Background: Due to high prevalence of diabetes and its complications, evaluating of the patients' quality of life is critical. EQ-5D-5 L is a valid tool for assessing the quality of life in chronic diseases including diabetes. The present study conducted to illustrate the quality of life for the patients who referred to the Diabetes clinic and determine its relationship with their demographic and clinical characteristics in Birjand in 2017. Methods: In this cross-sectional study, 300 patients with type 2 diabetes were selected through a systematic sampling in 2017. Data were collected using a checklist including patients' demographic, clinical and laboratory information and the EQ-5D-5 L. Data were entered the SPSS (22) software, analyzed by independent sample T-test, ANOVA, Chi-Square and logistic regression tests. Statistical significance was inferred at α = 0.05. Results: Mean age for the participants was 58.1 ± 9.6 years. The mean score for the quality of life based on the EQ-5D-5 L and VAS scale were 0.89 ± 0.13 and 65.22 ± 9.32, respectively. Moderate and severe problems were found in the anxiety/depression dimensions in 12% of the patients, while these numbers for the presence of pain/discomfort and mobility were slightly higher (13.7 and 13.6%, respectively). The mean scores for quality of life and VAS were significantly higher in the men, employed and patients < 50 years age. Conclusion: The quality of life for the type 2 diabetes patients is affected by numerous factors including sex, occupation, duration of the disease and the presence of complications such as neuropathy and nephropathy.
BackgroundInfection with the hepatitis B virus (HBV) is an important global health problem. Knowledge of the geographic distribution pattern of HBV infection can help to control the spread of the disease.ObjectivesTo determine the prevalence of HBV infections and risk factors for the disease for the first time in Birjand, Southeastern Iran.MethodsThis was an analytical cross-sectional study conducted in 2013 - 2014 of 5235 HBV cases in Birjand, South Khorasan Iran. Subjects aged 15 - 70 y were selected using the cluster sampling method. Blood samples were taken and tested at a reference laboratory for the hepatitis B core antibody (anti-HBc). Seropositive specimens were tested for the hepatitis B surface antigen (HBsAg).ResultsThe mean age (± SD) was 39.07 (± 14.04) y, and 786 (15%) subjects were anti-HBc positive. The prevalence of HBsAg was 1.6% (n = 85). The prevalence of anti-HBc seropositivity was significantly higher in subjects with a lower level of education (P = 0.09), older subjects (P = 0.001), intravenous (IV) drug users (P<0.05), subjects with piercings (P < 0.001), and subjects with a positive history of familial HBV or HCV infection (P < 0.05). It was also significantly higher in those who drank alcohol (P = 0.09) or had a history of blood transfusions (P = 0.001), cupping (P = 0.004), hospital admission (P = 0.03), or endoscopy (P = 0.002). The rate of HBsAg positivity was significantly higher in subjects with a history of cupping (P=0.03), a positive history of familial HBV or HCV infection (P < 0.05), and older subjects (P = 0.015).ConclusionsAlthough the frequency of HBsAg seropositivity in the present study was close to that observed in the overall Iranian population, the seroprevalence of anti-HBc was higher, possibly due to the exposure of the elderly to more risk factors. The risk factors were similar. These included a history of blood transfusions, cupping, hospital admission, endoscopy, or familial HBV/HCV infection, in addition to piercings and drug abuse.
BackgroundEssential primary health care is delivered through the public health center PHC network by public health workers (Behvarzs). Health workers are exposed to different types of stresses while working.ObjectivesThe aim of this study is to determine the prevalence of burnout and associated factors among rural health workers in the health centers of Birjand University of Medical Sciences.Patients and MethodsAll rural health workers of health centers under the coverage of the Birjand University of Medical Sciences selected through census sampling participated in this cross-sectional study. The Maslach Burnout Inventory, GHQ-12 questionnaire, and demographic questionnaire were completed by the participants. Data were analyzed by SPSS 15 using descriptive statistics, chi-square (χ2), t-test, and ANOVA test.ResultsA total of 423 health workers participated in this study, and their mean age was 39 ± 8.4 years. Among the participants, 34.5% had moderate to severe levels of burnout. About 31.4% of the subjects had abnormal scores in emotional exhaustion, 16.8% in depersonalization, and 47% in the personal accomplishment subscales. The rate of abnormal mental health among the participants was 36.68%. The prevalence of mental disorders was 24.5% in subjects with low burnout or without burnout against 60.4% of subjects with moderate or severe burnout (P = 0.001). Age, education level, number of children, and years of employment were found to have a significant association with the burnout level of the participants (P < 0.05).ConclusionsBurnout was prevalent among health workers. Based on the high level of burnout among health workers, reducing job ambiguity/conflict, participating in planning new programs, and improving interaction with health authorities may help them to overcome their job-related pressure and to give a more desirable performance.
Background: Hepatitis C virus (HCV) infection is an important global concern, with a frequency of 3% (i.e., 170 million of the population has HCV-Ab). Additionally, 50% of HCV and 80% of transfusion transmitted infections (TTI) are chronic. In 20% of cases, HCV occurs as an acute infection, and in the remaining 80% of cases, it becomes chronic. In chronic patients, risk of cirrhosis is up to 44%, risk of hepatocellular carcinoma (HCC) is 13%, and risk of mortality is 14%. As there is no vaccine available for the virus yet, and since most of the cases are asymptomatic, attention to the epidemiology of the disease among the population is a pressing concern. Objectives: The aim of this study is to determine the prevalence and risk factors of HCV in Birjand city. Patients and Methods:In this descriptive-analytical study, 5,235 people who live in Birjand city were selected; after gaining permission for the study, a signed consent form was obtained from each patient. Prevalence of HCV was determined by ELISA test, and positive cases underwent Polymerase chain reaction (PCR) and genotyping for confirmation. Results: The mean age of the participants was 39.7 ± 14.4. Among them, 52.2% were female and 29.9% had university degrees. Prevalence of HCV-Ab + was about 0.2% with ELISA, and 0.14% of entire group were confirmed by PCR. No significant relationship was found for age, sex, and education (P > 0.05). Also, there was no significant relationship found with risk factors such as endoscopy, blood transfusion, surgery, hospitalization, phlebotomy, and alcohol drinking (P > 0.05). HCV-Ab was 200 times more prevalent in IV-drug abusers compared to nonaddicted people. Also, the prevalence of HCV-Ab in non-IV-drug abuser addicts was 9.3 times higher than in non-addict patients. Prevalence of HCV-Ab in patients who reported illicit sexual activities was 13.3 times higher. In patients with a familial history of HCV, infection was 26.3 times more prevalent than in patients with no familial history (P < 0.001). Conclusions: In this study, the prevalence of HCV was 0.2%, which is lower than the mean prevalence in Iran (1%). Prevalence of HCV had a significant relationship with IV-drug abuse.
BackgroundCeftriaxone (CTX) is widely used for the treatment of bacterial infections; however, side effects such as gallstone and nephrolithiasis have been reported in children. There is limited information about urinary tract calculi as CTX side effects in adults. Therefore, the present study was aimed to evaluate the incidence of gallstone and nephrolithiasis following CTX administration.MethodsThe present study was conducted in the Vali-e-Asr Hospital. Eighty-four patients with various infectious diseases with different daily treatment (mean ± SD: 4.19±2.54) were included in this study, consisting of 49 females and 35 males. The mean of total doses used in patients was 10.2143 (SD: 5.8585). To detect possible gallstone, gallbladder sludge, and urolithiasis, patients were evaluated by serial ultrasound before and after CTX treatment. Patients with renal and hepatobiliary dysfunction were excluded from the study and did not receive any nephrotoxic drugs during this study. Demographic parameters including age, sex, body mass index, dosage of CTX, as well as the duration of treatment and hospitalization were determined. Statistical significances were determined using Fisher’s exact test and independent t-test.ResultsResults from our study showed that the incidence of gallstone and nephrolithiasis were 8.8% and 1.5% following CTX administration, respectively. Surprisingly, we found a significant correlation in terms of age between patients with and without gallstone (P=0.03).ConclusionOur findings suggest that the patients’ age might play a role in the development of such a complication. This indicates the need for a close monitoring of CTX-treated patients to assess the possible formation of gallstone and nephrolithiasis.
The results show that at least for IMR and U5MR, in addition to improvement in average national levels, the geographical disparities have decreased. In the cases of NMR and CDR, inspite of the improvements in national levels, the trends of health disparities are not as good. We need to use strategies to provide more specialised care fairly in addition to primary healthcare to reduce disparities in CDR and NMR and influence them more.
Background and Objectives:To determine the prevalence of impaired fasting glucose in adolescents in Birjand city in eastern Iran.Materials and Methods:This cross-sectional study was done on 2653 students aged 11–18 years selected through multi-stage stratified and random sampling. Fasting blood glucose (FBS) of these students was measured applying the enzymatic process. The obtained data were analyzed by means of SPSS software (V: 15) and statistical tests T and X2.Results:The mean age of individual was 14.5 ± 2 years. Mean FBS of the whole population was 89.8 ± 9.8 mg/dl, but it was significantly higher among boys than girls (P < 0.001). Out of the whole subjects (92.4%), 1,328 (95.1%) of the girls and 1,122 (89.3%) of the boys, FBS was less than 100 mg/dl among whom 64.4% had FBS above 86 mg/dl. In 200 subjects (7.5%) of whole population, FBS was 100–125 mg/dl; with that of the boys was 2.3 times than the girls revealing a prediabetes condition: OR = 2.3(CI: 1.7-3.2). Among the students, 3 (0.1%) had an FBS > 126 mg/dl. Mean blood glucose was significant regarding age and sex.Conclusions:High prevalence of high FBS (within normal range) among adolescents is warning and requires special attention of health officials. Screening of children and adolescents in order to identify those at risk and plan for intervening is urgent to prevent type-2 diabetes epidemic and following cardiovascular complications in the Society
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