[ effect of workplace organizing technique [5S] on nurses'productivity in Isfahan hospitals' operating rooms]

Introduction: One of the effective factors on nurse's productivity and nurse's retention is the workplace Characteristic. 5S is a powerful way to improve the work environment in health care organizations. The aim of this study was to determine the effect of workplace organizing technique [5S] on nurses' productivity in Isfahan hospitals' operating rooms in 2013.

Materials and Methods: The semi-experimental design was conducted. The population was consisted of 71 staff nurses of operating rooms in Isfahan educational hospitals. They were allocated by simple random assignment to intervention and control groups. sampling was conducted by census method. Data was collected through "Nurses Productivity Questionnaire". This questionnaire consisted of seven domains. The validity of the questionnaire was determined by 10 experts' opinions, and its reliability was calculated with Cronbach's alpha coefficient. "5S for Healthcare: Visual Workplace Audit" was applied for interventions evaluation, and it's validity was determined with Lawshe's technique. The 5S technique was trained and implemented for arrangement of the operating room in Beheshti Hospital [for 6 weeks]. After 30 days, participants were tested by the primary questionnaires. Data were analyzed using SPSS/ 16.

Findings: The scores of nurse's productivity in the intervention group have significant difference than the control group [p=0.02]. Analysis of covariance revealed that productivity of nurses in the intervention group after the implementation of this technique has increased by 6 percent.

Conclusion: This study showed that 5S technique can improve the nurses' productivity in operating room. It would be recommended to use as one of the ways to increase productivity in hospitals' setting.

prevalence of coronavirus in fecal samples of neonatal calf diarrhea using electron microscopic examination

Neonatal calf diarrhea [NCD], also known as calf scours, is caused by viruses, bacteria, and parasites. Coronavirus is one of the important causes of NCD syndrome. Electron microcopy has been used for demonstration of viruses in fecal samples of diarrheic calves since 1969. The aim of this study was to determine the prevalence of coronavirus in fecal samples of neonatal calf diarrhea using electron microcopy examination of fecal samples. For the purpose of this study, a total of 100 cases [under 2 months of age] of diarrheic calves from 25 commercial farms in four districts of East Azerbaijan province of Iran were used. Fresh Fecal samples using sterile swab were collected from every calf with clinical diarrhea. All samples were transferred into a sterile container and then were sent to the laboratory to be kept in -20oC freezer until examination. Electron microscopic examination was applied to all fecal samples. Chi-square test was used to analyze the data. According to the results of this study, coronavirus was present in 15% of cases and a significant difference was found between the prevalence rate and the seasons [p<0.05]. The highest prevalence was recorded in winter [28%] and the least prevalence was seen in summer [4%]. There was not any significant difference in both age groups and different districts according to the prevalence rate of infection. Neonatal calf diarrhea is a multi-etiological syndrome. Among the viral diarrhea, bovine coronavirus is one of the major causes of this syndrome. For detection of coronavirus in feces, electron microscope examination is a gold standard diagnostic technique. It seems that coronavirus can be considered as one of the important etiologies of neonatal calf diarrhea in east Azerbaijan of Iran

Thoracoscopic treatment of pulmonary hydatid cyst in children: a report of 25 cases

Open surgery is the standard option for the treatment of hydatid pulmonary cysts. Surgeons are able to replicate the principles of conventional surgery using minimally invasive techniques ,in particular thoracoscopy. However, there are few reports about this subject in children. To our knowledge, this is one of the biggest pediatric series ever reported in the literature.The purpose of this study was to determine the best indications of the thoracospic surgery for the treatment of the pulmonary hydatid cysts in children. We report a series of 25 cases with pulmonary hydatid cysts treated using the thoracoscopic approach from 2005 to 2009. We retrospectively analyzed the patients' sex, age, symptoms, biological data, characteristics of hydatid cysts [location, number and size] and the medical treatments. Pulmonary hydatid cyst diagnosis was performed on Chest x-ray, abdominal ultrasound and biological data in all the cases. Tomography was not systematic. All patients underwent video-assisted surgery. A conversion to thoracotomy was conducteded in 2 cases. All the patients had a chest tube and received an antibio-prophylaxy, without Albendazol . A concurrent hydatid cyst at the opposite lung or in the peritoneal cavity was treated later

[Investigating the relationship between workaholic and dimensions of general health in the employees of an organization in Isfahan]

Investigating the relationship between workaholic and dimensions of general health [Depression, Anxiety and sleep disorders, psychosomatic disorders and disability in social relationship]. Participants in the study were 100 employees who completed the General Health Questionnaire [GHQ] and Work Addiction Risk Test [WART]. For analyzing the data, Pearson and Canonical correlations and stepwise regression were used. Findings indicated that there was a significant relationship between workaholic and three of four dimensions of general health, namely anxiety and sleep disorders, depression and psychosomatic disorder [p<0.01] but there was no significant relation between Social react disorder. In addition findings showed that increases in workaholics predicted general health decrease. The current study shows that work can be a reason of diseases if employees get addicted to it. Thus organizations should pay more attention to this fact that working hard in work place, is not always beneficial for individuals and organization both. So managers have to consider ways to prevent these dangerous consequences which can be harmful for their employee's health

[Cervical teratoma in the newborn about 2 cases and literature review]

The cervical teratoma is an exceptional tumour. We report two observations diagnosed in neonates, both born with a cervical mass, which was associated with a dyspnea in a case. The surgical treatment consisted in a complete excision of the tumour. Histology concluded that teratoma was mature in a case and immature in the second. No complementary treatment was indicated. The evolution was uneventful in both cases with a follow-up of 8 and 3 years. In this work, the authors point out the clinical, radiological and therapeutic characteristics of these embryonic tumours

[Persistent hyperinsulinemic hypoglycemia [HHI] of infancy: about 3 cases]

Hyperinsulinaemic hypoglycaemia [HHI] is the most frequent aetiology of recurrent severe hypoglycaemia in newborn and infant. This pathology arises the problem of early medical and surgical management to prevent brain damage. The aim of this work is to stress on the treatment emergency, to underline difficulties to distinguish damage. The aim of this work is to stress on the treatment emergency, to underline difficulties to distinguish between focal forms and diffuse forms, and to discuss our results with literature data. Our work is a retrospective study of 3 observations of symptomatic newborn HHI. Due to failure of glucose supplementation and medical treatment based on diazoxide and hydrocortisone, the 3 patients were operated between 50 and 107 days of life. Surgical exploration did not find any macroscopic pancreatic abnormality and intervention consisted of subtotal pancreatectomy [90-95 percent]. Anatomopathological study showed diffuse form in 2 cases and focal form in one case. After a follow up of 3 months to 2 years and a half the 3 patients have a normal glycaemia with no need to medical treatment. Yet 2 patients present brain damages .HHI is an emergency which needs a rapid medical management. Medical treatment failure should lead quickly to surgery to prevent neurological complications

[Ileal prolapse through patent omphalomesenteric duct. A review of six cases]

Meal prolapse through the umbilicus is a severe complication of patent omphalomesenteric duct which exposes to the risk of intestinal necrosis in case of diagnostic or therapeutic delay. This is a retrospective study of six cases of ileal prolapse complicating a patent omphalomesenteric duct observed between 1986 and 2004 in the pediatric surgery department of Monastir. The mean age of the six patients was 67 days. The diagnosis was performed on the observation of an out-f low of intestinal liquid or stools through the umbilicus associated to an ileal prolapse. Five patients were treated by intestinal resection and anastomosis and the sixth had a wedge-shaped resection of the omphalomesenteric duct. One patient died from a severe sepsis. The evolution was favourable for the other patients. The ileal prolapse complicates 50 to 80 per cent of the umbilical enteric fistula. It exposes to the risk of occlusion and intestinal necrosis. So, the treatment must be urgent and consists on the resection of omphalomesenteric duct with ileal anastomosis.This treatment can be done by classic surgery or, more recently, by coelioscopy. The mortality can reach 33 per cent in the event of diagnostic or therapeutic delay. The ileal prolapse is a rare form of the patent omphalomesenteric duct which must be diagnosed and treated quickly to ovoid complications

[Effectiveness of play therapy on the bases of cognitive behavior approach on severity of symptoms of Attention Deficit/Hyperactivity Disorder [ADHD] among primary school male students aged 9-11]

ADHD is considered as the most prevalent disorder during childhood and adolescence. For the purposes of diagnosis and treatment various methods including play therapy one applied. This research has been conducted with the aim of studying the effectiveness of play therapy on severity of symptoms of Attention Deficit/ Hyperactivity Disorder [ADHD] among primary school male students aged 9-11. By considering a experimental design two psychological and counseling clinics in Isfahan were selected. From the population of all clients in the two clinics who were diagnosed as ADHD-C by the psychiatrists, 30 were selected randomly and assigned into the experimental and control groups [15 subjects each]. At the pre- and post - test stages, before and after 8 sessions which took 30-45 minutes every two days play therapy with emphasis on increasing attention and decreasing hyperactivity, CSI-4 and MFFT questionnaires were applied to both groups. Furthermore, in order to diagnose any change after the therapy, a follow-up study was conducted after a month. The data were analyzed by SPSS14 software, using ANCOVA. The play therapy decreased the amount of ADHD, hyperactivity, attention deficit, and response errors symptoms significantly, but increased response time significantly [all at p < 0.0001]. The fallow up results showed a significant increase of response time when using play therapy [P < 0.005], but it there was no significant effect on decreasing response error. Considering the significant differences between the experimental and control groups as well as the fallow - up, play therapy may be applied as an effective method of treatment for children and adolescence with ADHD preferably, a combination of this and other relevant methods may be used for the treatment of those with ADHD. As the ADHD symptoms were decreased significantly after the intervention, the effect of play therapy was confirmed

Chronological change in epidemiologic characteristics of paediatric urolithiasis in the Tunisian center during the past 25 years

The incidence of paediatric urolithiasis has been constantly decreasing during the past twenty-five years [1983-2007] in Tunisia as well as in other Mediterranean Countries. This study will reveal if the incidence of stone disease in children has changed and will show the change in stone composition. The incidence of paediatric urolithiasis has been constantly decreasing during the past twenty-four years [from 9,1 in eighties to 0,4 cases/1000 admissions/year in 2007]. The prevalence of calcium oxalate stones has been constantly increasing during the past twenty-five years in Tunisia [15.6 per cent in eighties Vs 51.5 actually]. Actually infections stones were less frequent[11.8 percent actually Vs 39.4 percent in eighties]. The decrease in struvite frequency in children patients during the past twenty-five years and the stabilization of calcium phosphate stones are the result of a significant improvement of diagnostics and the treatment of urinary tract infections in the young children in our country

[Treatment of urethral strictures by endoscopic internal urethrotomy: anatomical and functional results in a series of 244 cases]

To evaluate the results of a homogeneous series of urethral strictures treated exclusively by endoscopic internal urethrotomy and to determine the factors that may predict the outcome. Between 1989 and 2007, 244 patients were treated for urethral stricture. All of them were subjected to endoscopic direct vision internal urethrotomy [DVIU]. 34.3% of good results were achieved after the first DVIU. Mean follow-up was 3.5 years. No mortality was encountered, while the rate of morbidity was.5%. Better results were achieved in patients with short [<2 cm] and single strictures in the proximal urethra. Mean post-operative catheterization was 2 days; a further extension of the catheterization time did not yield any significant improvement. Unsatisfactory results [65.5%] were found in patients with large urethral strictures located in the distal urethra or in elderly patients. 62.5% of the patients showed a satisfactory outcome after a second urethrotomy, while the other patients required urethral dilatation or urethroplasty. DVIU is a simple procedure which does not have a high rate of morbidity and requires short hospitalization. With a steady success rate of around 75.4% after a follow-up of 3.5 years we feel that DVIU can be recommended as treatment of choice for all short, single and proximal urethral strictures, preferably in young patients without previous interventions on the urethra

[Primary peritonitis in children]

Background: Primary peritonitis is rare in children. It raise problems of aetiology diagnosis, and therapy. The aim of this study is to review the particularities of this pathology by emphasizing these difficulties of the treatment

Methods: Its a retrospective study of 14 cases of primary peritonitis treated in the infant surgery unit of Monastir hospital in the period between January 1984 and December 2003.The mean age was 2 years ;the sex ratio was 1/6.The beginning of the clinical symptoms were usually acute

Results: The diagnosis was done by surgical exploration in 13 cases/14; in only one case the diagnosis was highly suspected because of the results of the peritoneal drainage. The post operative course was uneventful for 11 patients; two died probably because of liver failure and presented a residual peritonitis

Conclusion: primary peritonitis of the child is rare. until now, it is still a controversial pathology. Its treatment can be only medical but the surgical treatment which can be laparoscopic must be indicated if there is a doubt

[Bilateral wilms tumors: diagnosis and therapeutic management. about 12 cases]

Bilateral Wilms tumor [WT] is uncommon malignancy, the incidence is about 5% of all nephroblastoma. It shows association with some congenital anomalies. there is no scheduled regimen for bilateral WT and their management offers a great challenge. To evaluate the clinical characteristics and the treatment result. 12 patients with bilateral WT diagnosed between 1997 and 2005, were retrospectively reviewed. Data collected: patients characteristics, chemotherapy, modality of surgical resection, renal function and survival. 11 patients [pts] had synchronous tumor and one metachronous lesions. The median age at primary diagnosis was 17 months [range 6m - 72m]. Congenital malformation were present in 4 children. 1 pt had hemi-hypertrophy, genitourinary horse kidney, 3 had hypertension.. All pts received preoperative prolonged chemotherapy [CT] for 25 to175 days [median 45 days] 7 received double agent chemotherapy. [VCR + Actinomycine], 2 triple agents: one [VCR + Actino + Adriblastine], the others [Etoposide, Carboplatine, Cyclophosphamied] for tumor progression. Two pt died before surgery due to infection. Bilateral partial nephrectomy 1 case total unilateral nephrectomy with partial nephrectomy on the other side in 3 cases. 9 pts are alive without disease and normal renal function 87 months after. The 10th in course of treatment after unilateral nephrectomy.Prolonged preoperative chemotherapy permit conservative surgical treatement of favorable histology bilateral Wilm's tumor and may improve the preservation of renal masses and function without impairing patient survival

[Rectal duplications. Report of two cases and literature review]

Rectal duplications are very rare and pose sometimes diagnostic problems. We report 2 cases of rectal duplication among 32 alimentary tract duplications [6%] observed over 17 years period. The 2 patients were female and were hospitalized respectively at the age of 20 days and one month. In the first case the diagnosis was early in front of a mass prolapsed to the anus. In the second case, the diagnosis was posed at age the 6 months after iterative interventions for perished abscess and anal dents. The treatment consisted on a subtotal resection of the malformation in the first case and a lowering of the colon after iterative interventions for recidivant anal dents. Evolution was favorable in the two cases with a follow up of 4 and 10 year. Although it's rare, the diagnosis of rectal duplication must be evoked in front of any crowned pre sacral mass. Only an early diagnosis and treatment make it possible to prevent the complications and the later evolution towards the degeneration

[ malignant adrenocortical carcinoma of the child to a comment]

Malignant corticossurrenaloma is very rare in childhood. It occurs more often before the age of 5 years. Its pathogeny remains unknown but a genetic predisposition was suggested. The tumor is usually of secreting type and revealed by virilisation and/or Cushing syndrome, seldom by feminization and exceptionally by Conn syndrome. We report the case of a 7 years old girl who presented with a hetero-sexual precocious pseudo-puberty associated to a Cushing syndrome. The clinical examination found an abdominal mass. Hormonal investigation confirmed androgen and gluco-corticoid hypersecretion. Malignancy of the tumor was evoked by MRI. Evolution was marked by a tumoral rupture which required a laparotomy in emergency. The anatomo-pathological examination confirmed the diagnosis. In spite of a favorable immediate post operative evolution, the child died eight days later. Through this observation, we discuss the clinical, biological, therapeutic and evolutive aspects of this affection

[ abdominal cystic lymphangioma in childhood: a report of 12 cases]

Cystic abdominal lymphangioma is a rare malformative tumor, often discovered in childhood. The aim of this work is to study diagnostic and therapeutic aspects of this malformation. We report a retrospective study of 12 cases treated at the pediatric surgery department of Monastir over a 19-year period. The average age of the patient was 4 years. Diagnosis was suspected prenatally in only 1 case. Clinical signs have no specificity. Ultrasonography [11 cases] suggested the diagnosis in 10 cases. Computed tomography was performed in 4 cases. All patients underwent surgery. Lymphangioma was intraperitoneal in 11 cases and retroperitoneal in 1 case. Total resection was possible in 9 cases. Pathology was confirmed diagnosis in all cases. Postoperative outcome was uneventful for all patients. Because of no specificity of its signs, lymphangioma had many diagnostic difficulties. Ultrasonography constitutes the most important diagnostic imaging. The treatment is surgical and total resection is wished, which will be correlated with an excellent prognosis

Identification and determination of PAHs compounds in anzali international wetland

The worst environmental pollutants in Anzali International Wetland are oily hydrocarbons especially aromatic and poly aromatic compounds [PAHs]. The existence of oily compounds with approximate limit of concentration of 0.1 micro g/l in aquatic environment bans the growth of fish larva and causes the generic state manner of animals. Anzali International Wetland, which is situated in the west - southern part of Caspian Sea where has environmental importance in life of living organisms and ecosystems. In this reseach, four sites, Pirbazar, Pasikhan, west and central parts, where are situated in Anzali International Wetland, have been studied in 2002. Waste sedimentation soil Sampling was performed during winter and spring in the above-mentioned regions. In the first stage, the purpose of sampling was to access optimum instrumental conditions and correct and precise procedures. Oily pollutants were extracted from water and it was done by using CC1[4] solvent after cleaning and concentrating. The extracted samples were identified with gas chromatographic method with using polyaromatic standard solutions. By the powerful GC/MS method; results of qualitative analysis were confirmed. Also by GC/MS using SIM mode quantitative analysis were performed. Quantitative study of polyaromatic compounds has also been done by luminescence spectrophotometry. Some compounds which were identified in the water samples were: olifinic, aromatic and poly - aromatic compounds such as: antracene, fluourine, xylene, methylbenzene, naphthalene and acenaphtylene. Finally, the degree of biodegradation of compounds such as pristan [C[19]H[40]] and phytan [C[20]H[42]] in water samples was integrated