---

 Background & Objective: The quality of services given to emergency patients at a hospital as well as these patients ’ satisfaction of the services is an index of overall services in that hospital. This study is an attempt to evaluate the degree of satisfaction among the patients referring to the emergency rooms of the hospital of Ardabil University of Medical Sciences during fall and winter 2000.

 Methods: In this cross-sectional prospective study, 600 emergency patients referring to emergency rooms of Alavi, Fatemi, Buali and Aliasghar hospitals were selected. They filled a questionnaire. The data were analyzed by SPSS software.

 Results: The findings indicated that 78.1% of the whole subjects were generally satisfied with the services. The greatest degree of satisfaction belonged to specialty services (93.8%) and the physicians ’ and nurses ’ contact (92.3% and 91.8% respectively). The least degree of satisfaction belonged to hospital charges (40.2%), and unavailability of non-emergency drugs in hospital pharmacy (42.9%).

 Conclusions: According to the results of this study the medical centers need to offer more coverage of national health insurance services. Furthermore it seems necessary to equip these emergency rooms with round the clock pharmacies and provide the required drugs.

---

 Background & Objective: Each year thousands of children under five years old die due to acute respiratory infection and diarrheal diseases. A huge number of infants and children are hospitalized and visited by the physicians whereas most of these diseases can be prevented with timely treatment. Child health maintenance and improvement is one of the most important considerations in each society. Moreover, identifying child morbidity patterns should be a matter of concern in order to improve the health services. This study provides an overview of the leading causes of hospitalization among children with the aim of determining the most important causes of hospitalization and offering appropriate strategies to decrease them.

 Methods: This cross-sectional study was conducted in 2001 in Ardabil Ali-Asghar hospital. The subjects were randomly selected from the admission list on a daily basis. A questionnaire including demographic characteristics such as age, sex, time of admission and primary diagnosis was completed for each subject. The data were analyzed by SPSS software using descriptive statistics.

 Results: A total of 1945 patients were admitted almost half of which were studied. Febrile convulsion was found to be the most common cause of hospitalization (26%) while gastroenteritis (22.1%) and pneumonia (20%) were in the second and third order. Other causes included epilepsy, drug poisoning, meningitis, mumps, drug encephalitis, asthma, etc.

 Conclusion: According to the findings of this study, standard case management is necessary especially about febrile convulsion which is the most common cause of hospitalization. Since the present pattern is different from similar studies, further investigations are required to identify its causes.

---

  Background and Objective: Staphylococcus aureus is known as an important pathogen causing a variety of bacterial infections. Treatment of this bacterium with antibiotics has led to antibiotic-resistancey, especially against methicillin (MRSA) and more recently rare resistance against vancomycin. The aims of this study were to determine nasal carriage rates of S. aureus in Meshgin Shahar Valiasr hospital’s personnel and to determine antibiotic-resistance patterns in the mentioned isolates.

  Methods: Staphylococcus aureus isolates were collected from the nose of 200 hospital personnel in Meshgin Shahar Valiasr hospital in a 2 month period in 2006. Antibiotic sensitivity of the collected strains were tested against antibiotics used in routine treatment of S. aureus infections. Oxacillin agar was also used to screen for MRSA according to NCCLS recommendation.

  Results: Our results showed there were 45% and 16% nasal carrier rate for S. aureus and MRSA (methicillin resistant staphylococcus aureus) strains, respectively in hospital personnel. Thirty two isolates were able to grow in oxacillin agar media, indicating 35% MRSA strains. Antibiotic resistant pattern of strains in disks method were recorded as follows: 35% to oxacillin, 97.8% to penicillin, 34% to erythromycin, 2.1% to chloramphenicol, 39.36% to tetracycline, 11.7% to gentamicin, 30.85% to trimetohoprim sulfamethoxazol and 19% to clindamycin. All of the isolates were sensitive to vancomycin and ciprofloxacin.

Conclusion: In this study, nasal carriage rate of Staphylococcus aureus among hospital Personnel was more than community expected rate (%40) and lower than hospital expeeted rate (%50-80). All of the test strains were sensitive to Vancomycin.

---

  Background & Objectives: Nosocomial infections occur following admission of patients in the hospitals and usually are accompanied by significant mortalities. This study was conducted to determine the frequency of nosocomial infections and the causatives in Ardabil Bu Ali hospital during 2010.

  Methods: This study was a cross-sectional study which has been done on collection of information through practical examinations, laboratory tests and files of nosocomillay infected patients in Ardabil Bu Ali hospital during 2010. Data were analyzed by SPSS.

  Results: From a total of 3254 patients, 42 (1.3%) had got nosocomial infections. Of these infected patients 47.6% was males and 52.4% was females. Infection was more frequent in patients with ages between 1 month to1 year old (45.2%). Sepsis (33.3%), pneumonia and blood stream infections (23.8%) and urinary tract infection (19%) were the most frequent infections. The mean length of hospital stay was 26.86 days. Klebsiella pneumoniae was the most common pathogen reported (23.8%). Infection was more common in NICU (38.1%).

  Conclusion: In this study, the frequency of nosocomial infection was lower than other studies. Distribution of infection differed with age, ward and length of stay in the hospital.

---

  Background & objectives: At the present time, health care services have been increasingly transformed to a competitive issue and many factors influence usage of hospital services and selection of a hospital by the patients. This study has been performed for surveying effective factors on selecting a public or private hospital among non-emergent patients of Ardabil hospitals in 2012.

  Method: This research was a cross-sectional descriptive-correlational study and the statistical population was non emergent patients of four public and two private hospitals of Ardabil in 2012. The samples (598 patients) were collected by stratified random sampling method. Data-gathering tool was a researcher-made questionnaire and data were analyzed by descriptive statistics, frequency [distribution] tables, and logistic regression analysis.

  Results: The results depicted a direct interdependence between selecting a hospital (public or private) and the three factors of social elements, hospital services, and hospital facilities with a confidence coefficient of 92%. Based on logistic regression analysis and Exp(B) coefficient, the patients’ priorities for hospital choosing were hospital services, social elements, and hospital facilities with Exp(B) of 1.932, 1.332, and 0.338, respectively.

  Conclusion: The most important factor for choosing public hospitals was lower cost of services and for private hospitals was physician’s recommendation. The strong effects of these two factors have overshadowed other variables.

---

Background & objectives: Parasitic infections are among important health problems all over the world especially in developing countries. Considering the epidemiological importance of parasitological diseases and necessity to evaluation the parasites prevalence in different areas and populations, current study aimed to determine the prevalence of intestinal parasites in patients admitted to the laboratories of Baqiyatallah Hospital in Tehran.

Methods: This is a retrospective cross sectional study in which stool examination reports of all referred patients (70978) to central and emergency laboratories of Baqiyatallah hospital were evaluated during 2010-2014. In this course, at least one stool sample of patients was assessed by direct smear and formalin-ethyl acetate methods. The data were analyzed using descriptive statistics in SPSS 16. Chi-square test was used for comparison of the prevalence.

Results: From 70978 patients, 42421(59.77%) and 28557(40.23%) were male and female, respectively. From 2617 infected individuals, 1841(70.3%) and 776 (29.7%) were males and females, respectively. The prevalence of pathogen and non-pathogen intestinal parasites was 2283(87.23%) and 334(12.76%) respectively. Also the prevalence of intestinal helminthes and protozoa in infected population was 0.42% and 99.57%, respectively. Blastocystis hominis and then Giardia lamblia were the prevalent parasites.

Conclusion: In current study the prevalence of parasites is lower than those reported in other investigations. Differences in geographical location, sample size, duration and type of study (prospective or retrospective) and study population may be effective agents. The higher prevalence of "Blastocystis hominis" in comparison with other parasites can attract more attention to improve the quality of laboratory and clinical diagnosis of this protozoa

---

Background & objectives: Coronary artery disease (CAD) is the most common cause of mortality and disability around the world. Determination of the health status and spatial and temporal patterns of the disease prevalence has a major role in health planning.
This study aimed to investigate the spatiotemporal pattern of CAD in Ardabil Province.
Methods: This descriptive and cross-sectional study was performed using the data belonging to 60156 patients with history of hospital admission due to CAD in Ardabil Province during 2010-2015. Hospitalization Rate (HR) was calculated after classification of the data in terms of location and date of hospitalization. The spatiotemporal and demographic variables, including age, gender, type of CAD, periods and duration of hospitalization were analyzed by descriptive statistics, ANOVA and repeated measures in SPSS v23 statistical software. Spatial distribution maps were drawn for each month and year in ArcGIS 10.2.
Results: Of 60156 hospitalized patients with CAD diagnosis, men (58%) were more in number than women (42%). The majority of hospitalized patients fell in the age range 60-69 years (25.3%), and 92.40% of patients were hospitalized for less than 7 days. An ascending pattern was observed in temporal hospitalization trend in Khalkhal and a descending trend in Ardabil. The lowest hospitalization rate, however, was observed in Kosar city despite the ascending trend. During the research period, the greatest decline in hospitalization rate was observed in temporal trend in Bilasuvar, Meshkinshahrand Namin cities, and the largest increase was observed in Germi, Pars-Abad and Kosar cities.
Conclusion: By using the comprehensive technology, GIS, spatiotemporal distribution and CAD trend during 2011-2015 were modeled in Ardabil province. Spatiotemporal trend of CAD in Ardabil province and allied cities indicated the necessity of paying more attention and studying community for further prevention of the disease. Community-based interventions should be implemented for prevention of risk factors of CAD during childhood and adolescence especially in the districts with high risk.

---

Background & objectives: Parasitic diseases are one of the health problems of all societies and are considered as barriers to progress socioeconomic development, especially in most developing countries. This study evaluated the frequency of intestinal parasites in patients referred to hospitals affiliated with Ardabil University of Medical Sciences in 2018.
Methods: a total of 409 stool samples were collected from laboratories of Imam Khomeini and Bouali hospitals and then transferred to the parasitology lab in the medical and paramedical school. Samples were evaluated using direct, concentration and culture methods. Data were analyzed using SPSS software version 21.
Results: Out of 409 samples, 22 cases (5.4%) were infected with intestinal parasites. Among them, 5.3% and 5.4% of infected cases were men and women respectively. Also, the rate of infection to the protozoans and helminths was 3.7% and 1.7% respectively. Among the positive cases, the highest percentage of infection was related to Giardia and Blastocystis.
The infection rate of each parasite among all patients and positive cases was 1.2% and 22.7% respectively.
Conclusion: The present study showed that intestinal protozoan infection, especially Giardia lamblia and Blastocystis hominis are high in Ardabil city, and therefore special infection control measures are urgently needed.
 

---

Background & objectives: The main motivator of hospitals is manpower. The expansion and complexity of educational medical centers and the appearance of new diseases such as Covid-19 have increased the need for effective management. During the Covid-19 crisis, in which hospitals are at the forefront, special measures should be taken for better management in critical situations. The current study has been conducted with the aim of identifying the main factors affecting management in crisis and its control.
Methods: The study method was the "Mix Method" performed in two stages. The first stage was exploratory; in this stage 19 university experts as a research sample were selected by simple random sampling. The second stage was a quantitative, confirmative, and survey study. 202 patients were selected randomly as a research sample from both educational-medical centers involved in Covid-19 of Ardabil city. Data were collected by using a questionnaire. Descriptive analysis of data was performed using SPSS software for heuristic factor analysis, and LISREL software was also used for confirmatory factor analysis and finding correlations between factors.
Results: In this study, 17 factors were identified and confirmed, affecting the crisis management in 5 dimensions, including; safety training, crisis control, trust in human resources, sense of vulnerability, the physical and mental health, transparency, justice, participation in decision-making, trust in the manager, honesty, the expectation of needs, efficiency, reward, elimination of stresses, fulfillment of manager's promises, controlling of crisis, inter-sectorial solidity. There was a significant correlation between factors with latent variables.
Conclusion: From the perspective of management, being prepared and training the committed forces are very important in controlling the crisis. Manpower plays the main role in the Covid-19 crisis and treating patients, so paying attention to them by considering the factors and dimensions of leadership, social, motivation, organization, and quickness has high importance.
 

---

Background & objectives: One of the main effective factors in combating gastric cancer is having good health literacy in the community. The aim of this study was to determine the health literacy of gastric cancer in clients and patients admitted to Imam Khomeini Medical Center in Ardabil.
Methods: The present study was a cross-sectional study. The sample of this study consisted of clients and patients admitted to Imam Khomeini educational -medical center in Ardabil in the second half of 2019. The sample size was 320 people which were randomly sampled. Researcher-made tools were used after ensuring validity and reliability. The questionnaire had two parts: demographic characteristics and items of health literacy dimensions. Patients' informed consent was obtained before completing the questionnaire. Data were collected by nurses and entered into SPSS-26 software. By using descriptive and analytical statistical parameters such as frequency and frequency percentage, mean and standard deviation, t-test and ANOVA analyzed.
Results: The mean and standard deviation of the age of participants was 42.98±14.35. The overall level of health literacy about stomach cancer was calculated as 31.13. The average gastric cancer health literacy in five dimensions in the clients and patients of Imam Khomeini educational-medical center in Ardabil was calculated as follows: access to health information resources was 38.02±10.6, reading health information was 13.47±4.41, understanding health information was 30.37±6.9, evaluation of health information was 16.73±4.58 and decision-making and application of health information was 58.49±10.77. Apart from reading in other dimensions of health literacy, no significant difference was found between clients and inpatients.
Conclusion: The results of this study showed that the mean score of health literacy of clients and patients admitted to Imam Khomeini medical center in Ardabil from gastric cancer is low and not sufficient. Considering the role of health literacy in energy storage, cost and time management of the individual's disease, it is necessary to plan and perform more efficient interventions to promote health literacy in the community, especially clients and patients admitted to Ardabil educational medical centers on gastric cancer.