Bahram Aminmansour; Mehdi Shafiei; Masih Sabouri; Mehdi Mahmoodkhani; Mehrnaz Hematzadeh; Donya Sheibani Tehrani
Abstract
Background: COVID-19 quickly spread around the world as an epidemic with potentially unknown hazards. Like its impacts on various occupations, neurosurgery has undergone changes due to the virus, including changes in surgical planning, inpatient and outpatient clinics, emergency management, and even ...
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Background: COVID-19 quickly spread around the world as an epidemic with potentially unknown hazards. Like its impacts on various occupations, neurosurgery has undergone changes due to the virus, including changes in surgical planning, inpatient and outpatient clinics, emergency management, and even academic activities.Objectives: The present study was performed to determine neurosurgery challenges during the COVID-19 pandemic in Iran.Methods: The present study was conducted as a mixed qualitative and quantitative study in 2021. In the qualitative section using the targeted sampling method, 11 members of the target community were selected using the available sampling method and completed a questionnaire. The qualitative part was conducted in two stages of reviewing texts and interviewing experts and in the quantitative part we evaluated the validity of the structure and the reliability of the questionnaire.Results: This study examined in detail all aspects of the effects of COVID-19 on neurosurgery. 9 dimensions and 61 items were identified as the challenges of neurosurgery during the COVID-19 pandemic. In order of importance, the aspects were: treatment outcome, manpower, management psychological and physical diseases, education and research, tools and physical space, ethics, financial implications and information technology.Conclusion: The outbreak of epidemics has different risks for specialties, among them neurosurgery. Accordingly, to observe patients’ right to treatment, all necessary measures were first taken to provide instructions, regulations, policies and ethical guidelines.
Manouchehr Avatef Fazeli; Arefeh Hedayati; Amrollah Dehghani; Mohamadreza Hedayati; Fatemeh Zaremehrjardi
Abstract
Background: Sleep disorders of breathing encompass a spectrum of disorders ranging from primary snoring to obstructive sleep apnea syndrome (OSAS), which leads to septoplasty in the most patients.Objectives: The aim of this study was to evaluate the effects of nasal septoplasty surgery on the severity ...
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Background: Sleep disorders of breathing encompass a spectrum of disorders ranging from primary snoring to obstructive sleep apnea syndrome (OSAS), which leads to septoplasty in the most patients.Objectives: The aim of this study was to evaluate the effects of nasal septoplasty surgery on the severity of OSAS.Methods: The current quasi-experimental self-controlled study was conducted on adult patients with deviated nasal septum and were candidate for nasal septoplasty. Before surgery and two months after surgery, patients underwent respiratory polygraph. The parameters assessed included the airflow and oximetry indices. The severity of sleep apnea will be assessed based on the ApneaHypopnea Index (AHI). Also, the severity of snoring was scored from zero to 10 based on the visual analog scale (VAS). The severity of daytime sleepiness was also determined using the Epworth Sleepiness Scale (ESS). Data were analyzed by using SPSS software.Results: There was a significant reduction in the mean score of ESS after the surgery (P<0.001), daytime fatigue (P=0.002), and daytime sleepiness (P<0.001). Also, breathing quality during sleep showed that the severity of apnea (P<0.001), snoring (P<0.001), as well as ESS (P<0001) were significantly improved. There were no significant changes in the means of oxygen saturation (P=0.14) and rapid eye movement (REM) sleep (P=0.06) after non-REM stage 1-2 (P=0.09), but following non-REM stage 3-4 significantly improved (P=0.03).Conclusion: The correction of nasal obstruction improved the general health of OSAS patients. These results further reflected that the corrective surgery could improve the patients’ emotional state and social performance, effectively upgrading their quality of life.
Ali Riazi; Mostafa Allami; Alireza Arabi; Mehrdad Larry
Abstract
Background: Craniosynostosis is a congenital deformity of the skull that occurs at birth.Objectives: This study aimed to investigate the frequency of different types of craniosynostosis in Isfahan, Iran.Methods: In this retrospective study, the records of all patients referred to the pediatric neurosurgery ...
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Background: Craniosynostosis is a congenital deformity of the skull that occurs at birth.Objectives: This study aimed to investigate the frequency of different types of craniosynostosis in Isfahan, Iran.Methods: In this retrospective study, the records of all patients referred to the pediatric neurosurgery clinic of Imam Hossein children’s hospital in Isfahan, Iran from 2013 to 2018 were diagnosed with craniosynostosis. Incomplete files were excluded. Demographic information of patients and type of delivery, underlying diseases of their parents, diseases of maternal pregnancy, type of craniosynostosis, syndromic or non-syndromic craniosynostosis were collected. Data were analyzed using SPSS software version 22.Results: The diagnosis of craniosynostosis in 63% of cases (n=121) was a single suture and in 37% of cases (n=72) was a complex suture. There was no significant difference in the frequency distribution of craniosynostosis in males and females (P>0.05).Conclusion: Due to the prevalence of 16 cases per 100,000, we can reduce the complications of this disease by educating doctors and parents.
Ahmad Chitsaz; Bahareh Rajol Dezfouli; Ahmad Rezaeian
Abstract
Background: Tinnitus is described as the perception of sounds occurring in one or both ears or inside the human head without external auditory stimuli.Objectives: This study aimed to compare the efficacy of amitriptyline and melatonin in the treatment of tinnitus.Methods: This study was a randomized ...
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Background: Tinnitus is described as the perception of sounds occurring in one or both ears or inside the human head without external auditory stimuli.Objectives: This study aimed to compare the efficacy of amitriptyline and melatonin in the treatment of tinnitus.Methods: This study was a randomized double-blind clinical trial of 60 patients referred to the neurology clinics of Kashani and Al-Zahra hospitals in Isfahan, Iran in 2020. Each patient was randomly assigned 1 code. Patients first filled in the THI and VAS questionnaires and were given either one of the two drugs (melatonin and amitriptyline) for 6 weeks. After collecting the desired information using an independent t test and paired t test in SPSS 26 software and error level of 0.05 the results were analyzed.Results: Thirty patients were in the amitriptyline group and 30 patients were in the melatonin group, of which 25 were men (41.7%) and 35 were women (58.3%) with a minimum age of 18 years and a maximum of 65 years. There was no significant difference between the reduction of tinnitus before and after taking the drugs based on VAS scale in amitriptyline and melatonin groups (P=0.234), however there was a significant difference between the effect of two amitriptyline and melatonin drugs on the reduction of tinnitus based on the THI questionnaire (P=0.018).Conclusion: The rate of tinnitus in patients decreased for 6 weeks with the use of amitriptyline and melatonin, but amitriptyline had a better effect on reducing the complications and pain of tinnitus.
Emmanuel O. Taiwo; Lateef O. Thanni; Oyesimisola P. Taiwo
Abstract
Background: The risk of developing diabetes mellitus for an individual with a positive family history of the disease is two-to fourfold higher in an offspring of a diabetic compared with offspring of non-diabetic.Objectives: This study aimed to assess the anthropometric parameters of offspring of type ...
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Background: The risk of developing diabetes mellitus for an individual with a positive family history of the disease is two-to fourfold higher in an offspring of a diabetic compared with offspring of non-diabetic.Objectives: This study aimed to assess the anthropometric parameters of offspring of type 2 diabetes mellitus (T2DM) patients in Sagamu, Nigeria.Methods: Study subjects were 100 offspring of consecutive T2DM patients’ attending a hospital endocrinology clinic. Diabetic offspring were exempted from the study. FBS was determined employing enzymatic hexokinase method. Height, weight, waist circumference (WC), and hip circumference (HC) were measured utilizing standard methods while body mass index (BMI) and waist-hip ratio (WHR) were calculated.Results: There were 50 males and 50 females study subjects, aged 16 to 65 years. The most populated aged group was 16 to 25 years of which 48.6% (n = 36) were males and 51.4% (n = 38) were females. Totally, 18 subjects were either obese or overweight. Significantly, male subjects had a greater mean weight compared to females (P = 0.021) while females had greater mean BMI (P = 0.037). Mean WHR was significantly higher among male subjects (P = 0.018).Conclusion: Common Anthropometric parameters are normal, female subjects tend to have higher BMI while males have higher weight and WHR.
Hemn Hassan Mohamed; Raouf Rahim Merza
Abstract
Background: The risk of fractured vertebral increases in patients with rheumatoid arthritis as they are more likely to suffer from osteopenia, and osteoporosis.Objectives: This study aimed to investigating the rate and risk factors of vertebral fractures in patients with rheumatoid arthritis.Methods: ...
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Background: The risk of fractured vertebral increases in patients with rheumatoid arthritis as they are more likely to suffer from osteopenia, and osteoporosis.Objectives: This study aimed to investigating the rate and risk factors of vertebral fractures in patients with rheumatoid arthritis.Methods: We recruited 201 patients aged between 30 and 70 who attended the rheumatology department at Shahid Hemn Teaching Hospital in Sulaymaniyah, between January and September 2022. Medical records were reviewed for disease and treatment characteristics while also clinically evaluated by a rheumatologist. Spinal radiographs were assessed by two experienced radiologists blinded to patients’ clinical diagnosis and status. Compression fractures were classified by using the Genant semiquantitative method, and the type of fracture was classified as wedged fracture, biconcave fracture, or crushed fracture.Results: Of the 201 included participants, 151 were female, and 50 were male. The BMI of women was higher than men by nearly four points (P<0.001). Most women were also illiterate (68/151, 45.0%) and unemployed (139/151, 92.1%). Hypertension (28.4%) and diabetes mellitus (14.4%) were the most reported comorbidities. Women were more likely to have higher DAS28 scores while men had more vertebral fractures (P=0.003). The probability of fractures increased with age, male sex, and illiteracy compared to primary school, osteopenia, and osteoporosis through simple and multiple logistic regression models.Conclusion: With at least one fracture affects females and males at a rate of 27.8% and 52.0%, respectively. Also reported that age, male sex, illiteracy, osteopenia, and osteoporosis significantly increase the risk of fractures.
Olayinka Stephen Ilesanmi; Aanuoluwapo Adeyimika Afolabi; Oladayo David Awoyale; Oluwatosin Enoch Fakayode
Abstract
Background: The health of healthcare workers (HCWs) is an indicator of the quality of health service provision during the COVID-19 pandemic.Objectives: This study aimed to describe the symptomatology and positivity of COVID-19 infection and the type of COVID-19 care received among HCWs in a North-Central ...
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Background: The health of healthcare workers (HCWs) is an indicator of the quality of health service provision during the COVID-19 pandemic.Objectives: This study aimed to describe the symptomatology and positivity of COVID-19 infection and the type of COVID-19 care received among HCWs in a North-Central State in Nigeria.Methods: This was a retrospective review of HCWs tested for COVID-19 as retrieved from the Surveillance Outbreak Response Management System between April 2020 and March 2021 in Kwara State, Nigeria.Results: Among the 1453 HCWs, 831 (57.2%) were above 35 years and, 874 (60.2%) were females. Among the 259 HCWs who tested positive for COVID-19, 122 (23.8%) lived in urban areas (χ2 = 13.94, P ≤ 0.001). Also, 83 (30.7%) of symptomatic persons tested positive for COVID-19 (χ 2 = 37.766, P ≤ 0.001). Overall, 33 (12.7%) of the 259 positive HCWs received hospital-based COVID-19 care, and 33 (16.1%) who had less than 2 symptoms received hospital-based COVID-19 care (χ2 = 9.962, P = 0.002). HCWs who had cough had three times odds of testing positive for COVID-19 (OR = 3.299, 95% CI = 1.571–6.927, P = 0.002). Also, HCWs who manifested loss of taste had three times odds of testing positive for COVID-19 (OR = 3.392, 95% CI = 1.010–11.393, P = 0.048).Conclusion: COVID-19 testing should be encouraged among HCWs, especially those with cough symptoms and loss of taste.
Raymond Ndikontar; Roddy Stephan Bengono Bengono; Albert Ludovic Amengle; Joel Noutakdie Tochie; Bonaventure Jemea; Junette Metogo Mbengono; Paul Owono Etoundi; Jacqueline Ze Minkande
Abstract
Background: There is scant data on the effectiveness and safety of adjuvant perioperative intravenous (IV) lidocaine in procuring postoperative analgesia and rehabilitation in gynecology surgery in low-resource settings.Objectives: To evaluate the effects of IV lidocaine on postoperative pain and rehabilitation ...
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Background: There is scant data on the effectiveness and safety of adjuvant perioperative intravenous (IV) lidocaine in procuring postoperative analgesia and rehabilitation in gynecology surgery in low-resource settings.Objectives: To evaluate the effects of IV lidocaine on postoperative pain and rehabilitation gynecology surgery.Methods: We carried out a randomized single-blinded controlled trial from April to August 2017 (5 months) at the Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Cameroon. The study population was made up of ASA 1 and 2, women admitted for elective gynecological surgery under general anesthesia divided into two groups of 17 patients: those to receive IV lidocaine and those to receive normal saline as placebo both intra-and postoperatively as an adjuvant to standard care. The variables studied included the additional doses of fentanyl, postoperative pain, side effects of lidocaine, time to first bowel sounds, the ease with which patients were mobilized and patient satisfaction.Results: Compared to patients in the placebo group, those in the lidocaine group had fewer mean amounts of fentanyl reinjections (P<0.0001), shorter recovery time (P=0.0044), reported lesser pain in the immediate postoperative period (P=0.012) till the 3rd postoperative hour (P<0.001), had more early postoperative bowel sounds (94.1% vs. 11.8%), rehabilitated earlier (P<0.001) and were more satisfied with pain management (P=0.001). The lone observed side effect of IV lidocaine was tolerable bradycardia in six (35.3%) patients.Conclusion: Adjuvant IV lidocaine can be effectively used in gynecological surgery, with the advantage of better postoperative analgesia, quicker rehabilitation and minimal side effects.
Mahdi Morshedi; Mohammad-Javad Babaei; Ali Bahramifar; Ebrahim Karimi; Shahriar Najafizadeh-Sari; Mehdi Raei; Hamed Gholizadeh
Abstract
Background: Supportive respiratory care and airway management are very important in treating COVID-19 patients with respiratory failure. There are two techniques for supporting patients with respiratory failure.Objectives: The current study aims to evaluate the efficacy and quality of patient care with ...
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Background: Supportive respiratory care and airway management are very important in treating COVID-19 patients with respiratory failure. There are two techniques for supporting patients with respiratory failure.Objectives: The current study aims to evaluate the efficacy and quality of patient care with early tracheostomy in intensive care unit (ICU) and compare mortality, hospital stay, and outcome between intubation and early tracheostomy.Methods: This study is conducted on total patients with confirmed COVID-19 in the ICU centers of a tertiary hospital. At the beginning of the study, all patients were intubated and connected to a mechanical ventilator. Within three days, the intensivists randomly performed bedside percutaneous dilational tracheostomy (PDT) for half of the patients. Early tracheostomy was defined as conducting tracheostomy within three days from intubation.Results: The total number of 36 patients was included in the study and categorized into two groups, including 18 patients in the early tracheostomy and 18 in orotracheal intubation. Half of the patients (50%) in the tracheostomy group were recovered from COVID-19 respiratory failure and discharged from ICU and hospital. All patients in the intubation group were expired. The length of staying alive in ICU in patients with an early tracheostomy was 26.47 ± 3.79 compared with 7.58 ± 2.36 days in intubated patients.Conclusion: The early tracheostomy compared with orotracheal intubation in respiratory failure patients with COVID-19 can significantly decrease mortality. However, airway management with an early tracheostomy increases the hospitalization stay and can increase recovery. So, conducting the early tracheostomy is recommended in this study.
Shervin Assari; Mona Darvishi; Arash Rahmani; Seyedeh Mohaddeseh Khatami; Izadrad Najand; Babak Najand; Hossein Zare
Abstract
Background: The broad scientific community generally associates high socioeconomic status (SES) with better health. However, the protective effects of high educational attainment on health may be weaker for racial and ethnic minorities than non-Latino White individuals. It is important to study whether ...
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Background: The broad scientific community generally associates high socioeconomic status (SES) with better health. However, the protective effects of high educational attainment on health may be weaker for racial and ethnic minorities than non-Latino White individuals. It is important to study whether this difference holds for chronic pain among Black and Latino individuals.Objectives: To compare the association between educational attainment and chronic pain in the US, considering the racial and ethnic background of individuals.Methods: The current study used baseline data from the Population Assessment of Tobacco and Health (PATH-Adults) study. All participants were 18+years old. A total number of 28204 Non-Latino, Latino, White, and Black individuals were enrolled. The outcome was chronic pain treated as a continuous measure. The predictor was educational attainment. Moderators were race and ethnicity.Results: Our linear regressions in the pooled sample showed that higher educational attainment was associated with a lower level of chronic pain; however, this association was weaker for Latinos and Blacks compared to non-Latino and White individuals. Our stratified models also showed that higher educational attainment was more consistently associated with a lower level of chronic pain for non-Latino White individuals than racial and ethnic minorities.Conclusion: The presumed protective effect of educational attainment against chronic pain among individuals varies between different racial and ethnic groups. Future research should test the role of stressful jobs and working conditions in weakening the protective effects of SES against chronic pain for Blacks and Latinos compared to non-Latino White individuals.
Soraya Shadmanfar; Gholamhosein Alishiri; Noushin Bayat; Morteza Izadi; Ahmad Salimzadeh; Abdolrahman Rostamian; Shahla Abolghasemi; Mohammad Hossein Azimzadeh Ardebili; Zeynab Rastgar Moqaddam; Marjan Hasani; Ehsan Rahmanian; Helia Iranpanah; Ghodrat Allah Islami; Amin Saburi
Abstract
Background: Among suggested medications for the treatment of COVID-19, chloroquine derivates and angiotensin-converting–enzyme inhibitors (ACEIs)/angiotensin II type 1 receptor blockers (ARBs) are the two medications with conflicting effects on the development of the disease.Objectives: The present ...
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Background: Among suggested medications for the treatment of COVID-19, chloroquine derivates and angiotensin-converting–enzyme inhibitors (ACEIs)/angiotensin II type 1 receptor blockers (ARBs) are the two medications with conflicting effects on the development of the disease.Objectives: The present study aimed to evaluate COVID-19 in patients with rheumatic diseases receiving chloroquine derivate.Methods: Every patient with proven rheumatologic diseases registered in two referral centers in Tehran and Alborz, Iran was enrolled in the present descriptive cross-sectional study between May and June 2020. At first, the symptoms of COVID-19 were assessed, and if a case had suspicious symptoms, reverse transcription-polymerase chain reaction (RT-PCR) COVID-19 tests were done. Demographic and clinical data are documented for every patient. Then, the patients were grouped once according to their COVID-19 infection status and another time according to their hydroxychloroquine use.Results: 1159 patients enrolled in the study with a mean age of 49.39 years. Frequency of hypertension was 22.17 %, diabetics (9.49%) and 20 (1.7%) patients were positive for COVID-19 testing. The most common symptoms of the COVID-19 positive cases were cough (5.2%) and fever (4%). There was no significant difference in receiving ACEIs/ARBs or other medications between COVID-19 positive or negative patients. Among the patients receiving hydroxychloroquine, 15 patients (1.7%) had proved COVID-19 versus 5 patients (1.7%) who were not receiving these medications (P>0.999).Conclusion: The present study demonstrated that receiving ARBs or ACEIs was not different among patients with or without COVID-19. Moreover, receiving chloroquine derivate was not related to the development of COVID-19 in patients with rheumatologic disorders.
Ali Riazi; Ali Abbasivand; Alireza Arabi; Mehrdad Larry
Abstract
Background: Craniosynostosis refers to the premature fusion of cranial sutures. Premature closure can impair brain development and cognitive problems. Only available treatment of craniosynostosis is through surgical intervention which is associated with excessive blood loss.Objectives: In this study, ...
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Background: Craniosynostosis refers to the premature fusion of cranial sutures. Premature closure can impair brain development and cognitive problems. Only available treatment of craniosynostosis is through surgical intervention which is associated with excessive blood loss.Objectives: In this study, we investigate the prevalence of each ABO/Rh blood group amongst patients with different types of craniosynostosis.Methods: We included 163 patients, under craniosynostosis treatment, in Imam Hossein children’s hospital at Isfahan, Iran. A retrospective analysis was performed and the frequency of blood groups as well as types of craniosynostosis were reported. Moreover, the connection between ABO/Rh blood groups and the types of craniosynostosis was examined by chi-square test.Results: Of 163 cases reviewed; The majority of participants had blood group A positive (32.5%), followed by O positive (31.3%). The rest of the blood groups were reported in order: B positive (22.1%), B negative (4.9%), AB positive (4.3%), O negative (2.5%), A negative (1.8%), AB negative (0.6%). Also, the most common type of craniosynostosis was metopic (27%) and the other types were pansynostosis (23.9%), sagittal (21.5%), coronal (16.6%), multisuture (10.4%) and lambdoid (0.6%) respectively. Due to connection between ABO/Rh blood groups and the types of craniosynostosis, no significant relationship was observed.Conclusion: Based on the results of the present study, it was found that the frequency of ABO blood groups in children with craniosynostosis can be different from the population of the same area. Also, the ratio of different types of craniosynostosis was different from previous data.
Shervin Assari
Abstract
Background: Perceived discrimination (PD) is a risk factor of suicidal thoughts and behaviors (STB) for children, youth, and adults. However, it is unknown whether the association between PD and STB frequency differs between African American (AA) and Non-Hispanic White children.Objectives: In this study, ...
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Background: Perceived discrimination (PD) is a risk factor of suicidal thoughts and behaviors (STB) for children, youth, and adults. However, it is unknown whether the association between PD and STB frequency differs between African American (AA) and Non-Hispanic White children.Objectives: In this study, we compared AA and non-Latino White children for the association between PD and STB frequency in a national sample of 9-10-year-old American children.Methods: This cross-sectional study used data from the Adolescent Brain Cognitive Development (ABCD) study, which included 7883 non-Latino White or AA children between the ages of 9 and 10. The predictor variable was frequency of PDs. Race was the moderator. The outcome variable was STB frequency, treated as a count variable, reflecting positive STB items endorsed over the life-course. Covariates included sex, age, marital status, household income, parental education, parental employment, trauma, and economic difficulties. Poisson regression was used for data analysis.Results: Of all the participants, 5994 were non-Latino Whites, and 1889 were AAs. Overall, PD frequency was positively associated with STB frequency. A statistically significant interaction was found between race and PD, suggesting that the association between PD and STB frequency is weaker in AA than non-Latino White children.Conclusion: The observed weaker association between PDs frequency and STB frequency in AA than non-Latino White children suggests that PD may be a less salient risk factor of STB frequency for AA than non-Latino White children. Researchers should explore factors other than PD for suicide prevention of AA children in the US.
Kamuran Cerit
Abstract
Background: Pandemics such as COVID-19 create heightened fear and anxiety, causing deterioration in the behaviours, social and psychological well-being of people. It can be thought that the anxiety levels of healthcare workers will increase more because they have a higher risk of contamination, work ...
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Background: Pandemics such as COVID-19 create heightened fear and anxiety, causing deterioration in the behaviours, social and psychological well-being of people. It can be thought that the anxiety levels of healthcare workers will increase more because they have a higher risk of contamination, work under COVID-19 isolation-measures and heavy workload.Objectives: The aim of this study is to determine the COVID-19-related anxiety levels of individuals, the ways of coping with, the demographic factors affecting anxiety, and whether the anxiety level of healthcare workers is different from others.Methods: This study was carried out with data obtained from 1017 participants via google forms between May-July 2020. In the collection of data, the 12-item COVID-19-related anxiety scale, which was developed by researcher and analysed for validity and reliability; 13 items for ways of coping; some demographic questions were used. The COVID-19-related anxiety scale consisted of three dimensions: “cognitive”, “physiological and emotional”, “behavioural”, which explained 71% of the variance. The Cronbach alpha of scale was 0.85.Results: The COVID-19-related anxiety levels of participants were slightly above the moderate level (2.83±0.72). The anxiety levels of healthcare workers were not different from others. There was a difference in anxiety levels according to demographic characteristics of participants, such as age, gender, living in Turkey or abroad, working status/type, and smoking addiction. Cognitive coping, social support, distraction, relaxation techniques were identified as ways of coping with anxiety.Conclusion: COVID-19 pandemic created anxiety in people. More studies need to understand the long-term effects of the pandemic.
Seyyedeh Farkhondeh Tayebnasab; Mohebali Rahdar; Farhad Hamidi; Hamid Raza Maleki
Abstract
Background: The cost of health care is a large part of every household’s budget. On the other hand, as an economic entity, the hospital is constantly faced with different aspects of cost and revenue. So, we are dealing with conflicting objectives.Objectives: The main purpose of the research is ...
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Background: The cost of health care is a large part of every household’s budget. On the other hand, as an economic entity, the hospital is constantly faced with different aspects of cost and revenue. So, we are dealing with conflicting objectives.Objectives: The main purpose of the research is to help financial management in a specialty hospital. This article provides part of operational research under bi-level optimization for hospital managers to provide targeted financial planning. The method is based on the fact that the objective is to maximize the hospital income on one level, and on the other level, the objective is to reduce the patient’s payment.Methods: The hierarchical and decentralized optimization problem is written as a bi-level model that minimizes patient costs and maximizes hospital revenues, which is an NP-Hard problem. The optimal solution to this problem is obtained using a genetic algorithm. Then, the hospital’s performance is evaluated by the Pabon Lasso diagram. It is shown that the use of this model has a significant effect on the hospital’s performance.Results: Implementation of this model in the studied hospital shows that patient payment costs decreased and hospital income increased (reaching equilibrium point).Conclusion: Hospital performance after model implementation was evaluated by the Pabon Lasso diagram and showed that it has an effective role in hospital performance.
Maged M. Yassin; Said S. Al-Ghora; Mohammed M. Laqqan; Saleh N. Mwafy; Soha A. Abdallah
Abstract
Background: Vitamin D deficiency is involved in a broad spectrum of diseases including chronic kidney disease (CKD).Objectives: This study was designed to assess serum vitamin D, renal biomarkers, protein profile, and electrolytes in CKD patients with a clinical trial of vitamin D therapy.Methods: This ...
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Background: Vitamin D deficiency is involved in a broad spectrum of diseases including chronic kidney disease (CKD).Objectives: This study was designed to assess serum vitamin D, renal biomarkers, protein profile, and electrolytes in CKD patients with a clinical trial of vitamin D therapy.Methods: This case-control follow-up interventional study comprised 42 CKD patients and 42 apparently healthy controls. Patients and controls were matched for age and gender. Patients were assigned to receive, a weekly oral dose of vitamin D3 (50000 IU) for 3 successive months. The follow-up therapy was conducted under direct and full physician supervision.Results: Vitamin D was significantly lower in CKD patients compared to controls (29.6±12.4 versus 35.2±9.9 ng/dL, P=0.033). Significant increases were shown in the urea, creatinine, and uric acid in patients compared to controls whereas glomerular filtration rate (GFR), total protein, albumin, and calcium were significantly lower in patients. A significant improvement was noted for vitamin D and calcium where they registered mean values of 43.8±9.1 ng/dL and 9.65±0.70 mg/dL at the end of the therapeutic period compared to 29.6±12.4 ng/dL and 8.61±0.77 mg/dL in patients before vitamin D therapy (P=0.028 and P=0.033, respectively).Conclusion: General amelioration of the metabolic profile of CKD patients in response to vitamin D therapy has been shown. Besides a significant improvement in vitamin D and calcium. Consequently, vitamin D is a useful candidate in clinical settings for the improvement of renal function and controlling of CKD, and more importantly its complications.
Tuba Erdem Sultanoğlu; Hasan Sultanoğlu
Abstract
Background: Overcrowding of emergency departments (EDs), which are not suitable places to treat chronic pain and are responsible for managing acute disorders, leads to prolonged waiting times, delays in treating conditions requiring rapid intervention, patient dissatisfaction, and chaos and exhaustion ...
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Background: Overcrowding of emergency departments (EDs), which are not suitable places to treat chronic pain and are responsible for managing acute disorders, leads to prolonged waiting times, delays in treating conditions requiring rapid intervention, patient dissatisfaction, and chaos and exhaustion in the ED.Objectives: Examine the characteristics of patients who presented to the ED with non-malignant chronic pain to determine the frequency of use and factors that caused ED use.Methods: This cross-sectional study was conducted in an ED. Three hundred ninety-two patients with chronic pain were included.Results: The mean age of the patients was 48.1 ± 15.3 years, 62.2% were female, and 37.8% were male. Of the patients, 59.2% were married, 42.6% had elementary school education, and 56.1% were unemployed. The most common cause of ED admission was low back pain (LBP), the 32.7% used non-steroidal anti-inflammatory drugs, 16.3% used opioid analgesics, 15.8% used anticonvulsants, 13.2% used anticonvulsants antidepressant drugs, 22% did not use any medication. The reasons for presenting to the ED for chronic pain were 13.3% for medication prescription, 74.5% for receiving analgesics, and 12.2% for a diagnosis. The mean Patient Health Questionnaire-9 (PHQ-9) scale score of the participants was 12.82 ± 3.98, which indicated moderate depressive symptoms. The mean Generalized Anxiety Disorder-7 scale score was 9.84 ± 3.23, which indicated mild generalized anxiety disorder.Conclusion: Instead of trying to suppress pain, emphasis should be put on preventing overcrowding in EDs, which are intended to manage acute conditions rather than chronic pai
Mehdi Mahmoodkhani; Soroush Najafi; Mehdi Shafiei; Shohreh Jafari
Abstract
Background: The COVID‑19 pandemic has caused severe complications, deaths, and damage to societies, and the disease course is unpredictable and ranges from asymptomatic infections to multi‑organ failure and death.Objectives: The present study determined the frequency of neurosurgeries canceled owing ...
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Background: The COVID‑19 pandemic has caused severe complications, deaths, and damage to societies, and the disease course is unpredictable and ranges from asymptomatic infections to multi‑organ failure and death.Objectives: The present study determined the frequency of neurosurgeries canceled owing to the asymptomatic COVID‑19 in the patients.Methods: The present study was descriptive‑analytical and was conducted on all neurosurgeries in Kashani hospital, Isfahan, Iran in 2021. Moreover, 116 (52.5%) out of 2100 neurosurgeries were canceled, among which 41 cases (35.4%) were related to asymptomatic COVID‑19. The necessary data were extracted from the information in the patients’ medical files and were included in the data collection forms. The data were analyzed in SPSS 22 after collection.Results: Among 41 people, whose neurosurgery was canceled, 7 had asymptomatic COVID‑19 with few or mild symptoms, and 34 were asymptomatic. The patients of the two groups with asymptomatic and symptomatic COVID‑19 were significantly different in age, albumin level, C‑reactive protein, and serum creatinine (P<0.05) as the mean age, albumin, and C‑reactive protein levels were lower, and serum creatinine was higher in the group of patients with asymptomatic COVID‑19.Conclusion: The prevention of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infections played a crucial role in the unhindered transmission of this virus and was the turning point in controlling the pandemic.
Humberto Guanche Garcell; Ariadna Villanueva Arias
Abstract
Background: Coronavirus disease 2019 (COVID-19) pandemic has been associated with various risks, including the exposure of infectious agents.Objectives: The study aims at describing the incidence of blood and body fluid (BBF) exposure in a COVID-19 facility so as viral transmission potential through ...
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Background: Coronavirus disease 2019 (COVID-19) pandemic has been associated with various risks, including the exposure of infectious agents.Objectives: The study aims at describing the incidence of blood and body fluid (BBF) exposure in a COVID-19 facility so as viral transmission potential through blood.Methods: A descriptive study of BBF exposure notified was carried out in a community hospital in Qatar.Results: In 2020, 29 needlesticks injuries were reported, which is a significant increase compared to the year 2019 (6 incidents) and 2018 (5 incidents). No evidence of SARS-CoV-2 transmission was shown concerning the injury using symptoms monitoring and lab test.Conclusion: The increased risk of BBF exposure during the pandemic provides insight into the need to review the prevention practices of occupational exposure during pandemics. Additional studies are required to define the risk of COVID-19 related to occupational exposure to BBF.
Kazem Hassanpour; Marjan Vejdani; Mozhdeh Navi Nezhad; Mehdi Jalili Akbarian; Esmat Davoudi-Monfared; Parastoo Amiri
Abstract
Background: Owing to the crucial role of nutrition with breast milk for both the mother and infant, the implementation of programs that support breastfeeding seems essential.Objective: This study aims to determine the effect of post-delivery telephone counseling on the rate of exclusive breastfeeding ...
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Background: Owing to the crucial role of nutrition with breast milk for both the mother and infant, the implementation of programs that support breastfeeding seems essential.Objective: This study aims to determine the effect of post-delivery telephone counseling on the rate of exclusive breastfeeding among infants.Methods: This study, as a randomized clinical trial, investigated 170 women who delivered their children in the Sabzevar Shahidan Mobini hospital, Iran in 2017. After acquiring the written informed consent, the researchers randomly assigned the subjects into two groups, including the telephone counseling recipient group (intervention) and the telephone counseling non-recipient group (control). The data collection instruments were questionnaires and checklists. The collected data were analyzed by the SPSS 18 software.Results: The findings of the study showed that 73.8% of the counseling non-recipient group had exclusive breastfeeding, and 26.2% did not have exclusive breastfeeding. In the telephone counseling recipient group, 90.4% exclusively breastfed their infants, while 9.6% did not. Thus, there was a statistically significant difference between the two understudy groups (P<0.05).Conclusion: This research revealed that although mothers were trained how to breastfeed when they were pregnant or were discharged from hospitals, and exclusive breastfeeding was emphasized, implementing the counseling program, even telephonic, and responding mothers’ questions regarding breastfeeding and prevalent problems in this period could be helpful in the first two months after delivery.
Reza Bidaki; Hamid Mirhosseini; Nahid Zare
Abstract
Introduction: The motor function is associated with the activity of both the motor and prefrontal cortices. The efficacy of transcranial direct current stimulation (tDCS) over specific brain cortices has been examined in many psychiatric and neurologic disorders. This study aims to report the tDCS effects ...
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Introduction: The motor function is associated with the activity of both the motor and prefrontal cortices. The efficacy of transcranial direct current stimulation (tDCS) over specific brain cortices has been examined in many psychiatric and neurologic disorders. This study aims to report the tDCS effects on two females of advanced age with idiopathic Parkinson’s disease (PD).Case Presentation: We considered 50-minute sessions of bilateral primary motor cortices and left dorsolateral prefrontal cortex (DLPFC) anodal stimulation using tDCS with passive stretching exercises simultaneously for a total of 20 sessions in 7 weeks. Clinical signs and electroencephalography (EEG) waveform were assessed at distinct times. Both of the two patients showed improved motor function for a short time. EEG changes to some extent concerned clinical states.Conclusion: It seems that tDCS can be an auxiliary treatment for motor dysfunction in PD; however, further studies must be carried out to prove the claim.
Mojtaba Sepandi; Yousef Alimohamadi; Mousa Imani
Abstract
Background: Outbreak detection algorithms could play a key role in public health surveillance.Objectives: This study aimed to compare the performance of three algorithms (EWMA, Cumulative Sum (CUSUM), and Poisson Regression) using the reported COVID-19 data for outbreak detection.Methods: Three outbreak ...
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Background: Outbreak detection algorithms could play a key role in public health surveillance.Objectives: This study aimed to compare the performance of three algorithms (EWMA, Cumulative Sum (CUSUM), and Poisson Regression) using the reported COVID-19 data for outbreak detection.Methods: Three outbreak detection algorithms were applied to the data of COVID-19 daily new cases in Iran between 19/02/2020 and 20/06/2022, and 344 simulated outbreak days were injected into the data sequences. The Area Under the Receiver Operating Characteristics (ROC) Curve (AUC) and its 95% confidence intervals (95% CI) were also computed.Results: EWMA9 had the lowest AUC (51%). Among the different algorithms, EWMA9 with λ = 0.9 and CUSUM 1 had the highest sensitivity with 100 and 87% (95% CI: 84%-91%), respectively.Conclusion: According to the results, CUSUM, EWMA, and poison regression showed appropriate performance in detecting the COVID-19 outbreaks. These algorithms can be extremely helpful for health practitioners and policymakers in the detection of infectious disease outbreaks.
Leila Ahmadi; Fatemeh Sadat Marashian
Abstract
Background: Healthcare workers are in close contact with patients and have serious responsibilities for the health and life of people. Moreover, dissatisfaction of employees with their jobs has a negative impact on the quality of services and ultimately leads to dissatisfaction of patients.Objectives: ...
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Background: Healthcare workers are in close contact with patients and have serious responsibilities for the health and life of people. Moreover, dissatisfaction of employees with their jobs has a negative impact on the quality of services and ultimately leads to dissatisfaction of patients.Objectives: The present study aimed to investigate the relationship between work engagement and professional ethics with organizational intelligence in healthcare workers through the mediating role of organizational support.Methods: The statistical population included all healthcare workers of Ahvaz (Iran) in 2022, 137 of whom were selected through convenience sampling. In this descriptive-correlational study, the Pearson correlation coefficient and mean structural equation modeling were employed for data analysis. The research instruments included the Utrecht Work Engagement Scale, the Professional Ethics Questionnaire, the Organizational Intelligence Questionnaire, and the Survey of Perceived Organizational Support.Results: According to the findings, there was a positive relationship between professional ethics and organizational support (β = 0.27, P = 0001). There was a positive relationship between organizational intelligence and work engagement in healthcare workers (β = 0.22, P = 0.003). There was also a direct relationship between organizational intelligence and organizational support (β = 0.51, P = 0.001), and a direct relationship between organizational support and work engagement (β = 0.35, P = 0.001). There was an indirect relationship between professional ethics and work engagement (β = 0.05, P = 0.002) as well as organizational intelligence and work engagement (β = 0.10, P = 0.001) mediated by organizational support.Conclusion: The final model had a good fit. The present study's results should be considered an essential step toward identifying the factors affecting the job performance of healthcare workers.
Charles Owusu-Aduomi Botchwey; Agartha Afful Boateng; Regina Brown; Francis Acquah; Farrukh Ishaque Saah; Vivian Kruh; Adwoa Otiwaa Ekanem; Yvonne Boatemaa-Yeboah
Abstract
Background: Hand hygiene has been recognized as an upfront yet a vital practice that halts the transmission of nosocomial contagions or healthcare-associated diseases in hospital locations. In healthcare organizations, hand hygiene is an important component of contagion prevention and protects patients' ...
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Background: Hand hygiene has been recognized as an upfront yet a vital practice that halts the transmission of nosocomial contagions or healthcare-associated diseases in hospital locations. In healthcare organizations, hand hygiene is an important component of contagion prevention and protects patients' safety as a low-cost intervention.Objectives: The objective of the present study was to evaluate hand hygiene practices among public health nurses in Trauma and Specialist Hospital and Winneba Municipal Hospital in the Effutu Municipality in the Central Region of Ghana.Methods: This study employed a quantitative approach with a descriptive cross-sectional design. Structured questionnaires were used to collect data from 100 respondents through simple random sampling technique. Data analysis was done using Statistical Package for Social Sciences (SPSS), version 21.Results: Findings revealed a low level of knowledge on hand hygiene (45%) among the respondents and a high hand hygiene practice (79%). Most of the respondents always washed their hands immediately after a risk of body fluid exposure (95%) and few always washed their hands before touching a patient (60%). Most of the respondents always rubbed soap on wet hands before rinsing (78%) and few of them always allowed their hands to dry (16%). The barriers which prevented most of the respondents from washing their hands in the health facility were busy work schedules (65%), forgetfulness (61%), lack of hand hygiene resources in the health facility (38%), minimal patient contact (37%) and lack of knowledge on hand hygiene (13%).Conclusion: Respondents in this study exhibited a low level of knowledge on hand hygiene yet, hand hygiene practice among them was found to be somewhat satisfactory. The study recommends that multifaceted and dedicated efforts must be made to rectify the barriers which impede public health nurses from effectively complying with hand hygiene practices in the health facilities.
Saidyaghoob Sehri
Abstract
Letter to Editor
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Letter to Editor