ABSTRACT
Objective@#Postoperative inflammation and infections are common complications of spinal surgery and have similar symptoms. However, postoperative infection may lead to a poor outcome and must be differentiated from postoperative inflammation. The objective of this study is determine the changing pattern of postoperative ESR and WBC counts, and investigate the effects of different variables. @*Methods@#A total of 61 patients who underwent spinal surgery were enrolled in this prospective study. The erythrocyte sedimentation rate (ESR) and white blood cell (WBC) counts were measured the day before surgery and on 1st, 3rd, 5th, 7th, and 14th postoperative days. @*Results@#WBC counts increased on the 1st postoperative day in comparison with the preoperative day (p<0.001), and they gradually decreased until the preoperative value was reached on the 14th postoperative day (p=0.14). The ESR also increased postoperatively, reaching a peak on the 5th postoperative day in comparison with the preoperative day (p<0.001) and gradually decreased thereafter. However, on the 14th postoperative day, the ESR was significantly greater than the preoperative value (p<0.001). In addition, a significant positive correlation was observed between ESR and age, duration of surgery, intraoperative blood loss, and duration of anesthesia. @*Conclusion@#WBC count continued to rise and was the highest on the 1st postoperative day, after which it gradually decreased and attained normal values on the 14th postoperative day, while the ESR increased on the 1st postoperative day, reached the highest level in patients with and without simultaneous instrumentation on 7th and 5th postoperative days, respectively, and gradually decreased.
ABSTRACT
Health care system is a complicated system that needs to harmonized prevention and medical activities. It should be authorized by a management-based organizational structure in social and political conditions. Health programs absolutely should be started by need assessment of people and their demand on the health care services. This is an applied study which was conducted in 2009 year. Study samples included community household dwellers that have been lived in the state of Isfahan- Naeen province. Random quota sampling method was used for selecting samples throughout of 3 blocks in health centers which included 130 household dwellers in each block. Statistical methods and SPSS software version [12] were used to this data analyses. According to the results, there was significant correlation between socioeconomic components [age of father and mother in a household, job status, education level of household dwellers, number of children, income amount, and types of insurance and living place] with the outpatient services benefit. There was significant correlation between demographic status with demand in diagnostic, inpatient services, and medicine purchased. Furthermore, the average of referral to GPs, specialist, dentist, pharmacists, and outpatient diagnostic services were 1.08, 1.44, 0.6, 2.52, 1.32 and 0.44, respectively. The average costs for receiving medical services were 366296 RLs in the Naeen city; although, but it was calculated 454585 RLs for receiving medical services in other cities. Regarding dissatisfaction among participated people in this study, e availability of inpatient services, interesting to refer to clinics into other cities in order to receive health services and also the negative effect on demand, in other hands, considering efficiency indexes in Naeen's health centers and imposing huge costs and spending long times to receive those services in other cities, it makes health-policy makers give more attention to quality of deliver services through health centers. It is recommended to do more studies in assessing the preventative interventions in level 1 and 2 in the health systems as consider as to common diseases, need assessments of different age groups in society, organizing different target groups in marketing, environmental changes, systematic planning, society training, delivering desirable services to target groups, reducing uncertainty feeling of outpatient, diagnostic and inpatient medical centers in Naeen city