ABSTRACT
Objectives@#Aging is assumed to be accompanied by greater health care expenditures. The objective of this retrospective, bottom-up micro-costing study was to identify and analyze the variables related to increased health care costs for the elderly from the provider’s perspective. @*Methods@#The analysis included all elderly inpatients who were admitted in 2017 to a hospital in Tehran, Iran. In total, 1288 patients were included. The Mann-Whitney and Kruskal-Wallis tests were used. @*Results@#Slightly more than half (51.1%) of patients were males, and 81.9% had a partial recovery. The 60-64 age group had the highest costs. Cancer and joint/orthopedic diseases accounted for the highest proportion of costs, while joint/orthopedic diseases had the highest total costs. The surgery ward had the highest overall cost among the hospital departments, while the intensive care unit had the highest mean cost. No statistically significant relationships were found between inpatient costs and sex or age group, while significant associations (p<0.05) were observed between inpatient costs and the type of ward, length of stay, type of disease, and final status. Regarding final status, costs for patients who died were 3.9 times higher than costs for patients who experienced a partial recovery. @*Conclusions@#Sex and age group did not affect hospital costs. Instead, the most important factors associated with costs were type of disease (especially chronic diseases, such as joint and orthopedic conditions), length of stay, final status, and type of ward. Surgical services and medicine were the most important cost items.
ABSTRACT
Purpose: according to frequent needs to gastric decompression by nasogastric tube insertion during laparoscopic Cholecystectomy, the current comparative study was accomplished through single blind clinical trial considering both the presence and the absence of guide wire insertion
Materials and Methods: twenty patients were selected for elective surgery of laparoscopic Cholecystectomywith general anesthesia.Guide wires were usedin the nasogastric tube insertion operation of patients with even numberswhile the operation of patients with odd numberswas not assisted withthese guide wires.Afterwards, the considered parameters between the two groups were evaluated.The gathered data was analyzed by SPSS softwareversion 18.The results were considered statistically significant for [P = .05]
Results: the two groups were uniform regarding demographic parameters such as age, and sex [P = .05].In the group utilized guide wiresthe surgeon's satisfaction rate was higher while some other parameters such as trial score, bleeding episodes, insertion time, and Rate-Pressure Production Index were meaningfully lower than the those of the group not utilized guide wires. Also, in both groups the success rate of insertion through left nostril was statistically higher [P = .05]
Conclusion: in laparoscopic Cholecystectomy, theinsertion method of nasogastric tube with guide wires is better than not using theguide wires
ABSTRACT
Ascorbic acid has protective effects against coronary heart disease. These effects are attributed to its antioxidant properties and its relation to plasma lipids. This study investigated the effects of supplementing one gram of vitamin C per day on the serum serum lipoproteins of healthy 18 to 55 years old individuals in Iran. This study was conducted on 55 healthy individuals aged 18 to 55 years old at a medical center of Iran's Army. None of the participants had taken vitamin supplements three months before participating in the study. Their diet patterns were evaluated by estimating the energy and nutrients intake. At the beginning of the study, serum triglyceride, high density lipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol [LDL-C] and total cholesterol levels of the participants were measured. Then, the participants received one gram of vitamin C on a daily basis for 30 days. Blood parameters were measured on the 15th and 30th days of supplementation and were compared with each other. The findings were analyzed with Student's t-test test and analysis of variance [ANOVA] test using Statistical Package for Social Sciences [SPSS] software version 18. After receiving vitamin C supplement for 30 days, a significant reduction was seen in the participants' total cholesterol level [12.2%] and average plasma triglyceride concentration level [8.09%]. HDL cholesterol level significantly increased [14.5%] after one month of vitamin C supplementation [P =.032]. Taking one gram of vitamin C daily may significantly reduce serum lipoprotein levels in healthy individuals
ABSTRACT
Despite discovering new antibiotics, mortality due to septic shock has remained high. This research has examined the effect of selenase in patients with septic shock admitted to the intensive care unit [ICU] of a hospital in Tehran. This double-blind clinical trial was done on 80 participants [40 case and 40 control] who were admitted to the ICU with septic shock. Every participant in the case group was administered 500 micro g selenase twice daily for 10 days. In contrast, each participant of the control group was treated with placebo [normal saline]. Data were collected by observation and recorded in a questionnaire. Chi-square and Student's t-test were used for data analysis. In this study 34 participants [42.5%] were men and 46 [57.5%] were women. The duration stay in the ICU in treatment group was less than in the observation group which was statistically significant [P =.01]. There was also a significant difference regarding the frequency of morbidity and mortality rates between the two groups [P =.03 and P =.02, respectively]. Selenium at a dosage of 500 micro g [twice daily] is effective in those who have suffered from septic shock. Still, more studies are needed to determine the best dosage and administration method of this drug
ABSTRACT
The aim of this study was to investigate the role of local pentoxifylline in reducing peritoneal adhesions after laparotomy performed on rats. In this randomized double-blind study, 30 male white rats weighing approximately 280-300 g were divided into two equal groups. In the control group, after induction of anesthesia and under sterile conditions, with a midline incision of 3 cm the muscles and the peritoneum opened. Animal cecum was determined by the surgeon and with one gauge, abrasions were made on antimesentric edge of cecum. Then the cecum was placed back in the abdomen and the abdomen was closed in 2 layers using nylon string "2-0" and running sutures. In case group all the above steps were repeated. The abdomen was washed with local pentoxifylline. After 2 weeks, rats were re- laparotomy. Blasting locations were studied in a previous surgery and adhesion were recorded from 0 to 3. And finally the data were analyzed by SPSS v.11 software using of statistical tests. In all of control group, adhesion was founded. In case group adhesions were founded in seven cases. Adhesion rate difference between the two groups was significant [P=0.013]. According to obtained findings from this and other similar studies, the surgeons can reduced adhesions after abdominal surgery by using local pentoxifylline
Subject(s)
Animals, Laboratory , Pentoxifylline/administration & dosage , Pentoxifylline , Rats , Double-Blind Method , Abdomen/pathology , LaparotomyABSTRACT
A reflex cough is often observed after intravenous bolus of fentanyl. This study was conducted to determine whether pre-treatment with oral clonidine could attenuate fentanyl-induced cough. Two groups, containing 80 patients each, were candidated for elective surgery under general anesthesia. They were randomly divided into case group, receiving preoperative oral clonidine tablet, and control group, receiving preoperative placebo. Then gathered data was analyzed with Chi - square, Mann-Whitney U, T-Student and Tukey tests by 13 spss software, version 13. The results were evaluated as the mean +/- SD and considered statistically significant for p <0.05. Two groups were similar with demographic parameters as age, weigh and sex [p>0.05]. In the clonidine group severity and frequency of fentanyl induced cough were lower [p<0.05]. The OAA/S scaling score in two groups were similar [p>0.05]. Pre-medication with oral clonidine can effectively attenuate fentanyl-induced cough with an unknown mechanism