Reliability of trauma coding with ICD-10 / 中华创伤杂志(英文版)

PURPOSE@#The reliability of trauma coding is essential in establishing the reliable trauma data and adopting efficient control and monitoring policies. The present study aimed to determine the reliability of trauma coding in educational hospitals affiliated to Shahid Beheshti University of Medical Sciences, Iran.@*METHODS@#In this descriptive cross-sectional study, 591 coded medical records with a trauma diagnosis in 2018 were selected and recoded by two coders. The reliability of trauma coding was calculated using Cohen's kappa. The data were recorded in a checklist, in which the validity of the content had been confirmed by experts.@*RESULTS@#The reliability of the coding related to the nature of trauma in research units was 0.75-0.77, indicating moderate reliability. Also, the reliability of the coding of external causes of trauma was 0.57-0.58, suggesting poor reliability.@*CONCLUSION@#The reliability of trauma coding both in terms of the nature of trauma and the external causes of trauma does not have a good status in the research units. This can be due to the complex coding of trauma, poor documentation of the cases, and not studying the entire case. Therefore, holding training courses for coders, offering training on the accurate documentation to other service providers, and periodically auditing the medical coding are recommended.

Evaluation of c-Myc mRNA expression level in benign prostatic hyperplasia and prostatic adenocarcinoma tissues and its correlation with clinicopathological characteristics

Background and Aims: Prostate cancer [PCa] is one of the most common cancers among men in Iran. Since changes in the regulation of proto-oncogenes expression are the main causes of most human cancers, including PCa, evaluating the expression of marker genes can be helpful for early diagnosis of cancer and better understanding of its etiology. The present study compared c-Myc expression level in prostatic adenocarcinoma and benign prostatic hyperplasia [BPH]

Material and Methods: Paraffin-embedded prostatic tissues from patients with prostate adenocarcinoma [n=38] and BPH [n=38] were selected. The samples were included only if the patients underwent radical prostatectomy and had no history of hormone therapy, chemotherapy, or radiotherapy. After RNA extraction and cDNA synthesis, c-Myc expression in the samples was compared using SYBR green-based real-time polymerase chain reaction

Results: Significantly higher c-Myc mRNA expression was observed in adenocarcinoma samples than in BPH group [p=0.001]. No significant correlation was observed between c-Myc expression and Gleason Score [p>0.05]. There were no significant correlations between c-Myc expression and prostate-specific antigen levels and age [p>0.05]

Conclusions: The c-Myc mRNA expression increased in the PCa samples compared with the BPH group. It seems that c-Myc expression can be introduced as a prognostic marker for determination of the invasive potential of tumor cells. Further tests and studies conducted with larger sample sizes may help to use this marker in differentiating malignant from benign samples

Utilization of site-specific recombination in biopharmaceutical production

Mammalian expression systems, due to their capacity in post-translational modification, are preferred systems for biopharmaceutical protein production. Several recombinant protein systems have been introduced to the market, most of which are under clinical development. In spite of significant improvements such as cell line engineering, introducing novel expression methods, gene silencing and process development, expression level is unpredictable and unstable because of the random location of integration in the genome. Site-specific recombination techniques are capable of producing stable and high producer clonal cells; therefore, they are gaining more importance in the biopharmaceutical production. Site-specific recombination methods increase the recombinant protein production by specifically inserting a vector at a locus with specific expression trait. The present review focused on the latest developments in site-specific recombination techniques, their specific features and comparisons

Relationship of physical activity facilitators and body mass index in Kashan elderly

Introduction: There are many factors that affect the level of physical activity and body mass index of the elderly. The current study aimed to assess the relationship of physical activity facilitators and body mass index of Kashan elderly

Methods: The cross-sectional study sampled 400 elderly older than 60 referred to 10 healthcare centers in Kashan, 2014, via multistage quota method. Participations were tested under demographic characters, body mass index [BMI] level, and exercise benefits part of exercise benefits and barrier scale [persian version] for measurig physical activity facilitators. Data were analyzed in SPSS software, descriptive statistic, Spearman correlation test, Chi-Square and Ordinal regression

Results: Of the participations73.6% were overweight or obese. Median and interquartile range of physical activity facilitators was 75 and 33 respectively. The most prominent physical activity facilitators was" physical activity increases my physical ability, [83.2%]. There was a significantly inverse relationship between physical activity facilitators score and BMI of participants [r = -0.233, p = 0.001]. Ordinal regression evealed that mostly predictor of BMI among physical activity facilitators was "physical activity improves the quality of my work " [OR = 8.683, o = 0.001]

Conclusion: Results identified physical activity facilitators directly is related to improve physical circumstances of the elderly people. Surly poviding physical activity facilitators through educational and interventional programs may improve the health status of aging population.

Modeling of outpatient prescribing process in Iran: a gateway toward electronic prescribing system

Implementation of electronic prescribing system can overcome many problems of the paper prescribing system, and provide numerous opportunities of more effective and advantageous prescribing. Successful implementation of such a system requires complete and deep understanding of work content, human force, and workflow of paper prescribing. The current study was designed in order to model the current business process of outpatient prescribing in Iran and clarify different actions during this process. In order to describe the prescribing process and the system features in Iran, the methodology of business process modeling and analysis was used in the present study. The results of the process documentation were analyzed using a conceptual model of workflow elements and the technique of modeling [As-Is] business processes. Analysis of the current [as-is] prescribing process demonstrated that Iran stood at the first levels of sophistication in graduated levels of electronic prescribing, namely electronic prescription reference, and that there were problematic areas including bottlenecks, redundant and duplicated work, concentration of decision nodes, and communicative weaknesses among stakeholders of the process. Using information technology in some activities of medication prescription in Iran has not eliminated the dependence of the stakeholders on paper-based documents and prescriptions. Therefore, it is necessary to implement proper system programming in order to support change management and solve the problems in the existing prescribing process. To this end, a suitable basis should be provided for reorganization and improvement of the prescribing process for the future electronic systems

Stereological study of the effects of letrozole and estradiol valerate treatment on the ovary of rats / 대한생식의학회지

OBJECTIVE: Letrozole and estradiol valerate are used to treat some hormonally-responsive symptoms and also in modeling of the polycystic ovary syndrome. However, the stereological analysis of the ovary has received less attention. Estimation of the whole ovary volume using the Cavalieri method can be applied in any orientation desired, but estimation of the mean volume of the oocytes requires isotropic uniform random sectioning. Here, a combined method was developed for estimating the parameters. To our knowledge, no comparison has been made of the effects of letrozole and estradiol on the ovary. METHODS: Sixty rats were divided into 4 groups receiving estradiol (4 mg/kg), olive oil, letrozole (1 mg/kg), or normal saline. After 21 days, their ovaries were studied. RESULTS: Relative to the control group, the total volume of the ovary and the cortex increased in the letrozole-treated and estradiol-treated rats. In addition, the number of the preantral, antral, and granulosa cells decreased by 43% to 56% in the letrozole- and estradiol-treated rats. On average, a 19% increase was observed in the atretic oocytes of the letrozole-treated and estradiol-treated rats, but the mean oocyte volume decreased by 29% to 44% in letrozole- and estradiol-treated rats. Furthermore, the letrozole-treated rats showed a 5-fold and 7-fold increase in the volume of the cysts and corpus luteum, respectively. A 3-fold increase was found in the volume of both the cysts and corpus luteum in the estradiol group. CONCLUSION: The structural changes of the ovary were most pronounced in the letrozole-treated animals.

Use of Data Mining Techniques to Determine and Predict Length of Stay of Cardiac Patients / 대한의료정보학회지

OBJECTIVES: Predicting the length of stay (LOS) of patients in a hospital is important in providing them with better services and higher satisfaction, as well as helping the hospital management plan and managing hospital resources as meticulously as possible. We propose applying data mining techniques to extract useful knowledge and draw an accurate model to predict the LOS of heart patients. METHODS: Data were collected from patients with coronary artery disease (CAD). The patient records of 4,948 patients who had suffered CAD were included in the analysis. The techniques used are classification with three algorithms, namely, decision tree, support vector machines (SVM), and artificial neural network (ANN). LOS is the target variable, and 36 input variables are used for prediction. A confusion matrix was obtained to calculate sensitivity, specificity, and accuracy. RESULTS: The overall accuracy of SVM was 96.4% in the training set. Most single patients (64.3%) had an LOS 10 days. Moreover, the study showed that comorbidity states, such as lung disorders and hemorrhage with drug consumption have an impact on long LOS. The presence of comorbidities, an ejection fraction <2, being a current smoker, and having social security type insurance in coronary artery patients led to longer LOS than other subjects. CONCLUSIONS: All three algorithms are able to predict LOS with various degrees of accuracy. The findings demonstrated that the SVM was the best fit. There was a significant tendency for LOS to be longer in patients with lung or respiratory disorders and high blood pressure.

Towards the application of open source software in developing national electronic health record - narrative review article

Electronic Health Record [EHR] is a repository of patient health information shared among multiple authorized users. As a modern method of storing and processing health information, it is a solution for improving quality, safety and efficiency of patient care and health system. However, establishment of EHR requires a significant investment of time and money. While many of healthcare providers have very limited capital, application of open source software would be considered as a solution in developing national electronic health record especially in countries with low income. The evidence showed that financial limitation is one of the obstacles to implement electronic health records in developing countries. Therefore, establishment of an open source EHR system capable of modifications according to the national requirements seems to be inevitable in Iran. The present study identifies the impact of application of open source software in developing national electronic health record in Iran

Clinical Care Improvement with Use of Health Information Technology Focusing on Evidence Based Medicine / 대한의료정보학회지

OBJECTIVES: Healthcare institutions need timely patient information from various sources at the point-of-care. Evidence-based medicine (EBM) is a tool for proper and efficient incorporation of the results of research in decision-making. Characteristics of medical treatment processes and practical experience concerning the effect of EBM in the clinical process are surveyed. METHODS: A cross sectional survey conducted in Tehran hospitals in February-March 2012 among 51 clinical residents. The respondents were asked to apply EBM in clinical decision-making to answer questions about the effect of EBM in the clinical process. A valid and reliable questionnaire was used in this study. RESULTS: EBM provides a framework for problem solving and improvement of processes. Most residents (76%) agreed that EBM could improve clinical decision making. Eighty one percent of the respondents believed that EBM resulted in quick updating of knowledge. They believed that EBM was more useful for diagnosis than for treatment. There was a significant association between out-patients and in-patients in using electronic EBM resources. CONCLUSIONS: Research findings were useful in clinical practice and decision making. The computerized guidelines are important tools for improving clinical process quality. When learning how to use IT, methods of search and evaluation of evidence for diagnosis, treatment and medical education are necessary. Purposeful use of IT in clinical processes reduces workload and improves decision-making.

Effects of 810nm diode laser irradiation on flexural strength of dentin: an in vitro study

Thermal changes in laser assisted root canal therapy with the use of diode laser can predispose tooth structure to the fracture. This study evaluated the changes in flexural strength of dentin blocks after diode laser irradiations [810 nm]. A total of 60 dentinal blocks were prepared from freshly extracted teeth in three different thicknesses [300, 500 and 1000 micro m] and 20 sections in each of these thicknesses were divided randomly to the test and control groups. Samples in the test groups were irradiated at 2W power setting by scanning movement of 2mm/s of diode laser, and the controls were stored in normal saline. The flexural strength of samples was evaluated by UTM [Universal Testing Machine]. Data analysis was done with the SPSS Software 11.5. Samples of 300 micro had the lowest flexural strength [mean: 71/65 mpa] followed by 500 [116.64 mpa] and 1000 micro [217.56 mpa]. Statistical analyses showed that after laser irradiation, the flextural strength in the samples of 300 micro was significantly lower than that in the other groups [500 micro, 1000 micro] [P= 0.017]. Within the limits of this study, diode laser irradiation in laser assisted root canal therapy has no significant effect on flexural strength of root dentinal walls with the thickness of more than 500 micro. Although in areas with critical dentinal width [

Synthesis of a novel siliconized analog of clofibrate [silafibrate] and comparison of their anti-inflammatory activities

Fibrates, as hypolipidemic drugs known as agonists of peroxisome proliferator-activated receptors, diminish inflammatory responses. Studies have shown that incorporation of a silicon atom into a drug structure improves its pharmacological potency, modifies its selectivity toward a given target, or changes its metabolic rate, in addition to increasing the lipophilicity of the compounds. A siliconized analog of clofibrate, ethyl-2-methyl-2-[4-[trimethylsilyl]phenoxy]propionate was synthesized, whereby the chlorine atom in the phenoxy ring was replaced by a trimethylsilyl group. The anti-inflammatory effects of the siliconized analog [silafibrate] were evaluated in an air-pouch model of inflammation and compared with those of clofibrate. Oral administration of both drugs produced a significant anti-inflammatory action by reducing carrageenan induced pouch leukocyte recruitment, exudates production, and granulated tissue weight. The silicon isostere of clofibrate has improved anti-inflammatory properties

Evaluation of the effect of oral ritodrine on implantation rate in in-vitro fertilization-embryo transfer cycles

Pregnancy rate with IVF cycle is almost 22%. Many investigations perform to increase this rate in IVF. Various factors affect the result of IVF cycles. One of these factors could be uterine contractions that expel transferred embryo. Ritodrine is a beta mimetic agent that can block and decrease uterine contractions. The objective of this study was to determine ritodrine effectiveness for increasing the implantation rate in IVF cycles, and its probable mechanisms in decreasing uterine contractions as well. A total of 100 patients of IVF-ET cycles were divided randomly in two groups in a university hospital, Hamadan, Iran. The case group were prescribed ritodrine 10 mg / bid orally after oocyte retrieval until 10 days. The control group didn't received ridotrine. In ritodrine group 14% of patients and in control group 16% had positive beta -hCG test [p-value>0.5]. Ritodrine did not improve the implantation rate in IVF-ET cycles

[Precision and accuracy of death certification data in Kashan Shahid Beheshti hospital]

Mortality data are a cornerstone of epidemiological research and health plan. Unfortunately they dose not completed coincident to international standards; so due to important of issue and had not any research for precision and accuracy of death certification data in this region, this study was done in death certification data in inpatient Kashan Shahid Beheshti hospital. An applied cross-sectional research on death certification data in inpatient Kashan Shahid Beheshti hospital with 4 checklist [face and content validity] included precision and accuracy of general identification data and precision and accuracy of causes of death data was done, after that data were grouped in table and analyzed with descriptive statistics. 301 death certification [60%] and 389 [77.5%] had precision and accuracy in view of general identification and 291 [62.3%] adults and 18 [51.4%] prenatal had precision and 328 [70.3%] adult and 19 [54.3%] prenatal had accuracy. 88 [17.5%] of general identification and 83 [17.8%] adult and 15 [42.9%] prenatal did not have completed, 309 [66.2%] adult and 21 [60%] prenatal had a correct sequence. More education for physicians for produce higher quality data and more emphasis for enough knowledge of illness and study of the medical record carefully, perform autopsy for necessary cases establishment of Medical Legal Department in hospital were recommended

Safety requirements for health electronic file; comparison between selected countries

With increasing production of health information, information technologies have been used for better management and usage of such data. This enormous increase in gathering and storing of information and widespread accessibility also concerns individuals regarding privacy and security of information. This research is concerned with this issue due to decisions on establishing individual health electronic files in Iran. During this descriptive-comparative study, security requirements of electronic health files in Iran, England and Canada were reviewed and compared. Checklist was used for data collection. Data was collected from journal papers, and books accessed through libraries and other credible online sources between 1995-2006. Security requirements regarding health electronic file such as information security systems, safety of communication and operations management, access control were established in those countries except for Iran. There is no safety and security requirements in this regard in Iran. Security and safety of health electronic file is one of the basic requirements, which lacks in Iran. Due to recent interests in establishing health electronic file in Iran by Ministry of Health and Medical Education, it is necessary that such requirements been established by responsible bodies

[Evaluation of structure and content of websites of the educational hospitals in Iran - 2007]

Nowadays, various tools are used in health informatics; the type of these tools should be related to the patients' and healthcare providers' needs. Hospital websites are suitable systems for data exchange and communication between patient and healthcare providers. This study performed for analysis and evaluation of structure and content of websites of the educational hospitals in Iran. In a descriptive study, 8 Iranian educational hospital websites were analyzed for structure, content and related links by using 4 researcher made check lists. The average score was 12/30 for structural analysis. 5.75/15, 2.6/19, and 2/24 were calculated scores for of, content analysis of homepage, [about us] page, and other links, respectively. In general, the structure of Iranian educational hospital websites is at medium level and their content is at very weak level