Faramarz Dobakhti; Ali Zargar; Taraneh Naghibi
Volume 11, Issue 1 , January 2023, , Pages 26-31
Abstract
Objective: Ventilator-associated pneumonia is the common cause of morbidity and mortality in the intensivecare unit. Due to the antimicrobial effect of chlorhexidine, and the long-lasting result of mucoadhesive drugs,this study aimed to determine the effect of chlorhexidine mucoadhesive gel on the prevention ...
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Objective: Ventilator-associated pneumonia is the common cause of morbidity and mortality in the intensivecare unit. Due to the antimicrobial effect of chlorhexidine, and the long-lasting result of mucoadhesive drugs,this study aimed to determine the effect of chlorhexidine mucoadhesive gel on the prevention of ventilatorassociatedpneumonia in critical patients.Method: In this clinical trial, 64 ventilated patients were selected and randomly allocated into two groups. Thefirst group received 0.2% chlorhexidine mucoadhesive gel and the second group received 0.2% chlorhexidinesolution as a mouthwash. Every three days, the incidence of ventilator-associated pneumonia was evaluatedby the clinical score of pulmonary infection. The data were analyzed by SPSS statistical software version 20.Results: There was no statistically significant difference in demographic characteristics between the twogroups. In the control group, 25% of the patients had ventilator-associated pneumonia, while it was only 15.6%in the intervention group; however, the incidence of ventilator-associated pneumonia revealed no significantdifference between the two groups (HR ratio, 0.86; 95% confidence interval, 0.49 to 1.83 p=0.356).In addition,there was no statistically significant difference between the number of days connected to the ventilator(p=0.854), the number of days hospitalized in the intensive care unit (p=0.423), and the death rate (p=0.634)between the two groups.Conclusion: Although no significant statistical difference was detected between chlorhexidine mucoadhesivegel and chlorhexidine solution in the prevention of ventilator-associated pneumonia, the incidence of pneumoniain the mucoadhesive gel group was clinically less than in the control group. It is better to repeat the study witha larger statistical population.
Saber Azami-Aghdash; Hassan Abolghasem Gorji; Naser Derakhshani; Homayoun Sadeghi-Bazargani
Volume 7, Issue 4 , October 2019, , Pages 390-398
Abstract
Objective: To identify the barriers to and facilitators of the prevention of road traffic accidents (RTIs) in Iran. Methods: In this qualitative study 42 key stakeholders and experts in the field of traffic injuries in Iran were selected based on purpose and theoretical sampling to reach informational ...
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Objective: To identify the barriers to and facilitators of the prevention of road traffic accidents (RTIs) in Iran. Methods: In this qualitative study 42 key stakeholders and experts in the field of traffic injuries in Iran were selected based on purpose and theoretical sampling to reach informational saturation. Their views concerning barriers to and facilitators of the prevention of traffic injuries in Iran were studied using semi-structured interviews. Data were analyzed using Content Analysis method. Results: Five themes were identified: structural barriers, organizational barriers and planning, socio-cultural barriers, scientific barriers, and inter-sector barriers and 22 sub-themes were extracted. The lack of lead agency, which was among structural barriers, was selected as the main barrier. The five general facilitators included: sensitization of society and authorities, improving the resources and infrastructure (software and hardware), increasing the attention to safety of vehicles and roads, increasing the information and awareness, and use of expert manpower. The sensitization of society and authorities was selected as the most important facilitator. Conclusion: According to the key experts, the barriers of policy changes to prevent the RTIs are more numerous than its facilitators. Therefore, planning and paying more attention to removing these barriers and promoting the facilitators seems necessary to reduce RTIs. Having a lead agency in this regard should be the highest priority.
Saber Azami-Aghdash; Mir Hossein Aghaei; Homayoun Sadeghi-Bazarghani
Volume 6, Issue 4 , October 2018, , Pages 279-291
Abstract
Objective: To systematically review the epidemiological patterns and interventions for prevention of road traffic injuries (RTIs) among elderly.Methods: Searching keywords including: accident, trauma, road injury, road traffic injuries, aging, old, elder, strategy, intervention, road traffic crash prevention ...
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Objective: To systematically review the epidemiological patterns and interventions for prevention of road traffic injuries (RTIs) among elderly.Methods: Searching keywords including: accident, trauma, road injury, road traffic injuries, aging, old, elder, strategy, intervention, road traffic crash prevention and traffic accident in databases including, Google scholar, SID, IranMedex, PubMed and Scopus. English and non-Persian articles, articles presented in congresses, articles that considered elderly people to have age under than 60 years were excluded. The reporting quality of articles was assessed by two experts using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) check list.Results: RTIs compromised 23.6% of total injuries among elderly. The most frequent injuries were about car accidents (51.4%). Pedestrian injuries composed 48.1% of the RTIs. Head and neck (32.1%) were most injured body parts. There was a significant difference between elderly and non-elderly people in terms of RTIs associated mortality (Odd=2.57 [1.2-5.4 CI 95%]). Overall 25 main domains of intervention and 73 subordinate domains were extracted in five categories (human, road and environment, tools and cars, medical, legal and political issues).Conclusion: According to the notable prevalence and fatality of RTIs, lack of sufficient studies and valid evidence of the present study can provide an appropriate evidence for better interventions for RTIs prevention among elderly.
Saber Azami-Aghdash; Homayoun Sadeghi-Bazarghani; Mahdiyeh Heydari; Ramin Rezapour; Naser Derakhshani
Volume 6, Issue 2 , April 2018, , Pages 90-99
Abstract
Objective: To review the effectiveness of Road Traffic Injuries (RTIs) interventions implemented for prevention of RTIs in Iran and to introduce some methodological issues.Methods: Required data in this systematic review study were collected through searching the following key words: "Road Traffic Injuries", ...
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Objective: To review the effectiveness of Road Traffic Injuries (RTIs) interventions implemented for prevention of RTIs in Iran and to introduce some methodological issues.Methods: Required data in this systematic review study were collected through searching the following key words: "Road Traffic Injuries", "Road Traffic accidents", "Road Traffic crashes", “prevention”, and Iran in PubMed, Cochrane Library electronic databases, Google Scholar, Scopus, MagIran, SID and IranMedex. Some of the relevant journals and web sites searched manually. Reference lists of the selected articles were also checked. Gray literature search and expert contact was also conducted.Results: Out of 569 retrieved articles, finally 8 articles included. Among the included studies the effectiveness of 10 interventions were assessed containing: seat belt, enforcements of laws and legislations, educational program, wearing helmet, Antilock Braking System (ABS), motorcyclists' penalty enforcement, pupil liaisons’ education, provisional driver licensing, Road bumps and traffic improvement's plans. In 7 studies (9 interventions) reduction of RTIs rate were reported. Decreased rate of mortality from RTIs were reported in three studies. Only one study had mentioned financial issue (Anti-lock Brake System intervention). Inadequate data sources, inappropriate selection of statistical index and not mention about the control of Confounding Variables (CV), the most common methodological issues were.Conclusion: The results of most interventional studies conducted in Iran supported the effect of the interventions on reduction of RTIs. However due to some methodological or reporting shortcoming the results of these studies should be interpreted cautiously.
Mojtaba Javaherzadeh; Ali Shekarchizadeh; Marjan Kafaei; Abass Mirafshrieh; Nariman Mosaffa; Babak Sabet
Volume 4, Issue 3 , July 2016, , Pages 156-160
Abstract
Objective: To determine the preventive effects of local administration of simvastatin for postoperative intra-abdominal adhesion formation in animal model of rat.Methods: In this experimental study, 32 Wistar albino rats as the animal model of intra-abdominal adhesion formation were included. Adhesions ...
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Objective: To determine the preventive effects of local administration of simvastatin for postoperative intra-abdominal adhesion formation in animal model of rat.Methods: In this experimental study, 32 Wistar albino rats as the animal model of intra-abdominal adhesion formation were included. Adhesions were induced in all the animals via abrasion of the peritoneal and intestinal surface during laparotomy. Afterwards, the rats were randomly assigned to receive simvastatin (30 mg/kg body weight) as a single intraperitoneal dose at the time of laparotomy (n=16) or normal saline in same volume at the same time (n=16). At the day 21, animals were euthanized and the adhesions were quantified clinically (via repeated laparotomy) and pathologically and compared between the two groups.Results: The baseline characteristics of the animals were comparable between two study groups. Clinically, in simvastatin group, 10 rats (62.5%) did not develop any adhesion and 6 (37.5%) had first-grade adhesion; whereas in the control group, 11 (68.8%) rats had first- and 5 (31.2%) had second-grade adhesions (p<0.001). Pathologically, in simvastatin group, 6 rats (37.5%) had first-grade adhesion, while in control group, 11 rats (68.8%) had first- and 5 (31.2%) had second-grade adhesions (p<0.001).Conclusion: Our findings suggest that intraperitoneal administration of simvastatin is an effective method for prevention of postoperative intra-abdominal adhesion formation in animal model of rat.
Hamid Reza Abbasi; Seyed Mohsen Mousavi; Ali Taheri Akerdi; Mohammad Hadi Niakan; Shahram Bolandparvaz; Shahram Paydar
Volume 1, Issue 2 , April 2013, , Pages 81-85
Abstract
Objective: To record and classify mechanisms of injury and injury severity score (ISS) in trauma patients admitted to the largest trauma center in Southern Iran.Methods: This was a prospective cross-sectional study including all the patients who were admitted to Nemazee hospital from 2009 to 2010. We ...
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Objective: To record and classify mechanisms of injury and injury severity score (ISS) in trauma patients admitted to the largest trauma center in Southern Iran.Methods: This was a prospective cross-sectional study including all the patients who were admitted to Nemazee hospital from 2009 to 2010. We recorded the trauma injury information of 1217 patients who were admitted to of emergency room of the Nemazee hospital during a 13-months period by means of a standard questionnaire. ISS was then obtained for every single patient.Results: The mean age of patients was 26.6 ± 15.1 (range 1–95) years. The commonest type of trauma including 279 cases (22.9%) was car accident and the least resulted from shotgun injuries in 13 (1.1%) patients. The lowest ISS was due to assault multiple blunt traumas and the highest ISS resulted from shotgun injury. The mean ISS was about 6.3 ± 1.8 (range 1-66). Overall, 86 patients had scores above 17 (7.1%). A total of 69 male patients (7.5%) compared to 17 females (5.7%) had severe injury (ISS>17). Trauma injuries were significantly more severe in males compared to females (p=0.014). In the sunny and hot seasons total number of patient was higher. The mean ISS was highest in during spring (p<0.001).Conclusion: In Shiraz, most of the trauma injuries are occurred during summer and hot weather. Men have greater number of injuries and higher ISS compared to women. The lowest ISS was due to assault multiple blunt trauma and the highest ISS was caused by shotgun injury, and car accident was the commonest cause of trauma with head and neck being the most frequent sites in our patients.
