Shiraz Emedical Journal
Volume:16 Issue: 4, Oct 2015

A variety of systemic and intrathecal adjuvants to local anesthetics have been found to expand the duration and improve the quality of spinal block and decrease pain after surgeries.. The aim of this study was to evaluate the effect of the addition of midazolam to lidocaine for spinal anesthesia in lower abdomen and lower limb surgeries..Patients and In a prospective, randomized, double blind study, 36 patients aged 20 to 60 years, and American Society of Anesthesiologists (ASA) I or II, were randomly allocated to receive either intravenous midazolam (30 μg/kg) or placebo in spinal anesthesia. Level of sensory block, time to achieve maximum motor and sensory block, duration of sensory and motor block, recovery time, side effects, heart rate, blood pressure, arterial oxygen saturation and sedation score were measured and analyzed using the SPSS software version 15 by t-test and ANOVA. Data were considered significant at 0.05.. The motor block duration in midazolam and control group was 82.9 ± 27.3 and 59.1 ± 26.5, respectively (P = 0.01). However the duration of sensory block was not different between the two groups (P = 0.07). The median of sensory block level was at T8 and T10 in midazolam and control group (P = 0.02). Recovery time was more prolonged in the midazolam group (P = 0.002). Hemodynamic indices did not show any significant differences between the two groups.. Addition of 30 μg/kg midazolam to lidocaine for spinal anesthesia improved duration of motor block and increased intraoperative sedation score without causing side effects in patients’ requiring lower abdomen and lower limb surgery..

Context: National Health Account (NHA) is an accepted tool for tracing the flow of health resources at country level. As policy makers concern about the effective allocation of scarce resources, thus NHA can play a dominant role in evidence-based decision making. Reevaluation of last NHA in Iran is required for helpful highlights..Evidence Acquisition: We reviewed last NHA documents in Iran which was performed in 2008 to highlight a good evidence for policy makers and compared it with other national and international available data.. Reevaluation of data highlighted some issues, which were compared with the national and international available data and useful evidences for policy makers were extracted. These evidences are mentioned in following part.. The issues highlighted in last NHA in Iran were: changes in the health insurance system, adopting approaches for increasing an insurance coverage in noninsured population, informing the population about insurance scheme, private insurance scheme according to indigenous conditions, applying a concerted national effort towards controlling the high cost of medicine alongside concerning about equity and coverage, and applying effective indigenous strategies for decreasing out-of-pocket health care expenditures.

Human Immunodeficiency Virus-1 (HIV-1) and Hepatitis B Virus (HBV) are transmitted through common routes; therefore, simultaneous infection with both viruses is common.. The current study aimed to determine HBV infection serological profile and the associated risk factors among HIV positive individuals in Shiraz..Patients and In this cross-sectional study, 186 HIV infected individuals above 18 years old, referring to Shiraz Voluntary Counseling and Testing Center from 2010 to 2011were enrolled. All participants were assessed for the serological status of HBV infection using Hepatitis B surface antigen, Hepatitis B surface antibody, Hepatitis B core antibody levels, and HBV Polymerase Chain Reaction.. A total of 186 HIV positive individuals eligible for analysis including 164 (88.2%) males and 22 (11.8%) females were selected for the study. Hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody (HBsAb) and Hepatitis B core antibody (HBcAb) were detected in 66 (35.5%), 62 (41.3%), and 39 (21%) subjects, respectively. HBV DNA was detected in 39 subjects (21%).. The current study showed that less than half of the HIV positive participants had evidence of previous exposure to HBV. Also, the risk of chronic HBV was higher in the subjects than the normal population. It is suggested to educate HIV positive individuals regarding prevention and transmission of other viral infections such as HBV, HCV, and compliance with their medication..

The behavior of physicians after graduating from universities is very important for policymakers. They want to follow these behaviors to find what happened to physicians after graduation. Increasing in physician labor participation rate and an efficient distribution of them by gender and geographical concerns are crucial decisions of policymakers.. This study aimed to determine the factors that affect the physician labor supply in Iran. We focused on the presence and absence of medical graduate students in the labor market and we also investigated the changes in labor supply in age groups and the differences in male and female physician labor supply. Moreover, the unemployment rate among physicians was calculated..Patients and In this study, we used population and census data of Iran in 2011. Data of the graduate medical university students were extracted. Some descriptive statistics like the physician labor participation rate and physician unemployment rate were calculated in this study. Also, a regression model for physician labor supply was estimated.. The results of this study showed that the physician labor participation rate and the unemployment rate were 61.6% and 7.8%, respectively. Both of these statistics were better than the overall labor force statistics of the country. The unemployment rate of male physicians was lower than female ones and the labor force participation rate for male physicians was higher than female ones. The results of the labor supply regression showed a positive relationship between age, being male, being married and labor supply. Moreover, a negative relationship was found between continuing the study at universities and physician labor supply.. In this study, some additional facts about Iranian physician labor behavior were presented. These results alert policymakers about the decisions in human resource management and play a major role in policy decisions..

Noncommunicable diseases (NCDs) are now the most important causes of mortality and morbidity in Iran.. Therefore, knowing about NCDs status and its socioeconomic determinants are the cornerstone for the interventions that policymakers and health providers apply to improve the health of community. This research includes a full exploration of the relevant data..Patients and This was a population-based cluster randomized sampling carried out in Shiraz, Iran. In this regard, demographic, socioeconomic status, and medical history of adult participants (at least 18 year old) were collected. In the next step, physical examination and anthropometric data were taken. Finally, fasting blood glucose (FBS), lipid profile, and complete blood count (CBC) measurement were done.. Overall, 777 participants, mean age of 42.6 ± 13.8 (ranging from 18 to 88) year, were included in this study while female (451; 58%), middle-aged (203; 26.1%), married (653; 84%), and those with up to 12 years of education (470; 60.5%) were the majorities. Among the participants, 453 (58.3%) were among overweight to severely obese groups, 441 (56.7%) did not have physical activity, 148 (19.3%) were smokers, 280 (36%) had hypercholesterolemia, 239 (30.8%) had hypertriglyceridemia, 54 (6.9%) had high LDL, 93 (11.9%) had low HDL, and 49 (6.3%) were anemic. Women had significantly lower height (P < 0.001), weight (P < 0.001), and waist circumference (P < 0.001), but higher BMI (P < 0.001) compared to those parameters in men. Of total participants, 240 (30.9%) had prehypertension, 62 (8.0%) had stage I hypertension, and 16 (2.1%) had stage II hypertension. Overall, 76 (9.8%) subjects had hypertension, while most of them (57; 75%) were aware of their disease and consumed antihypertensive drugs. Of 777 participants, 148 (19.1%) had impaired glucose tolerance test and 51 (6.5%) were diabetic. However, 46 (5.9%) were aware of their disease and only 35 (4.5%) consumed glucose lowering agents to control plasma glucose. Those with fewer years of education had significantly higher prevalence of obesity (P = 0.001), hypertension (P < 0.001), and DM (P = 0.02).. At least 1 out of 2 adult people in Shiraz does not have physical activity and has high BMI, while 1 out of 3 has at least one abnormal components in their lipid profile. Prediabetes, hypertensive, and diabetic groups comprised a significant portion of population. Among different groups, women and less educated people belonged to the high risk groups. Therefore a multidisciplinary approach is needed to control this event, especially in high risk population..