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Table of Contents
October-December 2016
Volume 4 | Issue 4
Page Nos. 109-142
Online since Tuesday, December 27, 2016
Accessed 22,416 times.
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ORIGINAL ARTICLES
Presentation of a fuzzy model for the crisis management during an earthquake in a Tehran Bus Company
p. 109
Amir Mahmoudzadeh, Peiman Sanandaji
DOI
:10.4103/2347-9019.196762
Introduction:
Tehran is the capital of Iran and Tehran Province. With a population of around 9 million in the city and 16 million in the wider metropolitan area, Tehran is the largest city and urban area of Iran, the second-largest city in western ASIA, and the third-largest city in the Middle East. It is ranked 29
th
in the world by the population of its metropolitan area, and the urban planning in crisis is the critical part of city management.
Materials and Methods:
In this study, we review literature on crisis management theories, approaches, and models of crisis management and the importance of this issue in Tehran public transport by extracting the functional components of transport management by the times of crisis. A research in Tehran Bus Company as one of the most important factors within urban transport during the years 2012 and 2013 conducted to assess the human impact among various factors, logistics, and factors related to buildings and inventory management through the use of expert opinions and research library and taking into account the behavioral patterns of residents and users of municipal services and various crisis scenarios.
Results:
It conducts behavioral model of urban transport services (Tehran Bus Company) and the strategic model in three stages. Information, technology, and the development of model behavior after the earthquake, the current situation from three perspectives, and single company-fleet-building of human resources ultimately provide a model for crisis management phase during an earthquake in the city of Tehran bus. We want to know how we can improve this mode of public transportation during an earthquake.
Conclusion:
The main purpose of this study is finding the main and underlying features of crisis management that in line with the cited purpose, and general framework for crisis management during earthquakes was established. According to the results of this study after determination of the strengths and weaknesses' points of the organization in crisis management, the organization can identify suitable approach and appropriate strategies for crisis management during earthquake and employ best practices in order to enhance crisis management in the organization and maintain their strengths and reinforce weaknesses and destroy barriers that reduce crisis management in organization.
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Learning from Chennai floods to mitigate epidemic
p. 114
TS Selvavinayagam
DOI
:10.4103/2347-9019.196767
Objective:
The experience of Government of Tamil Nadu handling Chennai floods 2015 in preventing the occurrence of epidemic is critically analyzed and presented. This simple methodology in epidemic prevention is useful and replicable in needed situations.
Materials and Methods:
The mechanism of controlling the epidemic through organizing screening camps, vector control, monitoring of water supply, sanitation and surveillance mechanism, etc., is described in detail.
Results:
Based on the Integrated Disease Surveillance Programme reports, which is part of a monitoring mechanism, we could show that occurrence of major epidemic following the floods was prevented through our efforts.
Conclusion:
This simple model of epidemic mitigation, which we practiced in Chennai, is useful and replicable in any disasters even with limited resources in any part of the globe.
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Emergency police station location to provide municipal services after earthquake (Case study: Kerman)
p. 120
Masoud Mojarad Kahani, Iran Ghazi, Zohre Nejad Akbari, Zahra Hosseini
DOI
:10.4103/2347-9019.196772
Background:
Proper planning and selection of places to construct emergency stations (temporary) is very important in reducing the effects of crises. Emergency stations must be established in proper areas with perfect opportunity compared to areas where the crises risk is further to act effectively in the shortest time and provide various municipal services.
Aims:
In this study, we examined the emergency station location in order to provide municipal services during natural disasters (earthquake). Then, we determined suitable places for construction of centers based on principles and location factors.
Subjects and Methods:
The research method is descriptive-analytic study based on approach and nature; also, it is applied in terms of study aim. The statistical population consisted of specialists and experts with experience in this area and study area is Kerman city. We used geographical information system (GIS) maps to access the options.
Results:
Eighty-one final options of emergency police stations were proposed for Kerman after conducting the necessary investigations in ArcMap and combining maps, and then we prioritized them in three groups through combining the corresponding subcriteria weights of GIS.
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Prognostic predictors of patients admitted in Intensive Care Unit through emergency ambulance services
p. 126
Prasad A Rajhans, Priya Yogesh Kulkarni, Dhananjay S Kelkar, Sameer A Jog, Gouri Ranade, Sonal Utpat, Varsha Hande
DOI
:10.4103/2347-9019.196793
Background:
Lot of progress has been made in emergency medical services (EMSs) in India in private and government sectors. Very few studies are done focusing the prognosis of patients utilizing EMSs.
Aim:
This study aimed to analyze the prognostic predictors of patients admitted in Intensive Care Unit (ICU) through EMSs.
Materials and Methods:
It was a hospital records-based study. EMS patients who were admitted in ICU were included in the study. Patients with a poor prognosis were defined as who died within 48 h of ICU admission, and patients who were stable and shifted to other wards after 48 h of ICU admission were defined to have a good prognosis. A person with medical background was trained to extract all the socioclinical information from hospital records from January 2013 to December 2014. Patients with incomplete records were excluded from the study. Data were entered in Microsoft Excel and imported in SPSS 15.0 software for analysis. Frequencies and proportions were enlisted. Associations were tested by Chi-squared test. Significant variables were entered in logistic regression model.
Results:
We included a total of 151 records in the study. Nearly 40.40% of the patients (61/151) had a poor prognosis while 59.60% (90/151) had a good prognosis. Baseline characteristics did not differ in both the groups (P > 0.294). In univariate analysis, breathlessness, anuria as purpose to call EMSs, severe condition as per Glasgow Coma Scale (GCS), and lifesaving interventions done during the transport were associated with a poor prognosis (P = 0.001, 0.029, <0.001, <0.001, and <0.001, respectively). Breathlessness as purpose of call and severe GCS of the patients were the independent predictors of poor prognosis after logistic regression analysis. Comorbidities were not associated with the poor prognosis.
Conclusion:
Assessment of GCS on call itself will help give highest priority to patients with severe condition and breathlessness, prescribe medicines before arrival of emergency team at the scene and to dispatch appropriate level of ambulance (advanced life support, basic life support, and specialty care transport) in resource-poor situations.
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Knowledge, attitude, and practices regarding radiological modalities among health-care providers, Karachi, Pakistan
p. 132
Mubashir Zafar, Aroob Farhan, Tooba Shaikh, Rida Rafiq, Salwa Usman, Hafsa Abrar, Madiha Saleem, Hafsa Naz, Nazia Haider, Sidra Khan, Arsalna Javed
DOI
:10.4103/2347-9019.196794
Background:
Health-care providers are unaware of the hazards associated with the use of radiation. Requesting radiological examinations send to underestimate hazards and have poor knowledge about the possible risks to the health of the patients. There are no any studies regarding awareness of radiation among health-care providers in Pakistan. The objective of the study is to assess the knowledge, attitude, and practice (KAP) regarding radiological modalities among young doctors in hospital.
Methodology:
It is a cross-sectional study and was conducted from February to July 2016. Convenient sampling was used. One hundred and sixty participants were selected. House officers and postgraduate's students were included, and structured validated questionnaire was used. Logistic regression was used to determine the association between sociodemographic characteristics and their KAPs level.
Results:
Majority of study participants had appropriate knowledge (72%), positive attitude (70%) but unsafe practices (65.5%). After adjustment of covariates, house officers and those order <30 investigation had more than two time inappropriate knowledge (odds ratio [OR]: 2.374, confidence interval [CI]: 0.836-6.379), (OR: 2.319 CI: 0.817-6.581), respectively, and more than one time negative attitude (OR: 1.372 CI: 0.491-3.835), (OR: 1.304 CI: 0.481-3.532), respectively. Female participants had more than one time unsafe practices (OR: 1.867, CI: 0.789-4.421).
Conclusion:
Health-care providers had appropriate knowledge, positive attitude, but unsafe practices because of lack of facilities in public sector hospitals. Proper providence of required facilities in health facilities will improve their practices.
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Candiduria: Managing a therapeutic challenge diagnostically
p. 139
Trupti Bajpai, Meena Varma, Ganesh S Bhatambare, Maneesha Pandey, Hariom Sharan
DOI
:10.4103/2347-9019.196795
Introduction:
Candida species are among the most common fungal pathogens that are capable of initiating infections in both immunocompetent and immunocompromised individuals. Candidiasis is rightly called as the "disease of diseased." Candiduria is regarded as "red flag" or "surrogate marker" for associated high mortality among patients.
Aim:
The aim of this study was to determine the prevalence of Candida species among women patients suffering from urinary tract infection.
Materials and Methods:
The present prospective study was conducted in the Department of Microbiology of a teaching tertiary care hospital located in Indore. A total of 96 Candida species isolated during June 2014 to November 2015 from female urine samples were subjected to species identification by microscopic, biochemical, enzymatic, and automated methods.
Results:
Among the 96 Candida species, 25% isolates were Candida albicans, 70.8% were non-albicans Candida, and 4.1% were identified as Geotrichum candidum. Candida glabrata (37.5%) predominated among all the species, followed by C. albicans (25%), Candida tropicalis (16.6%) and Candida krusei (16.6%).
Conclusions:
The finding of candiduria in a patient should neither be dismissed nor empirically treated but requires a careful and logical evaluation. The non-albicans Candida terror should be highlighted to manage the therapeutic challenge successfully.
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