Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 3 4 2018 10 01 Ultrasound Guided Infraclavicular Block for Pain Control After Upper Extremity Surgery 108 112 67492 10.15171/hpr.2018.24 EN Derya Yalçın Department of Anesthesiology and Reanimation, Ersin Arslan Educational and Research Hospital, Gaziantep, Turkey Dilek Erdoğan Arı Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Educational and Research Hospital, Istanbul, Turkey 0000-0002-3734-5323 Ceren Köksal Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Educational and Research Hospital, Istanbul, Turkey Cansu Akın Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Educational and Research Hospital, Istanbul, Turkey Sinan Karaca Department of Orthopedics and Traumatology, Fatih Sultan Mehmet Educational and Research Hospital, Istanbul, Turkey Özgür Karakuş Department of Orthopedics and Traumatology, Fatih Sultan Mehmet Educational and Research Hospital, Istanbul, Turkey Journal Article 2017 12 07 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.

https://www.jhpr.ir/article_67492_e3073c9cf27a471c511f7ca92842644a.pdf

Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 3 4 2018 10 01 CONUT: A Useful Alarm of Malnutrition in the Centralized Laboratory of a Spanish Hospital 113 117 68174 10.15171/hpr.2018.25 EN Miriam Menacho-Román Clinical Biochemistry Department. University Hospital “Ramón y Cajal”, Madrid, Spain 0000-0002-6422-8608 Gilberto Pérez-López Endocrinology Department. University Hospital “Ramón y Cajal”, Madrid, Spain José Manuel Del Rey-Sánchez Clinical Biochemistry Department. University Hospital “Ramón y Cajal”, Madrid, Spain Domingo Ly-Pen Abbey House Medical Centre, Navan, Ireland Antonio Becerra-Fernández Endocrinology Department. University Hospital “Ramón y Cajal”, Madrid, Spain Journal Article 2018 03 04 Background: Hospital malnutrition, usually secondary to various diseases and their treatments, is an important problem in our clinical practice. For its proper assessment, it is crucial to use a nutritional alert system, such as the CONUT (COntrol NUTrition) program; this tool uses 3 analytical parameters: serum albumin, total cholesterol, and total lymphocyte count. Objective: The current study assessed the results of the implementation of this program in the University Hospital Ramón y Cajal. Methods: The CONUT program has been used in the University Hospital Ramón y Cajal since 2013. This retrospective study, throughout 2016, was conducted in the Central Laboratory of Chemical Biochemistry at the University Hospital Ramón y Cajal. All blood tests with serum albumin, total cholesterol, and total lymphocyte count were studied. The degree of malnutrition was assessed using the scale of normal (=0), mild (=4), moderate (=8), and severe (=12). Results: In 2016, there were 405406 analytics performed in the laboratory of University Hospital Ramón y Cajal. The CONUT tool was applied to 3.64% of them (14741 analytics). In the outpatient setting, the highest malnutrition index comprised patients from the liver transplant consultation department, followed by the cardiology, rheumatology, and oncology departments. With inpatients, the hematology, cardiology, and endocrinology departments showed the most severe malnutrition index. Conclusion: The CONUT system seemed to provide useful information about the cohort of the studied hospital. The results showed that 94% of the patients were not classified with malnutrition, there was no gender predilection, and they were younger than the rest. Patients with more severe malnutrition were usually older and male.

https://www.jhpr.ir/article_68174_34ac4e5e1b1ad2e482ac11702f93805f.pdf

Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 3 4 2018 10 01 Evaluation of Flow Cytometry and Kleihauer Techniques for Quantification of Fetomaternal Hemorrhage: A Prospective Cohort Study in Southwestern Iran 118 122 74129 10.15171/hpr.2018.26 EN Zeinab Keshavarz Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Leili Moezzi Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Reza Ranjbaran Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Abbas Behzad-Behbahani Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Masooma Abdullahi Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Mahdokht Mahmoodi Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Sedigheh Sharifzadeh Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Journal Article 2018 05 17 Background: Quantification of fetal red blood cells (RBCs) in maternal blood is of great importance to calculate appropriate dose of post-deliver anti D immunoglobulin in a rhesus D (RhD)-negative woman. Objective: The aim of this study is to evaluate a direct immunofluorescence flow cytometry technique in artificial and clinical samples and compared it to the Kleihauer-Betke test (KBT). Methods: This study was a prospective cohort design. Blood samples from 26 pregnant women who gave birth to RhD positive babies were tested using direct immunofluorescence flow cytometry and KBT techniques to determine the amount of FMH in the maternal circulation. The zone of D-positive cells was identified employing artificial samples including 0.3%, 0.6%, 1%, 1.5%, 2%, 5%, 10%, and 50% of D-positive fetal cells in D-negative maternal cells. Results: Analysis of 26 clinical samples for FMH showed consistent quantification with the flow cytometry and Kleihauer techniques. Although a good correlation was found between the KBT and flow cytometry results, in artificial samples containing more than 2% of fetal RhD positive cells, the flow cytometry results were closer to theoretical percentages. In a patient with FMH >4 mL, the FMH and consequently the required vial of Ig were overestimated using KBT. Conclusion: Most of the FMH calculated could have been neutralized by doses less than 625 IU, whereas the routine dose in Iran is more than double that amount (1500 IU). This achievement demonstrates that adjusting between the RhD immune globulin (RhDIg) dose and FMH size is inevitable.

https://www.jhpr.ir/article_74129_516c1741c92119dea177822d03886351.pdf

Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 3 4 2018 10 01 Voluntary/Involuntary Admissions/Readmissions of Psychiatric Patients in a University Hospital in Turkey From 2008 to 2016 123 129 69412 10.15171/hpr.2018.27 EN Bahadır Geniş Department of Psychiatry, Faculty of Medicine, Gazi University, Ankara, Turkey 0000-0001-8541-7670 Behçet Coşar Department of Psychiatry, Faculty of Medicine, Gazi University, Ankara, Turkey 0000-0002-6422-499X Selçuk Candansayar Department of Psychiatry, Faculty of Medicine, Gazi University, Ankara, Turkey Nermin Gürhan Department of Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey 0000-0002-3472-7115 Journal Article 2017 11 30 Background: The treatment and hospitalization of psychiatric patients has been a dilemma for many years. Many countries have different specific legislations regarding the hospitalization and treatment of mental patients. Objective: In the current study, 4100 voluntary/involuntary psychiatric admissions and readmissions to a university hospital in Turkey were investigated, and patient groups were compared in terms of demographic variables and psychiatric diagnoses based on DSM IV-TR. Methods: The records of patients who had been hospitalized approximately 4–6 weeks were reviewed by two psychiatrists, and the patients were then divided into groups on the basis of single/multiple admissions and voluntary/involuntary admissions. The groups were compared based on psychiatric diagnoses. Results: Schizophrenia was the most common diagnosis in 71.5% (n = 865) of patients with multiple admissions. The second most common diagnosis was bipolar affective disorder with 13.1% (n = 159). The rate of schizophrenia in both voluntary and involuntary hospitalizations was significant (34.5% and 54.6%, respectively). However, depression, the second most common diagnosis requiring hospitalization with a rate of 23.2% of voluntary hospitalizations, accounted for only 3.7% of involuntary hospitalizations. Conclusion: Males constituted almost 75% of the single admission group. This difference may result from the socioeconomic and cultural profile of Turkey, as mental disorders make marriage impossible and are hidden in females suffering from them. Different findings from different cultures on single/multiple admissions and voluntary/involuntary admissions of patients lead to the conclusion that specific legislation covering treatment or hospitalization for mental disorders is needed in every country.

https://www.jhpr.ir/article_69412_65d9c8aa8382e68bd920056202a13c38.pdf

Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 3 4 2018 10 01 Design and Evaluation of a Mobile-Based Application for Patients With Type 2 Diabetes: Case Study of Shariati Hospital in Tehran, Iran 130 136 68430 10.15171/hpr.2018.28 EN Reza Safdari Department of Health Information Management, Faculty Member of Paramedical School, Tehran University of Medical Sciences, Tehran, Iran 0000-0002-4982-337X Leila Shahmoradi Department of Health Information Management, Faculty Member of Paramedical School, Tehran University of Medical Sciences, Tehran, Iran 0000-0002-2269-9022 Ali Garavand Department of Health Information Management and Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Nasim Aslani Department of Health Information Management, Iran University of Medical Sciences, Tehran, Iran Aliasghar Valipour Department of Epidemiology, Faculty Member of Abadan School of Medical Sciences, Abadan, Iran Hassan Bostan Department of Health Information Technology, Abadan School of Medical Sciences, Abadan, Iran 0000-0001-8295-0007 Journal Article 2018 05 01 Background: With regard to the particularly high prevalence, cost, and number of disabilities associated with diabetes, increasing patients’ knowledge and skills for managing the disease can help minimize the risks of complications. Objective: The present study aimed to design and evaluate a mobile-based application with which patients with type 2 diabetes can increase their knowledge of and skills for managing their disease. Methods: The current developmental-applied study was conducted in 2016 in a library and used a 2-step sectional format. The research population comprised 15 physicians and endocrinologists working in medical centers associated with Tehran University of Medical Sciences and 20 physicians and patients. Based on the library study, a checklist was designed and then distributed among participants. Their responses were analyzed using SPSS software version 20. Results: The data was divided into 4 main sections: identity information (patient demographics), clinical information, education curriculum related to diabetes management, and program requirements for diabetes management, which consisted of 52 subsets. The evaluation of the system by doctors and patients showed that the system has high capabilities. Conclusion: Mobile-based programs can help diabetics control blood glucose levels, reduce diabetes complications, and promote overall health.

https://www.jhpr.ir/article_68430_22c3333d7a7f70e280a3bd32c69ed6c8.pdf

Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 3 4 2018 10 01 Hypereosinophilic Cardiac Involvement Presenting With Left Ventricular Massive Thrombus and Cardioembolic Stroke: A Case Report 137 139 68188 10.15171/hpr.2018.29 EN Muhammet Gurdogan Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Turkey Ugur Ozkan Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Turkey Servet Altay Department of Cardiology, Faculty of Medicine, Trakya University, Edirne, Turkey 0000-0001-7112-3970 Fulya Puyan Department of Pathology, Faculty of Medicine, Trakya University, Edirne, Turkey Journal Article 2018 03 10 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.

https://www.jhpr.ir/article_68188_dc159a30f1e7fe7352b88109050f5512.pdf