ABSTRACT
Pacemaker infection has multiple risk factors. Its presentation is most often similar to infected endocarditis and the diagnosis is made through studying blood cultures. Transesophageal echocardiography can confirm the diagnosis. The most common microorganisms are staphylococcus speciesis. As a matter of fact, complete pacemaker removal appears to be the only definite treatment. We presented a case of infected pacemaker lead which was firstly referred with fever and nephritic syndrome. She had intermittent atrial flutter rhythm. Therefore, a total infected pacemaker system was removed under cardiopulmonary bypass support. Yet, the lead was firmly attached to the septal leaflet of tricuspid valve while leaflet repair was needed. As a result, atrial flutter rhythm was converted into sinus rhythm after an incidental interruption of the macroreentrant circuit in the process of the tricuspid leaflet surgery
ABSTRACT
To evaluate the admission electrocardiogram [ECG] patterns as prognostic factors and compare the Q wave with other criteria such as time, for choosing the best treatment in acute myocardial infarction [AMI] Prospective case-control study Cardiac Emergency Departments of Imam Reza and Qaem Hospitals, Mashhad, Iran A total of 143 consecutive patients between year 2010 and 2012, diagnosed with AMI who were candidates for reperfusion therapy were enrolled. The admission and control post-thrombolytic therapy ECGs were taken for all subjects. Then admission ECG patterns, time to therapy and their relation with the reperfusion rate were analyzed. 60.1% [n = 86] of patients achieved 50% or more ST recovery [good response group] and 39.8% [n = 57] of patients had lower than 50% ST recovery [poor response group]. The mean response rate was significantly lower in patients presenting with Q wave [p 0.023]. In patients with initial Q wave, there was no significant difference in response rate whether they were treated within three hours from the onset of symptoms or not [p = 0.75]. In contrast, patients without Q wave who received thrombolytic therapy within first three hours had significantly higher reperfusion rates in comparison with those treated after three hours [p = 0.004]. It is suggested that, time from the onset of symptoms along with initial Q wave is better for decision making in AMI management, than the time alone
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The basic responsibility of nurses is to maintain patient safety including notifying patients and colleagues about risk and risk reduction methods, supporting the patient safety and reporting events to a responsible person. Without creating a safety culture in all health facilities a sustainable development in the patient care do not occur. This study aims to determine the patient safety culture in teaching hospitals in Gorgan. In this cross-sectional study, a target group includes nurses at 5 Azar, Taleghani and Deziani Hospitals in Gorgan in 2011. The study population included 348 nurses in these hospitals. The data collection instrument was a questionnaire with 43 questions. Statistical tests were ANOVA and T-Test. Twenty four percent of nurses believed patient safety culture is weak, 46.8% of them, moderate and 30.7% good. The weakest dimension was non-punitive response to error and strongest dimension was organizational education. Statistic test showed significant relationship between patient safety culture and experience [p= 0.021], employment status [p= 0.001], hospital [p= 0.001], ward [p= 0.003]. The status of the patient safety culture was related moderate from the nurses' view point but it is necessary it improved in dimensions of the non-punitive response and the staff workload to note that it is highly recommended to take some actions in this regard. [Kabir M. Heidari A. Jafari N. Vatankhah S. Etemad K. Aarabi M. Aghapour SA. Lotfi M. The perspectives toward patient safety culture among nurses staff in educational hospitals in Gorgan in 2011. IJHS 2013; 1[1]:75-83] http:/jhs.mazums.ac.ir
ABSTRACT
Atrial fibrillation [AF] is the most common postoperative arrhythmic complication after coronary artery bypass graft surgery [CABG]. The aim of the present study was to compare AF prevalence after off-pump versus on-pump CABG. In this prospective study, performed between September 2008 and September 2009, 128 consecutive patients in our local cardiovascular surgery ward were allocated into two groups of off-pump [95 patients] and on-pump CABG [33 cases]. We compared preoperative risk factors such as left ventricular ejection fraction [LVEF]<%40, hypertension [HTN], and Cr>2mg/dl, site of grafting such as the left coronary descending artery [LAD], right coronary artery [RCA], and left circumflex artery [LCX] in the two groups of surgery techniques [on-pump versus off-pump CABG] with/without postoperative AF after 24 hours of surgery in the Intensive Care Unit, Statistical power of the study was 80%, and a P-value less than 0.05 was considered significant. The prevalence of AF was 15 [15.8%] in the off-pump group versus 7 [21.2%] in the on-pump group [p=0.67] 24 hours after CABG. In the on-pump group, there was no difference between age categories [p=0.11]. In the on-pump group, as opposed to the off-pump CABG group, there was no relationship between the surgery techniques with or without AF, LVEF <%40, and HTN. There was a significant relation with Cr more than 2 mg/dl in the on-pump CABG group [p=0.001] versus the off-pump CABG group [p=0.057]. There was no statistical relation between the type of vascular graft [LAD, RCA, and LCX] between the on-pump and off-pump CABG patients attributed to with or without AF. There was no reduction in the AF rate in the off and on-pump CABG versus off-pump CABG. It seems that there was another predictive factor for AF in the off and on-pump CABG groups, so further prospective trials with larger sample sizes are recommended
Subject(s)
Humans , Coronary Artery Bypass , Coronary Artery Bypass, Off-Pump , Postoperative ComplicationsABSTRACT
Objective [s]: To determine economics cost of diabetes in type II diabetic patients under the cover of Naderkazemi clinic in Shiraz in the first half of 2008
Methods: this study is an applicable one and the way of study is descriptive-analytic.the study society includes type II diabetic patients that referred to Naderkazemi clinic and made file. in this study among the 4900 files related to type II diabetic patient, at first, in the pilot study,30 files chosen by the way of systematic sampling and examined. standard deviation these files was +/-/38.that in respect to received standard deviation,220 files were chosen as samples that eventually with the help of statistics advisor,288 file were chosen as samples and were studied in a systematic way. the needed information in this study were gathered from observing the existing information in patient´s files, interviewing with personnel and manager and also from existing information and ducuments in provision, accounting and personnel departments. results were classified as charts and graphs and were expressed descriptively
Results: in this study, total economic costs of type II diabetes calculated 37942315040 Rials [4079818.8 dollar], that medical direct costs and indirect costs share was 3994348680[429499.9 dollar] and 33947966360[3650319 dollar] Rials, respectively. Medical direct and indirect costs of diabetes in a type II diabetic patient in first half of 1387 was 815173/2[87.65 dollar] and 6928156/4[744.96 dollar] Rials respectively, and altogether was 7743329/6 Rials [832.61 dollar]
Conclusion: Economic cost of type II diabetes is very high and complications of this disease can important influence on patient and their family. Because of restricting resources of medical-health in society, diabetes is one of medical-health priority in our country and should have large actions to reducing costs and complications of this disease
ABSTRACT
Using the conservative adhesive resin restoration [CAR] in uncooperative children lead to numerous problems because of being time consuming. The purpose of this study was to compare the microleakage of conservative adhesive resin restoration under separate curing and co-curing. In this experimental study, 120 intact premolar teeth were collected and 120 vertical grooves were prepared on them. Then the teeth were divided into four groups: group 1, separated curing of bonding agent, flowable composite and sealant; group 2, co-curing of all materials for 60 seconds; group 3, co-curing of all materials for 40 seconds and group 4, co-curing of all materials for 20 seconds. Then the specimens were thermocycled and immersed in basic fuchsin solution. The teeth were sectioned horizontally and dye penetration was evaluated with stereomicroscope. Date were analyzed using one-way ANOVA and Scheffe test. Mean value of dye penetration in groups 1, 2, 3, and 4 was 1.53 +/- 0.6, 2.06 +/- 0.6, 2.5 +/- 0.7 and 3.53 +/- 0.6, respectively. There was a statistically significant difference between group 1 and the other groups [P=0.0001]. Considering the problems caused by microleakage in conservative resin adhesive restorations, co-curing method should not be used. In the case of using co-curing method, 60 second curing time is suggested for sufficient polymerization
Subject(s)
Resin Cements , Dental Restoration, Permanent , Post and Core Technique , Dental Restoration Repair , Dental Prosthesis , Dental Leakage , Dental Restoration FailureABSTRACT
The aim of this study was to construct and validate a scale for measuring interpersonal forgiveness, suitable for Iranian socio-cultural features. The subjects were comprised of 400 college students [237 female, 167 male] selected through random stratified sampling from Ahvaz universities. Data were collected using family forgiveness scale [FFS]. Ahvaz Aggression Inventory [AAI], and Agreeableness from NEO Five Factor Inventory [NEO-FFI]. Data were analyzed using Pearson's correlation coefficient and stepwise regression analysis. Results of factor analysis showed that three factors comprised Interpersonal forgiveness Inventory [IFI]: from the total 25 items of the scale. 12 items were loaded on first factor [restructure of relationship and control of revenge], 6 items were loaded on second factor [pain control], and 7 items were loaded on third factor [realistic understanding]. The interpersonal forgiveness scale has appropriate reliability and validity for the measurement of this feature among student population
ABSTRACT
Glass ionomer is used in conservative adhesive restoration [CAR] in order to release floride. The purpose of this study was to evaluate the microleakage of glass ionomer and fissure sealant interface in in vitro conservative adhesive restorations [CAR]. In this in vitro experimental study, a cavity with diameters of 5 and 3mm and depth of 1mm was prepared in the buccal surface of 21 human's intact premolar teeth. The prepared cavities were filled with glass ionomer and cured. Then another groove with diameter of 5mmx0.5mmx0.5mm was prepared adjacent to and in touch with the first box and filled with fissure sealant and cured. In the lingual surface of each tooth, a cavity with diameter of 3mmx3mm and depth of 1 mm was prepared and filled with flowable composite and cured. Another groove with diameter of 3mmx0.5mm was prepared and filled with fissure sealant and cured. Next, the teeth were subjected to thermolcycling [1000 cycle at 5 to 55[degree sign] c sealant-tooth, and composite-tooth was evaluated with stereomicroscope after being buccolingually sectioned. Results were statistically analysed using the Friedman and Wilcoxon tests. The rate of microleakage between glass-tooth was greater than glass-sealant and also the microleakage between glass-sealant was greater than the microleakage between composite-tooth and composite-sealant. The microleakage between composite-sealant was less than the others. According to the results of this study, it is better to use composite instead of glass ionomer in conservative resin restorations