Incident reporting in Mashhad hospitals

In this study, our aim was to evaluate and classify the voluntary error reports in the hospitals of Mashhad University of Medical Sciences. Patients have the right to receive health care in accordance to the best standards. Health care carries a risk of harm for patient safety, and with respect to today's stressful systems with a large number of patients, it would be inevitable. The meaning of risk management is to predict adverse events and reduce their occurrence. A voluntary medical error reporting form was designed and approved by the clinical governance team of Mashhad Medical University. They were then distributed inside hospitals in the way in which everyone [health providers and patients] could access them easily. The forms were collected and classified monthly in all wards. Classification was performed on the base of type, outcome and reporter. Data gathering took place from spring to autumn 2012. The data was analyzed by the SPSS software. 2500 errors were extracted from 1000 voluntary error reporting forms of the 12 hospitals of Mashhad Medical University. The most frequent error type was treatment errors [36%] related to drug administration, standard procedures and surgical events. Error reporting as a basic activity has an important role in discovering pitfalls of the health care system. To promote the reporting culture, its non punitive base must become clear for all professors and staff members, because this kind of reporting could lead to fewer medical errors and higher staff awareness about probable errors.

Successful replantation of amputated penile shaft following industrial injury

Penile amputation is an uncommon urological emergency. Although rare, traumatic amputation of penis is a challenging injury to treat. However, modern microsurgical reconstruction techniques have improved success rate of penile replantation and become the procedure of choice for managing these patients. Herein, we report on a case of penile amputation following an industrial accident

nutcracker syndrome: an underdiagnosed cause for high grade varicocele

The nutcracker syndrome represents a clinical condition caused by compression of the left renal vein [LRV] between the superior mesenteric artery [SMA] and the aorta. One of its manifestations is left-sided varicocele. The aim of this study is to determine the prevalence of nutcracker syndrome in patients with primary and recurrent high grade left-sided varicocele. Fifty patients with primary and recurrent high grade left-sided varicocele were enrolled in this study. Color Doppler ultra-sonography [US] of renal vessels was done and diameter of LRV and peak systolic velocity [PSV] were measured in renal hilum and in site of compression of LRV be-tween SMA and the aorta and then magnetic resonance angiography [MRA] of renal vessels was done. Thirty six patients [72%] had primary high grade varicocele and 14 patients [28%] had recurrent high grade varicocele. Twelve patients [33%] with primary high grade varicocele and seven patients [50%] with recurrent varicocele had evidences of NCS in color Doppler US and MRA. The differences of LRV diameter in NCS group and in patients without NCS were statistically significant [P<0.001]. The differences of PSV in the LRV at the hilar portion in the NCS group and in the patients without NCS were not statistically significant. The differences of PSV in the LRV at the aortomesenteric portion in the NCS group and in the patients without NCS were statistically significant [P< 0.001]. In all patients with NCS, MRA showed dilatation and compression of LRV at site of passage between aorta and SMA. NCS should be suspected in patients with high grade primary and recurrent varicocele