@article { author = {Etezad Razavi, Mohammad and Sharifi, Mohammad and Abrishami, Majid and Zaker Abbasi, Mojtaba}, title = {Accommodative Ability in Prepresbyopic Diabetic Patients}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {3}, number = {2}, pages = {203-205}, year = {2015}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2015.4172}, abstract = {Introduction: To compare various accommodative parameters in prepresbyopic diabetic patients with age-matched healthy individuals. Materials and Methods: Study populationconsisted of 32 younger-onset diabetic patients (30-40 years of age) and 28 age-matched healthy normal individuals. Using the best correction for distance visual acuity (20.20 by Snellen chart), multiple accommodative ability tests such as near point of accommodation, accommodative amplitude, negative or positive accommodative facility and near point of convergence were measured in both groups. Results: Mean near point of accommodation in diabetic patients was significantly greater than the control group (18.5±4.4 centimeters [cm] versus 9.5±2 centimeters, p= 0.000). Mean accommodative amplitude was (5.93±1.75) Diopter (D) and (10.95±2.16) Diopter in diabetics and normal individuals, respectively (p=0.000). Mean accommodation facility was (3.19±3.04) cycle/minute [cyl/min] in patients and 10.01±5.09 cycle/minute in the control group (p= 0.000). Mean positive relative accommodation was (–3.37±1.19) D in diabetic and (-2.11±0.99) D in healthy participants (p=0.000). Mean negative relative accommodation was lower in diabetic patients compared with the control group, however, this difference did not reach statistical significance (2.61±0.65) D versus (2.61±0.60) D, p= 0.23). Mean near point of convergence was (8.23±1.43) cm and (7.13±0.67) cm in normal and diabetic groups, respectively which had insignificant difference (p= 0.45). Conclusion: Majority of accommodative ability functions decreased in prepresbyopic diabetic patients. Early detection and rehabilitation of such patients with corrective near spectacles are strongly recommended.}, keywords = {Accommodation,Convergence,Diabetic,Prepresbyopic}, url = {https://psj.mums.ac.ir/article_4172.html}, eprint = {https://psj.mums.ac.ir/article_4172_609caa19d4f3c7ed225ef7d46463442c.pdf} } @article { author = {Zandi, Behrooz and Hozhabri, Hadi}, title = {Correlation between Femoral Neck Anteversion in Patients with Osteoarthritis of the Hip and Normal Controls}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {3}, number = {2}, pages = {206-210}, year = {2015}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2015.4173}, abstract = {Introduction: Alterations in Femoral neck Anteversion (FAV) ranges from 30–40 degrees at birth which dwindles throughout life due to several hereditary and environmental factors. FAV has been proposed to be engaged in the pathogenesis of several diseases among which hip osteoarthritis is a contradictory issue of study. It was aimed to evaluate the correlation between FAV and hip osteoarthritis in adults. Materials and Methods:FAV was determined using Computed Tomographic Scanning (CT) in 36 patients with hip osteoarthritis and in 36 adults with normal hips. CT images of all cases were evaluated by an experienced radiologist and anteversion degree of femoral neck from both limbs were studied. Results: Mean total FAV angle was 27.08 ± 8.80° and 23.43 ± 8.95° in patients group and control group, respectively. Total FAV angle did not show any significant difference between the two groups. Left FAV angle in osteoarthritic group was significantly increased compared with the control group. Mean osteoarthritis degree was 2.13 ± 0.99 in the patients. Osteoarthritis degree did not have any significant correlation with FAV angle of either right or left hip. No significant correlation was observed between different FAV angles and age in the whole study population. Conclusion: Significant increased left FAV angle was reported among osteoarthritic patients compared with the control group and it was concluded that anteversion in femoral neck could be a contributing factor in the pathogenesis of osteoarthritis. Thus, in the management of hip osteoarthritis, anteversion of the femoral neck should be of importance.}, keywords = {Anteversion,Femur,Hip,Osteoarthritis}, url = {https://psj.mums.ac.ir/article_4173.html}, eprint = {https://psj.mums.ac.ir/article_4173_e261d5de3dcb8cc3dac7f813cf6dcc88.pdf} } @article { author = {Nikkhah, Karim and Sasannejad, Payam and Saeidi, Morteza and Muhebati, Mohsen and Nekuyi, Sirus and Chekani, Farid and Fallah Rastgar, Azadeh and Farzadfard, Mohammad Taghi and Ghabeli Juibary, Ali and Aminzadeh, Samira}, title = {The Comparative Study of ECG Findings in the Patients Suffered from Subarachnoid Hemorrhage and Control Group in Northeastern Iran}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {3}, number = {2}, pages = {211-215}, year = {2015}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2015.4174}, abstract = {Introduction: Subarachnoid Hemorrhage (SAH) which accounts for (5% to 10%) of cerebrovascular accidents is an important cause of mortality and disability. It can be complicated by many neurological and medical conditions including cardiovascular complications. During the course of SAH morphologic Electrocardiography (ECG) changes, arrhythmias, myocardial injury and elevation of cardiac enzymes, subendocardial hemorrhage and necrosis may be observed. Materials and Methods:102 SAH patients, without any history of Ischemic heart Disease (IHD), admitted in Ghaem Hospital were studied. Their clinical and radiological parameters were evaluated. Three serial ECGs were performed within the first 72 hours for each patient and the ECG findings were analyzed. The control group consisted of 102 elective patients of Ghaem hospital without any expected heart disease. Results: ECG changes were observed in 60.8% of SAH patients with average age of (53.4±14.2) years and in (2.9%) of control group. The ECG findings were as follows: chamber abnormalities (6.9%), conduction abnormalities (7.8%), repolarization abnormalities (49%), rhythm abnormalities (22.5%) and pathologic Q wave (6.9%). According to this study, ECG changes are related to subarachnoid hemorrhage (p<0.01). ECG changes are independent from age and sex but they are related to clinical grading and mortality of SAH patients (P<0.01). ECG changes are related to presence of intracranial aneurysm (p<0.05). Conclusion: Our clinical, radiological and ECG findings are compatible with the previous studies. In this study, ECG findings in subarachnoid hemorrhage are related to the prognosis and to presence of intracranial aneurysm.}, keywords = {Aneurysm,Electrocardiography,Subarachnoid Hemorrhage}, url = {https://psj.mums.ac.ir/article_4174.html}, eprint = {https://psj.mums.ac.ir/article_4174_9d40a2b2de26bcfb5485ca86a97b9234.pdf} } @article { author = {Rahimi, Leili and Farrokh, Donya and Khadem, Nayere and Khajedaluee, Mohammad and Fallah Rastegar, Yalda and Mirsalehi, Ali}, title = {Evaluation of Abnormal Mammographic Findings in Initial Screening of 1000 Patients during 2008-2009 in Radiology Department of Imam Reza Hospital}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {3}, number = {2}, pages = {216-219}, year = {2015}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2015.4175}, abstract = {Introduction: The aim of this study was to categorize abnormal mammographic findings in 1000 patients according to Breast Imaging-Reporting and Data System (BI-RADS) and to report most common age of abnormal mammographic findings, average age of incidence of malignancy and determination of suitable age to start the screening process in women. Materials and Methods:1000 patients attending Radiology department for mammographic screening during 2007-2008 were asked to participate in this study. One radiologist evaluated the mammograms and categorized patients based on the BI-RADS. Results: The average age of patients diagnosed with invasive ductal carcinoma and in situ ductal carcinoma was 48±6.51years. The average age of patients in category 5 (that translates into “probably malignant”) was (53±7.87) years. The average age of patients in other categories except for category 0 and category 1 that translates into “negative” was (52.07±7.81) years. There was also a significant relationship between patient’s age and BI-RADS categories according to findings of this study. Conclusion: Based on early incidence of irregular mammographies (52.07 years) and early incidence of malignant findings in such mammographies (48± 6.51 years), it is suggested to implement screening programs in a great scale for patients older than 35 years old. Based on high percentage of patients with increased breast density findings in mammograms (11.6%) and diagnosis of two cases with invasive ductal carcinoma in this group, we recommend sonography of patients with such findings to rule out the presence or absence of malignancy with a higher accuracy for which mammograms lack a diagnostic value.}, keywords = {BI-RADS,Breast Cancer,Mammography,Screening}, url = {https://psj.mums.ac.ir/article_4175.html}, eprint = {https://psj.mums.ac.ir/article_4175_d509dc2f00f2ce8e49a718fdab7772e2.pdf} } @article { author = {Masoumian Hoseini, Seyedeh Toktam and Manzari, Zahrasadat}, title = {Quality of Care of Nursing from Brain Death Patient in ICU Wards}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {3}, number = {2}, pages = {220-224}, year = {2015}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2015.4176}, abstract = {Introduction: Nowadays, Intensive Care Unit (ICU) nurses play a significant and key role in the care of brain dead patients and their families, therefore their Practice extremely important to the success of organ donation. To assess ICU nurse's practice in relation to nurse's role in the organ donation process from brain dead patients in Iran. Materials and Methods:In a cross-sectional analytical study 90 ICU nurses in Ghaem and Imam Reza Hospitals in Mashhad through stratified random sampling allocation method were selected. Data collection tools included a questionnaire on demographic information, factors influencing nurse's practice during the organ donation process and surveying "nurse's practice in relation to their roles in the organ donation process." Results: 90 nurses participated in this study. (70.0%) of the research subjects had spoken with their own families about organ donation, and (20.0%) had organ donation cards. Practice scores were calculated on a scale of 100. The mean score of nurses' practice was (6.04± 3.66). 96.7% of nurses’ weak practice in terms of their roles in the organ donation process. Conclusion: As a result, they do not have adequate practice regard nurse's role in organ donation process and in relation to brain death patient and their families. Therefore it is suggested to include nursing courses in the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the process to improve their practice by different training methods.}, keywords = {Brain death,Nurse's Role,Practice,Organ Donation}, url = {https://psj.mums.ac.ir/article_4176.html}, eprint = {https://psj.mums.ac.ir/article_4176_4cb3cb9a492b2e8de31e282f71311675.pdf} } @article { author = {Rajabi, Mehrdad}, title = {Correlation between Incomplete Hippocampal Inversions (IHI) with Incidence of Seizure Based on MRI Findings: A Systematic Review}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {3}, number = {2}, pages = {225-229}, year = {2015}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2015.4177}, abstract = {Introduction:Incomplete Hippocampal Inversions (IHI) is considered as leading cause of several neurological complications including epilepsy. This paper provides a systematic literature review about the possible causative role of incomplete hippocampal inversions in patient with epilepsy based on findings of Magnetic Resonance Imaging (MRI). Materials and Methods: The incomplete inversion of hippocampus with MRI imaging in patient with epilepsy was searched in PubMed and Scopuswith the following search strategy ((incomplete hippocampal inversion or hippocampal malrotations)) and epilepsy) and (magnetic resonance imaging or MRI). Then, data including the number of patients, and concluded results were extracted and compared between the groups. All types of articles including case series, clinical trials and cohort studies in English language with no time limitation were included.  All searches, selection of articles and the data extraction were performed by two independent reviewers. Results: Only 11 papers met the inclusion criteria. Data were extracted and compared between two groups of patients and healthy controls. Results of this review showed that among 854 healthy controls and 1402 patients with verified temporal lobe epilepsy or hippocampal abnormalities, 59 cases with Hippocampal Malrotation (HIMAL) were in control groups, and 165 cases were in patients with epilepsy. Conclusions: The results showed that incomplete hippocampal inversion can be considered as an important cause of seizure. But still, studies with large sample size and equal number of cases and controls should be conducted to strongly confirm this association.}, keywords = {Epilepsy,Incomplete hippocampal inversion,magnetic resonance imaging}, url = {https://psj.mums.ac.ir/article_4177.html}, eprint = {https://psj.mums.ac.ir/article_4177_be13a73647da7997a089ee88db62d7b3.pdf} } @article { author = {Izadi, Meisam and Salehnia, Nasim}, title = {The Role of CT Angiography in Diagnosing Patients Suspected to Pulmonary Embolism}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {3}, number = {2}, pages = {230-233}, year = {2015}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2015.4183}, abstract = {Pulmonary embolism (PE) is a blockage of the main pulmonary artery  or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream (embolism). Pulmonary embolism (PE) is the third most common cause of cardiovascular related mortality. Numerous diagnostic tools have been utilized in order to improve diagnosis and prompt appropriate treatment. Since the first introduction of Computed Tomography (CT) angiography in the setting of PE diagnosis algorithm, it has rapidly become as the first choice among imaging techniques. However, still there is long way to improve the abilities and lowering the possible hazards and problems. The purpose of this review is to evaluate and summarize the role of imaging tools in diagnosis of PE in suspected patients, with particular focus on CT angiography. We studied different areas related benefits, disagreements and challenges in utilizing CT angiography in the setting of PE diagnosis algorithm. Although CT angiography is still the imaging of choice in rule-outing PE in suspected patients, there are areas of uncertainty in the field of over-diagnosing of CT angiography and consequent over-treatment.}, keywords = {CT angiography,Deep Vein Thrombosis,Pulmonary Embolism,Venous thromboembolism}, url = {https://psj.mums.ac.ir/article_4183.html}, eprint = {https://psj.mums.ac.ir/article_4183_9898895e90e02ffa16beda587a30d87f.pdf} } @article { author = {Gholoobi, Arash}, title = {A Case of Metformin-Related Megaloblastic Anemia Presenting with Palpitation}, journal = {Journal of Patient Safety & Quality Improvement}, volume = {3}, number = {2}, pages = {233-237}, year = {2015}, publisher = {Mashhad University of Medical Sciences}, issn = {2345-4482}, eissn = {2345-4490}, doi = {10.22038/psj.2015.4178}, abstract = {Introduction:Metformin is the cornerstone of medical treatment in most diabetic patients with many beneficial effects on cardio-metabolic parameters. However, long term metformin is a known pharmacological cause of vitamin B12 deficiency leading to neurological symptoms, megaloblastic anemia and increased levels of serum homocysteine. Moreover, it is well known that vitamin B12 deficiency-induced neurologic symptoms precede the appearance of megaloblastic anemia. Case:We herein report the case of an old woman with a history of long term metformin consumption who visited the cardiology clinic with the chief complaint of palpitation due to megaloblastic anemia without any neuropsychiatric symptoms. She was successfully treated with a parenteral regimen of vitamin B12 within two months. Conclusion:Although annual measurement of serum vitamin B12 levels could be considered in patients on long-term metformin therapy, yet it seems more reasonable and cost-effective to prevent vitamin B12 deficiency and its related adverse effects with annual prescription of parenteral vitamin B12 in all such patients.}, keywords = {Megaloblastic Anemia,Metformin,Vitamin B12 Deficiency}, url = {https://psj.mums.ac.ir/article_4178.html}, eprint = {https://psj.mums.ac.ir/article_4178_be8dd7d9bc7dda44ec2a3ff76a337044.pdf} }