Disaster safety assessment of primary healthcare facilities: a cross-sectional study in Kurdistan province of Iran.

BACKGROUND: Kurdistan province of Iran is among disaster prone areas of the country. The Primary Health Care facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of such facilities is essential. METHODS: In this cross-sectional study, the instrument used to evaluate four sections of functional, structural, non-structural, and total safety of 805 healthcare facilities in Kurdistan Province was the safety evaluation checklist of primary healthcare centers, provided by the Iranian Ministry of Health and Medical Education. Each section scored from 0 to 100 points, and each section of the safety was classified to three safety classes according to their total score: low (≤34.0), average (34.01-66.0) and high (> 66.0). RESULTS: The levels of functional, structural, non-structural and total safety were equal to 23.8, 20.2, 42.3 and 28.7, out of 100, respectively. Regarding the functional safety, rapid response team scored the highest, while financial affairs scored the lowest. Nevertheless, in structural and non-structural sections, the scores of different items were almost similar. CONCLUSIONS: The results of the study revealed that safety score of primary healthcare facilities in general was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery of these facilities are essential to response to disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard.

The Effects of L-Carnitine on Echocardiographic Changes in Patients With ß-Thalassemia Major and Intermedia.

INTRODUCTION: Heart failure, fatal arrhythmias, and cardiac dilatation because of anemia are common causes of ß-thalassemia major-related deaths. The aim of this study was to determine the effect of L-carnitine on echocardiographic changes in ß-thalassemia major and intermedia patients in Besat Hospital in Sanandaj, Iran. METHODS: In a randomized clinical trial, 60 ß-thalassemia patients who were eligible for L-carnitine administration were randomly divided into 2 placebo and study drug groups. The duration of the study was 6 months. Using echocardiography and blood tests, cardiac parameters including left ventricular dilatation, left ventricular hypertrophy, and a number of cardiac blood indices were examined before and after the intervention. The data were analyzed using SPSS V.23 software, χ, and covariance statistical tests. RESULTS: There was no significant difference between the 2 groups in terms of age and sex. Patients treated with L-carnitine have a reduced rate of left ventricular dilatation, left ventricular hypertrophy, and systolic blood pressure compared with controls (P<0.05). Cardiac output increased from 43.5 to 56.5 (P=0.002). CONCLUSIONS: The results of this study showed that the drug has a positive effect on the improvement of cardiac indices in ß-thalassemia patients. Therefore, we suggest that further studies with more samples and other diagnostic modalities of the drug's effect be investigated.

A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery.

BACKGROUND: This study investigated the effects of Islamic religious and breathing techniques with heart rate variability (HRV) biofeedback therapies on HRV and psycho-physiologic coherence (resonance frequency), depression and anxiety in coronary artery bypass graft surgery (CABG) patients. METHODS: Sixty CABG patients were chosen and randomly assigned to religious, breathing techniques and control groups. The experimental groups received 8  weeks of treatments; a 2-h session with home works in each week. The control group received only their normal hospital interventions. The groups' depression, anxiety, HRV and psycho-physiologic coherence levels were assessed before and after the interventions by DASS-21 for depression and anxiety, and em-wave desktop software for HRV and psycho-physiologic coherence. The data were analyzed using ANCOVA with Bonferroni Comparison test and descriptive tests in SPSS software. RESULTS: The findings showed that there were significant differences in psycho-physiologic coherence (HRV), depression and anxiety scores among the three groups in the post-tests. In fact, depression and anxiety were reduced more in the religious group, while psycho-physiologic coherence raised more in the breathing with the HRV feedback group. CONCLUSION: The results showed that both Islamic religious and breathing techniques with HRV biofeedback therapies can be used in rehabilitation programs for CABG patients in clinics and hospitals.

Cancer incidence in Iran in 2014: Results of the Iranian National Population-based Cancer Registry.

BACKGROUND: We aimed to report, for the first time, the results of the Iranian National Population-based Cancer Registry (INPCR) for the year 2014. METHODS: Total population of Iran in 2014 was 76,639,000. The INPCR covered 30 out of 31 provinces (98% of total population). It registered only cases diagnosed with malignant new primary tumors. The main sources for data collection included pathology center, hospitals as well as death registries. Quality assessment and analysis of data were performed by CanReg-5 software. Age standardized incidence rates (ASR) (per 100,000) were reported at national and subnational levels. RESULTS: Overall, 112,131 new cancer cases were registered in INPCR in 2014, of which 60,469 (53.9%) were male. The diagnosis of cancer was made by microscopic confirmation in 76,568 cases (68.28%). The ASRs of all cancers were 177.44 and 141.18 in male and female, respectively. Cancers of the stomach (ASR = 21.24), prostate (18.41) and colorectum (16.57) were the most common cancers in men and the top three cancers in women were malignancies of breast (34.53), colorectum (11.86) and stomach (9.44). The ASR of cervix uteri cancer in women was 1.78. Our findings suggested high incidence of cancers of the esophagus, stomach and lung in North/ North West of Iran. CONCLUSION: Our results showed that Iran is a medium-risk area for incidence of cancers. We found differences in the most common cancers in Iran comparing to those reported for the World. Our results also suggested geographical diversities in incidence rates of cancers in different subdivisions of Iran.

Association of circulating CTRP9 with soluble adhesion molecules and inflammatory markers in patients with type 2 diabetes mellitus and coronary artery disease.

C1q/TNF-related protein 9 (CTRP9) is a paralogue of adiponectin with known favorable effects on lipid and glucose metabolism. A potential role of CTRP9 for regulation of endothelium function has been suggested by previous studies. However, no studies have examined the relation between serum CTRP9 levels and adhesion molecules in patients with type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD). The present study was conducted on 337 subjects who underwent coronary angiography and were categorized into four groups according to the presence of CAD and T2DM (control, CAD, T2DM and CAD+T2DM). Serum levels of CTRP9, adiponectin, sICAM-1, sVCAM-1, sE-Selectin, IL-6 and TNF-α were measured. It was found that the circulating CTRP9 levels were independently associated with increased risk of CAD and T2DM in addition to elevated levels of serum CTRP9 in CAD, T2DM and CAD+T2DM groups. A significant association of serum CTRP9 levels with adhesion molecules in CAD and T2DM patients as well as serum TNF-α levels in CAD individuals was noted. A significant relation between the circulating levels of CTRP9 and HOMA-IR in T2DM subjects was also observed. The results revealed increased circulating levels of CTRP9 in T2DM and CAD individuals which suggests a compensatory response to insulin resistance, inflammatory milieu and endothelial dysfunction; however, more studies are needed to confirm this.