A review on patient safety

Background: Patient Safety Events (PSEs) are important preventable issues with high morbidity and mortality rates, imposing high costs and the occurrence of legal and social problems in societies. Therefore, having a prevention program is very important for it. In this study, we have selected the most common and important errors and provide simple preventive measures for users.   Methods: In this review study, to obtain information associated to patient safety prevention, we used the scientific reliable literatures, registered in US National Library of Medicine/National Institutes of Health (PubMed), Google Scholar and Scopus data banks.   Results: Simple preventive measures for prevention of mistakes due to misidentification (nominal similarities, displacement of the patients, switching the newborns, etc.), miscommunication (improper communications, patient disrespect, misinterpretations due to language differences, giving bad news, etc.), misinterpretations, irrational administration and use of drugs (inappropriate medication, for the wrong patient, with wrong amount, via the wrong way, and for the wrong duration), incompatible blood transfusion, mistakes in anesthesia, surgeries and other procedures, medical complications due to PSEs (Health care associated infections, trauma and fall, thrombophlebitis and thromboembolism, bed sores, suicide, violence, and mismanagement of the hospital affaires were extracted and suggested to the hospital authorities.   Conclusion: We have extracted numerous suggested preventive measures from the accomplished studies for prevention of unpleasant patient safety related events in the hospitals

Effects of mustard gas on immune system of exposed Iranian people: a review of conducted studies

     Exposure to high dosages of sulfur mustard (SM) can cause bone marrow depression, immune system suppression, impairment of the immune functions, and eventually results in diseases due to secondary immune disorders. In this article, we have studied the effects of this poison on Iranian veterans by analysis of related published studies. In a systematic search, the effects of SM gas on Iranian victims were reviewed. We used known international medical databases such as   ISI, Medline, Scopus and Iranian databases such as Iranmedex and Irandoc. About 350 published articles were assessed. Among them, 43 articles were related to immunologic field. No special evaluation was conducted on the quality of the reviewed manuscripts and the credit of journal was considered sufficient. In accomplished studies conducted on Iranian people, both cellular and humoral immunity were affected. The reported changes were as follows:  increasing the number of inflammatory cells in chronic phase which indicates ongoing active alveolitis, neutrophils (in chronic bronchitis), eosinophils, CRP titer, RF titer, IgG (especially in asthmatic patterns) ,IgM , Ig E, IL-6, TFG-beta1target protein in bronchoalveolar lavage fluid, and decreasing the number of leukocytes , lymphocytes, natural killer cells (NKCs), IL-8and IL-6 in blood. Eventually, in reported changes, chemo taxis factors, plasma opsonins and  nitroblue tetrazolium (NBT) test were normal. In sever and prolonged exposure to mustard gas, the immune system would be suppressed. Therefore, the victims should be monitored for infections and even cancers

Synthesis of Nano-Crystalline TiC Powder from Active Impure Ti Chips via Self Propagating High-Temperature Synthesis and the Effect of Al on the Synthesis Temperature

In this research, the possibility of production of TiC powder from inexpensive raw materials via simple methods has been investigated. Impure Ti chips, carbon black and Al powder were activated by a highenergy ball mill. Then they were synthesized by the method of self propagating high-temperature synthesis (SHS) at various temperatures. XRD study indicated that TiC within 1000 °C to 1300 °C temperature range has been synthesized where the temperature in a sample containing Al was less than 1000 °C. From the broadening of the diffraction lines in the XRD patterns, it was concluded that the TiC crystallites were nanosized and the lattice parameter had deviated slightly from the standard size. The existence of Al increased the lattice parameter of TiC and the strain in the process

The impact of industrial wastewater on some of the morphological and physiologhical characteristics of Cyperus alternifolius, Chrysopogon zizanioide and Aloe vera

The increase of the entry of industrial effluents containing various types of heavy metals into water and soil leads to the ever-increasing spread of environmental problems. Therefore, it is necessary to find less expensive solutions to reduce the pollution. In this regard, in order to compare the effect of the removal of heavy elements on some of the morphological and physiological characteristics of C. alternifolius, Ch. zizanioides and Aloe vera plants, an experiment was conducted in the form of a randomized complete block design with three replications for 14 months at the University of Guilan. The results showed that under the treatment of industrial wastewater, the metal accumulation indices (MAI) of zinc, chromium, lead, copper, manganese, nickel, magnesium were higher in Ch. zizanioides and Aloe vera than those in C. alternifolius. In all three studied plants, the indices of root length, shoot length, total biomass and tolerance index (TI) had a significant decrease compared with those in the control plants, and Ch. zizanioides and A. vera plants had the lowest percentage of decrease. In addition, other investigated components including absorption index (UI), total soluble sugar, total phenol content, total flavonoid, total anthocyanin, total tannin, and DPPH free radical inhibition percentage increased in all three plants under industrial wastewater treatment. The highest percentage of increase in all investigated components, except DPPH free radical inhibition percentage, was observed in Ch. zizanioides. In general, it can be said that in terms of MAI and morphological and physiological characteristics, Ch. zizanioides and A. vera were more successful than the C. alternifolius. Therefore, it is recommended to plant the studied plants in the order of priority (Ch. zizanioides ˃ A. vera ˃ C. alternifolius) in soils contaminated with industrial effluents, in order to remediate the soil

Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital

BACKGROUND: Abdominal surgical site infections are among the most common complications of inpatient admissions and have serious consequences for outcomes and costs. Different risk factors may be involved, including age, sex, nutrition and immunity, prophylactic antibiotics, operation type and duration, type of shaving, and secondary infections. This study aimed to determine the risk factors affecting abdominal surgical site infections and their incidence at Imam Khomeini, a major referral teaching hospital in Iran. METHODS: Patients (n = 802) who had undergone abdominal surgery were studied and the relationships among variables were analyzed by Student's t and Chi-square tests. The subjects were followed for 30 days and by a 20-item questionnaire. Data were collected through pre- and post-operative examinations and telephone follow-ups. RESULTS: Of the 802 patients, 139 suffered from SSI (17.4%). In 40.8% of the cases, the wound was dirty infected. The average age for the patients was 46.7 years. The operations were elective in 75.7% of the cases and 24.7% were urgent. The average duration of the operation was 2.24 hours, the average duration of pre-operative hospital stay 4.31 days and the average length of (pre- and post-operation) hospital stay 11.2 days. Three quarters of the cases were shaved 12 hours before the operation. The increased operation time, increased bed stay, electivity of the operation, septicity of the wound, type of incision, the administration of prophylactic antibiotic, type of operation, background disease, and the increased time lapse between shaving and operation all significantly associated with SSI with a p-value less than 0.001. CONCLUSION: In view of the high rate of SSI reported here (17.4% compared with the 14% quoted in literature), this study suggests that by reducing the average operation time to less than 2 hours, the average preoperative stay to 4 days and the overall stay to less than 11 days, and approximating the timing of shaving to the operation and substituting cefazolin for cefaluthin when prophylactic antibiotic is to be administered, the SSI may be reduced to a more acceptable level

A Post-Marketing Surveillance Study to Evaluate the Safety Profile of AlvotereⓇ (Docetaxel) in Iranian Patients Diagnosed with Different Types of Cancers Receiving Chemotherapy

Background Docetaxel is a clinically well established antimitotic chemotherapy medication. Labeled docetaxel indications are breast cancer, gastric cancer, head and neck cancer, non–small cell lung cancer, and prostate cancer. Objective This is a Phase IV study to evaluate the safety profile of docetaxel (Alvotere; NanoAlvand, Iran) in Iranian patients diagnosed with different types of cancers receiving chemotherapy regimens with docetaxel. Methods Patients who received Alvotere as a part of their chemotherapy regimen were enrolled in this Phase IV, observational, multicenter, open-label study. Alvotere was administrated as a single agent or in combination with other chemotherapy agents. Safety parameters in each cycle were assessed, and the related data were recorded in booklets. Findings A total of 411 patients with different types of cancers were enrolled from 25 centers in Iran. The most common malignancies among participants were breast cancer (49.88%), followed by gastric cancer (22.63%). Participants’ mean age was 53.33 years, and the mean total dose used in each cycle was 132 mg. According to the results, 341 patients experienced at least 1 adverse event, that the most common was alopecia (41.12%). In total, 92 (22.38%) patients had at least 1 adverse event of grade 3 or 4, and 25 (6.08%) patients showed 54 serious adverse events, which the causality assessment for all was possibly related to Alvotere. There was a significant difference between men and women in the incidence of skin and subcutaneous tissue disorders (55.63% in women vs 41.73% in men; P = 0.009). Also, the incidence of gastrointestinal disorders, nervous system disorders, skin and subcutaneous tissue disorders, hepatic enzymes increase, and fluid retention was significantly higher (P < 0.05) in patients receiving anthracyclines in their chemotherapy regimens. Conclusions The findings of this open-label, observational, multicenter, postmarketing surveillance showed that Alvotere appears to have an acceptable safety profile in Iranian cancer patients receiving chemotherapeutic regimens. (Curr Ther Res Clin Exp. 2022; 82:XXX–XXX) © 2022 Elsevier HS Journals, Inc

MR fluoroscopy in vascular and cardiac interventions (review)

Vascular and cardiac disease remains a leading cause of morbidity and mortality in developed and emerging countries. Vascular and cardiac interventions require extensive fluoroscopic guidance to navigate endovascular catheters. X-ray fluoroscopy is considered the current modality for real time imaging. It provides excellent spatial and temporal resolution, but is limited by exposure of patients and staff to ionizing radiation, poor soft tissue characterization and lack of quantitative physiologic information. MR fluoroscopy has been introduced with substantial progress during the last decade. Clinical and experimental studies performed under MR fluoroscopy have indicated the suitability of this modality for: delivery of ASD closure, aortic valves, and endovascular stents (aortic, carotid, iliac, renal arteries, inferior vena cava). It aids in performing ablation, creation of hepatic shunts and local delivery of therapies. Development of more MR compatible equipment and devices will widen the applications of MR-guided procedures. At post-intervention, MR imaging aids in assessing the efficacy of therapies, success of interventions. It also provides information on vascular flow and cardiac morphology, function, perfusion and viability. MR fluoroscopy has the potential to form the basis for minimally invasive image–guided surgeries that offer improved patient management and cost effectiveness