[Evaluating the prevalence of canceling surgical operations, including its influening factors at Imam Khomeini hospital in Sari duing 2006-2007]

Hospital admission for surgery is an important event for patients. Canceling surgical procedures produce several unpleasant results for patients such as waste of time, including payment. The aim of this study is to identify the prevalence and causes of canceling surgical procedures, in order to achieve problem solving methods. This is a descriptive cross-sectional study. Statistical data regarding all surgical procedures [without sampling] performed during 2006 to 2007, were recorded in a checklist. Study variables were identified based on surgical procedures that were canceled during this study. Data was analyzed using SPSS software and statistical analysis tests. Of 4,711 scheduled patients, 510 [109%] surgical operations were canceled. The highest number of patient candidates for surgical operation was related to gynecology, orthopedic, urology, while the least were related to reconstructive and vascular surgery groups respectively. The most canceled surgical procedures were related to neurosurgical operation 32/4% [68 from 207 cases] while the least canceled cases belonged to gynecology 4/4% [48 from 1094 cases]. The results of our study showed that 54/2% of canceled cases were preventable. The results of this study and similar studies demonstrate that traditional pre-operative preparation for surgical scheduling, day before surgery is in need of serious consideration. We recommend a fundamental change by discarding traditional methods and creating a new committee including specialized bed or resource groups, monthly management meetings to discuss causes of canceling surgical procedures, in order to reduce its occurrence. Thus, decreasing the rate of canceling surgical operations can save hospital financial resources, preventing time wasted, while reducing anxiety in patients and their family

[Burn death rate among hospitalized patients in Zare' teaching hospital of Mazandaran medical University, Sari, Iran [2002-04]]

Burning is a general health problem and is also a global injury as well as a very serious sanitary issue in industrial and developing countries. In its severe form, burning can claim lives. It seems essential in every society to analyze burning, to study the causes of burning, treatment outcomes and the death rates, etc. to find proper preventive measures. In this cross-sectional study, the medical records of all patients who were hospitalized and finally deceased during the years 2002 and 2004 in Zare' teaching hospital, Sari, were examined. Some variables including the age span average, the degree and percentage of burning, patients' residence, gender, the cause of burning [i.e. boiling water, fire, acids and explosives], average hospitalization period, surgery and also the abundance of self - burning attempts were examined. This study indicate that during these 3 years the total number of those who died from burns was 506 [23.4%]. The residential places were in Mazanderan province [41.7%], Golestan province [41.4%], and Gilan province [10.2%]. The abundance of burning ranges as below: The 2 and 3 degree of burning at 91.8%. Regarding the percentage of burns, 31.7% of abundance pertains to burning at 90% and more. The greatest external causes leading to burns are petrol, gas, and gas oil at 57.9%. Also, the percentage of burns does not have much influence on death rate among 50 - year - olds and older people. This study indicated that the importance of death between burned patient in special sex and age. To establish hospitals, some issues must be considered as: distance, transportation, route dangers, characteristics of area, existing epidemiological survey, and finally the epidemics and event statistics

[Role of mother's preference for the type of delivery on the outcome of delivery]

The rate of cesarean section in our society is increasing every day. This research was done to study the effects of mother's personal preference about the mode of delivery on the outcome of delivery in pregnant women who recieved perinatal care in Taleghani and Mahdieh Hospitals. This cross-sectional study was done on 160 women pregnant with there first babies. Mothers' characteristics: First pregnancy, no systemic disease, no indication for cesarean section before labor pain, no history of infertility, non-smokers. All subjects were interviewed about their preferences regarding the method of delivery. Ninety-four women, [58.8%], preferred to have a normal vaginal delivery, and 66, [41.2%], chose cesarean section. From the first group, 65 [61.3%] cases and from the second group, 41 [38.7%] cases came back to the same hospital for delivery. The rate of cesarean section in the first group was 12.3% and in the second group was 34.1% [P<0.01]. There is a positive association between mother's wish about the method of delivery and its outcome

[ effects of anesthesiologist residency on mortality of patients in ICU in Imam Khomeini teaching hospital of Mazandaran Medical University Sari [2000-2004]]

Anesthesiologists have become the first priority since they can play an important role in crisis situations to support respiratory and cardiac urgencies. In this survey, the effects of the resident anesthesiologists were studied on the death of patients having been hospitalized in the Intensive Care Unit of Imam Khomeini training and treatment center, Sari from 2000 to August 2004. In this survey, the subjects of the "case group" [passed-away patients during the residency of the anesthesiologist] have been compared to the subjects of the "control group" [having no resident anesthesiologist]. The following variables were considered for analysis: age, gender, hospitalization reasons, the original ward, reason of and the service of reference to the Intensive Care Unit, the cause of death, hospitalization period in the original ward and Intensive Care Unit, as well as the number of the visits paid by anesthesiologist. Other interfering variables [such as facilities] were not taken into account, since they had been the same for both groups. Data were analyzed using the SPSS software and the descriptive and analytical [X2,Z,T] statistical tests. The findings of this survey showed that men have died more than women [61.9% vs 38.1%] in the intensive care unit. The total hospitalization period reduced from 14 to 11 days, having an anesthesiologist residing in this ward. It was revealed that the presence of an anesthesiologist reduced the death rate from 24% to 14%. According to the findings of this survey, it has been revealed that the presence of an anesthesiologist can have an outstanding effect on the reduction of the death rate. It is taken for granted that choosing patients must be done in accordance with Classic Indications since there are limited number of beds in ICU and the admission request for different patients. In equal situations, those patients who have better opportunity and less mortality probability and better prognosis in this unit have priority

Data recording for unidentified patients

Patients without known identification often cause problems in daily routine admission and discharge processes, and this asks for further consideration. If patient's identity is not determined until discharge, problems might be imposed on judicial system and forensic medicine authorities. Therefore, it's expected that authorities take appropriate universal measures, in all of the hospitals nationwide, immediately after such patients' admission to the hospital; hence, assisting in patient's immediate or later identification. In addition, these measures would protect authorities and clinicians against potential complaints and lawsuits. In our country, until now, there have been no approved guidelines, specifying the manner in which these unidentified patients should be admitted, and it is not established what specific measures should be adopted by health service providing centers while dealing with these patients, in order to prevent liability of hospitals and curtail further problems for patients. In this article, we examined this issue and reviewed the points that must be taken into consideration when admitting these patients. We also proposed a proceeding designed for covering necessary issues during admission of this group of patients