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   2017| September-October  | Volume 10 | Issue 5  
    Online since November 6, 2017

 
 
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REVIEW ARTICLES
Factors associated with malnutrition among under five-year-old children in Iran: A systematic review
Mohammad Mohseni, Aidin Aryankhesal, Naser Kalantari
September-October 2017, 10(5):1147-1158
DOI:10.4103/ATMPH.ATMPH_668_16  
Background: Children are one of the most important population groups in the world and malnutrition is considered as one of death causes among them, especially those under 5 years old. The aim of our study was to conduct a systematic review of malnutrition and its associated factors among under five-year-old children of Iran. Materials and Methods: Data were collected through searching electronic databases and searching motors of PubMed, Science Direct, Scopus, Google Scholar, Scientific Information Database, Magiran and IranMedex using key words of “malnutrition,” “under-nutrition,” “stunting,” “underweight,” “wasting,” “factor,” “children,” “under 5 years,” “Iran,” and their Persian synonyms. Some of the relevant journals and websites were hand searched. Results: Of 608 preliminarily retrieved articles, 36 were selected for the final phase of the study. The most important factors related to underweight were mother's education level, father's education level, and birth weight. In regard to wasting, gender was one of the main factors and the next four were living location, birth weight, mother's, and father's education levels. Mother education level, father education, gender, birth weight, and age group were mentioned as the most important factors resulting in stunting as well. Conclusions: In some regions with low socioeconomic status, especially rural areas, the focus should be on the improvement of households living conditions such as mothers' and children's nutrition. Improvement in parents' education, particularly mothers' education, can have a significant impact on children's health. Under 5 years old girls need more attention than boys regarding to their poorer indicators.
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A systematic review of medical service branding: Essential approach to hospital sector
Omid Khosravizadeh, Soudabeh Vatankhah, Mohammadreza Maleki
September-October 2017, 10(5):1137-1146
DOI:10.4103/ATMPH.ATMPH_328_17  
Introduction: Understanding the branding aspects of health care and its application and development strategies is undoubtedly necessary for hospitals to achieve optimal marketing. The purpose of the present paper was to systematically review healthcare branding factors, the results of which can be useful in the understanding of these factors and improving the healthcare services. Materials and Methods: The present systematic review was conducted in 2017. Research related to branding in the field of healthcare services was searched using valid keywords, including hospital, medical service, and healthcare combined with keywords such as brand and brand building and through various databases (e. g., Google Scholar, Scopus, PubMed, and Web of Sciences). Using a check list, analytical studies (SCORB) were evaluated qualitatively. Endnote X6 was applied to arrange and evaluate abstract titles and to remove duplicate abstracts. Results: A total of 54 papers were selected for the systematic review. The results were classified and reported based on three categories, including dimension, process/strategies, and results/benefits. The most important brand building dimension was brand equity, the most important process was stabilization of brand positioning, and the most important result was development of optimal marketing. Moreover, some of the results suggested the effect of branding on financial and clinical performance of hospitals. Conclusion: The concept of brand building in healthcare services is an emerging phenomenon, and most of the healthcare organizations have limited experience in building brand strategies and developing their services. In this regard, it is necessary for hospitals to identify comprehensively the dimensions, processes, and results of optimal branding in healthcare services and use them for planning, implementation, and management.
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Generation of electronic-waste and its impact on environment and public health in Malaysia
MD Abul Kalam Azad, Mohd Aminul Islam, MM Ismail Hossin
September-October 2017, 10(5):1123-1127
DOI:10.4103/ATMPH.ATMPH_349_17  
Generation of municipal solid waste as well as electrical and electronic waste (e-waste) is rapidly increasing in the developing countries, especially in the electronic manufacturing industries which have seen some technological growth within a short timeframe in Malaysia. The purpose of this study is to find out the factors that contribute to the generation of e-waste and to present the current scenario of Malaysia's e-waste management system. The data were collected from the review of various scientific journals and the Department of Environment Malaysia (DOE) which were published and available in online currently. It was observed that recently in Malaysia, the generation of e-waste is one of the environmental problems in Malaysia. Among other factors, besides industries, use pattern for households, business entities, and institutions are the main contributors of the increased e-waste generated in Malaysia. DOE reported that, the ratio of bought and possessed electronic appliances among the respondents in Malaysia is not balance. The rate of discarding is higher than possessed rate. Remarkably, in television, 95.6% of the television sets currently possessed are bought from shops, but only 33% of respondents were using it up to now, whereas 62.60% of people are not using their televisions and they have discarded it. Consequently, the discarded rate of other electronic appliances is also almost in the same trend by households, business entities, and institutions in Malaysia. E-waste containing a lot of dangerous chemicals and metals such as Mercury, Lead, Cadmium, Zinc, and Chromium causes diseases such as brain disorders, kidney, renal, and neurological damage, thus leading to even deaths, learning disabilities, lung damage, mental retardation, behavioral problems, hearing impairment, fragility of the bones, and high blood pressure. It is, therefore, recommended that government should develop the 3Rs initiatives to reduce, reuse, and recycle of e-waste. At the same time, create awareness among the society to prevent it from the negative impact on the environment through pollution and public health hazards.
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ORIGINAL ARTICLES
Radiographic lumbar spondylosis: Gender and age group prevalence in Nigeria
O Okpala Francis
September-October 2017, 10(5):1199-1204
DOI:10.4103/ATMPH.ATMPH_442_16  
Background: Lumbar spondylosis (LS) increases with, and is perhaps an inevitable concomitant of age, and is a major cause of low back pain and disability in the elderly. The prevalence in Nigeria is poorly documented, and its knowledge will assist in patient management. Objective: The aim is to study the gender and age group prevalence of LS in Nigeria. Materials and Methods: This is a retrospective review of 368 anteroposterior and lateral lumbosacral spine spondylotic radiographs of patients of both genders. Data analysis was performed with IBM SPSS Statistics 20.0 (New York, USA). The value of P < 0.05 was considered statistically significant. Results: The age range was 17–90 years, mean (standard deviation) was 51.96 (13.49) years. The majority (201 [55%]) were aged 45–64 years. The males (217 [59%]) were aged 17–90 years, and the mean (standard deviation) was 52.28 (14.49) years, whereas the females (151 [41%]) were aged 17–80 years, and the mean (standard deviation) was 51.51 (11.95) years. The mean ages showed no significant gender difference (P = 0.429). Male: female ratio was 1.4:1. LS prevalence increased with age, peaked at 45–54 years in females, 55–64 years in males, and steadily declined to zero, in females after 80 years, and in males after 90 years. Conclusion: LS prevalence started as early as 17 years of life, increased with age, peaked at 45–54 years in females, 55–64 years in males, and steadily declined to zero, in females after 80 years, and in males after 90 years. Sex ratio showed slight male preponderance.
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Antioxidant and anti-inflammatory activity of green synthesized silver nanoparticles using Salvia officinalis extract
Javad Baharara, Tayebeh Ramezani, Marzieh Mousavi, Majid Asadi-Samani
September-October 2017, 10(5):1265-1270
DOI:10.4103/ATMPH.ATMPH_174_17  
Background and Aims: Free-radical-mediated peroxidation of membrane lipids and oxidative damage of DNA and proteins are believed to be associated with a variety of chronic pathological complications such as cancer. The aim of this study was to describe antioxidant and anti-inflammatory of silver nanoparticles (AgNPs) synthesized using medicinal plant extract of Sage (Salvia officinalis). Materials and Methods: AgNPs were synthesized using S. officinalis as reducer agents and characterized using ultraviolet-visible, Fourier transform infrared spectroscopy, particle seizer, and transmission electron microscopy. Toxicity of AgNPs on MCF-7 cells was investigated using 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Changes in expression of inflammation related genes include cyclooxygenase-2, IL-8, and tumor necrosis factor-alpha (TNF-α) genes were evaluated using semi-quantification reverse transcription-polymerase chain reaction (RT-PCR). The antioxidant potential of capped AgNPs was assessed using 1,1 diphenyl-2-picryl-hydrazyl (DPPH) and 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulfonic acid (ABTS) radicals activity assay. Results: AgNPs successfully synthesis with an average size of 16 nm and spherical. FTIR spectrum from plant extract and AgNPs indicated the extract covered nanoparticles. AgNPs decreased cells viability with inhibitory concentration (IC50) of 25 μg/ml and 20 μg/ml after 24 and 48 h, respectively. To ascertain the anti-inflammatory genes expression, MCF-7 cells were treated with 20 μg/ml AgNPs (concentration below of IC50 value according to MTT assay). Semi-quantification RT-PCR results showed that AgNPs increased IL-8 and TNF-α genes expression 28.76% and 42%, respectively, but suppressed cyclooxygenase-2 gene expression with 20.5% comparing to control groups. Antioxidant assay of green synthesized AgNPs coated by S. officinalis extract showed free radical scavenging effect with IC50 of 830 and 800 μg/ml for DPPH and ABTS radicals, respectively. Conclusion: The coated AgNPs with S. officinalis have promising potential as a source for the development of chemotherapeutic agents in future.
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Malnutrition among patients suffering from HIV/AIDS in Kermanshah, Iran
Behrooz Hamzeh, Yahya Pasdar, Mitra Darbandi, Shahryar Parsa Majd, Seyed Amir Reza Mohajeri
September-October 2017, 10(5):1210-1214
DOI:10.4103/ATMPH.ATMPH_315_17  
Background: Inadequate food intake is one of the causes of malnutrition, which is an important complication of HIV and accelerates the progress of HIV toward acquired immunodeficiency syndrome (AIDS). Objective: The present study aimed to assess nutritional status of people with HIV/AIDS. Materials and Methods: The present cross-sectional study recruited 340 people with HIV/AIDS visiting Behavioral Diseases Counseling Center in Kermanshah Province. Malnutrition was measured by body mass index (BMI). Food Frequency Scale was used to assess food intake, and the amounts of food intake were compared to recommended daily allowance (RDA). The data were analyzed in Stata-11 using Chi-square, Kruskal–Wallis, and ANOVA tests. Results: Mean BMI among men and women was 22.12 ± 3.75 kg/m2 and 25.54 ± 4.66 kg/m2. The prevalence of BMI-based malnutrition was 42.21% (141 people). Of participating patients, 11.08% were underweight, 22.75% overweight, and 8.38% obese. Underweight was reported more prevalent in men than in women and also in singles than in married patients (P = 0.001). Intake of protein, folate, Vitamins A and E, and fiber was less than RDA in a significantly large number of patients. Vitamin A deficiency was more evident in men and folate and calcium deficiencies in women. Conclusion: The present study showed inadequate intake of micro- and macro-nutrients in patients with HIV/AIDS. Malnutrition was observed as varying degrees of underweight and overweight, which requires greater attention to and care for these patients.
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Assessment of level of satisfaction of national health insurance scheme enrolees with services of an accredited health facility in Northern Nigerian
Godpower Chinedu Michael, Hassan Hassan Suleiman, Bukar Alhaji Grema, Ibrahim Aliyu
September-October 2017, 10(5):1271-1277
DOI:10.4103/ATMPH.ATMPH_372_17  
Introduction: Consumer satisfaction is one of the driving goals of goods and service production. Patient satisfaction surveys, as a means of periodic evaluation of the quality of services offered by the National Health Insurance Scheme (NHIS) accredited facilities, is necessary to ensure that the goals of the scheme are achieved and sustained. Materials and Methods: This was a cross-sectional study of 202 respondents randomly selected from NHIS enrolees attending the Staff Clinic of Aminu Kano Teaching Hospital. It assessed respondents' perceived waiting time, level of satisfaction at the clinic's service units, and overall clinic satisfaction using a modified general practice assessment questionnaire. Results: The mean age of respondents was 36.4 ± 8.1 with a near equal sex ratio. They were predominantly civil servants (79.2%) with tertiary education (75.7%). Most respondents (70.3%) felt waiting time was too long; with 79.7% of those, feeling they spend at least 30 min after arrival at the registration unit to see their doctor. A majority of respondents: 90.1%, 86.8%, 79%, 76.8%, 75.9%, 77.5%, and 80.6% were satisfied with the consultation time, doctors' consultation, medical records, pharmacy, laboratory, accounts, and nursing services, respectively. However, 65.8% were satisfied with the overall clinic services. The perceived sufficiency of the consultation time was associated with overall satisfaction (χ2 = 6.199, P = 0.013). Conclusion: Although 65.8% of respondents were satisfied with the clinic services, the perceived clinic waiting time was dissatisfactory; therefore, further studies on the determinants of overall satisfaction may be required if improvement in the proportion of satisfied service consumers is desired by the clinic managers.
  2,081 19 -
Social determinants of tuberculosis contagion in Malaysia
Khairiah Salwa Mokhtar, Nur Hairani Abd Rahman
September-October 2017, 10(5):1215-1220
DOI:10.4103/ATMPH.ATMPH_371_17  
Context: Tuberculosis (TB) is primarily an airborne disease caused by the infection of a bacterium, Mycobacterium tuberculosis, which results in more than two million deaths per year worldwide. TB infection is spread when someone with active, infectious TB coughs, or sneezes. In Malaysia, TB is fast rising as a noncommunicable disease, with a death rate higher than death of human immunodeficiency virus (HIV)-AIDS. For instance, in 2015 health indicators, reported by the Ministry of Health, the mortality rate for TB was 5.33%, compared to HIV/AIDS at 1.91%. Aims: This study attempts to review the social determinants of TB transmission in Malaysia. Methods: This is a qualitative study and employs in-depth interview technique for data collection. A list of 36 informants was identified and approached; 22 of them agreed to be interviewed. The elites were chosen for their background, which related to public health and TB patient management. Each interview was recorded, transcribed, and analyzed using thematic analysis. Results: The study finds that the social determinants of TB transmission are related to the following factors: unhealthy lifestyle, inconvenient working environment, negative public perception and stigma, and financial concerns. Conclusions: The identification of as many TB contributing factors as possible is crucial in developing and implementing integrated programs and initiatives that involve all stakeholders in addressing and curbing the spread of the disease.
  2,042 21 -
Knowledge, attitudes, and practices toward onchocerciasis among local population in Bioko Island, Equatorial Guinea
Laura Moya Alonso, Zaida Herrador Ortiz, Belén Garcia, Rufino Nguema, Justino Nguema, Policarpo Ncogo, Teresa Gárate, Alba González-Escalada, Agustín Benito, Pilar Aparicio Azcarraga
September-October 2017, 10(5):1228-1237
DOI:10.4103/ATMPH.ATMPH_726_16  
Introduction: Since 1998, the African program for onchocerciasis control has been working with ultimate goal of reducing the public health impact associated with onchocerciasis in Equatorial Guinea. Although dedicated community engagement is crucial for the success of this program, there is no information on the levels of community's knowledge, attitude, and practice (KAP) toward onchocerciasis in this country. Methods: A cross-sectional study was carried out in Bioko Island from mid-January to mid-February 2014. Sampling was carried out by multistage cluster survey. Sociodemographic characteristics, KAP, and stigma-related questions were collected through a pretested questionnaire. A bivariate analysis was performed and results were adjusted by sex and age using logistic regression. Results: A total of 140 housekeepers or head of households agreed to participate. Around 54% of the interviewees had heard about the disease, of which more than one-third identified the disease as filariasis (28/68, 41.2%). Overall, 19.3% respondents highlighted the bite of a blackfly as the main mode of transmission. From those who had a familiar affected by onchocerciasis in the past, 21 out of 32 (65.6%) pointed ivermectin as the preferred treatment and 43.8% pointed out the health center as the first choice place to seek for treatment. About 67.1% of individuals believed that having onchocerciasis would not cause any contact avoidance with other members in the community. Conclusions: People's practices toward onchocerciasis tend to be better than disease knowledge in Bioko Island. Increasing awareness through community-based campaigns and educational activities is encouraged in the current onchocerciasis preelimination stage at Bioko Island.
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Utilizing the information and communication technology as a learning tool for students
Shahriar Sakhaei, Hossein Motaarefi, Soryya Zinalpoor, Hassan Ebrahimpour Sadagheyani
September-October 2017, 10(5):1189-1194
DOI:10.4103/ATMPH.ATMPH_325_17  
Introduction and Objective: The use of information and communication technology (ICT) to facilitate learning and training the students has led to the learning environment tend to become virtual and to change the communication and learning styles. This study aimed to investigate how students benefit from new learning technologies as a learning tool. Materials and Methods: This study is a descriptive–analytical study; the population included all students of the school of Medical Sciences in 2016, in Khoy, Iran. A questionnaire was used for data collecting. The questionnaire contains 50 questions regarding demographic information, the skills and the benefits of the students of computers and the Internet as the learning tools. After gathering the data, the analysis SPSS version 16 software and descriptive and inferential statistical analysis were used. Results: Students expressed their relatively high access to computers and the Internet (60.7%) and using ICT in learning (59.3%). The students' skills in the use of computers and the Internet (56%) were relatively high (97%). Most of the students used PowerPoint software as a learning tool, and the use of educational websites was relatively high in the nursing group (75%) compared to environmental health (50%). Conclusion: Considering the increased use of information technology proportionate with the students' personal skills and the effectiveness of multimedia educational software and Internet in learning, educational planners should provide access to e-learning by creating the conditions and introducing the high quality and rich educational software.
  1,919 19 -
CASE REPORT
Ruptured amoebic liver abscess with perforated amoebic typhlitis: A rare entity
S Nishanth, Sudhir Kumar Jain, Chandra Bhushan Singh, Lovenish Bains
September-October 2017, 10(5):1350-1353
DOI:10.4103/ATMPH.ATMPH_319_17  
Background: Amoebic liver abscess (ALA) is the most frequent extra intestinal manifestation of Entamoeba histolytica infection. Rupture of ALA is an important cause of morbidity and mortality mainly in developing countries. In invasive amoebiasis, the trophozoites penetrate the intestinal mucosa causing amoebic colitis. Simultaneous amoebic cecal perforation and ALA rupture is a rare complication of invasive amoebiasis with a high rate of mortality which mainly occurs in malnourished patients. We report 4 rare cases of amoebic cecal perforation with ruptured liver abscess. Cases Patients and Methods: 4 unusual cases of ruptured ALA associated with perforated cecum which were operated at Department of Surgery, Maulana Azad Medical College from June 2016 to May 2017 are reported along with relevant review of literature. Results: Three patients were male and 1 was female. The mean age was 35.5 years. All cases had generalized peritonitis. Two patients had a single abscess in the right lobe, 1 had an abscess in both lobes of liver and 1 had multiple abscesses. Liver abscess in all 4 cases were amoebic as amoebic serology of pus was positive in all cases. At presentation, all 4 cases had clinical signs of generalized peritonitis. Ultrasonography for collection in peritoneal cavity showed moderate free fluid in with internal echoes suggestive of pyoperitoneum. Two patients had free air under the diaphragm. All 4 patients underwent resuscitation and then taken up for surgery. Exploratory laparotomy was done which showed pyoperitoneum. One patient had sealed perforation in the cecum, 2 had a perforation in cecum, and 1 had multiple perforations in cecum and ascending colon. Limited resection was done in 3 cases and right hemicolectomy in 1 case who had multiple perforations in cecum and ascending colon, in all 4 cases, exteriorization of bowel was done. Postoperatively, 1 patient died of respiratory failure due to bilateral pneumonia. Conclusion: Ruptured ALA along with perforation of cecum is a rare condition presenting as acute abdomen with high mortality. Surgical intervention is mandatory in all these cases.
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ORIGINAL ARTICLES
Assessment of the birth preparedness and complication readiness among antenatal women at Ahmedabad city, India
Viral R Dave, Bhavik M Rana, Hardika J Khanpara, Kantibhai N Sonaliya, Jayshree Tolani
September-October 2017, 10(5):1278-1285
DOI:10.4103/ATMPH.ATMPH_318_17  
Introduction: Birth preparedness and complication readiness (BP/CR) improve preventive behavioral practices among to be mothers; thereby leading to improvement in care-seeking during obstetric emergency. Objectives: The objective of the study is to assess the knowledge and practices with respect to BP and CR and to find the determinants affecting them. Methods: A community-based cross-sectional study was carried out at urban slum area of Ahmedabad city, Gujarat, India from August 2015 to February 2016. Personal interviews of 350 antenatal women were conducted. Sociodemographic details, information of antenatal care pursuing and information pertinent to BP and CR were reviewed. Total ten variables, suggesting their knowledge and practices toward BP/CR were assessed. Correct response with at least five variables or more than that was considered as positive knowledge and practices for BP/CR. Results and Conclusion: The study sample mainly comprised of 21–25 years of age group (48%) of participants. Overall, 229 (65.43%) of total participants were found to have positive knowledge and practices in terms of BP/CR. The variables which had statistically significant effect on BP and CR were: level of education, socioeconomic class, age at the time of marriage, order of pregnancy, mode of last delivery, number of live children, history of abortion, and duration of current pregnancy. Fair numbers of women were lacking proper knowledge regarding dangers signs during pregnancy, labor or postpartum, prior identification of doctor for them as well for new born and saving money for pregnancy related needs.
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Investigating the relationship between self-leadership and resistance to organizational changes in the nursing managers of hospitals affiliated with Isfahan University of Medical Sciences, 2015
Sara Moradpour, Heidar Ali Abedi, Ahmad Bahonar
September-October 2017, 10(5):1333-1340
DOI:10.4103/ATMPH.ATMPH_205_17  
Background and Objectives: Change is the only solution for today's organizations. The organization as a social entity is both affected from and affecting the environment. To change the organization, people should change. Involving people in the management of the organization is effective in reducing the resistance to change. Strategies used to change attitudes, behaviors, and recognition of the individuals resulting in their success lie in leadership. Therefore, this study examines the relationship between self-leadership and resistance to organizational change in nursing managers. Materials and Methods: This study being a descriptive correlational study used Houghton and Neck's standard self-leadership questionnaire with 35 questions and reliability of 94% as well as resistance to organizational change scale of Wayne and Andy with twenty questions and reliability of 84% to collect the data. Content and face validities of the research tools were determined through the study of theoretical foundations as well as the opinions of professors and specialists. The population (250 people) included all nursing managers (matrons, supervisors, and head nurses) of educational centers of Isfahan in 2015. One hundred and fifty-six individuals were selected through the available sampling out of the 250 people of the population (males and females). Data analysis was conducted by SPSS software, version 22; in addition, statistical tests of Pearson, t-test, variance analysis, regression model, and Mann–Whitney tests were used. Results: In general, the average rating of the research units is above average (54.0 + 3.88) in self-leadership questionnaire of nursing managers. Besides, the amount of resistance to change in 92.2% of nursing managers is at average level. The findings also showed that there is a positive relationship between self-leadership and resistance to organizational change (P < 0.001, r = 0.310) and the score of self-leadership increases with the increase in job experience (P = 0.049, r = 0.154). It was observed that with the increase in age and job experiences, the resistance to organizational change also increases in nursing managers (P < 0.05). Conclusions: In this study, resistance to organizational change was at an average level with respect to the self-leadership of the managers. Increase in age and experience of nursing managers is associated with self-leadership and resistance to change. Thus, to move toward positive and useful changes in the organization and achieve noble objectives in educational centers, it is important to attract and guide the behavior of experienced managers and increase their knowledge of organizational behavior to reduce the resistance to organizational changes.
  1,692 19 -
REVIEW ARTICLES
HIV and sexually transmitted co-infections among sex workers in the Southern African economic region
Clarence S Yah, Ernest Tambo, Oluwafemi Adeagbo, Ayanda Magida
September-October 2017, 10(5):1128-1136
DOI:10.4103/ATMPH.ATMPH_31_17  
Background: The Southern African Development Community (SADC) economic block is the most affected region by HIV epidemic in Sub-Saharan Africa (SSA). Despite programmatic interventions, HIV infections remain unprecedentedly high among female sex workers (FSW) in the region. This review assesses the HIV burden and the drivers associated with FSW in the SADC region. Methods: We systematically extracted and analyzed HIV burden and other sexually transmitted infections (STIs) research data on FSW indexed in various journal platform and reports from governmental and nongovernmental organizations between 2003 and 2015. Meta-analysis technique was used to estimate the pooled prevalence of the HIV burden among FSW in the region. Results: Of the 192 peer-reviewed articles and reports addressing HIV burden, only 21 articles met eligibility criteria totaling 14998 FSW. The combined overall pool HIV prevalence was estimated at 42.0% (95% CI 0.41–0.43). The estimated pooled HIV prevalence ranged from 16% (95% CI 0.13–18) in Democratic Republic of Congo, 59% (95% CI 0.57–0.62) in South Africa and 71% (95% CI 0.65–0.76) in Malawi. The most common STIs reported were syphilis, Chlamydia, and gonorrhea with little emphasis on viruses. Structural factors such as stigma and discrimination, access to healthcare services and various socioeconomic and political barriers impeded treatment and prevention. Conclusion: The HIV prevalence among FSW was 5–30 times higher when compared to the overall female reproductive age population in the SADC region. This signifies and necessitates increase evidence based HIV/STIs research and programs among FSW in the SADC region.
  1,641 19 -
ORIGINAL ARTICLES
Lived experienced of patients with sickle cell disease anemia about disease management (a qualitative research)
Nasrin Elahi, Noorollah Tahery, Fazlollah Ahmadi, Shahnaz Rostami
September-October 2017, 10(5):1238-1242
DOI:10.4103/ATMPH.ATMPH_239_17  
Introduction and Goal: Sickle cell disease (SCD) is a group of disorders, comprising sickle cell anemia and compound heterozygous disorders. It is the most common inherited hematological disease in the world. The objectives of this study were to describe the lived experienced patients with SCD during the evolution of a painful event and their solutions for control and manage it. We hope that with finding and cumulative of these solutions help patient with SCD for the management of their painful event. Materials and Methods: This qualitative study explored the experiences of sickle cell patients in management and control of pain and disease crisis in Iran. In-depth, unstructured individual interviews were conducted to extract the subjects' experiences of sickle cell patients in management and control of pain and disease crisis. Results: Codes extracted from the interviews led to the emergence of fore themes, which include implementation of various strategies to pain relief, awareness of pain intensifying, need to have the full support, awareness of the disease process. Conclusion: It is recommended that the instructions and programs written by nurses, be taught to patients and received feedback, to ensure that these strategies will be used.
  1,594 20 -
The effect of mindfulness-based stress reduction on social anxiety of the deaf
Alemeh Dehnabi, Hamid Radsepehr, Kazem Foushtanghi
September-October 2017, 10(5):1248-1253
DOI:10.4103/ATMPH.ATMPH_280_17  
Background and Aim: Individuals with social phobia do not have flexible approach to deal with stress, and they are weak to practice social skills. The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) on social anxiety of the deaf. Research Methodology: In a quasi-experimental pre- and post-test study with a control group, in 2015, 24 deaf individuals in Sabzevar city were selected for sampling and were randomly divided into control and experimental groups. Subjects completed Social Anxiety Inventory (SPIN) in pre-test and post-test. Then, ANCOVA was used to analyze the data. Results: Data analysis showed that MBSR leads to a reduction in the total score of social anxiety and physiological responses component related to the experimental group compared with the control group treated. Conclusion: It was concluded that teaching MBSR resulted in decreased social anxiety of the deaf.
  1,568 19 -
Chemical composition and screening of antibacterial activity of essential oil of Pistacia khinjuk against two selected pathogenic bacteria
Reza Tahvilian, Rohallah Moradi, Hossein Zhaleh, Mohammad Mahdi Zangeneh, Akram Zangeneh, Hossein Yazdani, Majid Hajialiani
September-October 2017, 10(5):1159-1164
DOI:10.4103/ATMPH.ATMPH_630_16  
Background: Medicinal plants are considered as modern resources for producing agents that could act as alternatives to antibiotics in demeanor of antibiotic-resistant bacteria. The aim of the present study was to evaluate the chemical composition and antibacterial activity of the essential oil of Pistacia khinjuk (combined with the dominance γ-terpinene) against P. aeruginosa and B. subtilis. Materials and Methods: The chemical composition of the essential oil was identified using gas chromatography coupled with mass spectrometer detector (GC-MS). As a screen test to detect antibacterial property of the essential oil, agar disk diffusion and agar well diffusion methods were employed. Macrobroth tube test was performed to determinate minimum inhibitory concentration (MIC). Results: According to results of the GC-MS analysis, γ-terpinene (81.14%) (w/w), β-pinene (3.93%) (w/w), and α-terpinolene (2.38%) (w/w) were the abundant components of the essential oil. The MIC and MBC values were 0.015/0.031 g/ml for essential oil of P. khinjuk in case of P. aeruginosa and B. subtilis, respectively. Conclusion: We believe that the article provides support to the antibacterial property of the essential oil. In fact, the results indicate that the essential oil of P. khinjuk can be useful as medicinal or preservative composition. Fractionation and characterization of active molecules will be the future work to investigate.
  1,557 19 -
The evaluation of Valsalva maneuver on pain intensity within the needle insertion to the arteriovenous fistula for patients undergoing hemodialysis in the selected hospitals in Isfahan in 2015
Elham Davtalab, Sayedali Naji
September-October 2017, 10(5):1322-1327
DOI:10.4103/ATMPH.ATMPH_202_17  
Introduction: Pain is an unpleasant feeling and it is called as the fifth vital sign. Fistula cannulation in hemodialysis patients is a very stressful and painful process. Nurses can help relieve pain with the use of nonpharmacological pain management therapies, independently. This study conducted aimed to investigate and determine the effect of Valsalva maneuver on pain intensity during cannulation of arteriovenous fistula (AVF) in patients undergoing hemodialysis. Materials and Methods: This study was conducted on 35 hemodialysis patients who were selected by convenience sampling in two Amin Medical Center and Hazrat-e Zahra-e Marziye Hospital in Isfahan. Data collection was performed using an interview questionnaire developed by the researcher, Abbey pain scale, and numerical pain rating. Data analysis was done using the descriptive and analytic tests in SPSS Software Version 20. Results: Paired t-test results showed that the score average of objective and subjective pains was reduced significantly after intervention compared to before that (P < 0.001). Wilcoxon test showed that the objective pain is reduced after intervention (P < 0.001). Wilcoxon test showed that the subjective intensity due to the needle insertion had a significant reduction after intervention (P = 0.001). Conclusion: Performing the Valsalva maneuver before the AVF cannulation reduces pain in patients undergoing hemodialysis.
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Comparing the effect of endotracheal tube suction using open method with two different size catheters 12 and 14 on discharge secretion, pain, heart rate, blood pressure, and arterial oxygen saturation of patients in the intensive care unit: A randomized clinical trial
Mostafa Javadi, Hossein Hejr, Mohammad Zolad, Arash Khalili, Akvan Paymard
September-October 2017, 10(5):1312-1317
DOI:10.4103/ATMPH.ATMPH_181_17  
Background and Purpose: Performing suction with complications such as tachycardia or bradycardia, increase or decrease blood pressure, pain, discharge, and decrease arterial oxygen saturation. The aim of this study was to compare the effect of endotracheal tube suctioning to open two different size catheters 12 and 14 on the discharge, pain, heart rate, blood pressure, and blood oxygen saturation in patients admitted to the Intensive Care Unit (ICU). Materials and Methods: This clinical trial compared two interventions of a pre- and post-test, and sampling was random. 36 patients admitted to the ICU in Yasuj martyr Beheshti Hospital iran, in a group of suctioning with catheter size 12 and 14. Changes in heart rate, blood pressure, pain, discharge, and arterial oxygen saturation before, during, 5 min and 20 min after the suction were recorded. Data analysis was performed by analysis of variance with repeated measures and paired t-test. Results: The Heart rate increased during suction catheter 14 than to 12, and the difference was statistically significant (P = 0.000). Suctioning with both catheters decreased oxygen saturation, but the reduction was not significant between both (P = 0.149). Systolic pressure increased after suction, and this increase was significantly in the higher catheter (P = 0.05). Diastolic pressure increased during suction with the highest increase of 5 min. There were no significant differences between the two catheters (P = 0.186). In the third episode, the highest rated pain during suctioning was observed and the difference was significant between large and small catheters (P = 0.000). Post-suction discharge was in the higher catheter was more and statistically significant (P = .000). Conclusion: The use of small size suction catheter To a lesser extent in heart rate, blood pressure, pain and suffering oxygen saturation changed.
  1,534 18 -
The incidence and prevalence of hearing disorders in children according to the audiological screening
DE Zhaisakova, SF Kudaibergenova, ZT Mukanova, GK Djarkinbekova, Meruert B Kaltayeva, YA Kuzembayev
September-October 2017, 10(5):1345-1349
DOI:10.4103/ATMPH.ATMPH_210_17  
One of the important tasks of children's audiology is the early identification of hearing impairment in children and the timely commencement of rehabilitation activities, such as a hearing aid, and in the presence of deep hearing loss difficult to treat with traditional methods of hearing rehabilitation, cochlear implantation should be used. Currently, due to the introduction of objective methods of hearing evaluation in clinical practice,there is a real opportunity to detect hearing disorders in children from the βirst days of life including premature newborns. In this study, we analyzed data of hearing acuity audiological screening among children at the age of 0–17 years for the period from 2015 to 2016. During this period, 4,588,365 children were examined in 2015, and 4,562,489 children were examined in 2016, within the Republic of Kazakhstan.
  1,407 19 -
Effect of narrative writing on quality of life in chronic renal failure patients underwent hemodialysis
Akram Ahmadzade, Sayed Mojtaba Ahmadi, Khirollah Sadeghi, Akram Sanagu, Sayed Mojtaba Amiri, Arash Parsa Moghadam, Alireza Abdi
September-October 2017, 10(5):1165-1168
DOI:10.4103/ATMPH.ATMPH_105_17  
Background: Chronic renal failure is the most common chronic disease affects the physical and psychological health of suffers and their quality of life (QOL). Recently, narrative writing is considered as a new approach to improve the problems of these patients, moreover, there is a paucity of information in this regard; hence, the current study was conducted to determine the effect of narrative writing on the QOL of hemodialysis patients. Methods: In a clinical trial, 28 hemodialysis patients of Imam Reza Hospital of Kermanshah were enrolled to the study in 2015. They are divided into two groups: case and control through randomization. The information was gathered through the short form-36 QOL questionnaire before and after intervention. Data were entered into SPSS-22 and analyzed by descriptive and inferential statistics. Findings: The mean of QOL score for case and control groups was 94.92 and 97.53, respectively, before intervention, which increased to 98.85 in case group and declined in control group to 90.80. The analysis of covariance test showed a significant difference between two groups after intervention (P = 0.004). Conclusion: The results indicate narrative writing can enhance the QOL of hemodialysis patient; however, it is required to carry out more studies with higher sample size.
  1,365 19 -
Applying artificial neural network approach to predict nurses' job performance based on personality traits and organizational factors
Khatereh Khanjankhani, Roohollah Askari, Sima Rafiei, Mohsen Askari Shahi, Fariba Hashemi, Milad Shafii
September-October 2017, 10(5):1299-1305
DOI:10.4103/ATMPH.ATMPH_334_17  
Background: The main goal of every organization is to provide the best quality product or service which mostly depends on its employees' performance. Among various factors, both indoor environmental features in an organization and personality traits of working staff play important role in on job performance. Objective: The purpose of current study was to describe the effect of personality traits and organizational factors on nurses' job performance through applying neural network approach. Materials and Methods: This analytical, cross-sectional study was conducted among nursing staff working in inpatient medical departments of a training hospital in Yazd Province in 2016. The study questions were answered through analysis of data obtained from three standard questionnaires. Collected data were entered in SPSS version 20 and analyzed by artificial neural network approach. Results: Findings revealed that from study participants' viewpoint the highest mean score regarding to indoor organizational factors was given to helpful mechanism dimension (5.54 ± 0.79) while the least was mentioned for targeting (5.35 ± 0.81). In association with personnel personality traits, the highest and least mean scores were relatively dedicated to conscientiousness (44.5 ± 4.3) and neuroticism (31.8 ± 4.3). Results of comparing significance coefficients in neural networks depicted that from all study dimensions, agreeableness and reward have got the most importance on job performance (100% and 81.2%) while accountability and helpful mechanisms have got the least (28.5% and 16.5%). Conclusion: Strengthening staff personality traits and environmental factors of a hospital can play an effective role in improving nurses' job performance. Therefore it is suggested that hospital managers help employees to improve their performance through providing a productive work environment and manage the workplace in accordance with important organizational factors mentioned by staff and as well their personality and behavioral patterns.
  1,364 19 -
The effect of space face games on the amount of children attention with attention deficit hyperactivity disorders
Zahra Shahmoradi, Jahangir Maghsoudi, Mostafa Najafi, Saeed Pahlavanzadeh
September-October 2017, 10(5):1341-1344
DOI:10.4103/ATMPH.ATMPH_206_17  
Introduction: As ever play therapy using a special toy which is produced with therapeutic target in children with attention deficit hyperactivity disorders (ADHDs) has not been conducted, this study was carried out with the aim to determine the effect of space face games on the attention of children with ADHDs. Materials and Methods: In this research, 72 children with ADHDs referred to Isfahan's Noor psychiatric clinic were randomly placed in two test and control groups. Attention level of both groups was evaluated using continuous performance test before and after the intervention. The space face games in the test group were used for 16 sessions. Statistical analysis of data was conducted using descriptive and analytical statistics in SPSS Software Version 18. Findings: The average score of attention had no significant difference between the two groups before the intervention, but the number of correct answer in the test group was significantly more than the control group and the number of provided errors and the number of removed errors were significantly lower than the control group immediately after the intervention. Conclusion: Space face games are effective in the promotion of attention in children with ADHDs.
  1,324 19 -
The impact of guided mental imagery on the sleep quality of the elderly after having heart attack
Sepideh Aghababaei, Ahmad Reza Yazdannik, Mahrokh Keshvari
September-October 2017, 10(5):1328-1332
DOI:10.4103/ATMPH.ATMPH_204_17  
Background: There are numerous factors such as cardiovascular diseases which cause sleep problems for the elderly. Relaxation is one of the components of cognitive behavioral therapy which refers to the practice of relaxation solutions to improve the sleep quality. Objectives: This paper aims to examine the impact of guided mental imagery on the sleep quality of the elderly after having heart attack. Patients and Methods: This study is considered to be a two-group random clinical trial that was carried out on sixty elderly patients suffering heart attack who have been discharged with sleep problems from selected teaching hospitals of Isfahan University of Medical Sciences. Participants were placed in intervention and control groups through random allocation method. Two training sessions of calm making and guided imagery protocols were applied to the intervention group. The sleep quality in research units was examined before and after the intervention using Pittsburgh sleep quality questionnaire. Data analysis was carried out by the statistical software SPSS version 16 through paired and independent t-tests. Results: The mean sleep quality score in the intervention group was significantly lower after intervention (2.6 ± 2.3) (P < 0.001). Furthermore, the mean of changes in sleep quality score after intervention was significantly greater in the case group (−7.9 ± 2.3) compared to the control group (−2.9 ± 2.2) (P < 0.001). Conclusion: The guided mental imagery program was found to be effective in improving the sleep quality of the elderly suffering heart attack. The guided mental imagery is, therefore, recommended to be considered as a part of rehabilitation care for the elderly having heart attack with sleep disorders.
  1,312 20 -
The comparison of the tuition-paid and free tuition dental students' incentives in choosing their field of study at Ahvaz Jundishapur University of Medical Sciences, Southwest of Iran
Abdolreza Gilav
September-October 2017, 10(5):1254-1259
DOI:10.4103/ATMPH.ATMPH_316_16  
Background: Despite ascribed intellectual ability, academic success can be affected by progress motivation. Therefore, the aim of this study is to compare the tuition-paid and free tuition dental students' incentives in choosing their field of study at Ahvaz Jundishapur University of Medical Sciences in 2016 which has been carried out in a descriptive-analytical and comparative form. Methods: The statistical population includes all 484 students who study professional doctorate of dentistry at the University. Sampling was carried out using census method. The 118 free tuition students and 58 tuition-paid students filled out questionnaires. To analyze the data, descriptive statistics, frequency, frequency percentage, mean, Kolmogorov–Smirnov's normality test, and Mann–Whitney's nonparametric test for comparison of the mean were utilized using SPSS Version 21 software. Results: Having an independent clinic (0.75 ± 3.40), a high economic income (0.81 ± 3.16) and a proper social position (0.83 ± 3.09) were, respectively, the most important incentives in free tuition students to choose their field of study. In addition, having an independent clinic (0.53 ± 3.59), a proper social position (0.88 ± 3.17) and a high economic income (0.82 ± 3.09) were, respectively, the most important incentives for tuition-paid students to choose their field of the study. Discussion and Conclusion: Although access to a prestigious job and therefore, positions of high economic interests were the major motive of students in both groups, their excessive tendency toward dentistry has made the prospects of this field of study dim due to the saturation of the labor market and thus reduction of job mobility.
  1,309 20 -
A pilot study for the detection of Listeria in cerebrospinal fluid samples from children and adults with signs of meningitis admitted in a tertiary care hospital at Piparia Village, Vadodara, Gujarat, India
S Suguna Hemachander, Krunal K Shah, Yogita Verma, Anchal Malhotra, Himani Pandya, Khyati Passi
September-October 2017, 10(5):1243-1247
DOI:10.4103/ATMPH.ATMPH_268_17  
Introduction: Human listeriosis (HL) is a foodborne illness causing life-threatening disease of fetus, neonates, elderly, and others with immunosuppression. It is a public health concern because of the severity of disease. Listeria monocytogenes (Lm) has a predilection for central nervous system and placenta. Aims: To culture, cerebrospinal fluid (CSF) samples with special focus on the isolation of Lm. Materials and Methods: A prospective study on CSF samples with special focus on the identification of Lm by direct microscopy (wet film, Gram-stain) and culture on sheep blood agar and a plate of Listeria selective agar (Himedia). Results: 121 CSF samples were processed. Lm was isolated from blood and CSF samples from 8-day-old male neonate admitted with signs of septicemia and meningitis. The isolate was identified using Vitek 2 Compact; Biomerieux. The newborn was fed with goat milk on the 1st day after birth. Conclusions: As against the global focus on HL, documented cases from India are limited. The reasons and difficulties for poor isolation and diagnosis of Lm infections are discussed. Our single patient of neonatal meningitis as a case of community-acquired HL in our area is of significance.
  1,275 18 -
LETTERS TO THE EDITOR
The global public health challenge of malnutrition: Ensuring trend reversal
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1375-1376
DOI:10.4103/1755-6783.196635  
  1,248 27 -
ORIGINAL ARTICLES
An investigation of the frequency of the occupational accident in Kermanshah, Iran (2009–2013)
Masoud Ghanbari, Hossein Ashtarian, Hamed Yarmohammadi
September-October 2017, 10(5):1306-1311
DOI:10.4103/ATMPH.ATMPH_114_17  
Background: Occupational accident is an inseparable part of every work especially in the industrialized sections where it has huge adverse economic and social impacts on individuals' lives. Objective: The present study was aimed at investigating the frequency of occupational accidents in Kermanshah, West of Iran. Material and Methods: All registered occupational accidents in the Bureau of Labor and Social Affairs of Kermanshahfrom 2009–2013 were analyzed in this cross-sectional descriptive study. Using the pre-designed checklists, the required information that included demographic information of the casualties, type of job and industry, type of the accident, the limb affected in the accident, and the consequences was gathered. The collected data were then analyzed using software such EXCEL and SPSS 16. Results: Results indicated that the total number of the accidents were 1888 cases with 358, 393, 489, 402, and 246 cases occurring between 2009 and 2013. Kermanshah had the highest number of accidents (776) and Dalahoo had the lowest number of accidents (31). In total, 1455 accidents occurred in the morning shift, 391 in the afternoon, and 42 in the evening. Most of the accidents occurred between 10 am and 13 pm, and the lowest number accidents happened between 4 and 7 am. The most frequent accidents that were 1222 out of 1888 cases were related to construction industry occurring mainly in the form of injuries, fractures, and poisoning. Hand, leg, head, and neck were the most affected limbs during the accidents. The main causes of the accidents were fall from the height, getting trapped in the equipment, crashing into the objects and machinery, and slip and fall. Conclusion: Based on the result of this study and the high frequency of accidents in the workplace, more attention needs to be paid on the training of workers and employers about safety, following the safety rules, using individual safety tools, and controling some of the procedures to reduce the occupational accidents as much as possible.
  1,232 19 -
Relation between subjective sleepiness and changes in some vital signs among the clinical night workers
Alireza Khammar, Raze Nabi Amjad, Mitra Moghadasi, Marzieh Rohani, Arezoo Poursadeghian, Mahsa Hami, Mohammad Khandan, Hamed Yarmohammadi, Mohsen Poursadeghiyan
September-October 2017, 10(5):1179-1183
DOI:10.4103/ATMPH.ATMPH_303_17  
Background: Individuals with shift work sleep disorder are at risk for significant behavioral and health related such as emotional, psychological, and somatic issues. Sleeping problems in the health-care workers can lead to medication error incidents, resulting in undesired patients' safety. Objective: The aim of this study was to assess the relationship between the subjective sleepiness and changes in some vital signs of the night shift health care workers. Materials and Methods: This was a cross-sectional and descriptive-analytical study that has been done in a hospital in Iran, 2017. Clinical staffs were as the study population; all of them were in shift working schedule. Seventy-nine personnel were selected in random. Data gathered using a researcher-developed demographic questionnaire and Stanford Sleepiness Scale to measure the intensity of the sleepiness. Data were analyzed using t, ANOVA, and Pearson's tests by SPSS V20. Responders were aged 35.24 ± 6.35 (mean ± standard deviation) years. Results: Staff had the lowest amount of sleepiness at around 22:30 and the highest at the end of the shift. Sleepiness was significantly correlated with age, work experience, and body mass index (BMI), and level of education. A significant relationship was observed between age, work experience, BMI, and education level (P < 0.05). Beat and breath rates were in diverse and significant relationship with sleepiness (P < 0.05). Conclusions: Sleepiness in two studied groups was similar. Sleepiness can decrease beat and breath rates, so decision makers should pay attention to physical health of staffs, especially on health-care centers to increase staff and patients safety.
  1,224 18 -
Clomiphene resistant polycystic ovarian syndrome: Analysis of outcomes following laparoscopic ovarian drilling in infertile women in Ilorin, North-central, Nigeria
Lukman Omotayo Omokanye, Abdulwaheed Olajide Olatinwo, Abubakar Panti, Sabi Ibrahim, Kabir Adekunle Durowade, Olubukola Olanrewaju Oyedepo, Olufemi Ige, Majeed Babajide Adegboye
September-October 2017, 10(5):1292-1298
DOI:10.4103/ATMPH.ATMPH_774_16  
Background: Laparoscopic ovarian drilling (LOD) is one-off treatment modality for clomiphene citrate (CC)-resistant polycystic ovarian syndrome (PCOS) avoiding the need of medical therapy and its attendant complications. Aims and Objectives: This study aimed at determining the efficacy of LOD in women with anovulatory infertility secondary to CC-resistant PCOS and factors influencing reproductive outcomes. Materials and Methods: A cross-sectional study of infertile women who underwent LOD on account of CC-resistant PCOS between January 2012 and December 2015 at a tertiary institution. Results: Patients aged 24–38 years (29.7 ± 3.6 years) and their body mass index (BMI) ranges from 20 to 35 (26.3 ± 4.3). The majority (90.5%) were nulliparous. Most (61.3%) had primary infertility. Their duration of infertility ranges from 1 to 13 years (4.3 ± 2.7) and ovarian volume ranges from 10 to 24 cm3 (mean, right ovary = 15.2 ± 3.2; left ovary = 16.3 ± 3.2). The number of drills per ovary ranged from 4 to 14 (mean, right ovary = 7.4 ± 2.1; left ovary = 7.3 ± 2.1) and the luteinizing hormone/follicle stimulating hormone (LH)/FSH ratio ranges from 2 to 6 (3.2 ± 1.4). All achieved spontaneous resumption of menses and ovulation with mean durations of 4.0 ± 1.8 days and 5.3 ± 3.2 weeks, respectively. Eighty-three (60.6%) clinical pregnancies were recorded, of which 68 (49.6%) resulted to live births (61 singletons and 7 twin births) and 14 (10.2%) early first trimester miscarriages. The mean time interval from LOD to pregnancy was 4.4 ± 1.1 months. There was a significant association between BMI, duration of infertility, FSH/LH ratio, and pregnancy outcomes (P < 0.05). Conclusion: LOD is the most preferred treatment modality for CC-resistant PCOS as it resulted in higher pregnancy rate.
  1,221 19 -
Evaluating the understanding of nurses regarding pain management in neonatal units and special neonatal units of Qamar Monir Bani Haeshem Hospital in Khoy, Iran, in 2016
Soryya Zinalpoor, Shahriar Sakhaei, Hassan Ebrahimpour Sadagheyani, Linda Mehdizadeh Mollabashi, Hossein Motaaref
September-October 2017, 10(5):1286-1291
DOI:10.4103/ATMPH.ATMPH_327_17  
Introduction: Pain is a mental and multi-dimension phenomena, which its measurement and definition are difficult. Inability in expressing the pain clearly is the fundamental reason for the difficulty in pain measuring. Since newborns are unable to express their pains, to evaluate their pain quantitatively, valid, and standard tools should be used. The present study aimed to investigate the understanding of nurses about babies' pain in neonatal and special neonatal units of hospitals in Khoy. Materials and Methods: This is a descriptive and analytical cross-sectional study which was performed on 66 people by census method on nurses working in neonatal units and special neonatal units of Qamar Monir Bani Haeshem Hospital. Tool for collecting data includes 5 parts questionnaires containing demographic information, 7 questions related to understanding the pain of babies, 10 questions related to the effects of pain, 9 questions related to the tools of measuring the pain with criterion (true, false, I do not know), and the final part with 28 questions related to the attitude of measuring the pain in infants (I agree, I disagree). To determine the validity of the tool content validity was used and to determine the reliability Cronbach's alpha correlation test and preliminary study were performed (α = 0.82, α = 0.86). After coding, the data were described in frequency, mean, and standard deviation table using SPSS Version 16 software. To analyze the data statistical tests such as Pearson's correlation, t-test, and ANOVA were used (P < 0.05). Results: The majority of the participants were married (97%) with Bachelor education degree (95%) working in neonatal unit (45.5%) with a mean age of 33 years and servicing year of 8 years. The awareness rate of the physiology of pain, with the highest prevalence of 42.2%, complications and pain intensity by 45.5% were at good levels, and tools for measuring pain with 54.6% were poor. Nurses' attitude toward assessing and measuring the pain of babies with 54.5% was positive. Investigating the statistical relationships between the attitudes of nurses and awareness of severity and complications of pain (P ≤ 0.001), between the age and awareness of severity and complications of pain (P ≤ 0.002), and between the servicing year and awareness of pain physiology, severity, and complications of pain (P ≤ 0.003), significant statistical difference was found. Discussion and Conclusion: Based the results, focusing on pain of the babies and the infants in nursing education programs, holding the continuing education courses regarding the pain and pain assessment, and attaching pain assessment checklist for monitoring vital signs checklist and reporting it in each shift are recommended.
  1,197 19 -
LETTERS TO THE EDITOR
Preventing the outbreaks of food-borne botulism and minimizing the risk of fatality
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1360-1361
DOI:10.4103/1755-6783.196826  
  1,191 22 -
EDITORIAL COMMENTARIES
Continue the intensity of the ongoing prevention and control measures to contain the 2016 outbreak of yellow fever in Angola
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1099-1100
DOI:10.4103/1755-6783.217528  
  1,147 24 -
ORIGINAL ARTICLES
Comparison of two educational methods, lecturing and simulation, in adherence to ventilator set guidelines among emergency medicine residents
Hossein Saidi, Mahdi Rezai, Mani Mofidi, Reza Mosaddegh, Azra Riahi, Mohamad Tahmasbi Sisakht
September-October 2017, 10(5):1318-1321
DOI:10.4103/ATMPH.ATMPH_185_17  
Background: Due to developments in science, there is the need to develop approaches in the field of medical education. The utilization of educational technologies such as computers and instructional videos has been introduced rapidly into the education curriculum. This study compared video training tutorial method in ventilator settings with video traditional methods (lectures). Materials and Methods: In this statistical research, 33 assistant training groups lecture and video tutorial (video tutorial) were divided into two groups. The assistants in ventilator settings by observing the experimenter, the ventilators were assessed using the checklist. Research Findings: Adjusting the ventilator before and after training assistant was 13 (40%) and 18 (5.54%), respectively. However, in both groups after training, there was significant increase accuracy in the ventilator settings, but there was no significant difference between the two methods. Conclusion: The use of video tutorials and without training could be effective as attending lectures.
  1,086 18 -
Effects of cold alcohol compression on pain of preschoolers receiving intravenous fluid infusion
Atchariya Wonginchan, Sureeporn Thanasilp, Branom Rodcumdee
September-October 2017, 10(5):1169-1173
DOI:10.4103/ATMPH.ATMPH_269_17  
Purpose: The study aimed to determine the effects of cold alcohol compression on pain of preschoolers receiving an intravenous (IV) fluid infusion. Methods: In this quasi-experimental, four group study, 3–5-year-old children in the intervention groups (n = 20) received cold alcohol compression 1 min before IV insertion. The control group (n = 20) received conventional nursing care. The Children's Hospital of Eastern Ontario Pain Scale was used to assess pain intensity. The t-test was used to analyze pain. Results: The result indicated that the pain score of the experimental group was significantly lower than that of the control group (P < 0.01). Practice Implications: Cold alcohol compression is a time, cost-saving, and efficient method to reduce pain in preschoolers receiving the IV fluid infusion. Conclusion: Providing cold alcohol compression is the effective method which does not need intensive preparation.
  1,069 20 -
EDITORIAL COMMENTARIES
Necessity to strengthen prevention activities and expand treatment services to accomplish global elimination of Hepatitis C
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1101-1102
DOI:10.4103/1755-6783.217529  
  1,066 18 -
ORIGINAL ARTICLES
How is training hospitals of Qazvin preparedness against disaster in 2015?
Yousef Khazaei Monfared, Zahra Jamaly, Meysam Safi Keykale, Jalal Asgary, Mitra Khoshghadam, Seyed Amir Farzam, Soheyla Gholami
September-October 2017, 10(5):1205-1209
DOI:10.4103/ATMPH.ATMPH_267_17  
Introduction: Unexpected disasters such as floods, earthquakes, severe weather changes, bioterrorism, and epidemics around the world are increasing. Iran is a disaster-prone country and one of the most prone to accidents and disasters in the world. Hence, the aim of this study is to assess the disaster preparedness of hospitals in Qazvin. Materials and Methods: This cross-sectional, descriptive study was conducted on six hospitals of the Velayat, Rajaee, Booali, 22 Bahman, Kosar, and Ghods in Qazvin. The tools used to assess for the hospitals' risk of experiencing a disaster were observation, interviews, and a checklist of hospital disaster risk assessment which is provided by the World Health Organization (WHO), including 5 sections and 145 indices for the safety assessment of hospitals. To determine the general weight, three main parts of the questionnaire, that is, functional safety, nonstructural safety, and structural safety, were given weights of 0.2, 0.3, and 0.5, respectively, according to the original version of the indices. Each index was scored as 0, 1, and 2 based on the low, medium, and high scores. The safety scores were categorized in three groups, that is, low safety (≤34%), medium safety (34%–66%), and high safety (>66%). The data were analyzed by Excel 2007 and spss 17 software. Results: Functional, structural, and nonstructural safety scores were evaluated as 61.58% (average safety), 64.44% (average safety), and 61% (average safety), respectively. General preparedness of the hospitals we studied were 62.34%, an average safety level. Conclusions: Safety was evaluated in all hospitals at an average level. Although the hospitals' situation is not critical, because of the history of disaster in the province, it is very necessary to plan and carry out appropriate measures to improve hospital safety.
  1,056 18 -
LETTERS TO THE EDITOR
Thrombocytopenia and bleeding: Existed but little mentioned in Zika virus infection
Somsri Wiwanitkit, Viroj Wiwanitkit
September-October 2017, 10(5):1355-1356
DOI:10.4103/1755-6783.196753  
  1,048 22 -
ORIGINAL ARTICLES
The effect of life skills training program on quality of life and its dimensions in patients with type 2 of diabetes
Fariba Nasiri Ziba, Fatemeh Sadeghi Meresht, Naiemeh Seyedfatemi, Hamid Haghani
September-October 2017, 10(5):1174-1178
DOI:10.4103/ATMPH.ATMPH_276_17  
Background and Objective: Diabetes is a major cause of death and disability and worsening of public health which is a concern in the world. Patients with diabetes had significantly poorer mental health than normal subjects and patients are psychologically vulnerable. Therefore, life skills training can promote mental health and quality of life (QOL) of patients with diabetes. The aim of this study is to analyze the effect of life skills training on QOL in patients with type 2 of diabetes. Methodology: This research is a quasi-experimental study in which the effect on QOL and life skills training and its dimensions in patients with type 2 diabetes referred to health centers in Babolsar city. In this study, 100 patients with type 2 diabetes selected by convenience sampling in both experimental and control groups (each n = 50) were enrolled. To prevent data leakage, two centers were selected to test samples and controls separately; in this case, the experimental group and control group were selected from Arabkheil and Bahnamir health centers. For six 90 min, sessions for test group were trained in life skills. Moreover, after 6 weeks through QOL questionnaire (short-form 36), training effects in both groups were measured and compared. Data using Chi-square tests and t-test and Fisher's exact SPSS20 were analyzed using statistical software. Results: The mean scores at posttest in QOL (P = 0.005) and of energy and vitality (P = 0.002), mental health (P < 0.001), social functioning (P = 0.041), general health (P = 0.008) was a significant difference. Conclusion: The results of this study showed that life skills education program had an impact on the QOL in patients with type 2 diabetes.
  1,048 18 -
LETTERS TO THE EDITOR
Swine fluand lymphoma: A short summary
Somsri Wiwanitkit, Viroj Wiwanitkit
September-October 2017, 10(5):1354-1355
DOI:10.4103/1755-6783.196750  
  1,041 23 -
Prevention and control of Hepatitis A in developing nations: Public health perspective
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1382-1384
DOI:10.4103/1755-6783.196683  
  1,042 18 -
ORIGINAL ARTICLES
Investigating the relationship between the number of care provided and changes in the variables associated with diabetes in health homes and health centers affiliated to Lamerd Healthcare Network
Ebrahim Ezzati, Afshin Goodarzi, Mohammad-Rafi Bazrafshan, Foziyeh Faraji, Mahmood Rahmati, Amir Mansouri
September-October 2017, 10(5):1184-1188
DOI:10.4103/ATMPH.ATMPH_368_17  
Introduction: Diabetes influences the quality of life and the life expectancy of affected people and is an expensive disease to treat that imposes a heavy burden on the health and economy of each country. There have been few studies performed on the effectiveness of diabetes care in the clinical setting in Iran. Therefore, the aim of this study was to investigate the effectiveness of care in the clinical setting. Materials and Methods: This is a descriptive research, as an analysis of available data. Information about patients was extracted from the reports that submitted to Lamerd Healthcare Network. The criteria of the effectiveness of achieving the desired indicators in this study were in accordance with the goals of treatment of diabetes in country (Iran) about diabetic patients. Descriptive statistics and analytical statistics including Pearson's correlation coefficient and t-test were used to analyze the data. Results: About 59.7% of glycated hemoglobin (HbA1c) participants had <7% and 40.3% HbA1c >7%. About 45.3% of body mass index (BMI) participants had <25 and 54.7% of BMI >25. There was a significant relationship between the level of care and changes in hemoglobin glycolysis (r = 0.243, P < 0.05). Conclusion: In terms of achieving therapeutic goals for diabetes, blood pressure and BMI were within the acceptable range, but levels of fasting blood glucose and HbA1c were not in this range. Since there is a relationship between the changes of HbA1c and the number of physician care and health worker, it can be achieved by increasing the number of care for the purpose of treatment. Planning for weight loss in diabetic patients and increasing the number and quality of care for controlling blood glucose in Lamerd is recommended.
  1,041 19 -
Some aspects of the providing of medical and social assistance of elderly persons in the Republic of Kazakhstan
Alfiya I Igissenova, Botagoz S Tyrdalieva, Bakhyt Zh Nysanova, Meiramkul M Shayakhmetova, Zhazira M Utepbergenova, Serik Sh Shakiyev, Galiya S Ibadullayeva
September-October 2017, 10(5):1221-1227
DOI:10.4103/ATMPH.ATMPH_187_17  
Background: The demographic aging becomes a state problem for the majority countries, Kazakhstan is no exception: sharply increased the number of elderly and senile age people, which led to a number of problems caused by the aging of society, in connection with which the relevant improvement of medical and social assistance of elderly persons based on the study needs in the medical, social and psychological assistance. Methods: In the period from May 2016 for July 2016 was carried out complex research of the needs in the medical, social and psychological assistance to elderly persons in Almaty based on a specially designed questionnaire. The objects of this study are chosen by representatives of various socio-demographic groups (60 years and older), served in the clinics of the city. In total were interviewed 2996 elderly respondents, aged 60 years and older. Results: As an object of research are determined: Respondents' assessment of their health, financial situation, satisfaction with living conditions, some lifestyle factors, questions of life quality, needs in medical and social assistance. Conclusion: The analysis results of the study confirmed the urgency of activating the provision of medical and social assistance of elderly persons as well as low attendance of employees of social service of the elderly population, require regular monitoring of the activities of local governments and institutions, as well as officials for ensuring the rights of older disabled persons in the area of social services.
  1,026 18 -
EDITORIAL COMMENTARIES
Delivering comprehensive sexuality education among youths to eventually achieve human immunodeficiency virus-free generation
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1103-1104
DOI:10.4103/1755-6783.217530  
  1,013 18 -
ORIGINAL ARTICLES
Gastrointestinal carriage of Salmonella species and intestinal parasites, and nasal and hand carriage of Staphylococcus aureus among asymptomatic food handlers
Lona Dash, Ashvini Khaparde, Kumar Vivek, Jayanthi S Shastri
September-October 2017, 10(5):1195-1198
DOI:10.4103/ATMPH.ATMPH_200_16  
Background: Food borne diseases continue to be a public health problem globally. Food handlers (FHs) have been implicated in food borne outbreaks. Asymptomatic carriers go unnoticed and are thus an important source of pathogens. Aims and Objectives: This study was conducted to detect intestinal carriage of Salmonella species and parasites as well as nasal and hand carriage of Staphylococcus aureus (S. aureus) among asymptomatic FHs. Personal hygiene practices followed by them were recorded. Materials and Methods: A total of 300 asymptomatic FHs were studied. A semi-structured questionnaire was filled. Nasal swabs and finger impressions were taken on mannitol salt agar plates which were incubated overnight at 37°C; colonies suggestive of S. aureus were identified and confirmed by standard biochemical tests. Stool culture for Salmonella species was done on MacConkey agar, Xylose Lysine Deoxycholate agar and simultaneously inoculated in Selenite F broth for further processing; colonies suggestive of Salmonella species were identified by standard biochemical tests and Salmonella antisera (Denka Seiken, Japan). Stool-routine/microscopy for parasites was done by gross examination, direct saline, and iodine mount followed by concentration method (saturated salt solution). An arbitrary 10-point scale used in earlier studies was utilized for classifying the level of personal hygiene of FHs. Results: Salmonella Typhi was detected in stool culture of two FHs. Intestinal parasites detected in 10 (3.3%) subjects, included Ascaris lumbricoides (5;1.7%), Entamoeba histolytica (3;1.0%), and Giardia intestinalis (2;0.66%). S. aureus carriage was noted in anterior nares (116;38.7%) and hand (83;27.7%). A total of 149 (50%) FHs were S. aureus carriers. Conclusion: This study indicates that FHs may be a potential source of food borne pathogens.
  1,010 19 -
LETTERS TO THE EDITOR
Establishing connection among all through blood donation: Current status and public health implications
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1357-1358
DOI:10.4103/1755-6783.196825  
  985 26 -
Expanding the reach and utility of emergency medical teams to ensure appropriate management of disasters
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1356-1357
DOI:10.4103/1755-6783.196824  
  984 23 -
Cardiovascular diseases in low- and middle-income nations: Responding to the leading cause of mortality
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1397-1398
DOI:10.4103/1755-6783.196757  
  972 24 -
Noncommunicable diseases: Strengthening the process of data collection for potential risk factors
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1381-1382
DOI:10.4103/1755-6783.196677  
  964 27 -
Application of data available through health information systems in preventing maternal deaths
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1391-1392
DOI:10.4103/1755-6783.196752  
  964 24 -
Prevention and control of legionellosis: A public health perspective
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1370-1371
DOI:10.4103/1755-6783.196627  
  960 25 -
Public health measures to minimize exposure to arsenic and associated morbidities
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1388-1389
DOI:10.4103/1755-6783.196740  
  947 23 -
Ensuring delivery of integrated care for reducing the morbidity and mortality attributed to cardiovascular diseases
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1392-1394
DOI:10.4103/1755-6783.196754  
  939 24 -
ORIGINAL ARTICLES
Evaluation of risk factors impact on cataract development for uranium industry workers
Zhibek S Dautbayeva, Zeynet U Ahmedyanova, Polat K Kazymbet
September-October 2017, 10(5):1260-1264
DOI:10.4103/ATMPH.ATMPH_175_17  
The abundance and rough relative risk of cataract among 544 workers at the hydrometallurgical plant of Stepnogorsk Mining and Chemical Combine, depending on the total integrated dose of external irradiation, taking into account non-radiation factors, was studied. The conducted studies showed a statistically significant high abundance of ophthalmic pathology, including cataracts among workers in the main group compared with the control group. A statistically significant trend in the increase of cataracts with an increase in the total integrated dose, smoking index of more than 20 packs/year, increase in body weight and persons suffering from hypertension. As a result of a multivariate analysis of risk factors connection to cataract, we revealed that the cumulative dose and length of exposure are the main indicators predicting the development of cataracts for uranium industry adult workers. It is known that age is a key risk factor for many diseases, including cataracts. Lens opacity is a pluricausal manifestation, which is based on the mechanism associated with the course of time.
  939 19 -
LETTERS TO THE EDITOR
Responding to the rapid upsurge in the rise of overweight and obesity at global scale
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1384-1385
DOI:10.4103/1755-6783.196685  
  927 25 -
Ensuring availability of pregnancy and childbirth care services in conflict-affected regions of Syria
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1390-1391
DOI:10.4103/1755-6783.196748  
  924 24 -
Targeting asbestos across different industries to minimize the incidence of asbestos-related diseases on the global front
Saurabh R Shrivastava, Prateek S Shrivastava, Ramasamy Jegadeesh
September-October 2017, 10(5):1385-1386
DOI:10.4103/1755-6783.196698  
  919 26 -
Global health security: Transforming commitments into practical actions
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1387-1388
DOI:10.4103/1755-6783.196732  
  918 24 -
Extending humanitarian assistance to displaced pregnant women in armed conflict-affected nations
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1396-1397
DOI:10.4103/1755-6783.196756  
  915 25 -
Mobilizing youth population to spread peace in the conflict-affected regions of Central Africa
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1394-1395
DOI:10.4103/1755-6783.196755  
  894 23 -
How can we respond to the challenge of insufficient physical activity?
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1377-1378
DOI:10.4103/1755-6783.196636  
  886 23 -
Public health approach to minimize the prevalence and associated sequels of leishmaniasis in the affected regions
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1371-1372
DOI:10.4103/1755-6783.196628  
  879 25 -
EDITORIAL COMMENTARIES
Combating infectious diseases on the global scale in the era of the sustainable development goals
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1111-1112
DOI:10.4103/1755-6783.217535  
  880 19 -
LETTERS TO THE EDITOR
Elimination target for lymphatic filariasis attained in Sri Lanka and Maldives: World health organization
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1369-1370
DOI:10.4103/1755-6783.196626  
  851 23 -
Strengthening civil registration system on a global scale: Offering double benefit for the policy makers and the community
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1361-1362
DOI:10.4103/1755-6783.196602  
  847 26 -
Medical IT curriculum for local public health promotion: Expert comments on its way for actual implementation and operating
Bordinthon Jeenpea, Suphattra Wayalun, Wasana Kaewla, Viroj Wiwanitkit
September-October 2017, 10(5):1398-1399
DOI:10.4103/1755-6783.196641  
  846 23 -
Preventing the acquisition and progression of chronic Hepatitis B infection in middle and low income nations: World health organization
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1364-1365
DOI:10.4103/1755-6783.196619  
  832 26 -
Fast-tracking efforts to accomplish the global elimination of trachoma by 2020
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1366-1367
DOI:10.4103/1755-6783.196620  
  831 25 -
Aiming to achieve elimination of Chagas disease: Before it acquires a status of global public health concern
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1367-1368
DOI:10.4103/1755-6783.196623  
  828 23 -
Whether fractional dosing of yellow fever vaccine can be recommended to meet the challenges of the ongoing 2016 West African outbreak and the resulting vaccine shortage?
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1379-1381
DOI:10.4103/1755-6783.196650  
  820 26 -
EDITORIAL COMMENTARIES
Universal health coverage: Necessity, monitoring, and the vision ahead
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1107-1108
DOI:10.4103/1755-6783.217533  
  822 18 -
LETTERS TO THE EDITOR
Identifying gaps and recommending targeted strategies to ensure effective control of asthma
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1359-1360
DOI:10.4103/1755-6783.196601  
  811 23 -
Targeting the end of the AIDS epidemic in the era of sustainable development by the year 2030
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1374-1375
DOI:10.4103/1755-6783.196633  
  808 23 -
Targeting cervical cancer in low and middle income nations: Necessity of a comprehensive approach
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1363-1364
DOI:10.4103/1755-6783.196603  
  805 22 -
Dealing with the neglected issue of oral health: Building a global consensus
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1373-1374
DOI:10.4103/1755-6783.196630  
  804 23 -
Offering adolescent girls' centered care in developing nations: Fighting against all odds
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1378-1379
DOI:10.4103/1755-6783.196639  
  797 24 -
EDITORIAL COMMENTARIES
International agencies working together to empower adolescent girls in Mozambique: A community-based intervention
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1119-1120
DOI:10.4103/1755-6783.217539  
  781 18 -
Implementing maternal death surveillance and response through the Millennium Villages Project: World Health Organization
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1117-1118
DOI:10.4103/1755-6783.217538  
  770 19 -
Developing a mechanism to reduce after effects and track health workers affected by terrorism
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1113-1114
DOI:10.4103/1755-6783.217536  
  766 18 -
Young people acting as ambassadors for the accomplishment of women-related sustainable development goals
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1105-1106
DOI:10.4103/1755-6783.217532  
  766 18 -
Encouraging and expanding screening activities for cervical cancer in low-resource settings
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1121-1122
DOI:10.4103/1755-6783.217540  
  745 18 -
Meeting the sexual and reproductive health needs of young people in developing nations
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1115-1116
DOI:10.4103/1755-6783.217537  
  743 18 -
Building an effective mechanism to respond to the repeated outbreaks of cholera in the african region
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
September-October 2017, 10(5):1109-1110
DOI:10.4103/1755-6783.217534  
  743 18 -
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