The Accuracy of Urinalysis in Predicting Intra-Abdominal Injury Following Blunt Traumas

Introduction: In cases of blunt abdominal traumas, predicting the possible intra-abdominal injuries is still a challenge for the physicians involved with these patients. Therefore, this study was designed, to evaluate the accuracy of urinalysis in predicting intra-abdominal injuries. Methods: Patients aged 15 to 65 years with blunt abdominal trauma who were admitted to emergency departments were enrolled. Abdominopelvic computed tomography (CT) scan with intravenous contrast and urinalysis were requested for all the included patients. Demographic data, trauma mechanism, the results of urinalysis, and the results of abdominopelvic CT scan were gathered. Finally, the correlation between the results of abdominopelvic CT scan, and urinalysis was determined. Urinalysis was considered positive in case of at least one positive value in gross appearance, blood in dipstick, or red blood cell count. Results: 325 patients with blunt abdominal trauma were admitted to the emergency departments (83% male with the mean age of 32.63±17.48 years). Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of urinalysis, were 77.9% (95% CI: 69.6-84.4), 58.5% (95% CI: 51.2-65.5), 56% (95% CI: 48.5-63.3), 79.6% (95% CI: 71.8-85.7), 1.27% (95% CI: 1.30-1.57), and 0.25% (95% CI: 0.18-0.36), respectively. Conclusion: The diagnostic value of urinalysis in prediction of blunt traumatic intra-abdominal injuries is low and it seems that it should be considered as an adjuvant diagnostic tool, in conjunction with other sources such as clinical findings and imaging

A 55-Year Old Man with Acute Painful Flank Mass, a Case Report

Lumbar hernias (LH) accounts for less than 1.5% of total hernia incidence. It can occur in two separate triangular areas of the flank. About 300 cases have been reported in the literature. Here, we report a 55-year old man with acute painful left side flank mass and final diagnosis of LH. The mass was appeared about three hours before admission and his pain was slight at first but became more severe gradually. He had stable vital sign and the only positive finding on his physical examination was the sphere shape, firm, mobile, and mild tender mass at his left flank

Optic Neuropathy following Botulinum Toxin Injection into the Medial Rectus Muscle for Diplopia

Purpose: To report a case of optic neuropathy (ON) following botulinum toxin A (BTA) injection into the medial rectus muscle. Case Report: We describe a 37-year-old man with unilateral ON after a BTA injection into the left medial rectus for treatment of traumatic sixth nerve palsy. Oral prednisolone was prescribed for 14 days. After two weeks, his visual acuity returned to 20/20. Conclusion: Botulinum toxin-induced neuropathy is a rare and vision-threatening complication of BTA. In patients with recent injection of BTA who present with visual complaints, botulinum toxin-induced neuropathy should be considered

Factors predicting patient satisfaction in the emergency department: a single-center study

Objective: Patient satisfaction (PS) is a major quality assessment index for the emergency department (ED) which affects patient safety, litigation, reimbursements, and consumer satisfaction. In this study we aimed to recognize the factors affecting PS in our center. Method: Random shifts during a week were selected and all patients disposed from the ED were asked to fill out a revised and validated Persian version of the Press-Ganey questionnaire with the help of a research assistant. Results were analyzed using a linear regression model by SPSS software version 21. Results: Findings reaffirmed some of the factors previously described. These included longer door to treatment area times having a negative effect on satisfaction (P < 0.001), and providing vivid discharge information improving PS (P < 0.001). Other important factors were also found that had not previously been focused on, namely cleanliness of the area (P < 0.0001) and courtesy of the staff in charge of patient transfer (P = 0.03). We also found that men had a more satisfying ED experience (P = 0.002). Conclusion: Cultural expectations may have an important effect on PS. Thus, every institution should determine and alter the expectations most relevant to them

Organizational ambidexterity model for digital innovation in the banking industry

This article examined the organizational ambidexterity model for digital innovation in the banking industry and explained the dimensions of the ambidexterity model in this organization. Regarding intense competition and rapid changes and variations in products, processes, and technologies in today's world, organizations and managers must be ambidextrous to remain successful over time; Ambidexterity means the ability to simultaneously succeed in two contradictory abilities, for example, ambidexterity such as taking advantage of present opportunities, and discovering and creating new opportunities for the future, adaptation, alignment, flexibility, and efficiency. But the key questions are “what are the dimensions and components of organizational ambiguity?”, and “What is the current and favorable situation of Saderat Bank of Iran in this regard? Orienting an organization as an integrated set in order to reach ambidexterity and sustain it requires a set of causal, contextual, interventional, and strategic factors which ultimately lead to the consequences of organizational ambiguity. This study identified the dimensions and components of organizational ambidexterity through reviewing the literature on organizational ambidexterity as well as interviewing an expert group and analyzing their viewpoints. Then, by distributing a researcher-made questionnaire and statistical analysis, it examined the research pattern in the current and desirable situation of the organization

Production, Quality Control and Pharmacokinetic Studies of 166Ho-EDTMP for Therapeutic Applications

166Ho-EDTMP is a major therapeutic agent which is widely used in bone palliation therapy. In this study, a 166Ho-EDTMP complex was prepared successfully using an in-house synthesized EDTMP ligand and 166HoCl3. Ho-166 chloride was obtained by thermal neutron irradiation (1 × 1013 ncm−2s−1) of natural Ho(NO3)3 samples (specific activity = 3–5 GBq/mg), dissolved in acidic media. The radiochemical purity of 166Ho-EDTMP was checked by ITLC (>99%) and stability studies in presence of human serum and final preparation were performed. The biodistribution of 166Ho-EDTMP and 166HoCl3 in wild-type rats was checked by scarification. SPECT imaging of 166Ho-EDTMP was also performed in wild-type rats. A comparative accumulation study for 166Ho-EDTMP and 166HoCl3 was performed for vital organs up to 48h. Significant bone accumulation (>70%) of the tracer in 48h was observed

Power System Dynamic Stability Enhancement Using a New PID Type PSS 1

Abstract: Power System Stabilizers (PSS) are used to generate supplementary damping control signals for the excitation system in order to damp the Low Frequency Oscillations (LFO) of the electric power system. The PSS is usually designed based on classical control approaches but this Conventional PSS (CPSS) has some problems. To overcome the drawbacks of CPSS, numerous techniques have been proposed in literatures. In this paper a PID type PSS (PID-PSS) is considered for damping electric power system oscillations. The parameters of this PID type PSS (PID-PSS) are tuned based on Hybrid Genetic Algorithm optimization method. The proposed PID-PSS is evaluated against the conventional power system stabilizer (CPSS) at a single machine infinite bus power system considering system parametric uncertainties. The simulation results clearly indicate the effectiveness and validity of the proposed method

The effect of preoperative aspirin use on postoperative bleeding and perioperative myocardial infarction in patients undergoing coronary artery bypass surgery

Background: We tried to evaluate the clinical outcomes (mortality, postoperative bleeding and perioperative myocardial infarction) of patients who underwent first elective coronary artery bypass grafting and received aspirin during the preoperative period. Methods: The study was a prospective, randomized and single-blinded clinical trial. Two hundred patients were included and divided into two groups. One group received aspirin 80-160 mg, while in the other aspirin was stopped at least seven days before surgery. The primary end-points of the study were in-hospital mortality and hemorrhage-related complications (postoperative blood loss in the intensive care unit, re-exploration for bleeding and red blood cell and non-red blood cell requirements). The secondary end-point was perioperative myocardial infarction. Results: There were no differences in patient characteristics between the aspirin users and non-aspirin users. We found a significant difference between postoperative blood loss (608 &#177; 359.7 ml vs. 483 &#177; 251.5 ml; p = 0.005) and red blood cell product requirements (1.32 &#177; 0.97 unit packed cell vs. 0.94 &#177; 1.02 unit packed cell; p = 0.008). There was no significant difference between the two groups regarding platelet requirement and the rate of in-hospital mortality and re-exploration for bleeding. Similarly, we found no significant difference in the incidence of definite and probable perioperative myocardial infarction (p = 0.24 and p = 0.56 respectively) or in-hospital mortality between the two groups. Conclusion: Preoperative aspirin administration increased postoperative bleeding and red blood cell requirements with no effect on mortality, re-exploration rate and perioperative myocardial infarction. We recommend withdrawal of aspirin seven days prior to surgery. (Cardiol J 2007; 14: 453-457

Optimal PID power system stabilizer tuning based on particle swarm optimization

Abstract Power system stabilizers (PSS) are used to generate supplementary damping control signals for the excitation system in order to damp the low frequency oscillations (LFO) of the electric power system. The PSS is usually designed based on classical control approaches but this conventional PSS (CPSS) has some problems. To overcome the drawbacks of CPSS, numerous techniques have been proposed in literatures. In this paper a PID type PSS is considered for damping electric power system oscillations. The parameters of this PID type PSS are tuned based on particle swarm optimization method. The proposed PSS (PSO-PSS) is evaluated against the conventional power system stabilizer (CPSS) at a single machine infinite bus power system considering system parametric uncertainties. The simulation results clearly indicate the effectiveness and validity of the proposed method