Combining Discrete Wavelet Transform and Strong Ground Motion Duration to Reduce Computational Costs in Dynamic Analysis of Structures

The dynamic time history analysis is the most accurate method for calculating the structure response relative to the vibrating load. The use of this method is time-consuming due to the long-duration earthquakes and is generally less commonly used. Wavelet trans-forms are one of the new methods for filtering waves. The duration of a strong ground motion is actually a concept that can be used to turn an earthquake with a long time into an earthquake with a shorter time. In this paper, two concepts of filtration using wavelet transform and the use of a duration of strong ground motion are used for the time history analysis of structures. For this purpose, the acceleration of the earthquake in 5 states was filtered by wavelet transform. In each stage, the high and low frequencies are separated, and the number of earthquake acceleration points is half-past. Then the beginning and the end of the main earthquake and the approximate waves obtained from the wavelet transform are removed using the concept of the duration of the strong ground motion. Finally, two two-dimensional and three-dimensional structures are analyzed using the main earthquake and the waves obtained by combining the two concepts of wavelet transform and the duration of strong ground motion. The results show that by reducing the number of acceleration points of the main earthquake record to more than 95%, the dynamic response error is less than 8%

Re-admission Rate of Patients with Ureteral Stone: A Descriptive Study

Introduction: Patients with acute renal colic need to choose between undergoing medical treatments and receiving interventions. The Aim of this study is to evaluate the outcomes of patients who are discharged from emergency departments with ureteral stones lesser than 6 millimeters. In doing so, the effect of diagnostic treatment approaches on clinical outcomes and referral rate is to be assessed.Patients and Methods: This study was performed on patients with ureteral stones referred to emergency department of Shohadaye Tajrish Hospital between May2015 to June 2018. A checklist was filled out for each patient and it included their complete medical history, physical examination results and paraclinical data. Patients were then studied for 4 weeks to determine referral times to hospital and clinical outcomes.Results: 105 patients include 81 men (77.14%) with average age of 37.1±12.4 years were studied. The mean stone diameter was 4.2±2.1 mm.  Most of ureteral stones were seen in the right-hand side (60 percent). 71 patients (67.6%) did not have any history of nephrolithiasis and 73 (69.5%) did not have positive family history for nephrolithiasis. Ureteral stones were still observed in 42 patients (40%) after two weeks of studies and only one patient (1.1%) had stone in Ultrasound Imaging after 4 weeks of observations.Conclusion: Most Patients (95%) with stones smaller than 6 mm responded to Medical Expulsive Therapy (MET) after 4 weeks and passed spontaneously ureteral calculi

میزان همخوانی یافته های سی تی اسکن شکم با یافته های آزمایش ادرار در کودکان دچار هماچوری در اثر ضربه غیرنافذ شکمی

Introduction: The present study compares the diagnostic accuracy of urinalysis with computed tomography (CT) scan in pediatrics with blunt abdominal trauma. The aim of this study was comparing the diagnostic value of urinalysis and abdominal CT scan with contrast, as the gold standard, for predicting probable abdominal organ injury in these patients. Methods: The present diagnostic accuracy study was done on children with blunt abdominal trauma aged less than 16 years who were presented to emergency department and both urinalysis and abdominal CT scan had been done for them. Demographic data, trauma mechanism, and results of urinalysis, ultrasonography and abdominal CT scan regarding abdominal organs were recorded. To evaluate the diagnostic power of urinalysis, statistical indices such as sensitivity, specificity, positive and negative predictive value were used. Results: In this study, 70 children under 16 years old who visited ED were evaluated. Mean age of the studied population was 7.1 ± 4.86 years and 48 of the patients (68.6%) were male. The correlation between hematuria and positive CT scan findings was confirmed. Sensitivity, specificity and positive and negative predictive values of hematuria were calculated to be 26.67%, 92.73%, 50% and 82.26%, respectively. Conclusion: Based on the results of the present study, although presence of hematuria has acceptable specificity, its sensitivity is very low compared to CT scan for prediction of abdominal organ injuries in pediatrics with blunt abdominal trauma. In other words, absence of hematuria is not a good reference to dismiss abdominal organ injury, yet its presence can be an indicator of serious injury. مقدمه: مطالعه حاضر به بررسی دقت تشخیصی نتیجه آزمایش ادرار در مورد کودکان دچار آسیب غیرنافذ شکم، در مقایسه با سی تی اسکن می پردازد. هدف از این مطالعه بررسی مقایسه ای میان ارزش تشخیصی آزمایش ادرار و سی تی اسکن شکم با کنتراست به عنوان روش استاندارد طلایی تشخیص در پیشگویی آسیب احتمالی احشای شکمی در این بیماران است. روش کار: مطالعه حاضر از نوع ارزیابی دقت تشخیصی بر روی کودکان دچار ترومای بلانت شکم کوچکتر از 16 سال که به بخش اورژانس مراجعه کرده بودند و برای آنها آزمایش ادرار و سی تی اسکن شکم درخواست شده بود، انجام گرفت. اطلاعات دموگرافیک، مکانیسم تروما، نتایج آزمایش ادرار، سونوگرافی و سی تی اسکن شکم در خصوص آسیب احشای شکمی ثبت گردید. برای سنجش قدرت تشخیصی بیماران توسط آزمایش ادرار از شاخصهای آماری حساسیت، ویژگی، ارزش اخباری مثبت و منفی استفاده شد. يافته ها: در این مطالعه تعداد70 کودک بین 0 تا 16 سال مراجعه کننده به بخش اورژانس وارد مطالعه شدند. 48 نفر (6/68 درصد) از بیماران پسر بودند. میانگین سنی ایشان 6/4±1/7 سال بود. در این مطالعه ارتباط بین وجود خون در ادرار و یافته های مثبت سی تی اسکن تایید شد. میزان حساسیت،ویژگی،ارزش اخباری مثبت و منفی به ترتیب 67/26 % و 73/92 % و 50 % و 26/82 % بدست آمد. نتيجه گيری: طبق نتایج مطالعه حاضر وجود هماچوری با وجود ویژگی قابل قبول، از حساسیت بسیار پایینی در مقایسه با سی تی اسکن در پیشگویی آسیب احشای شکمی در کودکان دچار ترومای بلانت شکم دارد. به بیانی دیگر عدم وجود هماچوری معیار مناسبی برای رد آسیب احشای شکمی نیست ولی وجود آن می تواند مطرح کننده آسیب جدی باشد

Anti-phospholipase A2 receptor antibody in idiopathic membranous nephropathy: A report from Iranian population

Background: Idiopathic Membranous Nephropathy (iMN) is the most common cause of nephrotic syndrome in adults. Approximately one third of patients with iMN progress to end-stage renal disease. Anti-phospholipase A2-receptor (anti-PLA2R) antibodies are present in patients with iMN and appear to play a role in the pathogenesis of iMN. Objectives: In this study, we explored the prevalence of anti-PLA2R antibodies in a cohort of patients with iMN in Iran. We also sought to determine circulating levels of anti-secretory PLA2 (anti-sPLA2) antibodies in those with anti-PLA2R antibodies. Patients and Methods: Using an indirect immunofluorescence assay, we measured anti-PLA2R antibodies in a group of patients with iMN in Iran. The serum levels of anti-sPLA2 antibodies were also measured in those with positive results for anti-PLA2R antibodies. Results: We studied 23 patients with iMN (M/F 12/11, 34±9.8 year), two patients with secondary MN and five patients with the nephrotic syndrome of other causes.Anti-PLA2R antibodies were detected in 17/23 (74%) of patients with iMN, but not in those with secondary MN or other forms of primary glomerular diseases. We found no correlation between anti-PLA2R antibody titer and the degree of proteinuria. We found high titers of anti-sPLA2 antibodies in a subset of patients with high levels of anti-PLA2R antibodies. Conclusions: Anti-PLA2R antibodies are specific for iMN. Proteinuria may also reflect glomerular structural damage rather than immunological activity of the disease. The preliminary idea of any presumptive role of anti-sPLA2antibodies in iMN needs further investigation

سیستم های تریاژ بیمارستانی و پیش بیمارستانی در شرایط عادی و بحرانی؛ یک مقاله مروری

Triage is a priority classification system based on the severity of problem to do the best therapeutic proceedings for patients in the less time. A triage system should be performed in a way which can make a decision with high accuracy and in the least time for each patient. Simplicity and reliability of the performance are the most important features of a standard triage system. An appropriate triage causes to increase the quality of health care services and patients’ satisfaction rate, decrease the waiting time as well as mortality rate, and increase the yield and efficiency of emergency wards along with reducing the related expenses. Considering to the above statements, in the present study the history of triage formation was evaluated and categorizing of all triage systems regarding prehospital and hospital as well as triage in normal and critical conditions were assessed, too.به فرایند اولویت­بندی بیماران براساس شدت مشکل جهت انجام بهترین اقدامات درمانی در کمترین زمان ممکن تریاژ اطلاق می­شود. یک سیستم تریاژ کارا باید به گونه­ای باشد که بتواند در مورد هر بیمار به سرعت و با دقت تصمیم­گیری نماید. سادگی در اجرا و قابل اعتماد بودن به عنوان مهم­ترین ویژگی­های یک سیستم تریاژ استاندارد مطرح هستند. تریاژ مناسب باعث افزایش کیفیت خدمات مراقبتی بیماران، افزایش رضایت­مندی، کاهش زمان انتظار و اقامت بیماران، کاهش موارد مرگ و میر، افزایش راندمان و کارایی بخش­های اورژانس به موازات کاهش هزینه ­های مربوطه می­شود. با توجه به مطالب فوق، در مقاله مروری حاضر ابتدا به بررسی تاریخچه شکل­گیری سیستم­های تریاژ خواهیم پرداخت و در ادامه، ضمن تقسیم­بندی انواع سیستم­های تریاژ به موارد داخل و خارج بیمارستانی و همچنین تریاژ در شرایط عادی و بحرانی به بررسی انواع سیستم­های تریاژ موجود خواهیم پرداخت

Hospital and Pre-Hospital Triage Systems in Disaster and Normal Conditions; a Review Article

Triage is a priority classification system based on the severity of problem to do the best therapeutic proceedings for patients in the less time. A triage system should be performed in a way which can make a decision with high accuracy and in the least time for each patient. Simplicity and reliability of the performance are the most important features of a standard triage system. An appropriate triage causes to increase the quality of health care services and patients’ satisfaction rate, decrease the waiting time as well as mortality rate, and increase the yield and efficiency of emergency wards along with reducing the related expenses. Considering to the above statements, in the present study the history of triage formation was evaluated and categorizing of all triage systems regarding prehospital and hospital as well as triage in normal and critical conditions were assessed, too

Emergency nurses ‘ job satisfaction and its determinants

AbstractBackground and aim:  Job satisfaction and its effective factors is an important issue in prodctivity improvement.The main purpose of this study is evaluation of Job satisfaction and its effective factors in three teaching hospitals of Shahid Beheshti University of medical sciences.Materials and Methods:  In this cross sectional study, 100 nurses in three general hospitals were questioned ragarding Brayfield-Rothe job satiafactin questionare. Finnaly demographic and professional data as well as responses to questionair were analysed according to level of satisfaction and its effective factors.Findings:  Ninty nurses were answerd to questionair (78.9% female). The mean age of respondents was 28.8 ± 4.9 years. The mean level of job satisfaction was 54.6 ± 12.1 based on Brayfield-Rothe criterias. There is a direct relationship between job satisfaction and monthly income.Conclusion:  64% of emergency nurses had job satisfaction based on Brayfield-Rothe criterias. It seems that income satisfaction in compare with other effective factors play a significant role in job satisfactionKey words: Job satisfaction, nursing service, emergency department

The Efficacy of Magnetic Resonance Imaging and Color Doppler Ultrasonography in Diagnosis of Salivary Gland Tumors

Background and aims. Although salivary gland tumors are not very common, early diagnosis and treatment is crucial because of their proximity to vital organs, and therefore, determining the efficacy of new imaging procedures becomes important. This study aimed to evaluate the efficacy of magnetic resonance imaging (MRI) and color doppler ultrasonography parameters in the diagnosis and differentiation of benign and malignant salivary gland tumors. Materials and methods. In this cross-sectional study, color doppler ultrasonography and MRI were performed for 22 patients with salivary gland tumor. Demographic data as well as MRI, color doppler ultrasonography, and surgical parameters including tumor site, signal in MRI images, ultrasound echo, tumor border, lymphadenopathy, invasion, perfusion, vascular resistance index (RI), vascular pulse index (PI) were analyzed using Chi-square test, Fisher’s exact test, and independent ttest. Results. The mean age of patients was 46.59±13.97 years (8 males and 14 females). Patients with malignant tumors were older (P < 0.01). The most common tumors were pleomorphic adenoma (36.4%), metastasis (36.4%), and mucoepidermoid carcinoma (9%). Nine tumors (40.9%) were benign and 13 (59.1%) were malignant. The overall accuracy of MRI and color doppler ultrasonography in determining tumor site was 100% and 95%, respectively. No significant difference observed between RI and PI and the diagnosis of tumor. Conclusion. Both MRI and ultrasonography have high accuracy in the localization of tumors. Well-identified border was a sign of benign tumors. Also, invasion to adjacent structures was a predictive factor for malignancy