Отношение членов реанимационной бригады и сопровождающих пациента лиц к присутствию родственников пациента первой степени родства во время сердечно-легочной реанимации в отделениях неотложной помощи

The presence of the patient’s family at their bedside during cardiopulmonary resuscitation (CPR) is one of the challenging issues that has been frequently taken into consideration. Considering the importance of this topic. The objective of the present study was conducted to determine the attitude of the CPR team members and the patient’s companions toward the presence of the patient’s first-degree relatives during CPR.Materials and methods. The descriptive-analytical cross-sectional study was conducted on 100 CPR team members of two University Hospitals and 120 near relatives of patients undergoing CPR in 2021. The data were collected by the researcher-made questionnaire and depression, anxiety, stress scale (DASS) during CPR. The collected data were analyzed by SPSS (version 22) statistical software.Results. From the perspective of both the CPR team members and the patient’s companions, the highest mean response was related to the fact that it would be better for the patient to agree on the presence or absence of their family before hospitalization and whether they have favorable conditions. The attitude toward the presence of the patient’s family during CPR was statistically significantly associated with the companions’ gender (p < 0.05) and with the experience of work and participation in CPR of the CPR team members (p < 0.05).Conclusion. Taking into account the different opinions of the CPR team members and the patient’s relatives about the presence of family during resuscitation, additional studies with a large sample size should be carried out.Присутствие семьи пациента у его постели во время проведения сердечно-легочной реанимации (СЛР) является одним из вопросов, привлекающих внимание. Настоящее исследование было проведено с целью определения отношения членов реанимационной бригады и сопровождающих пациента лиц к присутствию родственников пациента первой степени родства во время проведения СЛР.Материалы и методы. Описательно-аналитическое перекрестное исследование проведено в 2 университетских больницах с участием 100 членов команд, проводящих СЛР, и 120 близких родственников пациентов, которым проводили СЛР в 2021 г. Данные были собраны с помощью разработанного исследователем опросника и шкалы стресса, тревоги и депрессии (DASS) во время СЛР. Собранные данные были проанализированы с помощью статистического программного обеспечения SPSS (версия 22).Результаты. С точки зрения как членов команды, проводящей СЛР, так и близких пациента, наиболее значимым был вопрос о том, что самому пациенту было бы лучше договориться о присутствии или отсутствии своей семьи еще до момента госпитализации и выяснить, насколько для этого созданы благоприятные условия. Отношение к присутствию семьи пациента во время СЛР было статистически значимо связано с полом сопровождающего (р < 0,05) и с опытом работы и участия в СЛР членов реанимационной бригады (р < 0,05).Вывод. Учитывая различные мнения членов команды, проводящей СЛР, и близких пациента относительно присутствия семьи во время реанимации, следует провести дополнительные исследования с большим объемом выборки

Surveillance for foodborne disease outbreaks in Iran, 2006-2011

Background: The outbreaks of foodborne diseases is a major health problem and occur daily in all countries, from the most to the least developed. This study is the first report of foodborne outbreaks in Iran that carried out from 2006 to 2011. Methods: A retrospective, longitudinal study carried out using foodborne disease national surveillance system data from 2006-2011, which have been reported by all provincial health centers to the Center for Communicable Disease Control. Collected data were analyzed using SPSS version 18 software. Results: Since 2006 to 2011, a total of 2250 outbreaks were reported in Iran. Analyzed data showed that the outbreak rate has increased from 0.07/100000 in 2006 to 1.38/100000 population in 2011. Khuzestan, Kermanshah and Qazvin were three provinces that reported more outbreaks than nationally expected outbreak incidence rate during 2011. Analysis of epidemiological characteristics of foodborne outbreaks during 2011 indicated that the numbers of outbreaks were highest in warm months, e.g. 17.8 of total outbreaks was just reported in August. Females and age group of 16-30 years old were more affected and 55 of cases occurred in rural area. Among 684 human samples which have been tested, E. coli, Shigella, Hepatitis A and Vibrio cholera were predominant etiologic agents respectively. Conclusion: Increasing the detection rate of foodborne outbreaks imply the expansion of surveillance activities and improved primary health care in Iran in recent years. Foodborne disease surveillance system is a new program in Iran that should be continued and strengthened including diagnostic laboratory capacities

Demographic Factors, Duration and Costs of Hospitalization, and Causes of Death in Patients Intoxicated with Opioids and Amphetamines

Background: Intoxications are medical emergencies and among the significant causes of morbidity and mortality worldwide. In recent years, prevalence of intoxication with opioids and stimulants, such as amphetamines, is increasing particularly among young people. In this study, we investigated demographic factors, duration of hospitalization, costs of hospitalization, and cause of death in patients intoxicated with amphetamines and opioids.Materials and Methods: This study was a prospective descriptive–analytic study. Sampling method was census, and Subjects were patients intoxicated with amphetamines and opioids, alone or combined, who referred to toxicology ward of Ali-Asghar hospital in Isfahan, from October 2009 to April 2010.Results: During 6 months, among 2325 subjects, 419 patients used opioids, 98 patients used amphetamines, and 25 patients used both of them. The mean age of patients in the three groups was not significantly different. Most patients were male in all groups. The most common route of intoxication was orally in opioid group and inhalation in amphetamine group. The most common cause of intoxication was intentional attempt. Vital signs at admission were normal in three groups, but the average of heart rate, body temperature, respiratory rate and blood pressure, was slightly higher in the amphetamine group than the opioid group. Duration and cost of hospitalization were not significantly different between groups. Four patients were died totally and the outcome was not significantly different between groups. The mean age and duration of hospitalization were significantly higher in died compared to living patients.Conclusion: Opioids and amphetamines accounted for high percentages of intoxication, especially in young single men with self-employed job. Therefore, control and prevention of opioids and amphetamines consumption are important ways to reduce this kind of intoxication in this group

Heparinized and saline solutions in the maintenance of arterial and central venous catheters after cardiac surgery

Background: Heparinized saline solution is used to prevent occlusion in the arterial catheters and central venous pressure monitoring catheters. Even at low dose, heparin administration can be associated with serious complications. Normal saline solution can maintain patency of arterial catheters and central venous pressure monitoring catheters. Objectives: The current study aimed to compare the efficacy of normal saline with that of heparinized one to maintain patency of arterial and central venous catheters after cardiac surgery. Patients and Methods: In the current randomized controlled trial, 100 patients, with an age range of 18 - 65 years of valve and coronary artery surgery were studied in Rajaie heart center, Tehran, Iran. Patients were randomized to receive either heparinized saline (n = 50) or normal saline flush solutions (n = 50). In the study, arterial catheters and central venous pressure monitoring catheters were daily checked for any signs of occlusion in three postoperative days as primary end-point of the study. Results: According to the information obtained from the study, four (8) arterial catheters in the saline group (P value: 0.135) and three (6) arterial catheters in the heparin group (P value = 0.097) were obstructed. Statistical analysis showed that the incidence of obstruction and changes in all other parameters between the two groups during the three-day follow-up was not significant (all P values > 0.05). Conclusions: It seems that there is no difference in the use of heparinized and normal saline solutions to prevent catheter occlusion of arterial and central venous pressure. © 2015, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM)

An 8 bit current steering DAC for offset compensation purposes in sensor arrays

Abstract. An 8 bit segmented current steering DAC is presented for the compensation of mismatch of sensors with current output arranged in a large arrays. The DAC is implemented in a 1.8 V supply voltage 180 nm standard CMOS technology. Post layout simulations reveal that the design target concerning a sampling frequency of 2.6 MHz is exceeded, worst-case settling time equals 60.6 ns. The output current range is 0–10 μA, which translates into an LSB of 40 nA. Good linearity is achieved, INL < 0.5 LSB and DNL < 0.4 LSB, respectively. Static power consumption with the outputs operated at a voltage of 0.9 V is approximately 10 μW. Dynamic power, mainly consumed by switching activity of the digital circuit parts, amounts to 100 μW at 2.6 MHz operation frequency. Total area is 38.6 × 2933.0 μm2

Methanol mass poisoning in Iran: Role of case finding in outbreak management

Background There are no guidelines addressing the public health aspects of methanol poisoning during larger outbreaks. The current study was done to discuss the role of active case finding and a national guideline that organizes all available resources according to a triage strategy in the successful management of a methanol mass poisoning in Rafsanjan, Iran, in May 2013. Methods A retrospective cross-sectional study was performed reviewing the outbreak Emergency Operation Center files. The objectives were to describe the characteristics, management and outcome of a methanol outbreak using Active Case Finding to trace the victims. Results A total of 694 patients presented to emergency departments in Rafsanjan after public announcement of the outbreak between 29th May and 3rd June 2013. The announcement was mainly performed via short message service (SMS) and local radio broadcasting. A total of 361 cases were observed and managed in Rafsanjan and 333 were transferred to other cities. Seventy-five and 100 patients underwent hemodialysis (HD), retrospectively. The main indication for HD was refractory metabolic acidosis. Eight patients expired due to the intoxication. Except for the deceased cases, no serum methanol level was available. Conclusion In developing countries, where diagnostic resources are limited, use of active case finding and developing national guidelines can help in the management of large outbreaks of methanol poisonings. © 2014 The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: [email protected]

The effect of combined conventional and modified ultrafiltration on mechanical ventilation and hemodynamic changes in congenital heart surgery

Background: Cardiopulmonary bypass is associated with increased fluid accumulation around the heart which influences pulmonary and cardiac diastolic function. The aim of this study was to compare the effects of modified ultrafiltration (MUF) versus conventional ultrafiltration (CUF) on duration of mechanical ventilation and hemodynamic status in children undergoing congenital heart surgery. Materials and Methods: A randomized clinical trial was conducted on 46 pediatric patients undergoing cardiopulmonary bypass throughout their congenital heart surgery. Arteriovenous MUF plus CUF was performed in 23 patients (intervention group) and sole CUF was performed for other 23 patients (control group). In MUF group, arterial cannula was linked to the filter inlet through the arterial line, and for 10 min, 10 ml/kg/min of blood was filtered and returned via cardioplegia line to the right atrium. Different parameters including hemodynamic variables, length of mechanical ventilation, Intensive Care Unit (ICU) stay, and inotrope requirement were compared between the two groups. Results: At immediate post�MUF phase, there was a statistically significant increase in the mean arterial pressure, systolic blood pressure, and diastolic blood pressure (P < 0.05) only in the study group. Furthermore, there was a significant difference in time of mechanical ventilation (P = 0.004) and ICU stay (P = 0.007) between the two groups. Inotropes including milrinone (P = 0.04), epinephrine (P = 0.001), and dobutamine (P = 0.002) were used significantly less frequently for patients in the intervention than the control group. Conclusion: Administration of MUF following surgery improves hemodynamic status of patients and also significantly decreases the duration of mechanical ventilation and inotrope requirement within 48 h after surgery. � 2016 Journal of Research in Medical Sciences

Home healthcare in Iran: A hybrid concept analysis

Background: Healthcare is changing from a focus on acute care health issues to one of managing chronic conditions. This change has resulted in the development of home health-care systems as a way of managing chronic conditions outside the hospital. The aim of this study was to analyze the concept of home healthcare using a hybrid model. Materials and Methods: This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical. Science Direct, PubMed, ProQuest, and Scopus were searched with related terms in the theoretical phase. In the fieldwork phase, six professionals with experience in home healthcare were interviewed and after each interview, qualitative content analysis was conducted. During the final phase, descriptions and themes from the first two phases were combined. Results: In the theoretical phase, the definition of home healthcare included descriptions answering the Who, What, When, Where, and Why questions. In the fieldwork phase, the results were divided into three areas: 1-comprehensive care; 2-extent of services; and 3-outcomes. The final analysis phase of this study indicated that the home health-care concept is a comprehensive, professional, and holistic care system accompanied by medical services and professionals whose goals are to support an individual's health and provide care in their home. Healthcare provided in one's home was found to preserve a patient's dignity and reduce health-care costs. Conclusions: The definition of the home healthcare concept establishes a foundation for developing a comprehensive home health-care system. This concept analysis for home healthcare could be a guide for future studies. © 2021 Wolters Kluwer Medknow Publications. All rights reserved

The Relationship between Atopic Dermatitis and Premenstrual Syndrome in Women Referred to the Skin Clinic of Hamadan

BACKGROUND AND OBJECTIVE: One of the factors affecting dermatophyte is hormonal factors, in which atopic dermatitis is more common in adult women. Since one of the psychotic problems regarding reproductive performance of women is premenstrual syndrome, in this study, the association between premenstrual syndrome and atopic dermatitis in reproductive age women was investigated. METHODS: This case-control study was performed on 82 women aged between 15 and 49 years old in two groups of atopic dermatitis referring to Skin Clinic of Sina Hospital in Tehran and control group including healthy women for atopic dermatitis. Demographic questionnaire and (PSST) Premenstrual Symptoms Screening Test (with score 42-0) were completed and evaluated by both groups. FINDINGS: The mean age of subjects in the case group was 17.17 ± 4.45 and in the control group was 27.29 ± 8.03 years. The results showed by controlling the possible confounding factors as age, occupation and marital status the probability of having moderate or severe premenstrual syndrome in patients with atopic dermatitis is 13.26 (OR= 13.26, 95% CI: 3.31, 53.07), as compared with healthy subjects. CONCLUSION: The results showed that there is a strong relationship between moderate to severe menstrual syndrome and atopic dermatitis in women

Are serial hematocrit measurements sensitive enough to predict intra-abdominal injuries in blunt abdominal trama?

Objective: Routine serial hematocrit measurements are a component of the trauma evaluation for patients without serious injury identified on initial evaluation. We sought to determine whether serial hematocrit testing was useful in predicting the probable injuries in blunt abdominal trauma. Materials and method: We performed a prospective study of trauma patients admitted in our observation unit over a 12-month period. Patients routinely underwent serial hematocrit testing in 6-hour intervals (two hematocrit levels). We compared trauma patients with a hematocrit drop of 5 and 10 points or more to those without a significant hematocrit drop. Results: Five hundred forty-two isolated blunt abdominal trauma patients were admitted to observation unit, and 468 patients (86.35) had serial hematocrit during their 6-hour stay. Of these patients, 36.11 had a hematocrit drop of 5 or more and 12.61 a drop of 10 or more. Of patients with the hematocrit drop >10, 50.8 have had diagnostic manifestations of intra-abdominal injury in both ultrasonographic and computed tomography scanning (P5 and positive imaging. Conclusion: Although serial hematocrit testing may be useful in specific situations, routine use of serial hematocrit testing in trauma patients at a level I trauma center�s observation unit did not significantly aid in the prediction of occult injuries. © 2019 Mosaddegh et al