[Effect of self care education on knowledge, performance and readmission of heart failure patients admitted in city hospitals of Ardabil]

Introduction: Heart failure, one of the most common chronic diseases and major causes of mortality in the world with high prevalence of progressive with hospital admissions are unpredictable. Self care one important aspect of treatment in patients with heart failure. Self-care education, is necessary part of the comprehensive plan of care for patients during hospitalization to be exposed. This study aimed to determine the effect of educational interventions on knowledge, performance and readmission in heart failure patients was conducted in Ardabil

Methods: This randomized clinical trial, a total of 44 samples from patients with heart failure hospitalization Sabalan and Emam Khomeini [RA] Ardabil gradual sampling were selected randomly in two groups case [n=22] and control [n=22] were studied. Patient groups, for four 20-minute sessions were trained by the researcher. Data from the questionnaires and during interviews with patients before and after the intervention were collected

Results: Data using SPSS version 16 software and using descriptive statistics and chi-square, independent t-test and the paired t-test were analyzed. Results indicate that after training, mean knowledge score in case group 89.60 +/- 5.95 in control group 62.47 +/- 8.84, mean performance score in case group 80.75 +/- 3.7 in control group 54.78 +/- 6.24, readmission rates in case group 15.8 with a mean and standard deviation of 1 +/- 0.15 and in control group 42.1 percent with a mean and standard deviation of 1.37 +/- 0.37 based on independent t-test mean knowledge and performance with P=0.0001 in the two groups had significant differences, but the amount Readmission Based on independent t-test with P>0.05 is not significant

Conclusion: The findings of this study indicate that educational programs implemented to promote awareness, self-care behaviors and decrease readmission of patients is effective. Therefore, planning authorities and health team members and provide educational services to patients with a purpose Improve self care behaviors can be largely prevented the readmission of patients and obviously it helped the family economy and society will and obviously it helped the family economy and society will And recommended the education of the patient privacy and the privacy will be respected

[Usage of direct laryngoscopy in patients with laryngopharyngeal lesions]

Endoscopy of laryngopharyngeal diseases by direct laryngoscopy [DL] is still a valuable and useful endoscopic method for diagnosis, treatment and following them up. In this study, the safety of DL as an outpatient procedure is associated. This prospective study was performed on 146 patients who needed an endoscopic evaluation based on primary clinical diagnosis during two years in ENT ward of Ghaem hospital. While DL, macroscopic evaluation and biopsy was done and patient's tolerance during DL with local anesthesia, complications, age and sex, chief complaint, primary clinical findings and the results of endoscopy and pathology was written in a questionnaire and then analyzed. In 146 patients, laryngoscopy was done with local anesthesia in 84% and as an outpatient procedure in 75% and complications resulting to admission were not seen .Age average was 55 +/- 14, male to female ratio 2 to 1, the most common decade 6 and 7, and the most common complaint was dysphonia. Also, 51% of lesions were neoplastic that the squamous cell carcinoma was the most common. 21% of squamous cell carcinomas were seen in hypopharynx and 78% in the larynx. In the larynx, supraglottis was the most common site [69%] while the glottis and infraglottis were the next sites [18% and 6% respectively]. Male to female ratio of laryngeal and hypopharyngeal carcinoma was 5.3 to 1 and 3 to 4 consequtively. Much less incidence of benign neoplasm in our patients compared with other populations and older age in average, are seen in our results. Also, much more involvement of supraglottis compared with the glottis of the larynx, and male to female ratio of 3 to 4 in hypopharyngeal carcinoma of our patients are of other main differences seen in this study. Similar studies using the newer techniques and equipments such as videolaryngoscopy are needed to confirm the accuracy and safety of them compared with DL in the future

[ case report of an ethmoid sinus osteoma with presentation of tension pneumoencephalus]

Osteoid osteoma is a benign tumor, which is mostly seen in the long bones but occasionally originates and grows inside the paranasal sinuses. It rarely may impinge the dura with growing upward inside the ethmoid sinus. As a result, it can cause dural rupture, CSF leak and tension pneumocephalus. This needs complete resection with dural repair as an effective treatment. In this case report, a 72 year old man with osteoid osteoma is reported who had been referred with headache, rhinorrhea, memory loss, mood disorder and mutism. Pneumo-encephalus due to injury of dura of the skull base by a left ethmoid sinus osteoma was later found by CT scan. This tumor was completely resected and dura repaired by a surgical team including neurosurgeon and otorhinolaryngologist. The signs and symptoms were disappeared during the next few days