[Effect of metoclopramide and ondansetrone plus dexamethason on postoperative nausea and vomiting in cholecystectomy laparoscopic surgery]

Nausea and vomiting are common complications after surgery which creates spasm, hypoxia and pulmonary aspiration. This study was done to determine the effect of ondansetrone, metoclopramide associated with dexamethasone on postoperative nausea and vomiting in cholecystectomy surgery using Laparoscopic method. In this double blind clinical trial study, 100 patients with ASA class I and II undergoing laparoscopic cholecystectomy divided randomly into two groups. The patients in the first group were received metoclopramide [10mg/kg/bw] with dexamethasone [8mg/kg/bw] and the second group were received ondansetron [4mg/kg/bw] with dexamethasone [8mg/kg/bw] intravenously 5 min before the final stage of surgery. Premedication and induction of anesthesia in patients were equal 5 minutes to 4 hours after surgery, postoperative nausea and vomiting were recorded for each patient. The rate of nausea in the first and the second groups were recorded 38% and 28%, respectively. The rate of vomiting in the first and the second groups were recorded 30% and 16%, respectively. These values were not significant. Ondansetron with dexamethasone non significantly reduced postoperative nausea and vomiting after laparoscopic cholecystectomy in comparison with metoclopramide with dexamethasone

[Study of the relationship between organizational justice, job satisfaction, and affective commitment on customer oriented behavior of nurses of Imam Reza Hospital, Mashhad, Iran]

The high levels of sensitivity and job stress for nurses require a necessity of voluntary extra-role behavior known as customer oriented citizenship behavior [COCB]. The aim of this research was to examine the influence of the most important factors on COCB in nurses. In this cross-sectional study, data were gathered by a questionnaire from 198 employee nurses at Imam Reza Hospital in Mashhad, Iran. In order to test the relationship, the structural equation method was used. Our results were in agreement with the significant impact of procedural justice, distributive justice, job satisfaction, and organizational commitment on external representation and internal influence, as the two elements of COCB. The effect of interactional justice on internal influence and the third element of COCB, service delivery, were also approved. In comparison to other dimensions of organizational justice, the procedural justice has the highest impact on job satisfaction and organizational commitment and through them on COCB. Therefore, organizational policies and procedures should be devised in a way that nurses find them fair and indiscriminating

[Survey the changes of thyroid functional tests in patients with liver cirrhosis due to hepatitis B and C and correlation of thyroid hormone levels with severity of liver dysfunction]

The liver played an important role in the metabolism of thyroid hormones and was involved in their conjugation, excretion and peripheral deiodination in synthesizing Thyroid Binding Globulin [TBG]. Thus liver dysfunction can be influenced thyroid function. Determine the changes of thyroid functional tests in patients with liver cirrhosis due to hepatitis B and C and correlation of thyroid hormone levels with severity of liver dysfunction. Sixty Four Cirrhotic patients due to hepatitis B and C referring to Razi hospital were studied during 2007-2009 years. Data were collected by prepared questionnaire. Thyroid hormone levels were measured in a unit laboratory. Liver dysfunction was scored by MELD and child pugh scoring systems. Mann-Whitney U, chi square and kruskal wallis test were used for measuring severity of liver dysfunction. Among 64 patients, [42 patients were male and 22 patients were female]. Mean age of patients was 55.03 +/- 12.05. Level of TT3 TT4 and FT3 had decreased in the majority of patients, TT3, TT4 and FT3 levels. There was a correlation between level of TT3 and severity of liver dysfunction base on Child score [p=0.0001] and MELD [p=0.02].There was a reciprocal correlation between TT3 level and probability of the history of digestive systems bleedings, Ascites and encephalopathy [P=0.01, P=0.011, P=0.009] .It means that when TT3 level was low probability of this complication was high. This study showed that liver disease is accompanied by changes in thyroid hormone levels specially decrease the level of TT3, TT4, FT3 and it is indicated that TT3 level can be used as liver function index in cirrhotic patients due to hepatitis B and C

Mercury bioaccumulation in some commercially valuable marine organisms from Mosa bay, persian gulf

This study was undertaken to determine the concentration of mercury in edible muscle of five commercially valuable marine organisms from Mosa Bay, Persian Gulf, Iran. The total mercury concentrations were determined by cold vapour atomic absorption spectrophotometry and expressed in micro g/g dry weight. Certified reference materials were used for each batch of analysis. Mercury concentration was 0.373 micro g/g for Liza abu, 1.172 micro g/g Sparidentex hast, 0.455 micro g/g for Acanthopagrus latus, 0.390 micro g/g for Thunnus tonggol, and 0.360 micro g/g for Fenneropenaeus indicus. Carnivorous fish had higher level of mercury than non-carnivorous. Statistical analysis revealed weak correlation between fish mercury and length for all studied organisms. The observed concentrations were comparable to those found in other areas of the Persian gulf and were lower than the WHO guideline of 0.5 mg/kg wet weight. Our result demonstrated that estimated daily and weekly intakes of mercury via consumption of fish flesh were far below the PTDI and PTWI values recommended by FAO/WHO

relationships between patient satisfaction and loyalty in the private hospital industry

In today's competitive world, organizations' survival and success depends on satisfying customer needs and expectations. This is particularly important in health care sector where quality of service and customer relations are the key success factors. The purpose of this research was to determine whether there was a relationship between patient satisfaction and loyalty to the service provider. A total of 240 patients in four private hospitals were invited to complete a survey questionnaire. Both parametric and nonparametric research analysis were performed to test the research hypotheses. In addition, sensitivity analysis was applied to identify the most critical satisfaction dimensions that provide the highest return for management effort and financial investment. The study used six specific-satisfaction dimensions, including nursing care, operating room, admission and administrative service, meal, cost and patient room to propose its hypotheses. The patient overall satisfaction was mostly affected by the nursing care, meal, patient room as well as admission and administrative services, respectively. Further, we found that patient overall satisfaction and loyalty were positively correlated so that one unit increase in patient overall satisfaction increases patient loyalty by 54% to 77%. Hospitals in devising their long-term strategy should pay sufficient attention to the development of their human resources. Such a strategy should be leveraged on attracting and retaining competent and customer-oriented nursing and administrative staff, investing in continuous professional development of staff and using advanced technologies to improve the quality and speed of customer services