Assessing the Preparedness of Healthcare Facilities for Disasters and Emergencies in Damghan, Iran.

OBJECTIVES: Iran is exposed to a wide range of natural and man-made hazards. Health-care facilities can play a significant role in providing life-saving measures in the minutes and hours immediately following the impact or exposure. The aim of this study was to determine the preparedness of health-care facilities in disasters and emergencies. METHODS: This cross-sectional study was conducted in Damghan, Semnan Province, in 2019. The samples consisted of all the 11 health-care facilities located in Damghan County. A developed checklist was used to collect the data, including 272 questions in 4 sections: understanding threatening hazards, functional, structural, and nonstructural vulnerability of health-care facilities. The data were analyzed using SPSS 21. RESULTS: The results revealed that the health-care facilities were exposed to 22 different natural and man-made hazards throughout the county. The total level of preparedness of the health-care centers under assessment was 45.8%. The average functional, structural, and nonstructural vulnerability was assessed at 49.3%, 31.6%, and 56.4%, respectively. CONCLUSIONS: Conducting mitigation measures is necessary for promoting the functional and structural preparedness. Disaster educational programs and exercises are recommended among the health staff in health-care facilities.

Primary vesicoureteral reflux in Iranian children.

BACKGROUND: Experience with vesicoureteral reflux (VUR) differs in different centers and there are plenty of controversies. OBJECTIVE: The aim of this study was to evaluate the outcome of primary VUR complications and the rate of recurrence of UTI. METHODS: The medical charts of all infants and children with primary VUR who were followed up by two nephrologist were reviewed. During 19 years (1985 to 2004), 330 patients (271 females, 59 males) with 496 refluxing ureters were followed up as primary VUR. RESULTS: The patients age at diagnosis was 54 days to 16 years (Mean: 4.1 years) and the mean duration of follow-up was 4.5 years. Urinary tract infection (UTI) was the presenting symptom in 95% and fever was recorded in 35% of cases. Frequencies of different grades of VUR at initial investigation were 10% 35% 30% 13% and 12% for grades I to V, respectively. Recurrence of UTI in VUR of grades I to V, were 22.2% 18.1% 20% 23.4% and 17.9% respectively. Follow-up voiding cystourethrogram revealed resolution of VUR in 55% improvement in 27.5%, no change in 12% and deterioration in 5.5% Complications such as chronic renal failure and hypertension were observed in 13 and 13 patients, respectively. Renal scarring was present in 52% of boys and 29% of girls. CONCLUSION: The present study indicates that symptomatic primary VUR is more common and has better prognosis in girls. Recurrence of UTI is not related to the grade of VUR.