Mohsen Saberi Isfeedvajani
Mohammadkarim Bahadori; Seyed Mojtaba Hosseini
Devon Evans; Margaret Burnett
Abstract
Background: Minimally invasive hysterectomy is generally preferable to abdominal hysterectomy. The technicity index (TI) is the proportion of hysterectomies performed by minimally invasive surgery. Many centers globally have started to audit local TI as a quality indicator, but only a handful have published ...
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Background: Minimally invasive hysterectomy is generally preferable to abdominal hysterectomy. The technicity index (TI) is the proportion of hysterectomies performed by minimally invasive surgery. Many centers globally have started to audit local TI as a quality indicator, but only a handful have published their results to help define international standards of care. Objective: In this study, TI was examined in Winnipeg and Canada to determine consistency between local and national patterns of practice, audit expected changes, and contribute to the growing body of literature defining international standards of care. Methods: A retrospective cross-sectional database review of hysterectomies performed in the Winnipeg Regional Health Authority (WRHA) from 2008 to 2015 was conducted. Mixed effects linear regression models were generated primarily to analyze TI and account for surgeon and hospital characteristics. The Canadian Institute for Health Information (CIHI) database was accessed to estimate the average national TI from 2009 to 2014. One-sample t tests compared annual WRHA and CIHI TI. Results: In Winnipeg, 1363±32 hysterectomies were performed annually for all indications with an average TI of 34% independent of time (P=0.09). The CIHI database recorded approximately 27 000 hysterectomies annually with increasing TI (41%-52%, 3.5±1.8%/year, P=0.025). WRHA TI differed from national TI every year (P<2.2x10-16). Conclusion: Over the study period, WRHA TI was below the Canadian average and static despite national increases. The importance of local audits to identify underperformance and stimulate initiatives for quality improvement is highlighted in this study.
Mohsen Vatandoost; Sanaz Litkouhi
Abstract
In this review article, we aim to depict how healthcare facilities may look in the near future from an architectural design point of view. For this purpose, we review newly introduced technology and medical advances in the field of healthcare, such as artificial intelligence (AI), robotic surgery, 3D ...
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In this review article, we aim to depict how healthcare facilities may look in the near future from an architectural design point of view. For this purpose, we review newly introduced technology and medical advances in the field of healthcare, such as artificial intelligence (AI), robotic surgery, 3D printing, and information technology (IT), and suggest how those advances may affect the architectural design of future healthcare facilities. In future hospitals, less space will be required; there will be no need for waiting areas. Most care will be given far from the hospital. Every human might have a computer chip attached to his body, with all his medical data ready and monitored by AI. In the future, all processes may be done by robots and AI, from reception to detection (radiology, scans, etc.). Nearly all surgery will be done by robots, so the architectural design of operation departments will need to be changed accordingly. AI is faster and better in disease detection than man; thus, there will be no need for laboratories or detection departments as we know them now. 3D printers are able to print almost everything from medical equipment to parts of the human body; thus, space will be needed for scanning and 3D printing in future hospitals. 3D printers might change the pharmaceutical industries, and drugs will be produced for any human individually.
Mohammad Javad Behzadnia
Dilceu Silveira Tolentino Júnior; Eliseu Miranda de Assis; Roberto Carlos de Oliveira
Abstract
Acute coronary syndrome (ACS) results from acute obstruction of a coronary artery which is responsible for a high mortality rate worldwide. The consequences depend on the degree and location of the obstruction and vary from unstable angina to non-ST segment elevation myocardial infarction (NSTEMI), ST-segment ...
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Acute coronary syndrome (ACS) results from acute obstruction of a coronary artery which is responsible for a high mortality rate worldwide. The consequences depend on the degree and location of the obstruction and vary from unstable angina to non-ST segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction, and sudden cardiac death. The symptoms are similar in each of these syndromes (except for sudden death), involving chest discomfort with or without dyspnea, nausea, and diaphoresis. The diagnosis is possible; thanks to the electrocardiogram that is essential and the existence or absence of serological markers. In addition to these initial resources, other diagnostic methods are noteworthy, such as stress electrocardiogram, echocardiography, nuclear cardiology, computed tomography angiography, and exercise test. Other necessary measures are the stratification of the identified cases according to the degree of risk, availability of a coronary intensive care unit, and the establishment of the opportune treatment that consists of oxygen therapy, analgesia, sedation, antiplatelet, anticoagulants, nitrates, beta-blockers drugs, reperfusion of emergency with fibrinolytic drugs, percutaneous intervention or, occasionally, myocardial revascularization surgery to provide the recovery and consequently a better quality of life for the patient. This brief review aims to discuss the available diagnostic and therapeutic resources and the appropriate risk stratification for adequate care for the victims of acute coronary heart disease promptly in a hospital setting.
Sogand Tourani
Mohsen Saberi Isfeedvajani
Shahrokh Mehrpisheh; Azadeh Memarian; Maryam Ameri; Mohsen Saberi Isfeedvajani
Abstract
The Qur’an, the word of God, is the best book that has been revealed to guide human beings contains a complete plan of human life. However, in addition to educational, ethical, and religious issues, it also contains valuable scientific information. Several verses in the Holy Qur’an discuss ...
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The Qur’an, the word of God, is the best book that has been revealed to guide human beings contains a complete plan of human life. However, in addition to educational, ethical, and religious issues, it also contains valuable scientific information. Several verses in the Holy Qur’an discuss the importance of breast milk and its proper planning. Qur’an also orders up parents, especially mothers, for getting this goddamn blessing to their children. Qur’an verses as well as Islamic hadiths emphasize that breast milk is an unparalleled and comprehensive food that plays a valuable and unique role in the improvement of mental health, physical development, and desirable development of children. Based on Islamic sources, such as the Holy Qur’an and the traditions of the Prophet (PBUH) and Islamic hadith, there are some interesting and important points about breastfeeding, its benefits and its provisions. The Qur’an verses and Islamic hadiths emphasize the importance of breastfeeding and the importance of continuing it until 24 months. The description of these hadiths and verses is presented in the text. Considering the religious and Qur’an educations regarding the importance of breastfeeding infants, it can be concluded that breastfeeding contains the most complete immune and growth factors in the infant. In addition to physical needs, breastfeeding provides emotional and mental development and also gives countless benefits to the mother.
Ahmad Salimzadeh; Alireza Jalali-Farahani; Mohammadjavad Alishiri; Gholam Hossein Alishiri; Ali Ayoubian
Abstract
Accessibility to all levels of information technology has experienced rapid progress in recent years, particularly in the health sector. Rapid penetration into this technology has led to changes in lifestyles and changes in the working procedures of institutions. In 2014, the number of Internet users ...
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Accessibility to all levels of information technology has experienced rapid progress in recent years, particularly in the health sector. Rapid penetration into this technology has led to changes in lifestyles and changes in the working procedures of institutions. In 2014, the number of Internet users reached 3 billion, and this number is predicted to exceed 8 billion in 2018. Statistics estimate the number of Iranian users of the Internet to be about 45 million. In 2014, more than 80% of Internet users searched for health information. Today, the Internet plays a vital role in providing such health services as education, disease management, support, basic medical treatment decisions, and doctor-patient communication.
Fakhri Allahyari; Fatemeh Abedi; Mohsen Saberi Isfeedvajani; Seyed Javad Hoseininejad Anbaran; Esmat Davoudi-Monfared
Abstract
Background: The field of neurology encompasses a wide range of disease types, and recognizing the most common manifestations of these diseases, particularly in subgroups, is critical for improving appropriate diagnostic and therapeutic measures.Objectives: The purpose of this study was to determine the ...
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Background: The field of neurology encompasses a wide range of disease types, and recognizing the most common manifestations of these diseases, particularly in subgroups, is critical for improving appropriate diagnostic and therapeutic measures.Objectives: The purpose of this study was to determine the frequency of common manifestations of neurological diseases in patients referred to a military hospital’s internal neurology clinic.Methods: This was a cross-sectional descriptive study of patients referred to the internal neurology clinic of a reference military hospital, Tehran, Iran in 2020. The sampling was done at random using a checklist. Finally data was analyzed by using SPSS software.Results: Women made up the majority of patients in 336 samples 182 (54.2 %) versus 154 (45.8 %). The patients’ average age was 49.5 ± 16.5 years, with 28.3 % (n = 95) being elderly. The three most common complaints raised by patients were headache, movement disorder, and sensory disorder, accounting for 29.5%, 27.7%, and 27.7% of complaints, respectively. Seventeen patients (5.1%) also mentioned other issues, with anger, anxiety, depression, and nausea being the most common complaints.Conclusion: Headache, movement disorder, and sensory disorder are the most common neurological disorders referred to a military hospital. Because of the high prevalence of these issues, it is necessary to establish specialized clinics and conduct additional research to determine the most common types of sensory and movement disorders, as well as the most effective methods of prevention and treatment in medical centers.
Snigdha Singh; Danish Javed; Sukhes Mukherjee; Rishabh Mittal; Nidhi Chourasia; Amit Agrawal; Ashwin Kotnis
Abstract
Background: Coronavirus disease 2019 (COVID-19) has become a global challenge to the health care system. A novel agent to combat this deadly virus is still a matter of research. Herbal molecules have served humanity since the beginning. Objectives: This narrative review aims to study the antiviral properties ...
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Background: Coronavirus disease 2019 (COVID-19) has become a global challenge to the health care system. A novel agent to combat this deadly virus is still a matter of research. Herbal molecules have served humanity since the beginning. Objectives: This narrative review aims to study the antiviral properties of medicinal plants, which are already effectively used in the past against various viruses. It derives the importance of exploration of such phytochemicals, which can be complementarily used to treat COVID-19. Methods: Studies related to traditional medicine and treatment for viruses were retrieved from databases including PubMed, Google scholar until December 2020 using the keywords SARS-CoV-2, COVID-19, Immunological, Phyto-chemicals, Traditional Medicine. The resulting publications were analyzed to develop a narrative review on the traditional Indian phytochemicals that have been shown to effectively treat various viral infections and potentially treat or prevent COVID-19. Results: Many of the researches are showing that Indian herbal compounds have a significant potential against viral diseases. Plants like Azadirachta indica, Withania somnifera, Tinospora cordifolia, Ocimum basilicum, and many more have been shown tremendous antiviral, anti-inflammatory, and immune-modulatory activities. Conclusion: Phytochemicals obtained from the herbs can be helpful in the treatment and prevention of SARS-CoV-2via various modes such as inhibition of attachment, penetration, uncoating, replication, assembly, and release of respiratory viruses. Further analysis of the potential phytochemicals in treating SARS-CoV-2 in clinical trials is warranted.
Humberto Guanche Garcell; Ariadna Villanueva Arias; Cristobal A. Pancorbo Sandoval; Adam Bode Sado; Ramón Nonato Alfonso Serrano; Francisco Gutierrez García
Abstract
Background: Identifying risk factors for surgical site infection (SSI) after appendectomies could be useful in focusing prevention programs. Objective: The current study aimed to identify the risk factors associated with SSI in a cohort of patients from a single center in Western Qatar. Methods: This ...
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Background: Identifying risk factors for surgical site infection (SSI) after appendectomies could be useful in focusing prevention programs. Objective: The current study aimed to identify the risk factors associated with SSI in a cohort of patients from a single center in Western Qatar. Methods: This cross-sectional study was carried out at The Cuban Hospital (Dukhan, Qatar) on patients who had undergone an appendectomy from January 2013 through September 2016. Data extracted from the patient files included demographics, comorbidities and toxic habits, surgery type, procedure duration, wound type, appendicitis-type, American Anesthesiology Score, body mass index, selected laboratory tests, and compliance with antibiotic prophylaxis. Results: The study variables, type of surgery performed, procedure duration, wound and appendicitis type, serum albumin, and timing of antibiotic prophylaxis, were found to be related to the occurrence of SSI in univariate analysis (P = 0.000). Logistic regression showed that open appendectomies (odds ratio [OR] = 22.90, 95% CI; 8.04-65.21), low serum albumin (OR = 0.92, 95% CI; 0.85-0.99), and improper timing of antibiotic prophylaxis (OR = 44.92, 95% CI; 3.39-594.91) were independently associated with the occurrence of SSI. Conclusion: Cases of complex appendicitis, open procedure, low serum albumin level, and improper timing of antibiotic prophylaxis constituted the risk factors for SSI in the setting of this study. The infection control program should focus on improving the quality of antibiotic prophylaxis and closely monitoring patients who undergo open surgical procedures.
Francesco Castagnini; Luca Busanelli; Giovanni Bracci; Enrico Tassinari; Federico Biondi; Claudio Masetti; Aldo Toni
Abstract
Background: Periprosthetic hip infections (PHIs) are troublesome complications of hip arthroplasties. The gold standard procedure for treating chronic PHI is a 2-stage approach. Recently, however, more conservative approaches have been developed to spare the osseointegrated components and avoid sequestra, ...
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Background: Periprosthetic hip infections (PHIs) are troublesome complications of hip arthroplasties. The gold standard procedure for treating chronic PHI is a 2-stage approach. Recently, however, more conservative approaches have been developed to spare the osseointegrated components and avoid sequestra, bone loss, devascularization, and difficult reconstructions. The partial two-stage approach, which leaves the well-fixed component in situ and removes the loosened component, may be an effective strategy. Objective: This paper, a narrative mini-review, analyzed the preliminary results of a partial 2-stage approach to treating chronic hip arthroplasty infections. Methods: Pertinent papers describing the partial 2-stage approach (leaving the well-fixed component in situ and removing the loosened component) were collected and evaluated. Results: Six main case series were selected. A total of 76 patients were included. Many patients were treated with socket removal and stem retention with quite similar surgical techniques. Many cases included highly virulent bacteria, and no pre-operative selection about comorbidities was performed. The first outcomes of this approach were promising, with a rate of infection control ranging from 81.3% to 100% at mid-term follow-up. Conclusion: This approach proved good at mid-term follow-up; however, many concerns still exist. In particular, the indications are imprecise, and the role of biofilm is still unclear. Despite the first good outcomes, the partial 2-stage approach for chronic PHI should be validated by multicenter prospective studies.
Zachary Paterick; Timothy E. Paterick
Abstract
Physicians working in hospitals face challenges when it comes to understanding and meeting the medical, legal, and ethical subjects outlined in the hospital bylaws. Hospital staff physicians and the hospital administration both aspire for high quality medical care and the assurance of patient safety. ...
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Physicians working in hospitals face challenges when it comes to understanding and meeting the medical, legal, and ethical subjects outlined in the hospital bylaws. Hospital staff physicians and the hospital administration both aspire for high quality medical care and the assurance of patient safety. Unfortunately, when quality concerns surface, there can be reasonable differences of opinion as to whether a physician’s practice pattern met the accepted threshold of the standard of care. Such differences of opinion can lead to conflict that fuels a physician review. One complication for physicians is that many of the issues that surface at peer reviews are veiled in legal concepts and underpinnings for which physicians lack education, training, and familiarity. It would be prudent for all physicians working in hospitals to become familiar with the hospital bylaws and regulations. Physicians must take a leadership role in assuring fair and equitable peer review.
Emmanuel Ajuluchukwu Ugwa; Ugwa Charity
Abstract
Background: There is a renewed interest in job satisfaction among healthcare workers including nurses in Africa and the West African sub-region due to the perception that global shifts in the internal structures and employment practices are inducing changes in the ties that bind employees to their job. ...
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Background: There is a renewed interest in job satisfaction among healthcare workers including nurses in Africa and the West African sub-region due to the perception that global shifts in the internal structures and employment practices are inducing changes in the ties that bind employees to their job. Therefore, it is necessary to examine various studies in order to establish an empirical base and utility for the theory of knowledge. Objective: This paper reviewed some of the available literatures on factors affecting job satisfaction among nurses around the world with special focus on the African continent. Methods: Electronic search of Medline, PubMed, Health Internetwork Access to Research Initiative (HINARI), and Google Scholar databases up to 2014 was carried out for studies which analyzed the factors affecting job satisfaction of nurses around the world, Africa and West Africa. Results: Although regional variations in levels of job satisfaction exist among nurses globally, there is more general trend of dissatisfaction and these are because of various factors related to the work environment. Nigerian nurses are generally more satisfied (as high as 92%) with their jobs when compared with their colleagues in other African countries. Socio-demographic and socioeconomic variables do not affect job satisfaction as much as leadership styles, promotion and other features related to the work environment. Conclusion: Strong leadership style is a probable reason why nurses in Nigeria are more satisfied with their jobs when compared with their colleagues in other countries even though they may work for longer hours or earn relatively less salaries.
Shervin Assari
Abstract
Most of what we know about the coronavirus disease 2019 (COVID-19) is limited to the severe acute respiratory syndrome, epidemiology, fatality, and acute care. However, infection with COVID-19 may also involve the central nervous system (CNS), which may or may not be due to a multi-organ injury. Our ...
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Most of what we know about the coronavirus disease 2019 (COVID-19) is limited to the severe acute respiratory syndrome, epidemiology, fatality, and acute care. However, infection with COVID-19 may also involve the central nervous system (CNS), which may or may not be due to a multi-organ injury. Our aim in this paper is to briefly summarize the main aspects of the growing literature on neurological manifestations of the COVID-19 infection. As such, after mentioned some general background on the economic and medical pandemic on the populations, the healthcare system, and the society, we summarize some common aspects of the published literature on neurological manifestations of the COVID-19 infection. We also highlight the existing gaps in the literature, which requires additional work. The most common neurological manifestation of COVID-19 infection is the olfactory deficit. However, it is still unknown if it is inflammatory or degenerative in nature. Still, the incidence of neurological involvement, and also mechanisms and their treatments are unknown. This literature is predominantly composed of opinions and reviews rather than original articles, so the patients’ data are not used for a majority of the studies. Multi-center studies that not only conduct chest CT or MRI but also brain CT or MRI are needed. Randomized trials are still required on the management of acute and chronic neurological conditions due to COVID-19 infection. Cohort studies may also determine the natural history of the conditions and factors that are prognostic. Furthermore, while disparities in COVID-19 infections are known, inequalities in neurological manifestations are unknown. Besides, the efficacy of specific treatments on CNS involvement is still unknown. We will discuss the health care needs of patients with chronic neurological conditions. We end the paper with a few recommendations for practice and research.
Seyed Alireza Seyed Ebrahimi; Elham Karamian; Zahra Sadat Goli; Leila Sadat Mirseifi
Abstract
Background: Hospitalization due to any reason or medical condition is associated with fear, anxiety, and depression. Psychological and physiological factors have a significant impact on hospitalization outcomes.Objectives: Given the functional importance of inflammatory cytokines and studies in previous ...
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Background: Hospitalization due to any reason or medical condition is associated with fear, anxiety, and depression. Psychological and physiological factors have a significant impact on hospitalization outcomes.Objectives: Given the functional importance of inflammatory cytokines and studies in previous studies on the relationship between inflammatory cytokines and major depressive disorder, we will focus more on studies on the role of interleukin 2 (IL-2) in the pathophysiology of major depressive disorder in hospitalized patients.Methods: We used PubMed, Scopus, and Elsevier databases to search for articles from 1999 to 2021, emphasizing the studies of the last five years.Results: In general, there was no consistent pattern in the observed relationships between cytokine concentrations or changes and clinical signs of significant depression. IL-2 and IL, two receptors in the body, play an essential role in the treatment and the pathophysiology of depression and major depression.Conclusion: Finally, it can be concluded that hospitalization generally exposes the patient to inflammation. Studies show an increased risk of inflammation following hospitalization of patients, and many studies confirm the association of major depression with inflammatory cytokines and, more concentrated, IL-2.
Carol Gravinese; Matteo Bianco; Enrico Cerrato; Paola Destefanis; Alessia Luciano; Alessandro Bernardi; Simone Bellucca; Ferdinando Varbella; Fiorenzo Gaita; Roberto Pozzi
Abstract
Aspirin is an irreversible and non-selective inhibitor of cyclo-oxygenase. It represents the cornerstone of antiplatelet therapy and is used in secondary prevention of cardiovascular disease. Disagreement over the optimal maintenance dosage still exists; in America and Europe the most used doses of aspirin ...
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Aspirin is an irreversible and non-selective inhibitor of cyclo-oxygenase. It represents the cornerstone of antiplatelet therapy and is used in secondary prevention of cardiovascular disease. Disagreement over the optimal maintenance dosage still exists; in America and Europe the most used doses of aspirin are 81 mg and 100 mg daily, respectively. There is also debate on the formulation and route of administration of the loading dose. The latest studies advise chewable and non-enteric coated aspirin; intravenous administration represents an alternative for unconscious or shocked patients. Aspirin hypersensitivity is characterized by the onset of respiratory, mucocutaneous, and systemic symptoms. It is marginally considered, but its prevalence is significant. International cardiologic guidelines only report the possibility of desensitizing intolerant patients or, alternatively, administering one single antiplatelet agent. Desensitization can induce a temporary tolerance to the drug and consists of the administration of sequential and incremental doses of aspirin. Rapid desensitization protocols have proven to be safe and effective in the vast majority of cases, and they should be included in the management of these patients. New studies are being carried out comparing aspirin with other antiplatelet agents, and the results will be available shortly.
Philippe Widmer; Peter Zweifel
Abstract
Background: In 2012, Switzerland changed from retrospective to prospective hospital payment based on diagnosis related groups (DRGs), following the example of the United States, Australia, and Germany. As in these countries, the objective of this transition was to motivate hospitals to improve efficiency ...
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Background: In 2012, Switzerland changed from retrospective to prospective hospital payment based on diagnosis related groups (DRGs), following the example of the United States, Australia, and Germany. As in these countries, the objective of this transition was to motivate hospitals to improve efficiency by making them bear financial risk to some extent.Objective: This contribution seeks to find out whether SwissDRG, the Swiss version of DRG payment, indeed provides hospitals with appropriate incentives, thus creating a level playing field enabling workable competition between them.Methods: Three conditions for creating a level playing are stated, of which the first is tested using data on some 757 000 patient cases treated by 93 hospitals in the year 2012.Results: The evidence suggests that hospital payment as currently devised by SwissDRG fails to create a level playing field. Differences in margins over cost of treatment can be traced to a hospital’s portfolio of specialties and mix of patients, both of which are largely beyond their control. The findings of this paper are subject to several limitations. The true DRG-specific cost distributions (and hence expected values) are not known; moreover, emphasis has been on variable cost, neglecting fixed (capital user) cost. Finally, hospitals with a high amount of capital user cost may well benefit from modern technology contributing to their efficiency in terms of variable cost.Conclusion: The finding that current hospital financing by SwissDRG fails to create a level playing field is likely to be robust, calling for an expeditious adjustment be-cause hospitals are exposed to financial risk to a greatly differing degree. It may be appropriate for them to purchase insurance against their financial risk, which is largely driven by influences beyond their control.
Derya Yalçın; Dilek Erdoğan Arı; Ceren Köksal; Cansu Akın; Sinan Karaca; Özgür Karakuş
Abstract
Background: Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration. These agents may also cause potentiation and prolongation of motor block. Objective: This study compared the postoperative effects of 30 mL of 0.25% ...
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Background: Opioids added to local anesthetics for peripheral nerve blocks may intensify analgesia and prolong analgesic and sensorial block duration. These agents may also cause potentiation and prolongation of motor block. Objective: This study compared the postoperative effects of 30 mL of 0.25% bupivacaine +50 mcg fentanyl and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl solutions for the ultrasound-guided infraclavicular block in patients undergoing elbow and forearm surgery. Methods: In this randomized double-blind study, thirty-six patients with risk of ASA class I-III were randomly allocated into 2 randomized groups. Ultrasound-guided infraclavicular blocks with 30 mL of 0.25% bupivacaine + 50 mcg fentanyl for group 1 and 30 mL of 0.25% bupivacaine + 100 mcg fentanyl for group 2 were performed before patients emerged from general anesthesia. After surgery, pain levels at rest and during movement were evaluated using the 10-cm visual analog scale (VAS) at recovery room admission, at the 15th and 30th minutes in the recovery room, and at the 2nd, 6th, 12th and 24th hours postoperatively. Both morphine and rescue analgesic requirements were recorded. Sensorial and motor block durations, patient satisfaction, and complications related to the infraclavicular block were recorded. Results: In both groups, no significant difference in VAS pain scores, total morphine and total rescue analgesic requirements, duration of sensorial and motor block, or patient satisfaction were observed. None of the patients experienced any complications. Conclusion: The mixtures of 0.25% bupivacaine + 50 mcg fentanyl and 0.25% bupivacaine + 100 mcg fentanyl showed similar postoperative effects.
Marzieh Pazokian; Maryam Esmaeili
Abstract
Background: Quality of life (QOL) is a powerful phrase that reflects maintaining health and well-being in different societies and cultures, reflecting the positive and negative aspects of people’s lives. Patients with liver cirrhosis (LC) have an undesirable QOL, and this has become one of the ...
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Background: Quality of life (QOL) is a powerful phrase that reflects maintaining health and well-being in different societies and cultures, reflecting the positive and negative aspects of people’s lives. Patients with liver cirrhosis (LC) have an undesirable QOL, and this has become one of the most important causes of mortality in the world. Objective: This review article aimed to summarize the results of previous studies on health-related QOL in patients with LC to determine their problems and needs. Methods: This review was conducted using Cochran’s seven-step model. This paper is the result of research on QOL in patients with LC through searches conducted in Google Scholar, PubMed, and Science Direct using the keywords liver cirrhosis, chronic liver disease, quality of life, health-related quality of life, and self-care for articles published between 2012-2018. Ultimately, 11 articles were obtained and analyzed. Results: The results of this review showed that the QOL in patients with LC is poor and is lower than in other populations. Many factors, such as age, gender, and education, influence QOL and should be addressed in order to solve the challenges and problems faced by these patients. Increasing awareness and education are the most important issues for LC patients. Conclusion: QOL in patients with LC is affected by many factors. The lack of awareness about the disease and its complications is considered the biggest problem for these patients. To improve the QOL and care of these patients, nursing care guidelines, awareness raising, and education about the disease and its complications, treatment, and new treatments are needed.
Olayinka S. Ilesanmi; Aanuoluwapo A. Afolabi
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has triggered an increased demand for health services. Public health facilities are becoming increasingly inadequate to provide care for the increasing COVID-19 cases. Therefore, positioning the private health facilities (PHFs) to contribute to the COVID-19 ...
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The coronavirus disease 2019 (COVID-19) pandemic has triggered an increased demand for health services. Public health facilities are becoming increasingly inadequate to provide care for the increasing COVID-19 cases. Therefore, positioning the private health facilities (PHFs) to contribute to the COVID-19 outbreak response is highly required. To position PHFs for an improved COVID-19 outbreak response, guidelines that provide clarity on the role of PHF in the COVID-19 outbreak response need to be developed. Specific regulations should be tailored towards the government acting as a financial risk protector for PHF. Also, equity in the distribution of personal protective equipment (PPE) across the public and PHF from the Federal Government should be ensured. Moreover, subsidies should be provided on PPE, including goggles, hand sanitizers, and face masks. Furthermore, the purchase of PPE could be made by PHF on a large scale at subsidized costs via the PHF professional bodies and associations. Moreover, a comprehensive assessment of the human and infrastructural capacity of PHF needs to be conducted regarding the COVID-19 response. Results obtained from such assessment would inform on the existing human resources needs of the private sector and opportunities by which PHF’s capacity could be enhanced. In addition, assessing the extent of representativeness of PHF in the existing rapid response team needs to be conducted. All challenges delimiting the active involvement of the PHF should be addressed. Additionally, adequate support systems need to be developed and well-placed to promote the involvement of the PHF in the outbreak response.
Jose L. Alfonso-Sanchez; Belen Alfonso-Landete; Maria Martinez-Martinez
Abstract
Background: Avoidable mortality (AM) is one of the most important health indicators (HI) and represents the quality of care in a hospital.Objective: This study measured the efficacy of a training program for a hospital healthcare staff to reduce AM.Methods: This epidemiological study on community intervention ...
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Background: Avoidable mortality (AM) is one of the most important health indicators (HI) and represents the quality of care in a hospital.Objective: This study measured the efficacy of a training program for a hospital healthcare staff to reduce AM.Methods: This epidemiological study on community intervention analyzed time-series data on HI by semesters from 2008 to 2015. The pre-intervention phase was examined from January 2008 to December 2014; the intervention phase was investigated in the first semester of 2015; and the post-intervention phase was examined in the second semester of 2015.Results: Resindicate a series with a rising tendency until the 14th semester and a pronounced descent in the 16th semester. The relative variation rate (RVR) was -20% to +20% with some exceptions. HI was 0.53% in the 16th semester rather than the expected 0.70% observed in the pre-intervention phase; therefore, 0.17% additional deaths were avoided because of the training seminar.Conclusion: The positive results suggest that this strategy is an important element in decreasing avoidable deaths in hospitals.
Shahram Manoochehry; Hassan Ali Mohebi; Mohammad Javad Behzadnia; Reza Mohtashami
Abstract
Background: Primary hyperhidrosis (PH) refers to excessive sweating, beyond normal physiological levels, in specific sites of the body for unknown reasons. It is usually bilateral and is most prominent in the palms, axillae, feet, and face. PH prevalence is estimated to be 0%-6.1% in different populations. ...
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Background: Primary hyperhidrosis (PH) refers to excessive sweating, beyond normal physiological levels, in specific sites of the body for unknown reasons. It is usually bilateral and is most prominent in the palms, axillae, feet, and face. PH prevalence is estimated to be 0%-6.1% in different populations. It usually begins in childhood and is more frequent in women. In 57% of cases, there is a positive family history. It is an autosomal dominant disorder with variable penetration in chromosomes 5, 14, or both. Objective: The aim of this study was to illustrate current treatments of PH while focusing on surgical therapies through a narrative review. Methods: A complete search of online articles from 2007 to 2014 in PubMed, Scopus, and the Cochrane Library was performed. A free search and a search in the MeSH database for the study’s keywords were also done. More than 600 relevant articles were found, of which 51 were chosen for this study. This article is based on those articles. Results: Surgery is the best and more permanent therapy for PH. The most common consequences of surgery are compensatory sweating and gustatory sweating. There is controversy concerning whether lowering the level and limiting the number of ganglia on which surgery is performed reduces compensatory sweating. Conclusion: It seems that ramicotomy (selective division of the sympathetic postganglionic fibers) reduces compensatory sweating, but this theory should be confirmed with more studies.