Heart surgery waiting time: Assessing the effectiveness of an action

Background: Waiting time is an index assessing patient satisfaction, managerial effectiveness and horizontal equity in providing health care. Although heart surgery centers establishment is attractive for politicians. They are always faced with the question of to what extent they solve patient’s problems. Objectives: The objective of this study was to evaluate factors influencing waiting time in patients of heart surgery centers, and to make recommendations for health-care policy-makers for reducing waiting time and increasing the quality of services from this perspective. Patients and Methods: This cross-sectional study was performed in 2013. After searching articles on PubMed, Elsevier, Google Scholar, Ovid, Magiran, IranMedex, and SID, a list of several criteria, which relate to waiting time, was provided. Afterwards, the data on waiting time were collected by a researcher-structured checklist from 156 hospitalized patients. The data were analyzed by SPSS 16. The Kolmogorov Smirnov and Shapiro tests were used for determination of normality. Due to the non-normal distribution, non-parametric tests, such as Kruskal-Wallis and Mann-Whitney were chosen for reporting significance. Parametric tests also used reporting medians. Results: Among the studied variables, just economic status had a significant relation with waiting time (P = 0.37). Fifty percent of participants had diabetes, whereas this estimate was 43.58% for high blood pressure. As the cause of delay, 28.2% of patients reported financial problems, 18.6% personal problem and 13.5% a delay in providing equipment by the hospital. Conclusions: It seems the studied hospital should review its waiting time arrangements and detach them, as far as possible, from subjective and personal (specialists) decisions. On the other hand, ministries of health and insurance companies should consider more financial support. It is also recommend that hospitals should arrange preoperational psychiatric consultation for increasing patients’ emotionally readiness. © 2015, Iranian Red Crescent Medical Journal

Modification of Moment Connection of I-Beam to Double-I Built-Up Column by Reinforcing Column Cover Plate

AbstractTraditional moment connections of I-beam to double-I built-up column have some problems. They are the stress concentration, brittle fracture of the welds and semi-rigid behavior of the connection. To upgrade the connection behavior, it is proposed to replace parts of the column cover plate, situated in critical areas where the beam flanges (or flange plates) connect to the column cover plate, by thicker and larger plates. To investigate the cyclic behavior of the proposed connection, a series of nonlinear finite element analysis were carried out on different models. Results indicate that the modified connection has such a strength and ductility that can be used in special moment frames. Its stiffness is also in the range of a fully restrained connection

Laser-induced forward transfer of thermoelectric materials on polymer and glass substrates

Laser-induced forward transfer (LIFT) is a laser-assisted direct write method that has been used to print a range of solids and rheological fluids. The donor that is to be printed is previously deposited onto a transparent support substrate that is usually referred to as a carrier. A highly energetic short-pulsed laser beam imaged through the transparent carrier onto the donor results in the forward transfer of a donor pixel onto a receiver substrate placed either in contact or a few microns apart. Solid films can be transferred with minimal change in their crystal and domain structure via LIFT

Prevalence of class D carbapenemases among extended-spectrum β-lactamases producing Escherichia coli isolates from educational hospitals in Shahrekord

Introduction: Extended-spectrum β-lactamases (ESBLs) are a set of plasmid-borne, various and quickly evolving enzymes that are a main therapeutic issue now-a-days for inpatient and outpatient treatment. Aim: The aim of this study was to determine multi-drug resistance (MDR) and ESBLs producing E. coli strains, prevalence of class D Carbapenemases among ESBLs producing Escherichia coli isolates from educational hospitals in Shahrekord, India. Materials and Methods: Uropathogenic Escherichia coli strains were isolated from patients with Urinary Tract Infections (UTIs). The agar disc diffusion test was used to characterize the antimicrobial sensitivity of the E. coli isolates. The ESBL positive strains were identified by phenotypic double-disk synergy test, by third-generation cephalosporin in combination with or without clavulanic acid. Multiplex PCR was carried out for detection of the three families of OXA-type carbapenamases including OXA-23, OXA-24, and OXA-48 in E. coli strains. Results: All bacterial isolates were susceptible to meropenem. Ninety isolates produced ESBL, 55 E. coli isolates from inpatients, and 35 isolates from outpatients, with a significant association (p< 0.05). The prevalence of OXA-23, OXA-24, and OXA-48 in the ESBLs producing isolates was respectively 21%, 18%, and 11% for inpatients, and 10%, 8%, and 6% for outpatients. Conclusion: ESBL-producing E. coli isolates are also a major threat in the clinical setting. The findings of this study indicated the high occurrence of ESBLs and multiple antibiotic resistance in E. coli isolates

Prevalence of extended-spectrum beta-lactamase-producing Klebsiella Pneumoniae isolates in nosocomial and community-acquired urinary tract infections

Background: Klebsiella pneumoniae is a family member of Enterobacteriaceae. Isolates of K. pneumoniae produce enzymes that cause decomposition of third generation cephalosporins. These enzymes are known as extended-spectrum beta-lactamase (ESBL). Resistance of K. pneumoniae to beta-lactamase antibiotics is commonly mediated by beta-lactamase genes. Objectives: The aim of this study was to identify the ESBL produced by K. pneumoniae isolates that cause community-acquired and nosocomial urinary tract infections within a one-year period (2013 to 2014) in Kashani and Hajar university hospitals of Shahrekord, Iran. Patients and Methods: From 2013 to 2014, 150 strains of K. pneumoniae isolate from two different populations with nosocomial and community-acquired infections were collected. The strains were then investigated by double disk synergism and multiplex polymerase chain reaction (PCR). Results: The study population of 150 patients with nosocomial and community-acquired infections were divided to two groups of 75 each. We found that 48 of the K. pneumoniae isolates in the patients with nosocomial infection and 39 isolates in those with community-acquired infections produced ESBL. The prevalence of TEM1, SHV1 and VEB1 in ESBL-producing isolates in nosocomial patients was 24%, 29.3% and 10.6%, and in community-acquired patients, 17.3%, 22.7% and 8%, respectively. Conclusions: Theprevalence of ESBL-producing K. pneumoniae isolate is of great concern; therefore, continuous investigationseems essential to monitor ESBL-producing bacteria in patients with nosocomial and community-acquired infections. © 2016, Ahvaz Jundishapur University of Medical Sciences

Prevention of acute ammonia toxicity in beluga, Huso huso, using natural zeolite

This study was accomplished to examine the efficiency of natural zeolite in preventing acute toxicity of total ammonia to Huso huso. The study was performed using Water Static Method in 96 hours. Fish averaged 46 ± 5 g in weight and 22 ± 4 cm in total length were exposed to four different concentrations (15, 30, 50, 75 mgL-1) of ammonia and a group was considered as control. Under stable condition, the lethal concentration of ionized ammonia was 75 mgL-1 in 96 hours. In the lethal concentration of total ammonia, different amounts of 5, 10, 15 g.L-1 granulated clinoptilolite zeolite were used. Results indicated significant differences between treatments and control (p<0.05). By increasing Clinoptilolite zeolite in each treatment, the survival rate of fish also increased significantly (p<0.05). In lethal concentration of ammonia, the use of 15 g.L-1 zeolite could prevent the mortality rate. Histopathological findings showed that major lesions in gill filaments included hemorrhage, hyperemia, hyperplasia, epithelial cells necrosis. There were hemorrhage, hyperemia, degenerated tubules of kidney, expansion of Bowman's capsule in kidney and hepatocytes necrosis in liver

The study of antibiotic resistance of extended-spectrum beta-lactamase-producing Klebsiella strains isolated from urinary tract infections in teaching Hospitals in Shahrekord

زمینه و هدف: سویه &zwnj;های کلبسیلا به ویژه کلبسیلا پنومونیه، از جمله پاتوژن &zwnj;های فرصت طلب در ایجاد عفونت ادراری به عنوان یکی از شایع ترین عفونت&zwnj; ها در انسان محسوب می &zwnj;شوند. این مطالعه به منظور بررسی مقاومت آنتی &zwnj;بیوتیکی در سویه &zwnj;های کلبسیلا مولد ESBL که از عفونت ادراری بیماران بستری و سرپایی مراجعه کننده به بیمارستان &zwnj;های آموزشی شهرکرد جدا شدند، صورت پذیرفت. روش بررسی: مطالعه حاضر در سال &zwnj;های 1393-1392 بر روی 150 ایزوله کلبسیلا جدا شده از عفونت ادراری بیماران بستری و سرپایی انجام گرفت. با انجام تست &zwnj;های تشخیصی بیوشیمیایی و استفاده از محیط &zwnj;های افتراقی، هویت ایزوله&zwnj; های جدا شده تعیین گردید. شناسایی ارگانیسم &zwnj;های مولد ESBL با انجام تست &zwnj;های غربالگری و تست &zwnj;های فنوتیپی تأییدی صورت پذیرفت. به منظور ارزیابی الگوی مقاومت آنتی &zwnj;بیوتیکی، از روش دیسک دیفیوژن بهره گرفته شد. یافته ها: از مجموع 150 ایزوله جدا شده از عفونت ادراری، فراوانی سویه &zwnj;های مولد ESBL، در بیماران بستری و سرپایی مراجعه کننده به بیمارستان &zwnj;های آموزشی شهرکرد به ترتیب 64 و 48 گزارش شد. نتایج الگوی مقاومت آنتی&zwnj; بیوتیکی در بیماران بستری و سرپایی به ترتیب برای آنتی &zwnj;بیوتیک &zwnj;های آمیکاسین 49 و 31، تری متوپریم سولفامتوکسازول 61 و 52، جنتامایسین 59 و 39، نیتروفورانتوئین 55 و 32، نورفلوکساسین 59 و 44، نالیدیکسیک اسید 72 و 53، سفپیم 45 و 33، ایمی &zwnj;پنم 8 و 3، سفتریاکسون 41 و 35، سیپروفلوکساسین 60 و 48، سفتازیدیم 64 و 48 گزارش شد. نتیجه گیری: بر اساس مطالعه حاضر، سویه&zwnj; های کلبسیلا جدا شده از عفونت &zwnj;های ادراری بیماران بستری به میزان بالاتری ESBL تولید کردند که می&zwnj;تواند به علت مصرف بی رویه و مکرر سفالوسپورین&zwnj; های نسل سوم و عدم تشخیص سویه&zwnj; های کلبسیلا مولد ESBL در محیط &zwnj;های درمانی باشد

Molecular Dynamic Simulation Model for the Growth of Thin Films in The Structure Zone Model

A two dimensional molecular dynamic (atomistic) simulation model was used to investigate the relationship between the nano-structure and the deposition parameters; namely, substrate temperature, deposition rate, angle of incidence, surface roughness. Qualitative agreements with the predictions of the structure zone model (SZM) and the theoretical results of Srolovitze and coworkers (1988), as well as expectations through changes in the activated processes during film growth due to changes in deposition parameters (Grovenor and coworkers (1984)) are obtained. It is shown that by enhancing the atomic mobility (i.e., increasing the substrate temperature or/and lowering the deposition rate) films of higher density with fewer voids are produced. By increasing the deposition angle, the nano-structure of the film changes from a dense film with few voids, to a nano-structure with columns/boundless inclined with the same angle ( β ) towards the incidence atoms with elongated voids. The angle β increases with increasing the deposition angle (α ), and in agreement with the tangent rule (Dirks and Leamy (1977)). The angle of bundles (or the angle of the formation of the voids between atomic bundles), and columnar structure are caused by shadowing effects. Results showed that β decreases slowly with increasing surface mobility (i.e., increasing the substrate temperature or/and reducing the deposition rate). In general, the model provides almost all predicted results and agrees well with observation

Phytotherapy for Bacillus cereus: A review of the most important medicinal plants of Iran effective on B. cereus

Infectious diseases are spreading day-to-day with excessive health care costs. Bacillus cereus is a known causative agent of foodborne diseases. Because of emergence of antibiotic resistance, it is necessary to develop nature- and plant-based antibiotics. Many of the medicinal plants are highly able to fight bacterial and fungal pathogens in humans. Scientists are interested in using these plants to treat infections because these plants cause much fewer side effects than chemical drugs. This review article reported the native medicinal plants effective on B. cereus. The findings indicate that Eucalyptus camaldulensis Dehnh, Zataria multiflora, Mentha pulegium, Artemisia persica, Cuminum cyminum, Cordia myxa L, Scrophularia striata, Mentha longifolia, Rosmarinus officinalis, and Lavandula sp. are effective on B. cereus. Because these plants have antimicrobial effects according to traditional medicine, their anti-B. cereus effects have been confirmed in scientific investigations, and their compounds have already been identified in phytochemical investigations, their effective compounds can be used to produce naturebased, anti-B. cereus antibiotics

Effect of copper sulphate on behavioral and histopathological changes in roach, Rutilus rutilus caspicus

The research was accomplished in order to study behavioral and histopathological effects of Copper on Rutilus rutilus caspicus under experimental condition. The study was performed using Water Static Method during 96 hours. 15 fish with averaged weight 2±0.5 g in weight were encountered to different concentrations (0, 0.1, 0.2, 0.3, 0.4 mg/l) of Copper. A group of fish was considered as control. Under stable condition and aeration, the lethal concentration was 0.4 mg/l. Results indicated that there was significant differences between treatments when copper concentration increased (p<0.05). It was found that in the high concentration of Copper nominal signs of toxicity such as convulsion, air gulping and flared operculum were observed. Histopathological sings were hyperplasia, edema, hyperemia, hemorrhage, expansion of Bowman’s capsule and hepatocytes necrosis. In control group no lesion was observed