Tuberculosis (TB) remains a global health problem. Treatment and prevention of TB has shifted from inpatient to outpatient settings. A report from the World Health Organization has emphasized educational strategy to ensure students graduate with the appropriate knowledge, skills, and attitudes essential to the effective management of TB. The objective of this study was to determine the level of knowledge, attitudes and practices among medical students. The survey was done from 2012 to 2013. Knowledge, attitudes and practices were assessed regarding tuberculosis with a questionnaire. Knowledge mean score of students was 16.13±2.06 and Attitude score was 36.08±3.76, Knowledge and attitude levels of students were moderate to high in the majority of them. Practice score of the study subjects was 22.77±4.95, 11.9% of students had poor practice level. 43% did not know that a sputum smear is the most important method used for diagnosis of TB. Two-thirds of them did not know the distance that should be kept from contagious patients. Half of them believed that the BCG vaccination has no role in the prevention of TB. This study concluded that more efforts should be made to improve the knowledge of students regarding TB transmission and the role of sputum smear in diagnosis. The importance of the BCG vaccination should be emphasized.
Glucantime is an effective drug for the treatment of cutaneous leishmaniasis in central Iran. However, because cutaneous leishmaniasis heals spontaneously and to prevent the acquisition of resistance, the indications for treatment in each region should be defined carefully.
Objective. To evaluate risk factors which influence sputum smear conversion, outcome, and trends of conversion of sputum smear during 5 years and compare outcomes in patients with different regimens. Methods. In a retrospective cohort study, all patients with sputum smear positive tuberculosis were evaluated for comorbidities and demographic, microbiological, and therapeutic data and outcome. Smear examinations were performed at the beginning, at 2 months for CAT I, at 3 months for CAT II, at the end of second month of maintenance phase, and at the end of treatment. Results. This study enrolled 211 sputum smear positive patients, but 189 patients who completed the intensive phase of treatment were evaluated. Sputum smear of 158 patients converted at the end of intensive phase (83.6). Univariate analysis indicated that the risk of a persistent positive smear at the end of intensive phase was greater in diabetic patients ((odds 4.038, 95% CI 1.123–14.516) P = 0.033), and also a 3+bacillary load had risk of 2.933-fold ((95% CI 1.278–6.732) P = 0.011). Overall rate of unfavorable outcome was 20.9%. Factors associated with unfavorable outcome were age (P value 0.000), male gender (P value 0.027), diabetes (P value 0.000), and delayed conversion of sputum at the end of intensive phase (P value 0.000). Outcome for different regimens was not different significantly. Two specimens were isoniazid resistant. Conclusions. We suggest supervised treatment and care for diabetic patients and those with higher bacillary load. Paying attention to early diagnosis of tuberculosis in the elderly to reduce poor outcome and further measures to prevent transfer-out could improve the success rate.
the objective of this study was to evaluate knowledge, practice and attitude of nurses, auxiliary nurses and midwifery staff towards standard isolation precautions.In a cross-sectional survey 200 nurses, auxiliary nurses and midwifery staff were recruited to complete a questionnaire about their knowledge, attitude and practice towards standard isolation precautions in a teaching hospital in Yazd, Iran. the data were collected and analyzed using SPSS 14.the initial sample consisted of 230 participants, of whom 200 (87%) responded to the distributed questionnaires. Knowledge and attitudes were moderate but their practice was relatively poor. Mean score of knowledge, attitude and practice towards standard isolation precautions were 11.9 (Maximum = 16.5), 27 (Maximum = 50), 4.6 (Maximum = 9), respectively. Practice scores of women were significantly higher than men (P = 0.028). The score of Knowledge increased significantly with age (P = 0.004). A positive linear correlation was observed between knowledge and practice (P =0.01, correlation coefficient = 0.173).this study revealed that there were serious defects in knowledge of health care workers regarding hand hygiene, disinfecting endoscopes, avoiding recapping needles and respiratory isolation precautions.
Catheter‐associated urinary tract infection (CAUTI) is the most common nosocomial infection, accounting for more than 1 million cases each year in the US hospitals and nursing homes. The significant number of infections and dissemination of resistant bacteria in hospitals make it important to find ways to decrease their incidence. The aim of the study was to describe the incidence and risk factors of CAUTIs. A cohort study was conducted from 2003 to 2008 on every patient who became catheterized consecutively. Variables included age, sex, indications for catheterization, antimicrobials usage, duration of catheterization and hospital stay, and type and colony count of microorganism. The incidence was 21·8%, the risk factor identified was duration of catheterization [relative risk 1·213, 95% CI (1·053–1·398)] while usage of antimicrobials was protective [relative risk 0·433, 95% CI (0·237–0·792)]. Organisms isolated were: Esherichia coli 23%, Enterobacter 8·1%, Staphylococcus aureus 10·8%, Pseudomonas aeuroginosa 5·4%, coagulase negative Staphylococcus 9·4%, klebsiella 4%, Proteus mirabilis 2·8%, yeasts 9·46%, Enterococcus 4%, Acinetobacter 1·4% and mixed growth of bacteria 21·6%. The incidence of CAUTI was slightly higher than in the studies from the developing countries. Daily monitoring to decrease duration of catheterization is reemphasized.
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