Ted Lee; Heiko Yang; David A. Haneuer; Julian Wan
Abstract
Background: Iatrogenic urethral injury is a well-known risk of urinary catheter insertion. Associated morbidities include stricture formation, catheter associated infection, risk for instrumentation, and extended length of stay. Yet, insufficient attention is paid to its prevention. Objective: This study ...
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Background: Iatrogenic urethral injury is a well-known risk of urinary catheter insertion. Associated morbidities include stricture formation, catheter associated infection, risk for instrumentation, and extended length of stay. Yet, insufficient attention is paid to its prevention. Objective: This study aimed to assess the effectiveness of a computerized ordering system in reducing iatrogenic urethral injuries in men at high risk for iatrogenic urethral injury from traumatic catheterization. Methods: A pre-post study was performed to assess the impact of a computerized ordering system that recommended a 16 Fr Coudé-tip catheter be used instead of the standard 16 Fr Foley catheter for men at high risk for difficult catheter insertion. The intervention was implemented in October 2012. The rates of traumatic and non-traumatic insertion consults were compared between the pre-intervention (10/1/2010-09/30/2011) and post-intervention (10/1/2012-9/30/2013) time periods. Results: The results showed that 78.5% of patients with iatrogenic urethral injury possessed at least one identified risk factor for difficult catheterization. There was no significant difference in frequency of traumatic or non-traumatic insertion consults between the pre- and post-intervention cohorts. Conclusion: The current study highlights the possibility of preventing traumatic insertions by targeting men at high risk for iatrogenic injury. Without a simultaneous plan for improving catheter placement awareness and training, any change in the ordering process is unlikely to succeed on its own.
Amanj Abubakr Jalal Khaznadar; Rebin Wahid Salh
Abstract
Background: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI ) are common types of acute coronary syndrome which are associated with the risk factors of age, obesity, hypertension, and diabetes. Objective: The present study aimed to examine ...
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Background: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI ) are common types of acute coronary syndrome which are associated with the risk factors of age, obesity, hypertension, and diabetes. Objective: The present study aimed to examine the effects of age on the risk factors and clinical symptoms of acute coronary syndrome. Methods: A cross-section prospective study was conducted on 125 patients with acute coronary syndrome chosen by non-probability convenience sampling method in the coronary care unit in Sulaimani, the Kurdistan region of Iraq. Acute coronary syndrome types were diagnosed through clinical presentations, electrocardiography (ECG), and troponin test. Data was collected using a researcher-based checklist through face-to-face interviews. Results: The results indicated that males were the dominant group. The age group 45-65 had the highest prevalence rate of acute coronary syndrome. The most frequent risk factors for acute coronary syndrome were hypertension (54.4%), dyslipidemia (52%), smoking (42.4%), and diabetes mellitus (38.4%). Typical chest pain was found to be the most frequent clinical presentation (88%). There was a significant difference between the age groups in terms of the effect of age on typical and atypical symptoms; however, neither age nor typical/atypical symptoms had a significant effect on type of acute coronary syndrome. Similarly, family history, hypertension, diabetes mellitus, obesity, smoking, physical inactivity, and dyslipidemia had no effect on type of acute coronary syndrome. Conclusion: Age is a predictive factor for acute coronary syndrome, but family history, hypertension, diabetes mellitus, obesity, smoking, physical inactivity, and dyslipidemia cannot predict acute coronary syndrome.
Reza Bidaki; Bita Tavana; Shima Hosseini; Negar Neshati; Mojtaba Babaei Zarch
Abstract
Introduction: Hypothyroidism is a common disorder of the endocrine system in which the production of thyroid hormones is inadequate. In addition to various physical manifestations, patients who suffer from hypothyroidism may also present with psychological problems, as described in previous studies. ...
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Introduction: Hypothyroidism is a common disorder of the endocrine system in which the production of thyroid hormones is inadequate. In addition to various physical manifestations, patients who suffer from hypothyroidism may also present with psychological problems, as described in previous studies. Case Presentation: Herein, the reports of 2 patients who suffered from hypothyroidism and experienced improvement in their psychological symptoms after levothyroxine therapy are presented. The patients referred with depressive mood with psychotic features and psychomotor retardation. Treatment simultaneously with psychopharmacotherapy and hormone therapy was considered. Conclusion: Although hypothyroidism and depressive disorders are separate issues, hypothyroidism can induce depression and psychosis, and psychopharmacotherapy plus hormone therapy can be effective and boost treatment.
Hamidreza Torabi
Abstract
Introduction: Because of bilateral involvement in many cases with diabetic macular edema, Intravitreal bevacizumab injection perform in both eyes. There are some reports of therapeutic effects in the fellow eye after monocular injection of anti-vascular endothelial growth factors. In this study we describe ...
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Introduction: Because of bilateral involvement in many cases with diabetic macular edema, Intravitreal bevacizumab injection perform in both eyes. There are some reports of therapeutic effects in the fellow eye after monocular injection of anti-vascular endothelial growth factors. In this study we describe a case of bilateral improvement of diabetic macular edema following unilateral intravitreal bevacizumab injection. Case Presentation: We report a patient with bilateral non-proliferative diabetic retinopathy and diabetic macular edema. Central macular thickness was 398µ in the right eye and 337µ in the left eye. Two months after intravitreal injection of 1.25mg bevacizumab in the right eye, significant improvement of diabetic macular edema was happened in both eyes including the left eye without intravitral injection. Central macular thickness was 245µ in the right eye and 250µ in the left eye. Conclusion: Unilateral injection of intravitreal bevacizumab may have therapeutic effects in the fellow untreated eye. Therefore; unilateral injection in bilateral cases may reduce the costs and complications of bilateral injection.
Amjad Mohammadi-Bolbanabad; Barzan Shirkhani; Samira Mohammadi; Heshmatollah Asadi; Abas Aghaei
Abstract
Background: Nowadays, quality of patient care is one of the major and important concerns of health care delivery which is extremely dependent on the medical staff. Objectives: The purpose of this study was to investigate the relationship between Quality of Work Life (QWL) and quality of patient care. ...
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Background: Nowadays, quality of patient care is one of the major and important concerns of health care delivery which is extremely dependent on the medical staff. Objectives: The purpose of this study was to investigate the relationship between Quality of Work Life (QWL) and quality of patient care. Methods: This study was a descriptive-analytic study based on correlation which was conducted in the educational hospitals of Kermanshah. A total of 320 medical staffs were selected for the study. Quality of Work Life and Quality of Patient Care questionnaires were used to collect the data. For data analysis, descriptive statistics, person correlation coefficient, t-test and multivariate regression were used by using SPSS16 Results: Data analysis showed that the Quality of Work Life of medical staffs was in a medium level. Our findings indicate that there is a significant, negative relationship between stress at work and quality of patient care (P-value=0.001 & r=-0.247) and there is a significant, positive relationship between control & job satisfaction and quality of patient care (P-value=0.001 & r=0.217). Results of multivariate regression analysis showed that stress at work net account for 6% of the variance of the quality of patient care. Conclusion: Focusing on improving the working conditions of medical staffs can be incredibly useful in increasing the quality of health care.
Tahereh Shafaghat; Mohammad Kazem Rahimi Zarchi; Zahra Kavosi
Abstract
Background: 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. Objective: This research evaluated factors affecting occupational stress and strategies for coping with it. Methods: ...
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Background: 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. Objective: This research evaluated factors affecting occupational stress and strategies for coping with it. Methods: 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. Results: 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. Conclusion: 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.
Saadet Lale Tarım; Yasemin Boy; Döndü Şanlıtürk
Abstract
Background: To test the effectiveness of concept maps used in the education of nursing students in the field of health, we need to use measurement tools.Objectives: The purpose of the study was to develop “Scale for the Effectiveness of Concept Maps in Nursing Education (SECMNE)”.Methods: ...
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Background: To test the effectiveness of concept maps used in the education of nursing students in the field of health, we need to use measurement tools.Objectives: The purpose of the study was to develop “Scale for the Effectiveness of Concept Maps in Nursing Education (SECMNE)”.Methods: This was a methodological instrument development study. This study was conducted in a university’s health of nursing department in Tokat, Turkey, between September and December 2019. The universe of this study, which used a methodological design, consisted of third and fourth-year nursing students, and the sample size was 174. The item pool was formed with 86 items. The content validity was assessed by 9 experts. The 86-item draft scale that had a 4-point Likert type scoring system. Content validity ratio (CVR), Kaiser-Meyer-Olkin (KMO) test, Bartlett test, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), Cronbach’s alpha, and Pearson product-moment correlation analysis techniques were used for the validity and reliability analyses of the scale.Results: The scale consists of 3 subscales (integration of information, integration of the care plan, perception) and 30 items. Scale’s Cronbach alpha is 0.97.Conclusion: The scale developed in this study was concluded to be a valid and reliable measurement tool that can be used to measure the effectiveness of the concept maps in nursing education. The SECMNE can help nursing student identify the lack of knowledge and negative attitudes about concept map in nursing education and prepare nursing care plan.
Mohsen Saberi Isfeedvajani; Esmat Davoudi-Monfared; Mojtaba Naderi
Abstract
Background: Physicians’ satisfaction is closely related to the effectiveness of health services, including quality of services as well as patient compliance, satisfaction, and outcomes. Objectives: This study was designed to examine the job satisfaction level of physicians working at a referral ...
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Background: Physicians’ satisfaction is closely related to the effectiveness of health services, including quality of services as well as patient compliance, satisfaction, and outcomes. Objectives: This study was designed to examine the job satisfaction level of physicians working at a referral hospital in Tehran. Methods: This research was a descriptive study performed on a population of physicians working at a referral hospital from April to August 2019. The sample size was calculated as 120 subjects. The Physicians’ Job Satisfaction Questionnaire (PJSQ), which is a valid questionnaire, was used as the data collection tool. The collected data was entered into SPSS Statistics 20. Mann-Whitney and t tests were used for data analysis. Results: The frequency of female and male physicians was 50 (38.2%) and 81 (61.8%), respectively. The total mean of Job satisfaction in physicians was 51±7.05. Overall satisfaction scores were 70.7±15.1, 51.5±11.1, 49.8±13.1, 49.5±11.2, 44.1±9.3, and 40.5±11.9 in domains of income satisfaction, physicians’ satisfaction with management, relationship between physicians and their colleagues, patients, staff, and physicians’ job satisfaction, respectively. 87% of physicians participating in this study were not willing to leave their jobs. The income satisfaction of the female physician group was significantly higher than that of men (P=0.029). The income satisfaction of subspecialists was significantly higher than that of specialists (P=0.022). The job satisfaction of physicians who were not faculty members was significantly higher than that of physicians who were faculty members (P=0.034). Conclusion: The job satisfaction level of physicians working at a referral hospital in Tehran was moderate. Income satisfaction and job satisfaction were the highest and lowest levels of satisfaction, respectively.
Thomas A. Paterniti; Lee Weber; Gene Krishingner; Sarfraz Ahmad
Abstract
Introduction: Essure® device malposition is a rare, but clinically significant complication, for which management is idiosyncratic. This case report describes an unusual example of Essure® migration in order to clarify reasonable management options. Case Presentation: A 50-year old G4P2022 underwent ...
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Introduction: Essure® device malposition is a rare, but clinically significant complication, for which management is idiosyncratic. This case report describes an unusual example of Essure® migration in order to clarify reasonable management options. Case Presentation: A 50-year old G4P2022 underwent hysteroscopic sterilization using the Essure® device. Insertion was complicated by fragmentation of both coils. Two years later, one of the coils was incidentally discovered protruding through the cervical os. The visible portion was clipped when attempts to remove the entire coil were unsuccessful. Conclusion: Difficult placement increases the risk of Essure® malposition. In asymptomatic patients, conservative management with removal of only a portion of the device is a rational approach.
Hanım Seyrek; Dilek Ekici
Abstract
Background: The ‘Organizational Justice’ concept is used in order to determine whether the administrator is fair to his personnel or not. It is said that those who get bullied are usually terrorized, annoyed, excluded, belittled, deprived of resources, isolated and prevented from claiming ...
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Background: The ‘Organizational Justice’ concept is used in order to determine whether the administrator is fair to his personnel or not. It is said that those who get bullied are usually terrorized, annoyed, excluded, belittled, deprived of resources, isolated and prevented from claiming rights. Objective: The purpose of this study is to determine nurses’ perception of organizational justice and its effect on the bullying behaviour they are exposed to. Methods: The cross-sectional study was conducted on nurses at a university hospital and a private hospital in Ankara. In this regard, 250 nurses who had been serving in their respective hospitals for 6 months participated in the study. The variables were measured under 2 categories: bullying and perception of organizational justice. A simple regression analysis was carried out in order to determine the bullying behaviour which causes the nurses’ justice perceptions. Results: According to the survey, the nurses are most likely to perceive injustice in the area of distributional justice. Results revealed that the ratio of nurses who were exposed to bullying in the workplace was 28%. There was a significant and negative relation between the nurses’ distributional justice perception and the bullying they were exposed to. Conclusion: The employees whose organizational justice perceptions are low, display a threatening and negative behaviour towards their colleagues and the institution. They feel themselves to be threatened when they think that they can’t communicate with upper management respectfully and also when they believe that their managers are unjust in performance assessment, in assessing salaries and promotion.
Arash Malakian; Mehdi Sayyah; Kowsar Motamed
Abstract
Background: Poor teaching and lack of proper relations between teacher and student and various other causes affect students’ academic burnout. Objectives: Present study was conducted to determine the relationship between educational justice and academic burnout in medical interns of Ahvaz Jundishapur ...
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Background: Poor teaching and lack of proper relations between teacher and student and various other causes affect students’ academic burnout. Objectives: Present study was conducted to determine the relationship between educational justice and academic burnout in medical interns of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Methods: This study was descriptive and analytical. The number of samples was equal to 300 medical interns identified and entered by the census sampling method. Data were completed by two questionnaires (researcher-made educational justice and burnout standard) whose reliability and validity were confirmed. Data were analyzed by SPSS Version 22. Results: There was no significant relationship between educational justice and academic burnout (P>0.05). Also, educational justice was below average and academic burnout was above average. There was a significant relationship between educational justice score and gender (P < 0.05), and there was no critical relationship with other demographic variables (P>0.05). There was no significant relationship between academic burnout score and all demographic variables (P>0.05). Conclusion: This study concluded that causes other than educational justice have been influential on students’ academic burnout. Hence, it suggested that studies be conducted on high academic burnout and identify influential variables. On the other hand, although the relationship between the two variables was not significant, due to the low level of educational justice, the university’s need for fair educational opportunities, especially professors, should be considered.
Neda Moein; Gholamhossein Ahmadzadeh; Alireza Safaeeyan
Abstract
Background: In providing optimum medical and health services, great pressure is put on the physical and mental health of family physicians. Job burnout is damaging to the health of family physicians and medical treatment personnel. It leads to reduced job productivity, increased absenteeism, increased ...
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Background: In providing optimum medical and health services, great pressure is put on the physical and mental health of family physicians. Job burnout is damaging to the health of family physicians and medical treatment personnel. It leads to reduced job productivity, increased absenteeism, increased healthcare costs, elevated turnover rates, a reduced level of service provided to patients, and ultimately, patient dissatisfaction. Objective: The current research investigated job burnout among family physicians in rural areas of Isfahan province during the years 2017-2018. Methods: This cross-sectional study was carried out in Isfahan province during the years 2017-2018. The research population included all family physicians working in Isfahan province, and 155 of whom met the inclusion criteria and participated in this research. Questionnaires were used as the data collection tool. Data was analyzed using SPSS software, and the analytical variables were analyzed using the independent t test and Pearson correlation coefficient. Results: A total of 45 men (29%) and 110 women (71%) comprised the research population. Participants’ mean age and mean duration of work experience were 35.3±8.1 and 7.5 years, respectively. The scores for overall job burnout, emotional exhaustion, depersonalization, and lack of personal accomplishment dimensions were low among the family physicians in Isfahan. The results showed no significant difference between male and female, single and married participants in any of the dimensions. The results also revealed a direct relationship between years of work experience and the overall job burnout and lack of personal accomplishment scores. Conclusion: According to the findings of the present research and considering the stressful nature of a family physician’s job, healthcare authorities need to pay special attention to job burnout and implement measures to prevent it or at least reduce its subsequent adverse effects.
Alireza Ehsanbakhsh; Nasrin Khorashadizadeh; Amin Saburi
Abstract
Introduction: Misdiagnosis and the resulting mismanagement are challenging issues in complicated cases which present with obscure complaints. Interpreting radiologic studies, especially conventional plain radiologic images, remains the most frequently prescribed and useful modality for the first step ...
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Introduction: Misdiagnosis and the resulting mismanagement are challenging issues in complicated cases which present with obscure complaints. Interpreting radiologic studies, especially conventional plain radiologic images, remains the most frequently prescribed and useful modality for the first step of assessment. Case Presentation: In this report, we present a case of mismanagement of a strange foreign body in the maxillary sinus of a child not found in a facial x-ray. Conclusion: Inexperienced non-radiologist physicians may make misdiagnoses when reading conventional x-rays.
Humberto Guanche Garcell; Luis Gonzalez Alvarez; Anayka González Valdés; Katerine Cardenas Goulet; Gloria Fresneda Septiem; Francisco Gutierrez García
Abstract
Background: Hand hygiene plays a key role in the prevention of healthcare-associated infection in critical patients. Objective: The current study aimed to evaluate compliance with hand hygiene practices. Methods: An observational and descriptive study was carried out in a 35-bed medical-surgical critical ...
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Background: Hand hygiene plays a key role in the prevention of healthcare-associated infection in critical patients. Objective: The current study aimed to evaluate compliance with hand hygiene practices. Methods: An observational and descriptive study was carried out in a 35-bed medical-surgical critical care unit in La Habana (Cuba) from January 2017 to December 2018. The observational method recommended by the World Health Organization (WHO) was used. Results: Overall compliance was 34.2% (5516/16 125), with better compliance among physicians (39%) compared with nurses (31.4%) and ancillary staff (19.5%). Better compliance was observed after patient contact (65.7%) and after contact with patients’ surroundings (42.0%) in comparison with greater focus on patient safety as before patient contact (23.3%) and before an aseptic task (11.4%). Hand washing was performed more frequently than hand rubs. Conclusion: Compliance with hand hygiene practices is low and no improvement in compliance was observed during the study period. This practice is related to the high risk of transmission of healthcare-related infections in critical patients and requires quality improvement interventions.
Seyed Jalal Madani; Majid Saeedi; Mohammad Saeed Gheasi; Masoud Saghafinia; Seyed Mohammad Reza Amouzegar; Ali Bahramifar; Vahid Shahkarami
Abstract
Background: Gastrointestinal surgery is one of the procedures that result to produce inflammatory reactions and pain to patients. Administrate of high-safe analgesia in surgery is very essential, to reduce pain and improve inflammatory reactions. Objectives: The present study compared inflammatory markers ...
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Background: Gastrointestinal surgery is one of the procedures that result to produce inflammatory reactions and pain to patients. Administrate of high-safe analgesia in surgery is very essential, to reduce pain and improve inflammatory reactions. Objectives: The present study compared inflammatory markers and pain relief with the epidural infusion of bupivacaine-fentanyl and intravenous morphine bolus in gastrointestinal cancer surgeries. Methods: This randomized control clinical trial study was carried out from December 2018 to October 2020, on ASA I and II patients aged between 30-80 years who referred for gastrointestinal cancer surgery. Cases were randomly distributed into two groups. Group I received epidural catheter with bupivacaine (18 cases), and group II received fentanyl and morphine bolus injection (18 cases). On the first and second days post-operation, data on pain scores based on visual analogue scale (VAS) score, inflammatory markers (procalcitonin [PCT] and C-reactive protein [CRP]), platelet (PLT), white blood cells (WBCs), and erythrocyte sedimentation rate (ESR) was recorded. Results: The mean age was 52.21±16.13 years (41.6% male, 58.4 female). The mean of ESR, CRP and PCT postoperative were significantly higher than preoperative (P < 0.05). There were no differences between the two groups regarding PLT, ESR, CRP, and PCT preoperative postoperative (P > 0.05). The mean of pain was less in the epidural group than in the morphine group postoperative (P = 0.02). Conclusion: The results showed that epidural fentanyl-bupivacaine infusion was more effective in pain reduction than the intravenous infusion of morphine in cases undergoing gastrointestinal cancer operation. However, both analgesic approaches were similar in inflammatory functions.
Farshid Rahimibashar; Mahmood Salesi; Amir Vahedian-Azimi; Masoum Khosh Fetrat
Abstract
Background: The study of neuromuscular blocking agents (NMBAs) in the management of acute respiratory distress syndrome (ARDS) has provided conflicting results in terms of their effect on mortality.Objectives: The main purpose of this study was to evaluate mortality in ARDS patients who underwent NMBA.Methods: ...
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Background: The study of neuromuscular blocking agents (NMBAs) in the management of acute respiratory distress syndrome (ARDS) has provided conflicting results in terms of their effect on mortality.Objectives: The main purpose of this study was to evaluate mortality in ARDS patients who underwent NMBA.Methods: A retrospective secondary analysis of 4200 patients with ARDS was collected from two academic medical centers, Tehran, Iran. This study was performed to assess the impact of NMBAs use in ARDS patients with different subgroups including mild and moderate-to-severe ARDS, age more and less than 65 years, having medical turnover vs. not-having, and high acute nursing care vs. moderate to low nursing care.Results: Intensive care unit (ICU) mortality has occurred in 1169 (27.8%) participants. The mortality rate was 28.6% and 27.5% in patients with mild and moderate-to-severe ARDS, respectively. In the subjects without medical turnover, the moderate dose of NMBAs significantly reduces the mortality of patients (P = 0.044). In patients who need high acute nursing care, increasing the NMBAs dose significantly reduces patients’ mortality (P = 0.010). In addition, increasing the NMBAs doses significantly reduces ICU length of stay (LOS).Conclusion: This study provides evidence that the administration of different doses of NMBAs had no effect on patients’ mortality with mild or moderate-to-severe ARDS. However, higher doses of NMBAs than low doses increased the risk of mortality in patients over 80 years and can reduce the risk of death in patients less than 55 years.
Chih-Hsuan Huang; Hsin-Hung Wu; Yii-Ching Lee; Li Li; Cheng-Feng Wu
Abstract
Background: Patient safety culture in healthcare organizations has become an important issue globally for improving medical services. In 2016, Taiwan’s National Health Insurance (NHI) system covered 99.6% of Taiwan’s population. With the enhancement of medical quality, patients expect medical ...
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Background: Patient safety culture in healthcare organizations has become an important issue globally for improving medical services. In 2016, Taiwan’s National Health Insurance (NHI) system covered 99.6% of Taiwan’s population. With the enhancement of medical quality, patients expect medical service providers to care more about safety and medical service. Understanding physicians and registered nurses’ attitudes toward patient safety is a critical issue for healthcare organizations wanting to improve the quality of the medical care they provide. Objective: The purpose of this study was to discern physicians and registered nurses’ attitudes toward patient safety using Sexton and colleagues’ Safety Attitudes Questionnaire (SAQ) in order to develop strategies for improving the quality of medical services. Methods: Pearson correlation analyses were conducted to demonstrate the relationships among six patient safety culture dimensions. Physicians and registered nurses were asked to complete the questionnaire in a case hospital in Taiwan in 2016. Results: The results of Pearson correlation analyses demonstrated a strong and positive relationship between perceptions of management and working conditions. Additionally, teamwork climate was highly correlated to safety climate. The results also illustrated that teamwork climate and job satisfaction were significantly related. Conclusion: The assessment of patient safety culture can provide a basis for hospital managers to monitor the quality of the medical care provided at their organizations. Hospital managers should put more efforts into the essentially important elements of patient safety culture, such as teamwork climate, safety climate, perceptions of management, and working conditions, so as to continuously improve the quality of medical care.
Muhammet Gurdogan; Ugur Ozkan; Servet Altay; Fulya Puyan
Abstract
Introduction: It is well known that the tendency toward thrombosis is increased in cancer patients. The increase in cancer procoagulant and tissue factor levels, endothelial damage, and stasis due to compression are among the most accused causes of thrombosis in cancer patients. Hypereosinophilia is ...
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Introduction: It is well known that the tendency toward thrombosis is increased in cancer patients. The increase in cancer procoagulant and tissue factor levels, endothelial damage, and stasis due to compression are among the most accused causes of thrombosis in cancer patients. Hypereosinophilia is a rare condition that causes endothelial damage leading to thrombosis. Case Presentation: We present a 64-year-old male patient with cardiac involvement of hypereosinophilia which developed in the T-cell lymphoma ground resulting in a fatal cardioembolic stroke. Despite normal left ventricular (LV) contractions, almost half of the ventricular volume was full of thrombus in this case. Conclusion: Hypereosinophilia is a rare cause of thrombus formation in the left ventricle in patients with preserved ejection fraction. However, hypereosinophilic cardiac involvement can lead to rapid, progressive, life-threatening complications.
Zahra Ismaili Shahroudi Moqaddam; Mohsen Saberi Isfeedvajani
Abstract
Introduction: Suicide is a major challenge to public health worldwide, and self-inflicted burn is one of the most violent suicide methods. Case Presentation: In this case, a self-inflicted hot oil burn in a male with schizotypal personality and major depressive disorder is reported. Conclusion: Psychiatric ...
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Introduction: Suicide is a major challenge to public health worldwide, and self-inflicted burn is one of the most violent suicide methods. Case Presentation: In this case, a self-inflicted hot oil burn in a male with schizotypal personality and major depressive disorder is reported. Conclusion: Psychiatric disorders, marital problems, and economic poverty are mentioned as risk factors for self-inflicted burn. Thus, these risk factors should be considered in the management of self-inflicted burn patients.
Effat Jahanbani; Reza Shakoori; Masoume Bagheri-Kahkesh
Abstract
Background: Drugs play a strategic role as a health commodity. Thus, the supply chain management of drugs is an important issue to reducing costs and thereby improving patient health. Objective: This study evaluated the status of drug supply chain management and health reform in the pharmaceutical sector ...
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Background: Drugs play a strategic role as a health commodity. Thus, the supply chain management of drugs is an important issue to reducing costs and thereby improving patient health. Objective: This study evaluated the status of drug supply chain management and health reform in the pharmaceutical sector of teaching hospitals in Ahvaz, Iran. Methods: This cross-sectional study was carried out in pharmacies of teaching hospitals in Ahwaz, Iran in 2015. Data was collected through a checklist extracted from the Evaluation Checklist of the Food and Drug Deputy and related articles. The study checklist examined six dimensions of the Evaluation Checklist, including drug storage, administrative regulations, preparation of medicines, drug distribution, taking medication, and implementation of health reforms in the pharmaceutical sector. The content validity of the checklist was confirmed by experts and pharmaceutical specialists. Data was analyzed for descriptive characteristics such as frequency and percentage using EXCEL version 2010 software. Results: The findings show that hospitals met standards for administrative regulations with 78.5% and preparation of medicines with 77.25%. The dimensions of drug storage with 74.75%, taking medication with 74.25%, implementation of health reforms with 71.5%, and drug distribution with 62.5% were in a near-standard state. Conclusion: Supply chain management systems of medicines in teaching hospitals are near-standard. To improve hospitals, offering proper training to employees, using the fixed-rate shopping system, and providing facilities to patients are recommended.
Mahmud Nayeri; Somayeh Hessam; Amir Ashkan Nasiripour; Katayoun Jahangiri
Abstract
Background: One of the most important issues in the health system is to provide the necessary resources to present health services. To increase the role of charities and facilitate public participation in the treatment area and to develop hospital units, the cooperation between charity organizations ...
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Background: One of the most important issues in the health system is to provide the necessary resources to present health services. To increase the role of charities and facilitate public participation in the treatment area and to develop hospital units, the cooperation between charity organizations and public hospitals must be highlighted. Objectives: This study aimed at identifying the type of contract for the transfer of health services to charities in the teaching hospitals of Shahid Beheshti University of Medical Sciences in Tehran, Iran. Methods: This study was conducted in hospitals of Shahid Beheshti University of Medical Sciences in 2019. The statistical population of the study consisted of 411 people, including managers, chiefs, and deputies, contracting experts, hospital social workers, managers and lawyers of the university, trustees, and managers, and charity experts. The research sample consisted of 330 people who were selected using a stratified random sampling method. SPSS version 18 and AMOS software were used to analyze the data. Results: By identifying the selection criteria of a charity to operate in the hospital, identifying the contract model, identifying the share of capital and current costs, and selecting the type of department in the contract with path coefficients of 0.78, 0.72, 0.68, 0.73, and 0.73, respectively, it can be ensured that the costs of an inpatient ward were supplied by the charity during the contract term. Conclusion: The study showed that the partnership contract model is the most appropriate type of contract in the transfer of health services to charities.
Zahra Danial; Malihe Moayed; Mohammad Hossain Kalantar Motamedi; Sedigheh Mirhashemi; Heshmatosadat Zamanian
Mohamad Amin Pourhoseingholi; Farshid Rahimibashar; Masoum Khosh Fetrat; Amir Vahedian-Azimi
Abstract
Background: Retraction of articles occurs as a result of scientific misconducts or honest errors. Objectives: This study aimed to identify the frequency of retracted Iranian publications, compared to those of other countries and adjust them with influential parameters. Methods: All publications that ...
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Background: Retraction of articles occurs as a result of scientific misconducts or honest errors. Objectives: This study aimed to identify the frequency of retracted Iranian publications, compared to those of other countries and adjust them with influential parameters. Methods: All publications that were indexed on the Scopus database from 2008 to 2017 and then retracted, due to scientific misconduct were extracted through the Retraction Watch database and selected as the research community. To calculate the growth of retraction for each proposed country (or region), first, the rate of an absolute number of retracted papers for the years 2013-2017 was divided by the similar number for years 2008-2012, then this rate was adjusted to the retracted rate which is similarly computed for the total retracted statistics of the world. Results: Overall, 545 Iranian retracted publications from 2008 to 2017 were identified, of which 240 and 305 retracted articles were related to the first five years and the second five years of the study, respectively. The results showed that less than 1% (0.82) of all scientific articles published by Iranian researchers were retracted. However, the rate of retracted scientific articles in Iran compared to this rate in the world was significantly higher. Conclusion: Although retracted Iranian publications make up a small percentage of all Iranian publications, the number of retracted publications is increasing. It is important to recognize the reasons for scientific misconducts and to provide researchers with proper education.
Nurullah Damburacı; Barış Sevinç; Şirin Küçük; Nebi Sürüm; Cenk Şahin Güler; Ömer Karahan
Abstract
Introduction: Steroid cell tumors (SCTs) constitute less than 0.1% of all ovarian tumors. They are divided into 3 categories according to cell of origin: Stromal Luteoma arising from stromal cells of the ovary, Leydig cell tumor arising from Leydig cells, and SCT not otherwise specified (NOS) when the ...
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Introduction: Steroid cell tumors (SCTs) constitute less than 0.1% of all ovarian tumors. They are divided into 3 categories according to cell of origin: Stromal Luteoma arising from stromal cells of the ovary, Leydig cell tumor arising from Leydig cells, and SCT not otherwise specified (NOS) when the origin of the tumor is not defined. Case Presentation: Herein is presented a case of SCT diagnosed one month after a caesarian section delivery of a female fetus with ambiguous genitalia. The patient was admitted to the emergency department with the findings of acute abdomen, and surgery was performed under emergency conditions. The patient had virilization and hoarsening of the voice before surgery. Intraoperatively, a 21-cm ovarian mass was detected and resected with unilateral salpingo-oophorectomy. Conclusion: A histopathological examination of the tumor showed a tumor with cystic degeneration, necrosis, hemorrhage, and tumoral embolism. The pathological examination revealed ovarian SCT. Virilization was resolved immediately after the surgery. In women with virilization who give birth to a fetus with ambiguous genitalia, SCTs should be kept in mind.
Zahra Motaghed; Payman Mahboobi-Ardakan; Mohammad Meskarpour-Amiri
Abstract
Background: A patient's satisfaction with nursing service is one of the main indices for measuring the quality and effectiveness of health care. Objective: The purpose of this study was to investigate and compare patients' satisfaction with the nursing service provided in selected training hospitals ...
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Background: A patient's satisfaction with nursing service is one of the main indices for measuring the quality and effectiveness of health care. Objective: The purpose of this study was to investigate and compare patients' satisfaction with the nursing service provided in selected training hospitals in Tehran. Methods: This cross-sectional study was conducted in 2013 using Patient's Satisfaction Standard questionnaire (PSI) in 7 selected training hospitals in Tehran. In this study, 336 patients discharged from 4 major units of each hospital namely internal, surgery, obstetrics and gynecology and pediatrics, were selected and studied randomly. Data were analyzed using the SPSS18 software. Results: The results of this study showed that the pediatric unit recorded maximum patients’ satisfaction with nursing care with a mean and SD of 3.78±0.68, while the surgery unit recorded minimum satisfaction with a mean and SD of 3.35±0.65. Also, a significant difference was observed between patients' satisfaction with nursing service in major units such as internal, surgery, obstetrics and pediatrics (P=0.015). Conclusion: However, significant differences were found in terms of degree of satisfaction with nursing service between the major units of the hospitals. These differences may be due to the characteristics of providing care, unit, patient or family. Therefore, future research should be conducted in order to identify the cause of the difference in satisfaction between the different hospital units.