Evaluation of medical error status in various wards of Shohadaye Ashayer Hospital, Khorramabad, Iran

Abstract: Medical errors are known as the most important challenges that healthcare systems in all countries are encountered to them. To provide security and safety for patient is one of the major items in the health care systems. Confessing medical errors imposed on patient and education system is found to be an important aspect of medical ethics and care in turn lowers incidence of errors. Given the importance of identifying and reporting occurred medical errors, the present research aimed to assess medical errors in hospital wards of Shohadaye Ashayer Hospital Khorramabad so that findings of this research can inspire us to incorporate medical errors as a very important subject in the curriculum of medical students and finally physicians can do best examination and treatment with minimal or no errors and inaccuracies. The present research is descriptive in nature which lasted from April to March 2015. Statistical population (subjects) included employees and supervisors, nurses, staffs, lab safety facilitator, pharmacy safety facilitator, surgery room personnel, equipment and personnel in the hospital wards, including the emergency department, men surgery, women surgery, operating room, orthopedics, internal medicine ward, neurology, laboratory room, surgery, infectious, ophthalmic, reception, pharmacy and CCU hospital in Shohadaye Ashayer Hospital- Khorramabad. © 2009-2016, JGPT

Effect of Zinc Supplementation on Physical and Psychological Symptoms, Biomarkers of Inflammation, Oxidative Stress, and Brain-Derived Neurotrophic Factor in Young Women with Premenstrual Syndrome: a Randomized, Double-Blind, Placebo-Controlled Trial

Zinc is known to have multiple beneficial effects including anti-inflammatory and antioxidant and anti-depressant actions. Data on the effects of zinc supplementation on biomarkers of inflammation, oxidative stress, and antidepressant-like effect among young women with premenstrual syndrome (PMS) are scarce. This study was a randomized, double-blind, placebo-controlled trial. Sixty women (18-30 years) with premenstrual syndrome diagnosed according to 30-item questionnaire were randomly assigned to receive either 30-mg zinc gluconate (group 1; n = 30) and/or placebo (group 2; n = 30) for 12 weeks. Premenstrual syndrome symptoms, total antioxidant capacity, high sensitivity reactive protein, and brain-derived neurotrophic factor were measured at study baseline and after 12-week intervention. After 12 weeks of intervention, PMS physical symptoms (P = 0.03) and psychological symptoms (P = 0.006) significantly decreased in zinc group compared to placebo group. We observed a significant increase in brain-derived neurotrophic factor (P = 0.01) and total antioxidant capacity (P < 0.001) after 12 weeks of intervention with zinc compared to placebo. We failed to find any significant effect of zinc supplementation on high sensitivity reactive protein. Overall, zinc supplementation for 12 weeks among women with premenstrual syndrome had beneficial effects on physical and psychological symptoms of premenstrual syndrome, total antioxidant capacity, and brain-derived neurotrophic factor

Comparison of Haloperidol, Promethazine, Trifluoperazine, and Chlorpromazine in Terms of Velocity and Durability of the Sedation among Acute Aggressive Patients: A Randomized Clinical Trial

Background: Knowledge and skill about sedation of aggressive patients is necessary for each psychiatrist. The purpose of this study was comparing the velocity and durability of sedation induced by the haloperidol, trifluoperazine, promethazine, and chlorpromazine in aggressive patients. Materials and Methods: This randomized clinical trial was done on 76 aggressive patients referred to Psychiatry Emergency Service of Noor Hospital of Isfahan University of Medical Sciences that were randomly divided into four groups of haloperidol, promethazine, chlorpromazine, and trifluoperazine. Patients were evaluated at 30 min intervals for aggressive symptoms, and if they did not respond to intervention after the first 30 min or if they showed aggression again, a same dose of the injected drug was prescribed. The length of sedation time was recorded for each patient. Results: Seventy-six patients with the mean age of 31.89 +/- 8.73 years were participated and 63.2 of them were male. Response to intervention after the first injection was seen in 40.8 and 59.2 needed the second injection. The mean time needed for obtaining sedation was 17.38 +/- 8.23 and 19.66 +/- 4.64 min after the first and second injection, respectively. The mean times of sedation induction were not significantly related to age, gender, type of substance used, type of aggression, and type of psychiatric disorder. Considering the type of drugs, there was no significant difference between velocity and durability effect of sedation after the first and second injection. Conclusion: Comparing the velocity and durability of sedative effect of the four studied drugs on acute aggressive patients, did not show any significant difference between them

Nifedipine, Captopril or Sublingual Nitroglycerin, Which can Reduce Blood Pressure the Most?

BACKGROUND: Hypertension (HTN) is one of the most important problems in all parts of the world. Although the disease is usually asymptomatic, its diagnosis and treatment are easy. The aim of this study was to compare the effect of Nifedipine (Adalat®), Captopril and sublingual Nitroglycerin on reducing blood pressure (BP). METHODS: This study was a parallel group randomized controlled trial. From the patients referred to our heart clinic, 120 patients with severe HTN were enrolled in the study. The patients were randomly allocated into 3 groups A, B, and C. The patients were advised to use 5 drops of Adalat in group A, Captopril 25 mg sublingually in group B, and 1 sublingual Nitroglycerin pearl in group C. The BP was measured every 20 minutes during one hour. RESULTS: Systolic BP was reduced significantly by Adalat and Captopril compared with sublingual Nitroglycerin in the 20th, 40th and 60th minutes (P = 0.001), but there was no significant difference between Adalat and captopril in reducing systolic BP. In addition, the result of reducing diastolic BP was not significantly different among the three groups. CONCLUSION: We saw the same effect on reducing BP by Captopril, Adalat, and sublingual Nitroglycerin. Among these three drugs, the side effects of Captopril were the least frequent. Adalat caused headache and flushing. Thus, it seems Captopril can be used instead of Adalat in medical centers. Keywords: Adalat, Captopril, Nitroglycerin, Severe Hypertensio

Effectiveness of Dialectical Behavioral Therapy on Executive Function, Emotional Control and Severity of Symptoms in Patients with Bipolar I Disorder

Background: Bipolar disorder is a disabling illness characterized by recurrent episodes of mania, hypomania, and depression. The dialectical behaviour therapy (DBT) is basically designed to help regulate excitement, tolerance of discomfort, mindfulness and interpersonal relationships. This study aimed to determine the effectiveness of DBT on executive function, emotional control and symptom relief in patients with type 1 bipolar disorder. Materials and Methods: This clinical trial was conducted on 50 patients with type 1 bipolar disorder. These patients were divided into two 25 populated groups of controls and intervention. The control group did not receive any other alternative therapy apart from routine medications, but in the intervention group, in addition to routine medications, DBT treatment was also done as complementary therapy in 12 sessions based on Dick's protocol. Then, Mania severity, emotional control and their executive functions were evaluated before and after the intervention and compared in two groups. Results: After the intervention, the scores of mania and depression mood with the mean of 2.12 +/- 3.09 and 31.08 +/- 8.98 respectively in intervention group were significantly lower than control group with the mean of 4.24 +/- 4.11 and 39.92 +/- 9.05 respectively (P < 0.05). Depression and executive function of the patients had no significant difference between the two groups in the post-intervention period and had a modest and non-significant change. Conclusion: DBT has been effective in decreasing the intensity of mania, but, it cannot be used to reduce the emotional instability and impulsivity of these patients along with drug therapy although it has improved the executive functions and depression of the patients

Effectiveness of Emotion Regulation Group Therapy on Craving, Emotion Problems, and Marital Satisfaction in Patients with Substance Use Disorders: A Randomized Clinical Trial

Objective: Psychological and environmental factors, such as difficulties in emotion regulation (ER) and marital problems, are involved in relapse and craving in patients with substance use disorders. Emotional regulation therapy can help maintain opioid withdrawal and improve marital relations by focusing on appropriate adjustment of emotions. This study aimed to evaluate the effectiveness of emotion regulation therapy on craving, emotion regulation, and marital satisfaction in patients with substance use disorders. Method : This randomized controlled clinical trial with pretest and posttest was performed in 2014 in Noor hospital, Isfahan, Iran. In this study, 30 patients who were admitted to the addiction center of Noor hospital were selected using purposive sampling. They were assigned into two groups randomly: (1) 15 patients in treatment as usual (TAU group); (2) 15 patients in emotion regulation group therapy (ERGT). The ERGT group received eight weekly treatments, based on Gross model, to learn recognize emotions and their effects, overcome obstacles of positive emotions, accept emotions, identify regulatory maladaptive and adaptive strategies of emotions, and modify behavior. Before and after the emotion regulation sessions in experimental group, Craving Beliefs Questionnaire (CBQ), Emotion Regulation Questionnaire, and Dyadic Adjustment Scale (DAS) were administered in both groups. Results: The results of analysis of variance indicated that mean scores of marital adjustment increased in ERGT (93.66 +/- 15.81) compared to TAU group (55.26 +/- 20.98) and the mean scores of craving were decreased in ERGT compared to TAU group (56.66 +/- 18.39 and 105.2 +/- 34.5, respectively). Also, most aspects of ER improved in ERGT compared to TAU group, and the total score of ER was increased in ERGT significantly (96.69 +/- 5.38 in ERGT versus 73.70 +/- 5.05 in TAU). Conclusion: Based on the findings of this study, emotion regulation group therapy has a significant effect on reducing Craving and improving marital adjustment and emotion regulation in Patients with Substance Use Disorders. So, it can use as a useful psychotherapy in addiction treatment centers

Electrocardiogram Changes in Patients With Acute Ethanol Poisoning

Background: Alcohol consumption leads to a significant number of deaths, mostly in men, worldwide. Considering the effect of ethanol toxicity on the heart, we studied various Electrocardiographic (ECG) changes in patients with acute ethanol poisoning. Methods: A cross-sectional study was performed on patients admitted to Khorshid Hospital (affiliated to Isfahan University of Medical Sciences) due to ethanol poisoning. All 15- to 50-year-old patients with acute ethanol intoxication were included in the study (N=250). The patients’ information, including the demographic characteristics, clinical manifestations, and ECG changes were recorded and analyzed. Different variables were compared between the patients with or without ECG changes.Results: Most of the research patients (n=208) were men (83.82%). The Mean±SD age of the study patients was 26.8±8.87 years. About 54.8% of the patients presented abnormal ECG. The changes in ECG were not significantly different based on the demographic characteristic and clinical manifestations. The time interval between ethanol consumption and admission was significantly higher in patients with abnormal ECG, compared to those with normal ECG (Mean±SD: 7.09±10.67 vs. 4.77± 4.54 hours, respectively) (P=0.03).Conclusion: ECG changes are common in patients with ethanol poisoning. The time interval between ethanol consumption to hospital admission may be an important factor in the occurrence of ECG changes

The effect of informational-emotional support program on illness perceptions and emotional coping of cancer patients undergoing chemotherapy

Purpose The present study aims to assess the effect of a nurse-led informational-emotional support program on illness perceptions and emotional coping of cancer patients undergoing chemotherapy. Methods We used a quasi-experimental design, pre- and post-test. A total of 80 cancer patients undergoing chemotherapy were selected by convenience sampling method and assigned to experimental (n = 40) and control groups (n = 40). The nurse-led informational-emotional support program included five face-to-face sessions, educational booklet, and five phone follow-ups, and was conducted for the experimental group over 10 weeks. The control group received routine cares. The outcomes were assessed at baseline and end of intervention and included illness perceptions, which were assessed using the Illness Perception Questionnaire-Revised (IPQ-R), and emotional coping as the secondary outcome using the Coping Through Emotional Approach Scale. Data were analyzed in SPSS using multivariate analysis of covariance (MANCOVA) models, t test, paired t test, and chi-square. Results Between group analysis showed that the mean scores of global illness perceptions and subscales including timeline, consequences, controllability, and coherence significantly increased in the experimental group compared to the control (P < 0.001), but no significant change was observed in two groups in the subscale of emotional representation (P < 0.571) and in the secondary outcome including emotional coping (P < 0.08). Conclusions A 10-week nurse-led informational-emotional support program can lead to changed illness perceptions without changing emotional coping. The effect of this support program should be studied on the coping and illness perceptions over the trajectory of cancer, especially in end stages in the future

Substance abuse behaviors among university freshmen in Iran: a latent class analysis

OBJECTIVES Substance abuse behaviors among university freshmen in Iran are poorly understood. This study aimed to identify, for the first time, subgroups of university freshmen in Iran on the basis of substance abuse behaviors. Moreover, it examined the effects of socio-demographic characteristics on membership in each specific subgroup. METHODS Data for the study were collected cross-sectionally in December 2013 and January 2014 from 4 major cities in Iran: Tabriz, Qazvin, Karaj, and Khoramabad. A total of 5,252 first-semester freshmen were randomly selected using a proportional cluster sampling methodology. A survey questionnaire was used to collect data. Latent class analysis (LCA) was performed to identify subgroups of students on the basis of substance abuse behaviors and to examine the effects of students’ socio-demographic characteristics on membership in each specific subgroup. RESULTS The LCA procedure identified 3 latent classes: the healthy group; the hookah experimenter group; and the unhealthy group. Approximately 82.8, 16.1, and 2.1% of students were classified into the healthy, hookah experimenter, and unhealthy groups, respectively. Older age, being male, and having a family member or a close friend who smoked increased the risk of membership in classes 2 and 3, compared to class 1. CONCLUSIONS Approximately 2.1% of freshmen exhibited unhealthy substance abuse behaviors. In addition, we found that older age, being male, and having a close friend or family member who smoked may serve as risk factors for substance abuse behaviors

The relationship between the severity of asthma and the severity of symptoms of anxiety and depression: A cross-sectional study

Background: Depression and anxiety are two common mood disorders in modern societies with global expansion, which reduce the quality of life. A number of recent studies have investigated the relationship between anxiety and depression in patients with asthma. Due to the lack of studies in this area, especially in Iran, we studied this issue in Iranian population. Methods: This was a cross-sectional study on 151 patients with asthma referred to lung subspecialty clinics in Isfahan and Shahrekord cities, Iran, in 2016. The participants were included using sequential sampling method. The Hospital Anxiety and Depression Scale (HADS) questionnaire was used as an instrument for measuring anxiety and depression. Data were analyzed using t and Spearman correlation tests via SPSS software. Findings: 151 patients with asthma entered the study. By controlling demographic characteristics, and considering the underlying disease, the relationship of depression scores with the severity of asthma was not significant. Anxiety scores related to having the disease and gender. Conclusion: It can be concluded that the level of anxiety and depression was not related to the severity of asthma. Considering the high prevalence of asthma and the role of depression and anxiety in people's quality of life, more studies, using different tools to measure the level of anxiety and depression, shows to be needed. © 2019, Isfahan University of Medical Sciences(IUMS). All rights reserved