Familiarity of Physicians and Nurses with Different Aspects of Oxygen Therapy; a Brief Report

Introduction: Oxygen is a drug and physician and nurses should be familiar with the effects and potential risks of oxygen therapy. The current study aimed to assess familiarity of physicians and nurses with various aspects of oxygen therapy.Method: In this cross sectional study, the familiarity of physicians and nurses with various aspects of oxygen therapy in a teaching hospital was evaluated using a validated questionnaire. The collected data were analyzed using SPSS 21 software.Results: 57 physicians and 79 nurses returned the completed questionnaire (response rate 97.1%). Mean clinical work experience of participants was 6.9±5.7 (1–15) years.98.2% of physicians believed that oxygen therapy can be associated with risk and should be recorded in the patient's medical file. These measures were 92.4% and 98.2% for nurses. 38 (27.9%) participants correctly pointed out the reasons for oxygen therapy. Regarding necessary measurements and monitoring for oxygen therapy, 49 (86%) physicians and 65 (82.3%) nurses chose the correct answer. In addition, regarding necessity of blood gas analysis during oxygen therapy, 44 (77.2%) physicians and 55 (69.6%) nurses chose the correct answer.Conclusion: The findings showed that the familiarity level of participants with some aspects of O2 therapy such as its indications, necessary measurements and monitoring during therapy, and identifying delivery devices was fair to weak (<80%)

Twin pregnant woman with COVID-19: a case report

A Case of pregnant woman (G2Ab1, twin pregnancy with microinjection, Gestational Age 23 weeks and 3 days) referred to our center with a complaints of fever and dry cough and dyspnea. She was admitted with a diagnosis of COVID-19. During the hospitalization, O2 saturation progressively decreased, which led to patient get intubate. Gradual recovery with treatment occurred and the patient was extubed. Unfortunately, she was intubated again due to decreased O2 saturation, 5 days later. Liver enzymes increased, then both fetuses died intrauterine, the cardiac output then declined to 10% and the mother died within hours

Invasive candidiasis in intensive care unit; consensus statement from an Iranian panel of experts, July 2013

Invasive candidiasis (IC) is associated with high mortality in intensive care unit (ICU) patients. Timely diagnosis of this potentially fatal condition remains a challenge; on the other hand, the criteria for initiating empirical antifungal therapy in critically ill patients are not well defined in different patient population and ICU settings. Alongside the international guidelines, reaching regional and local consensus on diagnosis and management of IC in ICU setting is essential. This report summarizes our present status of IC management in ICU, considered by a group of Iranian experts in the fields of intensive care and infectious diseases. A round table of 17 experts was held to review the available data and discuss the optimal treatment strategies for IC in critical care setting. Comparative published data on the management of IC were analytically reviewed and the commonly asked questions about the management of IC in ICU were isolated. These questions were interactively discussed by the panel and audience responses were taken to consolidate point-to-point agreement with the panel arriving at consensus in many instances. The responses indicated that patient's risk stratification, clinical discretion, fungal diagnostic techniques and the empirical therapy for IC are likely to save more patients. Treatment options were recommended to be based on the disease severity, prior azole exposure, and the presence of suspected azoleresistant Candida species. This report was reviewed, edited and discussed by all participants to include further evidence-based insights. The panel expects such endorsed recommendations to be soon formulated for implementation across the country. © 2014 The Author(s)

Packaging Operations in the Automotive Industry - Revealing Operational Gaps Related to Network Inefficiency, using Volvo Cars Packaging Operations as an Example

The automotive industry has evolved into an industry of complex supply chains and networks, requiring many activities to be aligned and well-managed in order to avoid abnormalities in both the material flow and information flow. The car assembly requires many different components and material, which also in turn require different types of packaging when being transported to the production plants. This thesis has extended the limited research involving packaging operations of an automotive company, using Volvo Cars as an example. The study focuses on revealing possible gaps that could have a bad impact on the packaging operations and its network balance and flow. The coordination of the packaging requires a well-balanced network of suppliers, production plants, transportation and terminals, where also time management is of high significance as the market demand needs to be responded to. The striving towards efficiency in terms of reducing lead time is however not always flawless. By using the SERVQUAL and CATWOE models as well as previous research, it was possible to reveal and conclude gaps within the organization in terms of communication both internally and externally. Also, by using data compiled by the Volvo Cars Packaging Operations, it was possible to further analyze the packaging network and its lead time between the terminals, production plants and suppliers, and reveal gaps within this operational loop. The study further concluded that the most critical problem in terms of time was found on supplier level, among other factors in the loop

The Formal Structure of the U.S. Food and Drug Administration – Its Effects on Pharmaceutical Spending and Drug Innovation Character

The pharmaceutical market is considered as one of the most regulated in the developed world. Still, we see an ongoing trend with increasing global pharmaceutical spending and lack of breakthroughs in life science discoveries. The reasons are different depending on which source you rely on. The payers, the originators and the drug agencies are arguably the key players in this market. This study examined the current status of the industry, how the market rules have changed and how the absence of isomorphism between the world’s biggest drug agency, the U.S. Food and Drug Administration, and the pharmaceutical companies may be a source of the problems. The employees interviewed at the agency partly explained their views, which mostly were consistent with the current limited literature. In conclusion, the formal structure of an independent organization limits the isomorphism with the environment, and thereby the success for cost containment and drug innovation management

Study of the Neuroprotective Effects of Memantine in Patients with Mild to Moderate Ischemic Stroke

Abstract Ischemic stroke is amongst the top four causes of mortality and the leading cause of disability in the world. The aim of this study was to evaluate the efficacy of a high dose memantine on neurological function of patients with ischemic stroke. In a randomized, 2 armed, open-label study, patients with mild to moderate cerebral thromboembolic event (CTEE) who admitted to Imam Hossein Hospital, Tehran, Iran, during preceding 24 hours, entered the study. Patients allocated in two study groups of memantine (as add-on therapy) and control. All patients were managed based on the American Heart Association and American Stroke Association (AHA/ASA) guidelines. Patients in memantine group received conventional treatment plus memantine 20 mg TID. The National Institute of Health Stroke Scale (NIHSS) was determined and recorded daily. The primary objective was comparison of the changes in NIHSS in the study groups at day 1 and day 5 of intervention. Significance level of p<0.05 was considered for statistical analysis. Patients were randomly allocated in control (15 women and 14 men, age 70.78 ± 10.92 years) and memantine (16 women and 8 men, age 73.33 ± 9.35 years) groups. There were no significant differences in age and sex distribution of two study groups as well as in comorbidities and concurrent drugs. NIHSS changes were significantly different between control (1.24 ± 0.96) and memantine group (2.96 ± 0.1), (p < 0.0001). Our results reveal that memantine added to standard treatment of CTEE could result in a remarkable decrease in the NIHSS confirming improvement of the neurological function of the patients