eng
Mashhad University of Medical Sciences
Journal of Patient Safety & Quality Improvement
2345-4482
2345-4490
2014-10-01
2
4
142
147
10.22038/psj.2014.3397
3397
Diagnostic Value of Ultrasound Compared to Electro Diagnosis in Carpal Tunnel Syndrome
Seyed Mansour Rayegani
1
Elham Kargozar
2
Darioush Eliaspour
d.eliaspour@yahoo.com
3
Seyed Ahmad Raeissadat
4
Ehsan Sanati
5
Masoumeh Bayat
6
Department of Physical Medicine and Rehabilitation, Shohada Tajrish Educational Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Physical Medicine and Rehabilitation, Shohada Tajrish Educational Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Physical Medicine and Rehabilitation, Shohada Tajrish Educational Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Physical Medicine and Rehabilitation, Modarres Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Physical Medicine and Rehabilitation, Imam Reza Hospital, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.
Department of Physical Medicine and Rehabilitation, Mahdieh Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Introduction: Carpal Tunnel Syndrome (CTS) is one of the main causes of disability. The diagnosis of CTS confirm by electrodiagnostic tests. Sonography is an alternative method for diagnosis of CTS that can investigate anatomy and probable pathology. The aim of this study is to investigate the multiple sonographic diagnostic criteria and compare its diagnostic value with electrodiagnosis. Materials and Methods:In this descriptive-cross sectional study, 84 wrists (42 patients with CTS and 42 individuals without any clinical signs in upper limb) were investigated. Symptomatic patients underwent clinical examination, standard electrodiagnostic evaluation of upper limb and sonographic investigation of median nerve in forearm and wrist. The control group underwent sonographic investigation. Results: Cross Sectional Area (CSA) of Median nerve at distal wrist crease, at the level of Hamate hook and Trapezium, the amount of flexor retinaculum bowing, ratio of CSA at the forearm to distal wrist crease and ratio of CSA at the Pisiform level to distal wrist crease had significant difference in the case group compared to the control group (P-value<0.05). Among these criterion, the most sensitivity, NPV and accuracy was for CSA at distal wrist crease (73.8%, 72.5%, 71.4% respectively), the most specificity, PPV was at the level of Hamate hook and Trapezium (85.3%, 80% respectively). Conclusion: Our study reveals that sonography is a somehow sensitive and specific method in diagnosis of CTS and can be used as an adjuvant method in diagnosis of CTS but cannot substitute electrodiagnosis.
https://psj.mums.ac.ir/article_3397_8a8410c43d0550116128b0812ef5e92a.pdf
Carpal tunnel syndrome
Electrodiagnosis
Median nerve
Sonography
eng
Mashhad University of Medical Sciences
Journal of Patient Safety & Quality Improvement
2345-4482
2345-4490
2014-10-01
2
4
148
150
10.22038/psj.2014.3398
3398
Incidence of Diarrhea in Hospitalized Patients with Standard Enteral Formula
Shabbu Ahmadi bonakdar
1
Mahdieh Pouryazdanpanah
2
Zahra Ganie Far
3
Saba Ghazanfari
4
Abdolreza Norouzy
norouzya@mums.ac.ir
5
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Pharm. D- Mashhad, Iran.
Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Introduction: Malnutrition is common in intensive care unit, occurring in (30% to 50%) of hospitalized patients. To prevent malnutrition, nutritionists recommend industrials formula for patients who cannot eat but with functional gastrointestinal track, But due to verbal nurse`s reports standard enteral formula is inducing diarrhea. In this study our purpose is to evaluate the incidence of diarrhea in hospitalized patients with standard Enteral Nutrition (EN) formula intake. Materials and Methods:13 patients participated in our study. We used Milatech brand as entral formula. Formula administration was depended 200 or 250 cc every two or three hours a day in dependent to patients needs and tolerance. Gastro Intestinal (GI) complications were recorded by nursing stuff in patients medical records. Complication frequencies were considered during three days for each person. Results: No patients have diarrhea, only residue was seen in four patients. Conclusion: Evaluation of patients receiving Milatech standard formula showed that diarrhea wasn’t seen in hospitalized patients. Diarrhea was reported by the nurses may refer to other diarrhea genic causes including of long length of stay, entral duration or medical side effects or infections.
https://psj.mums.ac.ir/article_3398_567f40d316f61cb529ca0ebac5c9812b.pdf
Diarrhea
Enteral Nutrition
Formula
eng
Mashhad University of Medical Sciences
Journal of Patient Safety & Quality Improvement
2345-4482
2345-4490
2014-10-01
2
4
151
155
10.22038/psj.2014.3399
3399
The Effect of Education-Based Intervention Using Small Group Discussion in Empowering Adolescent Girls to Prevent Iron Deficiency Anemia
Fatemehsadat Seyed Nematollah Roshan
1
Hasan Navipor
naviporh@modares.ac.ir
2
Fatemeh Alhani
3
Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Introduction: Iron deficiency is one of the most common nutritional disorders worldwide. Regarding that fact, the aim of this study was to study the effectiveness of education-based intervention using small group discussions in empowering adolescent girls to prevent Iron deficiency anemia. Materials and Methods:The present semi-experimental practical research was performed by choosing 60 female high-schoolers through random cluster sampling (n=30 test group and n=30 control group). The research tools included one questionnaire of demographic information & an assessment questionnaire for subjects’ empowerment in preventing iron deficiency anemia. After collecting pre-test data, the educational intervention was implemented for adolescent girls in the test group & the post-test was carried out one week after the intervention ended. The data were analyzed using SPSS software and applying appropriate statistical tests. Results: At baseline, independent T-test showed no significant difference between the two groups in the perceived susceptibility, perceived severity, and self efficacy, all of which could be regarded as empowerment process components (P>0.05). However, significant differences were observed after intervention. Also, the paired T-test showed a significant difference before and after the intervention in the test group in means of the perceived susceptibility, perceived severity, self efficacy and, in the grand scheme, adolescent girls' empowerment (P<0.05). No significant differences were evident in the control group. Conclusion: Our findings showed that the education-based intervention using small groupdiscussions was effective in empowering adolescent girls to prevent Iron deficiency anemia.
https://psj.mums.ac.ir/article_3399_e716d1888007207fad564c1730be686a.pdf
adolescent girls
Empowerment
Group discussion
Iron Deficiency Anemia
eng
Mashhad University of Medical Sciences
Journal of Patient Safety & Quality Improvement
2345-4482
2345-4490
2014-10-01
2
4
156
159
10.22038/psj.2014.3400
3400
A Study on the Frequency and the Reasons for Cancellation of Surgical Operations in Khatam Hospital (Mashhad, Iran) in 2013
Hossein Ebrahimipour
hebrahimip@gmail.com
1
Arash Shirdel
shirdel@mums.ac.ir
2
Mohammad Esmaeil Rahimi
3
Marzieh Meraji
4
Elaheh Hooshmand
phd_hooshmand@yahoo.com
5
Arefe Pourtaleb
pourtaleb@tums.ac.ir
6
Ebrahim Mohammad Pour
7
Ali Dehghani
8
Ali Vafaee Najar
vafaeea@mums.ac.ir
9
Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Department Stats, Khatam-al-Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Executive Management, Khatam-al-Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
Introduction: Operations cancellation at the last minute is one of the main reasons of inefficiency and waste of resources in Hospitals. This study aims to investigate the reasons and the frequency of operations cancellations in Khatam-al-Anbia Eye Hospital (Mashhad-Iran) in 2013. Materials and Methods:In this descriptive and cross-sectional study, all canceled scheduled operations in 2013 in Khatam-al-Anbiya Eye Hospital were investigated and the data were recorded in a checklist. Study variables included: 1) the number of planned operations, 2) the number of canceled operations, 3) age, 4) gender and 5) the reason of operation cancellation. Data were analyzed using descriptive statistics and SPSS16. Results: Of 16512 operations scheduled during 2013, 329 cases (1.99 percent) were canceled. The reason of cancellation was not mentioned in (28.6 percent) of cases. Other reasons of operations cancellation included, in the order of importance, high-risk underlying disease (22.5%), medical advice ignorance from the patient's behalf (10.6%), change in clinical status (7.9%), prolongation of previous operations (7%), patient’s dissatisfaction (5.8%), Patients' incomplete Nil Per Os (NPO) time (5.5%), inadequate equipment (4.6%), lack of lab tests and consultations (2.7%), diagnosis change (2.4%), surgeon's absence (1.8%), and incomplete admission documents (0.6%). Conclusion: In a high percentage of canceled cases, the reasons of operation cancellations had not been mentioned in the patient’s file. A significant portion of theses cancellations can be attributed to the patients' incomplete cooperation. Cancellations can be significantly reduced through providing the patient with enough instructions and explanations.
https://psj.mums.ac.ir/article_3400_1b3eb93757b38ed5dbf45a1572a0b9ae.pdf
Hospital
Operation
Surgery cancellation
eng
Mashhad University of Medical Sciences
Journal of Patient Safety & Quality Improvement
2345-4482
2345-4490
2014-10-01
2
4
160
164
10.22038/psj.2014.3401
3401
Medical Waste Management in the second largest City of Iran (Mashhad) with Three-Million Inhabitants
Rozita Davoodi
davoodir@mums.ac.ir
1
Saeed Eslami Hasan Abadi
eslamis@mums.ac.ir
2
Golnaz Sabouri
sabourig1@mums.ac.ir
3
Maryam Salehi
salehim@mums.ac.ir
4
Haleh Ghooshkhanei
5
Shaghayegh Rahmani
rahmanish3@mums.ac.ir
6
Azadeh Soltanifar
7
Maryam Zare Hoseini
8
Mahbobeh Asadi
9
Malek Gharaeian Morshed
10
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Introduction: One of the first and important steps to improve medical waste management is awareness and monitoring of the quality and quantity of medical waste. The aim of this study was to determine the present status of waste generation and the process of waste management in hospitals. Materials and Methods:This cross sectional study was performed in ten university hospitals in Mashhad. A standard questionnaire was prepared according to the National Health instructions and completed by the project team members who were environmental health experts. Results: The total waste which was generated in the studied hospitals was 7683 kg/day. The study showed total waste generation in selected hospitals as (61.85%) general medical waste, (34.90%) infectious waste and (3.25%) sharp waste. The average generation rate for total, general, infectious and sharp waste was (2.6, 1.5, 1.01) and (0.08) kg/bed/day, respectively. Mean scores of the different steps of waste management process with respect to National Health instructions were as follows: waste segregation (64%), waste storage (67%), waste transportation (76 %) and waste treatment 63%. There was no significant difference between the average rate of waste generation per bed in public and specialized hospitals (P=0.34). Conclusion: High rate of infectious waste shows the need for establishing executive rules and standards for medical waste management. Medical managers should update their knowledge and further educating their staff; implying careful and constant monitoring of waste management.
https://psj.mums.ac.ir/article_3401_4e01e70edf33fb9279a520bce4ce4a45.pdf
Hospital
medical waste
waste management
eng
Mashhad University of Medical Sciences
Journal of Patient Safety & Quality Improvement
2345-4482
2345-4490
2014-10-01
2
4
165
167
10.22038/psj.2014.3402
3402
Mental Retardation (MR) Etiology in Children Referred to Care Services
Mahdi Foroutan
foroutana861@mums.ac.ir
1
Behzisti organization, Mashhad, Iran
Introduction: It is estimated that 2800000 to 4800000 individuals in Iran suffer from some kind of mental or physical handicap. According to Iranian social welfare university, about 24000 mental retard children would be added to this population. The aim of this study was to evaluate demographic factors which were associated with mental retardation in Khorasan Razavi population. Materials and Methods:In this cross sectional study, the records of all mentally retarded children who had been referred for further evaluation to Mashhad social welfare was evaluated between 2004 and 2013. To evaluate mental retardation severity, Vineland social maturity scale was used for children younger than (5.5) years old, or the older children who did not respond to other tests. In cases of children older than (5.5) years who could communicate, Wechsler Intelligence Scale for Children (WISC) and Raven's Progressive Matrices were performed. Tests final confirmation hanged on psychiatric interview and clinical assessment. Data was analyzed by SPSS version 16 and parametric and non parametric tests were used. Results: A population of 200 children with a mean age of 7.5±6.6 years were evaluated. Smoking, drug abuse and consanguineous marriage were the main factors associated with mental retardation severity. (57%) of children had a relative with mental retardation. Conclusion: Considering Mental Retardation (MR) financial burden, planning to reduce and control preventable factors such as parents’ drug abuse could be possible through education and cultural changes.
https://psj.mums.ac.ir/article_3402_b036c0aba869a0654e89dc4dcc4454dc.pdf
Children
Mental retard
Social welfare
eng
Mashhad University of Medical Sciences
Journal of Patient Safety & Quality Improvement
2345-4482
2345-4490
2014-10-01
2
4
168
170
10.22038/psj.2014.3403
3403
BCC and Childhood Low Dose Radiation
Arash Beiraghi Toosi
1
Hamed Shariat Razavi
hamedsr@yahoo.com
2
Plastic Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Patient Safety Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Skin cancer is a late complication of ionizing radiation. Two skin neoplasms prominent Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) are the most famous complications of radiotherapy. Basal Cell Carcinoma (BCC) is the most common human malignant neoplasm. Many genetic and environmental factors are involved in its onset. BCC is observed in sun-exposed areas of skin. Some patients with scalp BCC have had a history of scalp radiation for the treatment of tinea capitis in childhood. Evidence that ionizing radiation is carcinogenic first came from past reports of nonmelanoma skin cancers on the hands of workers using radiation devices. The total dose of radiation and irradiated site exposed to sunlight can lead to a short incubation period. It is not clear whether BCC in these cases has a more aggressive nature and requires a more aggressive resection of the lesion. The aim of this review was to evaluate the differences between BCC specification and treatment results between irradiated and nonirradiated patients.
https://psj.mums.ac.ir/article_3403_b93fe0dcb8385e7b49dcb22c2739826c.pdf
BCC specification
Childhood radiation
Scalp BCC
eng
Mashhad University of Medical Sciences
Journal of Patient Safety & Quality Improvement
2345-4482
2345-4490
2014-10-01
2
4
171
174
10.22038/psj.2014.3404
3404
Pre-term Spontaneous Unscarred Uterine Rupture; A Case Report and Review
Shima Sheybani
sheybanish@mums.ac.ir
1
Nahid Zirak
zirakn@mums.ac.ir
2
Razieh Poorandi
3
Elnaz Hosseini
4
Cardiac Anesthesia Research Center, Anesthesia Department, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran
Cardiac Anesthesia Research Center, Anesthesia Department, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran
Cardiac Anesthesia Research Center, Anesthesia Department, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran
Cardiac Anesthesia Research Center, Anesthesia Department, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran
Introduction: Spontaneous uterine rupture, a life-threatening condition for both parturient and their fetus, often tends to occur during labour, particularly in those with a scarred uterus (rare in unscarred ones). The diagnosis must be born in mind in case of a pregnant woman presenting with shock, abdominal pain and diminished fetal heart rate. Any additional preoperative evaluation seems redundant as it only wastes golden surgical time. Case:The case we intend to present is a multigravid woman (G3L2) in 28th week of gestation with an unscarred uterus. She had cardiac surgery six months earlier Atrial Septal Defect (ASD) device closure with Percutaneous Coronary Intervention (PCI). She presented with severe dyspnea, diminished lung sounds in the right lower zone, chest pain at rest, and radiating pain to her right shoulder from 12 hours earlier. No FHR was detected by auscultation with Doppler. She had generalized abdominal tenderness and rebound tenderness.
https://psj.mums.ac.ir/article_3404_260b7c9ad07a0579dc1a4ddf899ea5f0.pdf
Preterm uterine rupture
Pregnant woman
Spontaneous uterine rupture