Baqiyatallah University of Medical SciencesHospital Practices and Research2476-390X3220180501Arrhythmias in Patients With Pulmonary Hypertension; A Narrative Review of the Current Literature37436053410.15171/hpr.2018.09ENDirk BandorskiUniversity of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL), Klinikstrasse 33, 35392 Giessen, GermanyReinhard HoeltgenKlinikum Westmünsterland, St. Agnes-Hospital Bocholt Rhede, Medical Clinic 1 – Cardiology/Electrophysiology, Barloer Weg 125, 46397 Bocholt, GermanyJournal Article20171212Incidence and prognostic relevance of supraventricular arrhythmias were evaluated in nine studies. These studies investigated patients with different forms of pulmonary hypertension. Supraventricular arrhythmias were more often found in patients with group two pulmonary hypertension. Common findings in these patients were elevated right atrial pressure and diameters and reduced tricuspid annular plane systolic excursion (TAPSE). Elevations in other parameters like systolic pulmonary arterial pressure, mean pulmonary arterial pressure, and pulmonary vascular resistance (PVR) were inconsistent. Most of the patients with arrhythmias suffered symptoms and improved after sinus rhythm (SR) was restored. The prognostic relevance of non-sustained ventricular tachycardia was evaluated in only one study. Non-sustained ventricular tachycardia does not seem to be prognostically relevant. Extending Holter electrocardiogram (ECG) monitoring over 24 hours up to 72 hours raises the detection rate of arrhythmias. Ablation of arrhythmias, especially atrial flutter and atrioventricular node reentry tachycardia, is feasible and safe in these patients.https://www.jhpr.ir/article_60534_2f70f67355c0e63f29a74848a915cad0.pdfBaqiyatallah University of Medical SciencesHospital Practices and Research2476-390X3220180501A Study of Cerebral Performance Categories Based on Initial Rhythm and Resuscitation Time Following In-Hospital Cardiac Arrest in a State Hospital in Turkey44496071410.15171/hpr.2018.10ENFaruk CicekciDepartment of Anesthesiology, Medical Faculty, Selcuk University, Konya, Turkey0000000232480745Ali Ulvi UcaDepartment of Neurology, Necmettin Erbakan University, Medical Faculty, Konya, Turkey0000-0002-5783-8061Inci KaraDepartment of Anesthesiology, Medical Faculty, Selcuk University, Konya, TurkeyIskender KaraDepartment of Anesthesiology, Konya State Numune Hospital, Konya, TurkeyJournal Article20171123<strong>Background:</strong> The cerebral performance category (CPC) score is widely used in research and quality assurance to assess neurologic outcome following cardiac arrest. However, little is known about the results of the CPC in Turkey.<br /> <strong>Objective:</strong> This study aimed to determine whether the CPC is associated with the initial rhythm and resuscitation time following resuscitation from in-hospital cardiac arrest.<br /> <strong>Methods:</strong> This study compared the CPCs (CPC 1-2 and CPC 3-4-5) of patients discharged from the hospital after surviving cardiopulmonary arrest (CPA) during a 2-year period between June 2013 and June 2015 (at discharge, and at 6th, 12th, 18th, and 24th months) based on the initial rhythm (asystole/pulseless electrical activity and ventricular fibrillation/pulseless ventricular tachycardia) and resuscitation time (0–14 min and 15–30 min) at the time of arrest.<br /> <strong>Results</strong>: No difference was found between CPC 1-2 and CPC 3-4-5 scores at discharge or at 6th, 12th, 18th, and 24th months in terms of the first rhythm and resuscitation time (P > 0.05).<br /> <strong>Conclusion:</strong> Patients discharged from the hospital following in-hospital cardiopulmonary resuscitation (CPR) were found to have no difference in 2-year CPC scores with respect to cardiac rhythms and resuscitation durations at the onset of resuscitation.https://www.jhpr.ir/article_60714_ecfe8541441cf26beb98b8d5a13c5032.pdfBaqiyatallah University of Medical SciencesHospital Practices and Research2476-390X3220180501Understanding Patients’ Meal Experiences through Staff’s Role: Study on Malaysian Public Hospitals50586053810.15171/hpr.2018.11ENReena Kumari VijayakumaranNutrition & Dietetics Department, School of Health Sciences, Health Campus, University Sains Malaysia, Kelantan, Malaysia0000-0002-9597-9981Anita EvesFaculty of Business, Economics and Law, School of Hospitality and Tourism Management, University of Surrey, Guildford, Surrey, UKMargaret LumbersFaculty of Business, Economics and Law, School of Hospitality and Tourism Management, University of Surrey, Guildford, Surrey, UKJournal Article20180131<strong>Background:</strong> One way to improve hospital food provision is certainly by understanding the management of hospital foodservices, but there is limited detailed information about staff roles in food provision in many hospitals around the world.<br /> <strong>Objective:</strong> The hospital meal experience of patients, a part of the services provided by hospitals, is becoming important. Therefore, the role of various hospital staff members was studied through their behavior, attitudes, and practices so as to understand how the foodservice system works to address patients’ food consumption.<br /> <strong>Methods:</strong> This qualitative research used the convenient sampling method. Data was collected by interviewing twenty hospital employees with different job scopes (nurses, doctors, dietitians, foodservice managers, and directors of hospital foodservices) in 6 public hospitals.<br /> <strong>Results:</strong> Themes such as <em>providing familiar food, food as the motivational factor for consumption, empathy shown by staff, and influences of the eating environment</em> were identified using content analysis.<br /> <strong>Conclusion:</strong> The viewpoints and experiences of key stakeholders facilitated the understanding of various factors involved in the provision of hospital food which affect patients’ decisions to accept and consume food.https://www.jhpr.ir/article_60538_2dce76b65e58aa8b58d5804639648345.pdfBaqiyatallah University of Medical SciencesHospital Practices and Research2476-390X3220180501Intrapleural Fibrinolysis in Post-tubercular Loculated Pleural Effusions at a Tertiary-Care Respiratory Center: An Uncontrolled Blinded Before-After Intervention Study59636071610.15171/hpr.2018.12ENNarayanan SubramanianArmy College of Medical Sciences and Base Hospital, New Delhi, India0000-0002-5153-3136Debajyoti BhattacharyyaArmy Hospital Research and Referral, New Delhi, India0000-0001-9999-6765Inam Danish KhanArmy College of Medical Sciences and Base Hospital, New Delhi, India0000-0002-9824-8711Vishnu PrasadArmy College of Medical Sciences and Base Hospital, New Delhi, IndiaArun KotaruVenkateshwara Hospital, Dwarka, New Delhi, IndiaVasu VardhanArmed Forces Medical College, Pune, IndiaKapil PandyaArmy College of Medical Sciences and Base Hospital, New Delhi, IndiaJournal Article20171209<strong>Background:</strong> Tuberculous, parapneumonic and traumatic loculated pleural-effusions pose therapeutic challenges due to resultant pleural-thickening and compromised lung-function for life. Tuberculosis is widely prevalent in developing countries, necessitating appropriate, effective, and economical treatment for loculated pleural-effusion to reduce the burden and sequelae.<br /> <strong>Objective:</strong> An uncontrolled and blind before-after intervention study to determine the effectiveness of intrapleural fibrinolytic therapy (IPFT) using urokinase in loculated pleural effusions was conducted at a tertiary-care respiratory center after obtaining approval and written informed consent.<br /> <strong>Methods:</strong> Fifty-one patients with loculated pleural effusion were administered with repeated cycles of three doses of 1 Lakh IU of urokinase intrapleurally until complete drainage of pleural fluid. Pre- and post-IPFT clinical and radiological responses were compared using removal of fluid, ultrasound, and chest radiography were compared. The Kolmogorov-Smirnov test and paired t test with significance at a P value less than 0.05 were applied to test statistically significant differences in proportions and means, respectively.<br /> <strong>Results:</strong> Tuberculosis was the most common etiology leading to loculated pleural effusion (80%), and 82.4% of tuberculosis patients required at least two cycles of IPFT. Complete resolution in chest radiograph after IPFT was observed in 80.4% of patients. Chest pain (13.7%) and fever (9.8%) were the most common undesired effects associated with IPFT. A statistically significant reduction in mean intrapleural fluid levels pre- and post-IPFT from 184±81 ml to 67±52 ml was observed.<br /> <strong>Conclusion:</strong> IPFT with urokinase is an effective treatment modality in patients with post-tubercular loculated pleural effusions. IPFT has minimal and tolerable undesired effects and prevents sequelae such as pleural thickening and consequent compromise of respiratory function.https://www.jhpr.ir/article_60716_913555d0fefa13cd7dcc8d9d4d6c97a8.pdfBaqiyatallah University of Medical SciencesHospital Practices and Research2476-390X3220180501Occupational Stress and How to Confront It: A Case Study of a Hospital in Shiraz64686152310.15171/hpr.2018.13ENTahereh ShafaghatDepartment of Health Services Management, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8681-0423Mohammad Kazem Rahimi ZarchiDepartment of Health Services Management, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran0000-0002-6122-2737Zahra KavosiDepartment of Health Services Management, School of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran0000-0001-8662-7987Journal Article20180223<strong>Background:</strong> Although all jobs can be stressful, occupational stress is an important issue in jobs that deal with human health. Evidence indicates that nursing is a stressful occupation.<br /> <strong>Objective:</strong> This research evaluated factors affecting occupational stress and strategies for coping with it.<br /> <strong>Methods:</strong> This cross-sectional descriptive-analytic study was conducted in 2015. The study population comprised all nurses at Shahid Rajaee hospital, from whom 190 nurses were selected by random sampling. Data was collected by questionnaire and analyzed using SPSS software (version 19), Pearson correlation coefficient tests, Mann-Whitney tests, and t tests.<br /> <strong>Results:</strong> Occupational stress was rated as moderate among the studied nurses. Significant positive correlations were found between occupational stress level and less effective coping method, occupational stress level and work experience level, and ineffective coping methods and age. Moreover, a significant difference was seen between men and women in terms of emotion-focused coping.<br /> <strong>Conclusion:</strong> According to the research findings, occupational stress was at a moderate level among the studied hospital nurses, indicating that the authorities need to focus on efforts to reduce occupational stress for nurses.https://www.jhpr.ir/article_61523_0bae8d6856b65aa8ef73c4491cabc723.pdfBaqiyatallah University of Medical SciencesHospital Practices and Research2476-390X3220180501Delusion of Pregnancy as a Somatic-Type Delusional Disorder in a Young Male From the South of Iran69706154810.15171/hpr.2018.14ENReza BidakiResearch Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, IranDiabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran0000-0002-5482-9143Bonnie BozorgTehran University of Medical Sciences, Tehran, IranMohammad AyatollahiShahid Sadoughi University of Medical Sciences, Yazd, IranMehrdad RoozbehMedical Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, IranJournal Article20171130<strong>Introduction:</strong> Delusion of pregnancy is a bizarre delusion in which one feels s/he is carrying a fetus. The etiology is unknown, but aloneness, masturbation, and stress may precipitate this disorder.<br /> <strong>Case Presentation:</strong> We introduce a young, single man who has delusions of pregnancy. This type of delusion is not a well-known disorder; based on investigated articles, this type of somatic delusion is rare.<br /> <strong>Conclusion:</strong> This was a chronic case, the exact cause and development of which was unknown. We suggest this phenomenon as a novel symptom. No similar case was found in the literature.https://www.jhpr.ir/article_61548_fcb64893e18955afb6a985d691bfad85.pdf