Patient accounting systems: Are they fit with the users� requirements?

Objectives: A patient accounting system is a subsystem of a hospital information system. This system like other information systems should be carefully designed to be able to meet users� requirements. The main aim of this research was to investigate users� requirements and to determine whether current patient accounting systems meet users� needs or not. Methods: This was a survey study, and the participants were the users of six patient accounting systems used in 24 teaching hospitals. A stratified sampling method was used to select the participants (n = 216). The research instruments were a questionnaire and a checklist. The mean value of �3 showed the importance of each data element and the capability of the system. Results: Generally, the findings showed that the current patient accounting systems had some weaknesses and were able to meet between 70 and 80 of users� requirements. Conclusions: The current patient accounting systems need to be improved to be able to meet users� requirements. This approach can also help to provide hospitals with more usable and reliable financial information. © 2016 The Korean Society of Medical Informatics

Ten Years� Survival in Patients with Cervical Cancer and Related Factors in West Azerbaijan Province: Using of Cox Proportion Hazard Model

Objective: There are two basic ways to analyze survival data including nonparametric and parametric methods. Considering that cervical cancer is the fourth most common cancer among women, this study was conducted using a suitable regression model for survival data for patients with cervical cancer in Urmia. Material and Methods: In this historical retrospective study, all patients with cervical cancer who referred to Motahhari Hospital of Urmia during 2004 and 2015 were included in the study and consisted of 109 women with cervical cancer. The data were collected using checklist which filled with records of patients. The data were described with percent, mean and standard deviation. The survival function was computed with the Kaplan-Meier method. The adjusted Hazard Ratio for variables were estimated after fitting the Cox proportion hazard model using Forward Stepwise Likelihood Ratio method with PE=0.1, PR=0.15. Results: Of the 109 patients, the mean (SD) time of diagnosis was 50.1 (11.7) years. The mean (SD) and median of follow-up time was 38.23 (32.50) and 27.1 months (Mim:2 months and Max:132 months). Ninty-Three of patients (88.7) were in urban area. Using Log-Rank test, the mean score of survival in patients with recurrence of 38.8 months was significantly lower than those without recurrence (102.5 months) (P <0.001). The results of the COX model showed that the adjusted relative risk of mortality with a diagnostic age of 50 years or more compared to those under 50 years of age was 1.978. The risk for marriage under age 20 was 3.189 compared to the marriage age of 20 years or more. Conclusion: According to results, the low age of marriage increases the occurrence of advanced stages of cancer in older ages and as a social and cultural factor has a significant effect on the survival of patients with cervical cancer. Creative Commons Attribution Licens

Analgesic effects of intravenous ketamine during spinal anesthesia in pregnant women undergone Caesarean section; a randomized clinical trial

Suitable analgesia after cesarean section helps mothers to be more comfortable and increases their mobility and ability to take better care of their infants. Objectives: Pain relief properties of ketamine prescription were assessed in women with elective cesarean section who underwent spinal anesthesia with low dose intravenous ketamine and midazolam and intravenous midazolam alone. Patients and Methods: Sixty pregnant women scheduled for spinal anesthesia for cesarean section were randomized into two study groups. Ketamine (30 mg) + midazolam (1 mg = 2CC) or 1mg midazolam (2CC) alone, was given immediately after spinal anesthesia. Pain scores at first, second and third hours after CS operation, analgesic requirement and drug adverse effects were recorded in all patients. Results: Ketamine group had significant pain relief properties in compare with control group in first hours after cesarean section (0.78 ± 1.09 vs. 1.72 ± 1.22, VAS score, P = 0.00). Total dose of meperidine consumption in women of ketamine group was significantly lower than women of control group (54.17 ± 12.86 vs. 74.44 ± 33.82 mg, P = 0.02). There were no significant drug side effects in participated patients. Conclusions: Intravenous low-dose ketamine combined with midazolam for sedation during spinal anesthesia for elective Caesarean section provides more effective and long lasting pain relief than control group. © 2013 Iranian Society of Regional Anesthesia and Pain Medicine

Green Synthesized Silver Nanoparticles as Potent Antifungal Agent against Aspergillus terreus Thom

Medicinal plants are composed of a rich pool of biomolecules and have been increasingly recognized for their antimicrobial properties; however, increasing concerns have been put on the bioavailability features. Thus, this study is aimed at exploring the synthesis and characterization of silver nanoparticles synthesized by Chenopodium album L. leaf extract and assessing the antifungal activity against Aspergillus terreus Thom. Plant extract was prepared in methanol to synthetize silver nanoparticles, which were then characterized by Scanning Electron Microscopy (SEM), UV-Visible spectroscopy, and particle size analysis. UV-Visible analysis indicated maximum absorption at 378 nm, and an average particle size was observed as 25.6 nm. Oval to hexagonal shape was observed by SEM. Antifungal activity of silver nanoparticles (1, 1.5, 2, 2.5, 3, and 3.5%) was addressed against A. terreus biomass. At 3.5%, silver nanoparticles revealed to be highly effective, leading to 92% retardation in fungus growth. In next phase, various organic fractions, viz., chloroform, n-butanol, n-hexane, and ethyl acetate, were obtained from plant methanol extract, and the corresponding silver nanoparticles were prepared. These fractions were also assessed for antifungal activity, and n-hexane fraction led to 64% inhibition in A. terreus biomass. Following gas chromatography-mass spectrometry (GC-MS), 18 compounds were identified, namely, 1,3-cyclopentadiene-5-(1 methylethylidene and o-xylene), ethyl benzene, octadecane, nonane, decane, 2-methylheptane, n-hexadecane, 2-methylheptane, and eicosane, along with carbonyl compounds (4,4-dimethyl-3-hexanone) and phenols, like stearic acid, propionic acid hydrazide, and 2,4-di-T-butylphenol. These findings proved that C. album silver nanoparticles are highly effective against A. terreus.N.C.-M. acknowledges the Portuguese Foundation for Science and Technology under the Horizon 2020 Program (PTDC/PSI-GER/28076/2017)

Protein tyrosine phosphatase 1B inhibitors isolated from Artemisia roxburghiana

Artemisia roxburghiana is used in traditional medicine for treating various diseases including diabetes. The present study was designed to evaluate the antidiabetic potential of active constituents by using protein tyrosine phosphatase 1B (PTP1B) as a validated target for management of diabetes. Various compounds were isolated as active principles from the crude methanolic extract of aerial parts of A. roxburghiana. All compounds were screened for PTP1B inhibitory activity. Molecular docking simulations were performed to investigate the mechanism behind PTP1B inhibition of the isolated compound and positive control, ursolic acid. Betulinic acid, betulin and taraxeryl acetate were the active PTP1B principles with IC50 values 3.49 ± 0.02, 4.17 ± 0.03 and 87.52 ± 0.03 µM, respectively. Molecular docking studies showed significant molecular interactions of the triterpene inhibitors with Gly220, Cys215, Gly218 and Asp48 inside the active site of PTP1B. The antidiabetic activity of A. roxburghiana could be attributed due to PTP1B inhibition by its triterpene constituents, betulin, betulinic acid and taraxeryl acetate. Computational insights of this study revealed that the C-3 and C-17 positions of the compounds needs extensive optimization for the development of new lead compounds

A Criterion for Brittle Failure of Rocks Using the Theory of Critical Distances

This paper presents a new analytical criterion for brittle failure of rocks and heavily overconsolidated soils. Griffith’s model of a randomly oriented defect under a biaxial stress state is used to keep the criterion simple. The Griffith’s criterion is improved because the maximum tensile strength is not evaluated at the boundary of the defect but at a certain distance from the boundary, known as the critical distance. This fracture criterion is known as the Point Method, and is part of the Theory of Critical Distances, which is utilized in fracture mechanics. The proposed failure criterion has two parameters: the inherent tensile strength, ó0, and the ratio of the half-length of the initial crack/flaw to the critical distance, a/L. These parameters are difficult to measure but they may be correlated with the uniaxial compressive and tensile strengths, óc and ót. The proposed criterion is able to reproduce the common range of strength ratios for rocks and heavily overconsolidated soils (óc/ót=3-50) and the influence of several microstructural rock properties, such as texture and porosity. Good agreement with laboratory tests reported in the literature is found for tensile and low confining stresses.The work presented was initiated during a research project on “Structural integrity assessments of notch-type defects", for the Spanish Ministry of Science and Innovation (Ref.: MAT2010-15721)

Association between adolescent idiopathic scoliosis prevalence and age at menarche in different geographic latitudes

BACKGROUND: Age at menarche is considered a reliable prognostic factor for idiopathic scoliosis and varies in different geographic latitudes. Adolescent idiopathic scoliosis prevalence has also been reported to be different in various latitudes and demonstrates higher values in northern countries. A study on epidemiological reports from the literature was conducted to investigate a possible association between prevalence of adolescent idiopathic scoliosis and age at menarche among normal girls in various geographic latitudes. An attempt is also made to implicate a possible role of melatonin in the above association. MATERIAL-METHODS: 20 peer-reviewed published papers reporting adolescent idiopathic scoliosis prevalence and 33 peer-reviewed papers reporting age at menarche in normal girls from most geographic areas of the northern hemisphere were retrieved from the literature. The geographic latitude of each centre where a particular study was originated was documented. The statistical analysis included regression of the adolescent idiopathic scoliosis prevalence and age at menarche by latitude. RESULTS: The regression of prevalence of adolescent idiopathic scoliosis and age at menarche by latitude is statistically significant (p < 0.001) and are following a parallel declining course of their regression curves, especially in latitudes northern than 25 degrees. CONCLUSION: Late age at menarche is parallel with higher prevalence of adolescent idiopathic scoliosis. Pubarche appears later in girls that live in northern latitudes and thus prolongs the period of spine vulnerability while other pre-existing or aetiological factors are contributing to the development of adolescent idiopathic scoliosis. A possible role of geography in the pathogenesis of idiopathic scoliosis is discussed, as it appears that latitude which differentiates the sunlight influences melatonin secretion and modifies age at menarche, which is associated to the prevalence of idiopathic scoliosis