &surveys (Iran Ministry of health and medical education)Results:Factors affecting the health are: social and economic factors 50%, access to health services 25%, biological and genetic factors 15% and physical factors 10%. If the development programs in this country will not proceed in a smooth and stable way, the present acceleration of all existing programs will deteriorate.The Census 2016 showed that all provinces were experiencing the positive growth rate. According to the same census provinces like Hamedan, Ardebil, Kermanshah, Kurdistan, Zanjan, Gilan, Lorestan, east and central Azerbaijan, with the population proportion of 23% of total population of Iran had the population growth rate of less than 1% . Life expectancy at birth, during the two decades with the 5.3 year increase, has reached to 72.5 years..According to child health information in Iran, health development is achieved during several recent years by PHC program and trend of child mortality and morbidity decreased significantly by health care programs for this vulnerable ages.
Hamideh Ebrahimi Gore; Ali Taghizadeh; AmirAli Moodi Ghalibaf; Ali Shamshirian; Mohammad Reza Motie
Abstract
Introduction: The breast cancer burden is still increasing, both in developing and developed countries. The present study was conducted to determine the survival rate of breast cancer based on tumor biological subtypes in patients referring to three referral oncology centers at Mashhad University of ...
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Introduction: The breast cancer burden is still increasing, both in developing and developed countries. The present study was conducted to determine the survival rate of breast cancer based on tumor biological subtypes in patients referring to three referral oncology centers at Mashhad University of Medical Sciences, Mashhad, Iran.Methods: The present population-based study was conducted at Imam Reza Hospital, Omid Hospital, and Reza Oncology Center, Mashhad University of Medical Sciences, Mashhad, Iran Demographic information, the status of biomarkers in immune-histochemical evaluation, clinical and pathological features of the tumor, type of therapy, recurrence, or death was recorded for each eligible patient.Results: In total, 247 patients were included in the study. The mean age of patients was 48.8 ± 1.3 years. The mean time of survival was 2.64±0.13 years. In detail, the survival rate from the first year to the fifth year was reported as 100%, 96%, 91%, 90%, and 89%, respectively. The survival rate of the luminal B subtype was higher than other subtypes but the difference was not significant (P=0.7). Only in terms of metastasis, there was a significant difference between the alive and dead patients (P=0.0001).Conclusion: Despite no significant relationship between biological markers, the breast cancer subtype, and its survival rate, the overall survival rate of the patients decreased lightly through five years. However, further studies are required to indicate more accurate data about the breast cancer survival rate in our region.
Alireza Sedaghat; Amene Raouf-Rahmati; Katayoun Samadi; Farida Daneshvar Mozaffari; Ahmad Nemati; Benyamin Fazli
Abstract
Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: ...
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Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: This retrospective study included a total of 191 confirmed COVID-19 patients aged ≥18 who were admitted to an intensive care unit in the northeast of Iran in 2020. Clinical, therapeutic, and laboratory findings were recruited. The data were analyzed using SPSS software (version 23) through the Mann-Whitney U test, Chi-Square test, independent sample t-test, as well as a single variable and multivariable logistic regression.Results: Out of a total of 191 hospitalized patients, 137 (71.7%) survived and 54 (28.2%) expired. The mean age of non-survived patients was 17 years higher than that of survived patients (P<0.0001). Hypertension, diabetes, and coronary and pulmonary diseases were significantly related to mortality (OR: 3, 2.8, 21.4, and 5.4, respectively; P<0.05). Respiratory rate >24/min, heart rate>125/min, platelet count <100*109/L, creatinine >133 μmol/L, LDH >245 U/L, WBC count >10*109/L, lymphocyte count <0.8*109/L and D-dimer >1 μg/mL were frequently observed in non-survivor patients (P<0.05). Most of the patients had an abnormality on chest radiographs, and bilateral pulmonary infiltration was the dominant chest radiograph abnormality in these patients. Moreover, consolidation and ground-glass opacification were observed more frequently in non-survived patients (P<0.05). More than 57% of severe cases required non-invasive and invasive mechanical ventilation before they died, while it was 1% in survived cases (P<0.05).Conclusion: Older age, previous comorbidities such as diabetes, hypertension, coronary and pulmonary diseases, lymphopenia, leukocytosis, increased respiratory rate, creatinine, LDH, and D-dimer levels were related to a poor prognosis and mortality in patients with SARS-CoV-2 infection.
Maryam Salehian; Nahid Maleki-Saghooni; Fatemeh Zahra karimi
Abstract
Introduction:Child abuse is a global problem that is deeply rooted in the cultural, social, and economic performance of society. It is a behavior that occurs in various forms of physical, mental, emotional, or sexual, which can cause harm to the health, welfare, and education of the child. The present ...
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Introduction:Child abuse is a global problem that is deeply rooted in the cultural, social, and economic performance of society. It is a behavior that occurs in various forms of physical, mental, emotional, or sexual, which can cause harm to the health, welfare, and education of the child. The present study was conducted to estimate the prevalence of child abuse and its related factors in Iran.Methods:In the present systematic review study, to find articles related to the prevalence of child abuse in Iran, valid databases such as Scopus, PubMed, Cochrane, SID, Magiran, IranDoc, and Google Scholar was were searched using the keywords of “child abuse”, “physical abuse” “emotional abuse”,” neglect”, “prevalence” and “Iran”.Results: In this study, 22 articles were analyzed. Based on this review about 4.5%-58.2% of children reported physical abuse, 7.3%-91.6% emotional abuse, and 5.5%-85.3% neglect. Factors associated with child abuse were hyperactivity anxiety and mental status disorder. All studies showed a significant relationship of abuses with education, occupation, addiction, and divorce of parents. Moreover, depression and anxiety of parents and poor parental relationships were related to abuse of children. Conclusion: Child abuse has many negative effects on childish and adolescent health. It seems that child abuse in Iran is in critical condition; therefore, policymakers must take action to solve this problem and prevent it by designing special programs and effective policies in Iran.
Razieh Amirfakhrian; Atieh Yaghobi; Roya Saddat Ghaderi; Seyed Isaac Hashemy; Kiarash Ghazvini
Abstract
Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity ...
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Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity and mortality worldwide. The purpose of this study was the assessment of the prevalence and frequency of colistin resistance among gram-negative bacilli (Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp.) in Iran and around the world. Methods: For this systematic review and meta-analysis, we searched international and national databases, including PubMed, Google Scholar, SID, and Magiran, from 1998 to 2018 for articles and abstracts describing colistin resistance among gram-negative bacilli. We have included 92 studies that met our inclusion criteria, and the outcomes were combined using a random-effects model to derive the event rate of colistin resistance among gram-negative bacilli. Data were analyzed by the Comprehensive Meta-Analysis Software (V2), and the heterogeneity of the studies was assessed using the I2 index. Results: Out of the 11050 papers identified, 92 studies met the strict inclusion criteria and were finally included. The overall event rate of colistin resistance among gram-negative bacilli (GNB) was about 6.6%, while the event rate of colistin resistance among Acinetobacter spp. (n = 18504) was 2.8% (summary: 95% confidence interval (CI): [0.02, 0.041], P = 0.001, I2 = 70, df (Q) = 36, Q-value = 121.924). The colistin resistance among Pseudomonas spp. (n = 15094) was 3% (95% CI: [0.022, 0.041], P = 0.001, I2 = 68.3, df (Q) = 25, Q-value = 85.648), and the colistin resistance among Enterobacteriaceae spp. (n = 44772) was 0.8% (95% CI: [0.004, 0.014], P = 0.001, I2 = 87.6, df (Q) = 15, Q-value = 71.291). Therefore, the event rate of resistance to colistin among GNB was relatively low (6.6%). Conclusion: The event rate of resistance to colistin among GNB was low. Therefore, this antimicrobial agent can still be administered as a suitable option against GNB that are resistant to other antibiotics such as carbapenems.