Effective indicators of hospital resilience in epidemic conditions

Introduction: The concept of hospital resilience means "the ability of a hospital to withstand, absorb and respond to catastrophic shocks ."Humans have been plagued by a variety of disasters throughout their lives, including emerging diseases, and have suffered irreparable loss. Hospitals play a key role in crisis management and control of epidemics, and therefore the hospitals readiness to continue medical services in crises is of particular importance. Therefore, the present study was conducted with the aim of obtaining effective indicators on hospital resilience in epidemic conditions. Materials and Methods: A qualitative study was conducted to identify the indicators. The main method of data collection was semi-structured interviews with experts and also review of extensive texts. Finally, using qualitative content analysis method and with the help of MAXQDA software, the main dimensions, indicators and below Indicators were extracted. Results: According to the results, the main dimensions included: 3 dimensions (management and leadership, readiness and adaptability capacity ) and the main indicators include 11 indicators (manpower management, support services management, disease management, cohesion and structuring, redundancy, knowledge management, Organizational culture, service delivery, infection prevention and control, environmental health, recovery). The number of sub-main indicators is also 43. Conclusion: In order to improve resilience, hospitals can focus on the identified indicators and monitor and improve them. Correction and improvement of effective indicators will lead to the promotion of resilience and effective management and control of pandemic crises in hospitals.

Flatfoot and obesity in school-age children: a cross-sectional study

Childhood obesity exerts abnormally high stresses on developing foot structures which can lead to structural deformity of the foot. Screening for foot problems in children with overweight helps detect interior risks restricting normal lifestyle in these individuals. The purpose of this study was to investigate the effects of excess weight on the structure and function of the developing foot in students aged 7-14 years. A total of 667 participants were recruited for this cross-sectional study via a multi-level cluster sampling method (randomization was used within each cluster). All subjects (340 boys and 327 girls) attended primary and secondary schools in Isfahan City, Iran. The children's feet were evaluated using clinical assessments and footprint-based measures whilst fully weight bearing. Significant differences were observed in the frequency of flatfoot between normal weight, overweight and obese groups (P < 0.001); participants who were more overweight had flatter feet. Children with higher weight also had a more pronated heel, less dorsiflexion range and higher reported pain within physical activity. This study indicated that childhood obesity is associated with structural foot and ankle deformities and activity-related foot pain.

The effect of iron supplement on children with euthyroid goiter: a randomized placebo-controlled clinical trial

BACKGROUND

Endemic goiter is present in most parts of Iran. Iron deficiency adversely affects the physiology of thyroid. The initial steps of thyroid hormone synthesis are catalyzed by thyroperoxidases and are dependent on iron. In many developing countries, children are at high risk of both goiter and iron deficiency anemia. In addition, iron deficiency may alter central nervous system control of thyroid metabolism; andalso Iron-deficiency anemia decreases plasma concentrations of thyroxine and triiodothyronine.

MATERIAL AND METHOD

We conducted a randomized, double-blind,controlled trial in 2-12-y-old children with euthyroid goiter and without iron-deficiency anemia. THE CHILDREN WEREDIVIDED INTO TWO GROUPS: The Patients who were under treatment with ferrous-sulphat and controls .active treatment consisted of iron supplementation was administered orally with a dose of 2 mg/kg day. The duration of active treatment was 12 weeks.

RESULTS

In this study 40 children (female: 22, male: 18) were divided into two groups randomly. (20 patients in each group).There were no significant differences at baselines between groups with regard to gender, age and weigh. At the end of the study, the reduction of more than one grade of goiter was significant between iron-treated and placebo groups. In treatment group, 16 patients (80%) had decreased grade of goiter, while in the control group, 3 patients (15%) had grade reduction(P-value<0.001).

CONCLUSION

At the end of the study, decrease of more than one grade of goiter had significant differences between iron-treated and control groups.

Cancer in pregnancy: a 10-year experience in shahid sadoughi hospital, yazd, iran

INTRODUCTION

Although occurrence of cancer during pregnancy is rare, it leads to high morbidity and mortality in both mother and fetus. Recent trends in prolongation of child-bearing age have made cancer-associated pregnancies more frequent than past. As yet there are few documents concerning cancer and its related treatment outcomes during pregnancy. This study aimed at describing clinical characteristics of pregnant women with cancer in the Shahid Sadoughi hospital in Yazd, Iran.

MATERIALS AND METHODS

Case series were reviewed retrospectively, which included 19 pregnant women diagnosed with cancer in Shahid Sadoughi hospital from 2002 to 2012. Data collected comprised demographics, pregnancy characteristics and outcomes, type of cancer, clinical stage, treatment and oncological.

RESULTS

From 17 pregnant women with cancer, 4 women had gynecologic cancers and 13 had non-gynecologic cancers. The Following tumors were observed: breast [6], acute myeloblastic leukemia [3], uterine cervix carcinoma [3], ovary [1], chronic myelogenous leukemia [1], lymphoma [1], papillary carcinoma of thyroid [1], and pseudopapillary carcinoma of pancreas [1]. The mean age of patients was 30.6 years, and the mean gestational age at diagnosis was 21.1 weeks. Surgical treatment was performed in 3 patients, 6 patients were treated by chemotherapy, and in 3 by both.

DISCUSSION

Although cancer during pregnancy is uncommon, it is considered an important problem due to unsuitable maternal and fetal outcomes and lack of standard management guidelines. Our cases represent examples of feasible or justifiable managements for them.

Five-Year Status of Malaria (a Disease Causing Anemia) in Yazd, 2008-2012

BACKGROUND

Yazd province which is the host of local and foreign immigrants may be faced with contacting malaria. Plasmodium falciparum malaria remains a major cause of mortality throughout in the tropical regions of the world. Pthophysiologic mechanisms of anemia in malaria is such as direct invasion of Red cells, anemia of chronic disease hypersplenism, Hemophagocytic syndrome and erythrophagocytosis, dyserythropoirsis, immune haemolysis and cytokine deregulation anemia of chronic disorder is characterized by moderate to mild normocytic, normochromic anemia along with microcytic hypochromic cells. Malaria occurs predominantly in children in the first three years of life. The purpose of this study was Demographic study of malaria during 2008 to 2012 in Yazd.

MATERIALS AND METHODS

This study was an analytic-descriptive and manner descriptive study. All episodes (Imported Malaria) of disease from 2008 to 2012 which were documented in Yazd Central Health Service were carefully studied and reported.

RESULTS

A total of 206 confirmed reported malaria patients from 2008 to 2012 were studied; Plasmodium (P). vivax species was mostly, 187(90.78%) and Plasmodium (P). Malaria species was Lesley, 1(0.49%). The mean age groups, accommodation with local malaria and years of reported outbreaks of different strains of the parasite conducted by Fisher exact Test, showed no significant difference(P-value>0.05), but the mean of foreigner immigrants of outbreaks of different strains of the parasite conducted by Fisher exact Test, showed significant difference (P-value= 0.01).

CONCLUSION

Although malaria has been designed on elimination program in Iran, but in the province of Yazd is reported imported malaria and its importance in causing anemia and other blood disorders is not negligible.