Evaluation the Efficacy and Complication of Nutrika Supplement in Intensive Care Unit of Ghaem Hospital-Mashhad
Peyman
Rezaie
Biochemistry and Nutrition Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
author
Samaneh Sadat
Ayoubi
Biochemistry and Nutrition Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
author
Mohsen
Mazidi
Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science
(IC-UCAS), Beijing, China.
author
Abdolreza
Norouzy
Biochemistry and Nutrition Research Center, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
author
text
article
2015
eng
Introduction: Malnutrition is a general problem in hospitalized patients. Enteral feeding in Intensive Care Unit (ICU) has been stated to decrease the metabolic response to stress, decline bacterial translocation, and preserve gut mucosal integrity. To assess the efficacy and complications of Nutrika supplement for enteral feeding in Intensive Care unit. Materials and Methods: Nutrika is an enteral nutritional supplement. 12 patients (six male, six female) who received Nutrika supplement through Nasogastric Tube (NGT) in ICU department of Ghaem Hospital were studied. Evaluating gastrointestinal tolerance, biochemical tests, daily calorie intake and the measurement of arm circumference were done daily. Mean admission duration of these hospitalized patients was ten days and it should be noted that the average amount of received gavage was 200 ml/2h. Results: four patients (two male, two female) had diarrhea when they received this supplement in consecutive meals. Two patients (female) experienced abdominal pain after consuming this supplement; however the prevalence of all gastrointestinal intolerance symptoms among patients were not statistically significant (P=0.25, P=0.50, P=0.50). Albumin and Urea level alter significantly during supplementation (P=0.001, P=0.002). Rest of the laboratory values did not change significantly. In two patients (one male, one female) who were completely intolerant to this solution, arm circumference had two cm decrease. Conclusion: Although this supplement has some complication including distension and diarrhea, however it is strongly suggested to use due to severe malnutrition in ICU ward and plays a significant role in improving general condition of these patients.
Journal of Patient Safety & Quality Improvement
Mashhad University of Medical Sciences
2345-4482
3
v.
1
no.
2015
175
178
https://psj.mums.ac.ir/article_3808_39446b56d651e166e39af8dc46df8ae5.pdf
dx.doi.org/10.22038/psj.2015.3808
Patient Satisfaction Analysis in Emergency Department in Imam Reza Hospital of Mashhad
Hamidreza
Reihani
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Elham
Pishbin
Emergency Department, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Zahra
Abbasi Shaye
Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Mohsen
Ebrahimi
Emergency Department, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Ehsan
Bolvardi
Emergency Department, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Morteza
Talebi Delooi
Emergency Department, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Davood
Momeni Moghaddam
Emergency Department, Motahari Hospital, Golestan University of Medical Sciences, Golestan, Iran.
author
Veda
Vakili
Department of Community Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
text
article
2015
eng
Introduction: Patient satisfaction is an accurate assessment factor for evaluating the performance of health policies in the community. The purpose of this study is to assess patients' satisfaction with emergency department of Imam Reza hospital of Mashhad Iran. Materials and Methods: In this cross-sectional study, during six months period from April to October 2012, 420 patients were entered to study in morning, evening and night shifts before being discharged or transferred from emergency department. The Press Ganey questionnaire of patient satisfaction was completed. Results: 420[daneshgar1] patients in three work shifts of morning (140 patients) evening (140 patients) and night (140 patients) participated in our research. 226 (53.8%) of participants were male and 194(46.2%) were female. The average of patients’ time waiting for doctors' visit was 10.7±6.1 minutes. The mean score of satisfaction during attendance in Emergency Department (ED), during physicians' visit and overall satisfaction was 25.24±5.04, 25.32±5.42, 8.52±1.91 respectively. The highest level of satisfaction is related to speed of admission (81%), medical treatment (76%), nursing skills for doing medical orders (71.4%) and lowest level of satisfaction is related to comfort and pleasantness of the waiting area (45.9%), time the physician spent with the patient (56.5%) and length of wait before going to an exam room (62.8%). Conclusion: Attempt for reducing waiting time, providing comfort environment, increasing the time of visit with emergency physicians and enhance service quality based on patient needs can reduce the patient dissatisfaction.
Journal of Patient Safety & Quality Improvement
Mashhad University of Medical Sciences
2345-4482
3
v.
1
no.
2015
179
183
https://psj.mums.ac.ir/article_3809_21ecba8b503408dcd2b631ecb13af79b.pdf
dx.doi.org/10.22038/psj.2015.3809
Nausea and Vomiting after Septorhinoplasty Using Alfentanil or Remifentanil
Masoomeh
Tabari
Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Alireza
Bameshki
Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Maryam
Salehi
Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Iman
Mirisoleiman
Department of Anesthesiology, Resident of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Kamran
Khazaeni
Department of Otorhinolaryngology, Mashhad University of Medical Sciences Mashhad, Iran.
author
text
article
2015
eng
Introduction: The aim of this study was to compare Alfentanil with Remifentanil regarding postoperative nausea and vomiting. Materials and Methods: In this double-blind randomized controlled trial, we studied 60 patients, between 17-48 years old with American Society of Anesthesiologists class I or II undergoing septorhinoplasty. The patients signed informed consent and then were randomly divided into two groups. Induction was started similarly in both groups using Midazolam, Propofol and Atracurium whereas group one Alfentanil group (AL group) received Alfentanil and group two Remifentanil group (R group) received Remifentanil. We used Alfentanil with Propofol in the AL group or Remifentanil with Propofol in the R group as maintenance drugs. We assessed nausea and vomiting with Visual Analogue Scale (VAS) from the extubation time until 24 hours after the surgery. We used ondansetrone to relieve nausea. Results: Our patients had a mean age of 25.7±5.4. 75% were female and 25% were male. Duration of surgery had a mean time of 167.5±15.8 minutes and there was not statistically any difference between the two groups. We assessed nausea and vomiting incidence and severity on Visual Analogue Scale score in 0-1 hour, 1-6 hours and 6-24 hours after surgery. The highest nausea and vomiting incidence was in 1-6 hours after the surgery and the two groups were statistically the same. Conclusion: Our results did not show a statistically significant difference between using Alfentanil and Remifentanil as induction and maintenance drugs, regarding nausea and vomiting in the 24 hours post operation period.
Journal of Patient Safety & Quality Improvement
Mashhad University of Medical Sciences
2345-4482
3
v.
1
no.
2015
184
187
https://psj.mums.ac.ir/article_3810_e1f708f9853276e43f90c81c8c00659c.pdf
dx.doi.org/10.22038/psj.2015.3810
Evidence-Based Medicine: Studying the Attitude of Medical Residents in Mashhad
Rozita
Davoodi
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Shapour
Badiee Aval
Chinese Medicine Traditional and Complementary, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Maryam
Salehi
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Shaghayegh
Rahmani
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Golnaz
Sabouri
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Azadeh
Soltanifar
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Mahboubeh
Asadi
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Maryam
Zare Hoseini
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Parvin
Zohorian Sadr
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
text
article
2015
eng
Introduction: Evidence-Based Medicine (EBM) means ensuring that the right patient has received the appropriate treatment and it strives to form a common scientific language for all doctors. It uses the combination of the best available knowledge (evidence) and clinical experience beside the patient values. This study was designed to investigate the attitude of medical residents of Mashhad University of Medical Sciences towards EBM. Materials and Methods: In this cross sectional study a self-designed questionnaire was used for data collection. The study was performed in the autumn of 2012 in Mashhad University of Medical Sciences, Mashhad, Iran. The study aimed at investigating the attitude of medical residents towards EBM and evaluating its use in medical practice. Questionnaires’ data were analyzed by the SPSS Version 13. Results: 49 (52.1%) residents were familiar with the concept of EBM whereas 45 (47.9%) were not. The rate of familiarity with EBM concepts was (26.5%) in the surgical fields and (73.5%) in the non-surgical ones, showing a meaningful difference (p=0.014). There was a significant correlation between the field of study and knowledge about the concepts of EBM, whereas a greater number of non surgical residents were familiar with its concept in comparison to surgical residents (73.5% vs. 26.5%, p=0.014). Conclusion: The concepts of EBM are familiar to (82%) of medical residents of Mashhad and regarding the increasing importance of this science, upgrading EBM concepts in a timely and accurate planning is highly recommended.
Journal of Patient Safety & Quality Improvement
Mashhad University of Medical Sciences
2345-4482
3
v.
1
no.
2015
188
192
https://psj.mums.ac.ir/article_3811_d9266bf1d26b24a453712892807c22e3.pdf
dx.doi.org/10.22038/psj.2015.3811
Axial Length in Retinal Vein Occlusion
MirNaghi
Mousavi
Eye Research Center, Khatam-al-Anbia Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Mohammad Hashem
Naseri
Eye Research Center, Khatam-al-Anbia Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Naser
Shoeibi
Eye Research Center, Khatam-al-Anbia Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
text
article
2015
eng
Introduction: Retinal vein occlusion is one of the most common forms of vascular disease in retina, and leads to visual loss in patients. Various treatment options were proposed for this disorder. The aim of this study was to compare axial length in eye with retinal vein occlusion in comparison with intact eye. Materials and Methods: After ethical approval, this case-control study was designed in Mashhad University of medical sciences. We selected 63 patients with retinal vein occlusion and 23 control group. Axial length was measured by a mode scan (NIDEK-US 4000, Japan), macular thickness (macular edema) was evaluated by Optical Coherence Tomography (ZEISS, Germany). Data were analyzed with SPSS Version 16. PResults: Axial Length (AL) in eye with central retinal vein occlusion was significantly shorter in comparison with control group (P=0/003). AL was not differed significantly in affected eye in patients with Central Retinal Vein Occlusion (CRVO) and Branch Retinal Vein Occlusion (BRVO) (P=0.8). There was not a significant difference between AL in intact eye of patients with CRVO (P=092) and BRVO (P=0.54) in comparison with control group. Conclusion: Axial length in patients with central retinal vein occlusion was shorter than AL in BRVO and control group.
Journal of Patient Safety & Quality Improvement
Mashhad University of Medical Sciences
2345-4482
3
v.
1
no.
2015
193
195
https://psj.mums.ac.ir/article_3812_2598c468188422a63eb5a19274bf456a.pdf
dx.doi.org/10.22038/psj.2015.3812
Surgical Causes in Lower Respiratory Tract Infection in Children
Ahmad
Bazrafshan
Department of Pediatrics, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Farhad
Heydarian
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Ahmad
Hashemzadeh
Department of Pediatrics, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Shaghayegh
Rahmani
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
text
article
2015
eng
Introduction: To evaluate the surgical causes in pulmonary infection in children. Materials and Methods:In this cross sectional study 203 patients aged between one month and 12 years old were studied in pediatric wards at Ghaem hospital in Mashhad, Iran. Results: Most of patients were male and younger than one year old. Fever and cough were among the most common presentations. Foreign body aspiration, hydatid cyst, empyema and lung abscess were the most common causes that required surgical intervention. Conclusion: Foreign body aspiration and hydatid cyst, empyema and lung abscess are the most common causes of surgical intervention in children with pneumonia.
Journal of Patient Safety & Quality Improvement
Mashhad University of Medical Sciences
2345-4482
3
v.
1
no.
2015
196
197
https://psj.mums.ac.ir/article_3813_5957e9008d1176df24af8dc77220a72d.pdf
dx.doi.org/10.22038/psj.2015.3813
Evaluation of BCL6 and MUM1 Expression in Patients with Diffuse Large B Cell Lymphoma (DLBCL) and Their Correlation with Staging and Prognosis of the Disease
Hossein
Rahimi
Department of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran
author
Amir Hosein
Jafarian
Cancer Molecular Pathology Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Alireza
Samadi
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Bahram
Meamar
Cancer Molecular Pathology Research Center, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
text
article
2015
eng
Diffuse Large B-Cell Lymphoma (DLBCL) is the most common type of Non-Hodgkin Lymphoma (NHL) which includes about (25%) of the cases. Patients with DLBCL have a rapidly growing mass that is located in the neck or abdominal region. Multiple Myeloma Oncogene (MUM1) has an important role in lymphoid cell differentiation. MUM1/IRF4 is as oncogene related to myeloma and translocation (p25; q32), t (6; 14) and leads to a change in the heavy chain of Immunoglobulin (IGH). BCL6 exists in approximately (100%) of follicular cell cancer cases, (100%) of Burkitt lymphoma, (80%) of large B-cell lymphoma, and in more than (80%) of nodular lymphocytic Hodgkin lymphoma cases. BCL6 is related to cancers with a high proliferation cell index. In some studies BCL6 is expressed as a prognostic factor in LBCL patients
Journal of Patient Safety & Quality Improvement
Mashhad University of Medical Sciences
2345-4482
3
v.
1
no.
2015
198
200
https://psj.mums.ac.ir/article_3814_6825530c5a8c66f49e20f7286b63d927.pdf
dx.doi.org/10.22038/psj.2015.3814
Simple Suturing Procedure to Manage a Flat Anterior Chamber Secondary to a Malfunctioned Ahmed Glaucoma Valve
Siamak
Zarei-Ghanavati
Eye Research Centre, Khatam-al-Anbia Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Saeed
Shokoohi-Rad
Eye Research Centre, Khatam-al-Anbia Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
author
Mohammad Hashem
Naseri
Retinal Research Centre, Khatam-al-Anbia Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
Reza
Alizadeh
Cornea Research Centre, Khatam-al-Anbia Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
author
text
article
2015
eng
Introduction: Presenting a case with repeated episodes of flat Anterior Chamber (AC) after Ahmed valve implantation, and suggesting a simple suturing procedure to manage these recurrences. Case:A 65-year-old woman presented to our clinic with uncontrolled Neovascular Glaucoma (NVG) in her left eye due to advanced Proliferative Diabetic Retinopathy (PDR) despite full medication to reduce Intraocular Pressure (IOP). After Ahmed valve implantation, anterior chamber became flattened spontaneously on postoperative day one. Therefore, we filled the AC with air at the first attempt but this procedure failed a day later. Then, we filled the AC with an ocular viscoelastic device. Because of these procedures failed to keep the AC formed, we hypothesized that it may be a malfunctioned valve. Therefore, we inserted 5-0 Nylon in Ahmed tube through AC and fixed it to the subconjunctiva two days after the second procedure. Anterior chamber remained deep and its shallowing did not occur despite removing the suture two weeks after the insertion. The IOP was controlled well with a functional filtering device at the last follow–up visit four months after the surgery. Conclusion: Spontaneous episodes of flat AC after Ahmed valve implantation in an eye can be well managed by inserting a removable suture into the Ahmed valve tube.
Journal of Patient Safety & Quality Improvement
Mashhad University of Medical Sciences
2345-4482
3
v.
1
no.
2015
201
202
https://psj.mums.ac.ir/article_3815_5b4f73556f5be51f07f0ac94cbda5651.pdf
dx.doi.org/10.22038/psj.2015.3815