Umbrella repair of giant omphalocele, A new technique.

Introduction: Although many techniques have been described for reconstruction of the giant omphalocele, we present a simple , effective and safe new technique.Materials and Methods: We have studied 11 neonates with giant omphalocele that were treated by a new technique, Umbrella repair, in Sarvar pediatric hospital of Mashhad, Iran. In this new technique we released the skin around the omphalocele membrane just near the junction and a purse string suture is placed at the edge of the skin with beads beneath each bite and graded tightening of the suture in order to pushing the omphalocele toward the abdominal cavity. Finally we compare the results.Results: Among total 11 patients, mean age and weight at the time of operation were 2.18 days and 2150 grams respectively. comparing the results between groups, we observed significant less operative time and number of surgeries in neonatal period among patients who managed by umbrella repair. Post-operative complications, morbidity and mortality in umbrella repair group were also less than coventional methods.Conclusion: Umbrella repair provide a rapid and safe method for management of giant omphalocele with acceptable results and low morbidity and mortality

Evaluation of the catheter tip position among children with totally implantable port during 2015 in Dr. Sheikh Children’s hospital

Introduction: Totally implantable port insertion is a common procedure in pediatrics surgery and the main concern is the position of catheter tip, which is directly related to its complications, failure and durability. The best position is in superior vena cava (SVC)/ right atrium (RA) junction which is compatible with carina or T5-T6 vertebral level in chest x-ray. In our center we routinely use surface anatomy to estimate the adequate length for the tip to reach SVC/RA junction. In this study we compared the precision and accuracy of this method by post-operative chest x-ray study.Materials and Methods: as a retrospective study we evaluated the accuracy of surface anatomical land marks to estimate the catheter tip position, considering the carina or vertebra in chest x-ray which represents the SVC/RA junction. Fourty eight patients were included and their records were reviewed in Dr. Sheikh Children’s hospital in Mashhad.Results: Considering the carina as the best radiographic land mark, we had accurate tip position only in 29.2%, over insertion in 45.8% and under inserted catheter tip in 10.4%. Considering the vertebral bodies as radiographic land mark, 50% were over inserted, 35.4% accurate and 14.6% under inserted.Conclusion: Regarding our high rate of catheter tip mal-position arising from considering surface anatomy alone, we suggest not only to rely on surface anatomy but use imaging modalities such as portable X-ray, fluoroscopy or ultra-sonography within the operation room while inserting implantable port devices

The role of commitment to supervisor on organizational justice and citizenship among Iranian employees

The current study examined the relationship between commitment to supervisor, organizational justice, and organizational citizenship behavior among Iranian employees working at private and public companies. 160 employees from various organizations across industries were used to test the hypotheses in this study. Participants completed three questionnaires related to the variables in this study. Results were in congruity with the findings of the previous research, that organizational justice was positively correlated with both commitment to supervisor and organizational citizenship behavior. The results of the current study have important implications for organizations in that the impact of the relationship formed between a supervisor/manager and their employees can have far reaching implications for overall organizational functioning and ultimately organizational profitability

The role of commitment to supervisor on organizational justice and citizenship among Iranian employees

The current study examined the relationship between commitment to supervisor, organizational justice, and organizational citizenship behavior among Iranian employees working at private and public companies. 160 employees from various organizations across industries were used to test the hypotheses in this study. Participants completed three questionnaires related to the variables in this study. Results were in congruity with the findings of the previous research, that organizational justice was positively correlated with both commitment to supervisor and organizational citizenship behavior. The results of the current study have important implications for organizations in that the impact of the relationship formed between a supervisor/manager and their employees can have far reaching implications for overall organizational functioning and ultimately organizational profitability

Studying the Relationship between Factors related to Stress and Stress Management of Insurance Employees of Iran Social Security Organization

Introduction & Purpose: Considering the stressors in the Social Security Organization and the management of these factors in order to improve efficiency and quality of medical services, the present study aimed to to provide a stress management model for insurance employees of the Social Security Organization of Iran. Materials and Methods: This research is applied in purpose and is survey in method. The statistical population consisted of three groups: Experts familiar with the field of employee stress management that by selective non-random sampling method, 15 individuals were selected. Results: All employees and managers of the Social Security Organization of Iran that 462 were selected based on the Cochran's formula, and 232 people were selected by stratified random sampling method appropriate to the size of the population. In this study, a questionnaire was used to collect the required data. The model design and approval questionnaire with 29 components and indicators was changed to 24 items after obtaining the opinion of experts using the Delphi method. The Stress-Related Factors Questionnaire included 72 questions and the Stress Management Questionnaire consisted of 24 questions. In this study, the content validity of the questionnaire of factors related to stress and stress management were 0.915 and 0.921 respectively, and their reliability was calculated to be 99.1 and 94.6, which was greater than 0.7 and it was acceptable. Data analysis was performed using structural equation modeling with Lisrel software. Discussion: At 5% level error between individual factors (-0.33), occupational factors (-0.37), managerial factors (-5.99), organizational factors (-4.62), environmental factors (0.76 0), there was a significant and inverse relationship between stress and stress management of insurance employees of the Social Security Organization of Iran. Conclusion: The existing facts in the discussion of psychopathology and mental health in the workplace show that a significant percentage of the causes of mental illness and work fatigue among the employees of organizations can be found in the behavior methods and personality of managers

Studying gap junction beta 2-related deafness in Iranian population

Hearing loss is the most common sensory disorder in humans, from every 1000 births, 1 is affected by severe to profound deafness. Many genes are involved in deafness that GJB2 gene is one of the most important ones and encodes the connexin 26 proteins. A mutation called delG35 composes most of mutated alleles of connexin 26 and is also the most common cause of congenital sporadic and hereditary deafness. Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO), and Web of Science have been searched for literature. GJB2 gene mutations play the most significant role in non-syndromic deafness in Iran. 35delG mutation has a high frequency in most parts of Iran, especially in the North and North-West and is also the most common mutation in GJB2 deaf population of Iran. GJB2 gene mutations in Iran play less important roles compared with other countries in causing deafness; however, so far, it has been introduced as the gene that plays the most significant role in causing deafness gene in Iran. It seems that many other genes and loci play roles in causing deafness in Iran that requires more studies to be conducted. (Cite this article as: Mehri-Ghahfarrokhi A, Hashemzadeh-Chaleshtori M, Shojaeian A, Mahmoudian-Sani MR. Studying gap junction beta 2-related deafness in Iranian population. Otorinolaringol 2017;67:89-95. DOI: 10.23736/S0392-6621.17.02115-4

Thoracoscopic Congenital Diaphragmatic Hernia repair in neonate: The First Experience of Iranian Group

Background: Congenital diaphragmatic hernia (CDH) occurs due to a failure in closing pleuroperitoneal membrane thus resulting in an incomplete diaphragm formation1, which allows passage of the abdominal viscera into the thorax.1,3 Until 1995, the standard method for treatment of CDH was performed by open surgery through the abdomen or thoracic cavity. Minimally invasive approach via thoracoscopy or laparoscopy is applicable for treatment of CDH since 1995.4 Now a day’s thoracoscopic repair of CDH (T’Scopy CDH) is performed in many centers. In this paper, we present our experience of T’Scopy CDH repair from Iran.Patients and Methods: From 2011 to 2015, 74 patients with CDH were admitted to Pediatric Surgery Department of Dr. Sheikh (Sarvar) Pediatric Hospital. Twenty one patients (28%) met our inclusion criteria and underwent T’Scopy CDH repair. The median age at the time of repair was 5 days (2-daysold to 4-years-old patients). Inclusion criteria were weight over 2 kg and stable hemodynamics and arterial blood gas. Fourteen cases were intubated before entering the operating room. The defect was in the left side except in two cases. In 8 cases, we used thoracic wall as part of repair. Also, mesh support was utilized in 8 cases even in cases were primary repair of diaphragm was possible in order to reinforcing the repair (5 cases). Of these 8 cases, in 3 patients, whole repair was accomplished by mesh due to presence of a large defect.Results: The mean time of operation was 80 minutes (40-230 minutes). Intraoperative mortality was zero. In hospital, mortality occurred in two cases due to septicemia in one and respiratory and cardiac failure in another. Conversion to open surgery was required in 6 cases. Late recurrence was observed in 2 cases. The mean time of follow up was 14.6 months (3-36 months).Conclusion: It seems that appropriate case selection and liberal use of thoracic wall and mesh as a part of repair may cause better results and decreased chance of early and late recurrence

Study of common mitochondrial mutations in patients with nonsyndromic hearing loss

Hearing loss is the most common sensorineural disorder involving one out of 1000 people. Around 50% of hearing losses occur due to genetic causes. Three mitochondrial mutations, A1555G in MTRNR1, A3243G in MTTL1, and A7445G in MTTS1, are the most important non-syndromic sensorineural causes of hearing loss in some populations. The aim of this review was to study common mitochondrial mutations in people with hearing loss in Iran. EVIDENCE ACQUISITION: Directory of Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO) and Web of Science were searched. EVIDENCE SYNTHESIS: Studies have indicated that the mitochondrial mutations A3243G, A1555G, and A7445G play no significant part in the development of hearing loss in Iran. Different variants of A7445C and G3316A have been identified in Iran. CONCLUSIONS: Further studies on other ethnicities and with a larger sample size are necessary to elucidate the role of these genes in hearing loss development in Iran

Coordinated control of PSS and TCSC for improving transient stability in power system with coherent generators

In large electrical systems including FACTS devices, control approaches are complicated and time consuming. An integrated model for a part of power system which consists of an equivalent generator can fixed these problems. In this paper, the equivalent machine parameters are derived based on the weighted mean values of the parameters of the machines included in the group. TCSC control signals obtained from the integrated model is applied to the actual system. Linear optimal control method is used to stabilize a coherent three machines infinite bus using TCSC Controller .The purpose of the derived control laws for oscillation damping system seems to be simple and effective

Peritoneal Inclusion Cyst in a pre-pubertal male

Introduction Peritoneal inclusion cyst (PIC) is a cyst lined with mesothelium and usually full of fluids in the pelvis and it is most usually seen in young women and rarely, they may occur in males.Case Presentation A 12 year old boy was referred with a two-day history of abdominal pain. Abdominal examination revealed lower abdominal tenderness. Laboratory tests were normal. Imaging by abdominal ultrasound and CT scan showed collection of fluid in the pelvis with some septations and lymphadenopathies. Shapeless cystic mass with thin membrane which was independent of abdominal organs was found during laparoscopy and extracted from pelvic cavity. Histopathologic examination established the diagnosis of peritoneal inclusion cyst.Conclusion peritoneal inclusion cyst should be in mind as differential diagnosis in a patient with intra-abdominal cystic fluid collection even in childhood and male gender