Hasheminejad Hospital Research Articles

Investigating the Effect of Longitudinal Biomarkers on Hemodialysis Elderly Survival: A Single Central Study

Objectives This study aims to identify the factors affecting the survival of hemodialysis patients using a two-stage survival/multivariate longitudinal modelling. Methods & Materials The is a retrospective cohort study on 395 patients aged > 60 years who underwent hemodialysis in Hasheminejad Hospital in Tehran, Iran. Data were collected over a 15-year period from 2004 to 2019. Phosphate, calcium, parathormone and creatinine variables were considered as longitudinal variables and mortality as a survival response. The two-stage survival and multivariate longitudinal modeling for long-term hemodialysis patients were fitted and the results were compared according to theirs likelihood function. Data analysis was performed in RStudio v. 3.4.3 and SAS v. 4.9 applications. The significance level was set at 0.05. Results The mean age of patients was 70.41±6.11 years. Of 395 patients, 249(63%) were male. Based on the log-likelihood function, the communication structure of the cumulative effect of longitudinal biomarkers and survival data was selected. Assuming that other variables were constant, the significance of values for mobility impairment, calcium level and parathormone level indicated that these variables were good predictors of the occurrence of death in hemodialysis patients over time. By each unit increase in each variables of mobility impairment, calcium level, and parathormone level, the risk of death increased by 1.391, 0.927, and 0.967, respectively. Conclusion By using a two-stage modelling, the variables of mobility impairment, calcium level and parathormone are found as factors affecting the risk of death in hemodialysis patients. Therefore, therapists should focus on changing health behaviors of these patients in consuming calcium and parathormone.

RETRACTED: Association of PSA density and Gleason score of the positive surgical margin with biochemical recurrence in prostate cancer; a historical cohort study.

This study aimed to investigate the association between PSA Density and Gleason score of the positive margin after radical prostatectomy with biochemical recurrence in patients with prostate cancer. In this retrospective cohort study, patients with prostate cancer referred to Hasheminejad Hospital in Tehran during 2009-2019, who underwent radical prostatectomy were assessed to enter the study. Patients were selected by the convenience sampling method. The follow-up period was determined as at least 1 year after radical prostatectomy to determine biochemical recurrence. PSA Density (PSAD) and the Gleason score of surgical specimen and positive surgical margins (PSM) were evaluated and their association with biochemical recurrences was investigated. One hundred and three patients entered the study. The overall biochemical recurrence rate was 48.5% with a mean follow-up of 24 months (12-42 months) and an average time to biochemical recurrence of 18 months (16-20 months). BCR-free survival rates of patients divided based on to the PSAD cut-off point (0.205 ng/ml/cc) were significantly different using the log-rank test (p = 0.008) (85.7%, 57.1%, and 14.3% for values ⩽0.205 ng/ml/cc vs 55.8%, 20.9%, and 0% for values ˃0.205 ng/ml/cc, respectively for 1-, 2- and 3-year survival). In addition, Cox regression showed that the Gleason score of PSM, the Gleason score of the surgical specimen, and the PSAD predicted biochemical recurrence to most extent, respectively. PSAD and PSM Gleason score were strong predictors of biochemical recurrence after radical prostatectomy and their use along with other common indicators including tumor grade and stage and PSA level can increase the accuracy of risk assessment in patients with prostate cancer.

Comparison the Emergency Severity Index and Manchester Triage System in Trauma Patients.

Objective:To compare the emergency severity index (ESI) and Manchester triage system (MTS) in trauma patients.Methods:This cross-sectional study was conducted by census method in Hasheminejad hospital during 2019. Patients referred to a trauma center triaged by five trained triage nurses based on ESI and MTS. Outcomes were considered as length of stay at the emergency department, admission to the other sectors and discharge or leave the hospital. Information from the triage form, nursing registry office and hospital registry system were extracted and analyzed by SPSS software.Results:Totally 447 and 468 patients triaged with the ESI and MTS were included, respectively. Seventy percent of patients triaged with ESI and 34% with MTS were placed in level 3 or the yellow group (equivalent group 3 triage). The hospitalization rate is approximately equal at each triage level in the both systems. The mortality rate in both groups was 0%. Mean length of stay was significantly lower in the MTS group compared to ESI in the emergency department (p<0.05).Conclusion:Using of ESI triage in the trauma center causes to arrive more patients to the emergency department instead of the fast track and leads to waste the time and energy of staff’. However, further studies are needed to prove this result.

Examining the Relationship between Salivary Amylase Level, Head Trauma Severity and CT Scan Results in Patients with Isolated Mild Head Trauma.

Objective:To investigate the relationship between salivary amylase level and computed tomoraphy (CT scan) findings in patients with isolated mild traumatic Brain Injury (mTBI) referred to the emergency department of Shahid Hasheminejad Hospital.Methods:Patients with isolated mTBI and indication for brain CT scan who referred to the trauma center of Shahid Hasheminejad Hospital, Mashhad, Iran in 2019 were included in a cross-sectional study. In the initial examination, the patient’s level of consciousness was measured using the Glasgow Coma Scale (GCS), and saliva samples were taken at the emergency department to determine the level of salivary amylase. A brain CT scan was performed for all patients. Age, gender, cause of trauma, the trauma severity and CT scan results were recorded. Statistical analysis was performed on the data.Results:One-hundred fifty patients were enrolled in this study (men=101, women=49). The trauma causes were included accidents (n=88; 58%), falls (n=37; 25%) and miscellaneous factors (e.g., quarrels; n=25; 17%). GCS was 15 in 142 patients and 14 in the rest. In all patients, the trauma severity was mild to high risk (Minor). CT scan results unfolded pathology in 10 cases (7%), while the residues (93%) had normal CT scans with no pathological evidence. Salivary amylase level in the patients’ saliva samples was between 137 to 8000 units per liter. Using the t-test to evaluate the relationship between salivary amylase levels and CT scan results uncovered a significant relationship. Spearman correlation revealed no significant relationship between the amylase and GCS levels.Conclusion:Data statistical analysis from 150 patients with isolated head trauma manifested that salivary amylase levels were significantly higher in the patients with pathological findings on CT scans. However, no significant relationship was found between salivary amylase level and age, gender, cause of trauma, and level of consciousness.

Evaluation of risk factors for catheter-related infections with gram-negative bacteria in Tehran, Iran

Introduction: Catheter infection is due to gram-negative, gram-positive bacteria, and fungi. Gram-positive bacteria are the most prevalent cause of catheter infection, although gram-negative bacteria seem to have escalated in recent years, which may have numerous risk factors. In this report, we intended to study these risk factors. Objectives: This study aimed to investigate the risk factors for catheter-related infections caused by gram-negative bacteria in hemodialysis patients, to prevent catheter-related infections, which are unfortunately abundant. Patients and Methods: This cross-sectional study was conducted on128 hemodialysis patients known cases Hasheminejad hospital in Tehran, Iran in 2019. Patients were assigned into two groups as the case group (catheter-related infection caused by gram-negative bacteria) (n=64) and the control group (catheter-related infection caused by gram-positive bacteria) (n=64). Risk factors for catheter-related infection, including hemoglobin, phosphorus, albumin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), total iron-binding capacity (TIBC), catheter insertion site, urinary tract infection (UTI), urinary tract manipulation, and urinary tract anomalies were obtained and analyzed via SPSS version 26. Results: Two groups were significantly different in serum albumin level (3.7±0.5 g/dL in gram-negative group and 3.9 ± 0.5 g/dL in gram-positive group; P=0.009) and in UTI (23.4 % in gram-negative group and 7.8 % in gram-positive group; P=0.015). Additionally, no significant differences were observed in serum ferritin, phosphorus, ESR, CRP, TIBC, duration, and site of catheter insertion. Regression analysis shows that, for every unit increase in albumin, the chance of developing a gram-negative catheter infection is 0.356, or about one-third. In other words, with decreasing each unit of albumin, the chance of a gram-negative catheter infection is 2.8 times (reverse 0.356). Conclusion: Serum albumin levels were significantly low in gram-negative group. Moreover, UTIs were significantly higher in this group. It is also important to consider hypoalbuminemia and UTI as risk factors for catheter infection with gram-negative bacteria.

The success rate of posterior tibial nerve block in the ankle with and without ultrasound guidance: A clinical trial study for pain management in emergency departments

Objective: The purpose of the current study was to assess the success rate of posterior tibial nerve block in the ankle with and without ultrasound guidance for pain management in emergency departments. Methods: This clinical trial was conducted on 80 individuals who needed posterior tibial nerve block in the ankle at the emergency department of Hashemi Nejad hospital and Edalatian emergency center in Mashhad, Iran. The eligible individuals were randomly assigned to one of two groups, designated the control (landmark-based nerve block) and the case group (ultrasound-guided nerve block). The two groups were compared in terms of the main measurable outcomes. The data were analyzed using SPSS software (version 20) by nonparametric tests. Results: According to the findings, the mean and median of nerve block success in the landmark-based and ultrasound-guided methods were significantly different between the two groups, both 15 (P=0.02) and 30 (P=0.001) min post-intervention. In this regard, nerve block with ultrasound guidance had a higher success rate compared to the landmark method. However, no significant difference between the two interventions was found in terms of the mean and median of the procedure duration (P=0.8) and injection frequency (P=0.4). On the other hand, the two groups were significantly different regarding the median and mean of patient satisfaction (P=0.00), duration of analgesia (P=0.004), and nerve block-related complications (P=0.03). Conclusion: The findings revealed that the relatively new technique of nerve block by ultrasound-guide resulted in better outcomes than the landmark-based method. Consequently, this method could be adopted to control acute pain in the emergency departments and improve patient care.

Can public-private partnership (PPP) improve hospitals' performance indicators?

Background: This study was conducted to compare the main performance indicators of Hasheminejad hospital before and after implementing PPP model. Methods: This cross sectional study was conducted in Iran in 2015. Performance indicators of Hasheminejad hospital, the only Iranian unit that implemented PPP model, were applied. Data were collected based on a researcher-designed checklist after ensuring its validity and reliability. Data were analyzed applying SPSS21, and the Shapiro-Wilk test was used to examine the relevant data normalization. After confirming the normality of the data, descriptive statistics and paired t test were used to analyze the data at a significant level of 0.05. Results: Dramatic variations were observed in the status of the studied indicators after the implementation of PPP in Hasheminejad hospital, and the changes were statistically significant in all these indicators (p<0.05). Conclusion: It seems that implementing PPP in Hasheminejad hospital can be considered as a successful experience in Iran’s health sector. The significant improvement in this hospital’s performance indicators can emphasize the effective role of PPP in administration of this hospital. However, service quality and patient satisfaction should be considered as qualitative indicators, along with the present quantitative indicators because better judgment about the changes was achieved in this hospital after implementing PPP.

The Relationship between Clinical Findings of Shoulder Joint with Bone Damage of Shoulder Joint in Patients with Isolated Shoulder Blunt Trauma.

BACKGROUND:Due to the prevalence of shoulder injuries among athletes and other people and the prevalence of radiography for these injuries, there are still no valid criteria for indication of doing shoulder radiography.AIM:This study aimed to examine the relationship between some signs and clinical examinations of the shoulder with shoulder bone injuries and the need for radiography.METHODS:This is a cross-sectional study. All patients aged 18-70 years who referred to the emergency ward of Imam Reza and Hasheminejad Hospital in the year 2014 due to blunt trauma and had criteria for entering the study and lacking exclusion criteria were included in the study process. Data on clinical symptoms, radiographic results, and final diagnosis were extracted from the patients’ records through a questionnaire and analysed statistically.RESULTS:There was a significant relationship between the clinical signs of patients Existence of ecchymosis in the shoulder fractures with glenoid and humerus fractures (p = 0.029, p = 0.004 respectively). There was also a significant relationship between clavicle fracture and limitation in shoulder rotation and abduction (p = 0.000 and p = 0.001 respectively). Other clinical symptoms did not show any significant relationship with radiographs indicative of the problem requiring specific treatment.CONCLUSION:Although it is possible to define critters based on clinical symptoms that reduce the need for unnecessary radiographs that the does not reliably help inpatient treatment, but finding these critters to indicate the performance of the graphs in shoulder injuries requires further studies with the higher population and more clinical variables.

Clonidine versus Tramadol for postanesthetic shivering: a randomized clinical trial study

Introduction: To compare the effects of oral clonidine and tramadol on shivering caused by spinal anesthesia in patients undergoing transurethral lithotripsy (TUL).&#x0D; Methods: The present study is a triple-blind clinical trial conducted on 80 elective urologic surgical candidates during 2016-2017 at Tehran Hasheminejad Hospital in Iran. Using the Balanced Block Randomization method, the patients were randomly assigned into two groups (40 patients per group) 90 minutes before performing spinal anesthesia. The first group (group C) received 150 µg of oral clonidine and the second group (group T) received 50 mg of oral tramadol. Body temperature, core body temperature, heart rate, diastolic blood pressure and shivering were recorded for the patients at different time periods, and entered in the SPSS22 software program. The above variables were then statistically analyzed using independent sample T-tests chi-squared tests and Repeated Measure ANOVA.&#x0D; Results: The results of this study indicated that there was a significant statistical difference (P&lt;0.05) between the clonidine and tramadol treatment groups with regards to some variables, such as average body temperature and average core temperature, at different time periods. However, for other variables, such as heart rate, systolic blood pressure, diastolic blood pressure and shivering, there were no significant statistical differences between the two treatment groups (P&gt;0.05).&#x0D; Conclusion: Clonidine and tramadol treatment groups were only significantly different in terms of body temperature and core temperature. Therefore, it is recommended that other precise randomized clinical trials be performed to ensure the accuracy of the results of this study.&#x0D; &#x0D; Peer Review Details&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Peer review method: Single-Blind (Peer-reviewers: 02) Peer-review policy &#x0D; Plagiarism software screening?: Yes&#x0D; Date of Original Submission: 04 September 2017&#x0D; Date accepted: 30 September 2017&#x0D; Peer reviewers approved by: Dr. Lili Hami &#x0D; Editor who approved publication: Dr. Phuc Van Pham&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Performance Evaluation of Mashhad University of Medical Sciences’ Hospitals During 2006-2011: Application of Pabon Lasso Model

Background: Performance evaluation is a process, which deals with the evaluation, measurement and judgment of performances over a certain period of time. Objectives: The aim of this study was to evaluate the performance of Mashhad University of Medical Sciences’ hospitals using the Pabon Lasso model. Methods: In this descriptive cross-sectional study, ten educational hospitals of Mashhad University of Medical Sciences (MUMS) were investigated. Data included the following indicators: bed turnover rate (BTR), bed occupancy rate (BOR) and average length of stay (ALS). The data-gathering tool was standardized by the deputy of curative services of the ministry of health and medical education (MOHME). Data was collected from the information technology and statistics management department of MUMS databank, entered into the Excel software, validated, and implemented to depict the Pabon Lasso graphic chart. The position of the hospitals was recognized and analyzed in terms of the above indexes. Results: Doctor Sheikh hospital has been shifting variably between the second and third quadrants; Hashemi Nejad hospital was moved to the third quadrant in 2006 to 2011 and finally to the first quadrant in 2011. The status of Shariati hospital and Omolbanin hospital remained constant in the first and second quadrants during these six years. Finally, the KhatamolAnbiya hospital was moved from the second quadrant to the third quadrant during these six years Conclusions: According to the results, only 30% of Mashhad’s medical centers (Hashemi-Nejad, Anbiya and doctor Sheikh hospitals) were in the third quadrant. In addition, the study findings showed the performance of each hospital according to the Pabon Lasso model. This information can be used to gain the awareness of hospital administrators about their hospital’s situation and position compared to other hospitals, to maintain and upgrade their performance.

The Identification of Chemical and Bacterial Composition and Determination of FimH Gene Frequency of Kidney Stones of Iranian Patients

Background: There is rare study on the association between FimH and kidney stone formation in our country. Objectives: Here we studied on stones and identified the bacteria in stones isolated from kidney stone disease and/or UTI patients attending to Hashemi-Nejad hospital (Tehran, Iran) to find out a possible correlation between stone composition and the diseases. We also measure the frequency of fimH gene and its related protein in Escherichia coli isolated from the patients to clarify the effect of this gene in kidney stone formation. Patients and Methods: In This observational-descriptive study, 40 kidney stone samples were gathered and the composition of each sample was determined. The frequency of fimH gene and its related protein was measured using PCR and protein extraction from separated E. coli bacteria. Results: The most prevalence of stones belonged to calcium oxalate stones and the most frequent bacterium in kidney stones was E. coli. The frequency of fimH gene in isolated E. coli was 57.14%. Conclusions: Our data indicated that almost all chemical types of kidney stones may involve in UTI and kidney stone formation. We also realized that although E. coli is a non-urea splitting bacteria, it is the most causative microorganism found in urine and stones. Finally we recognized that fimH gene is seen in the majority of kidney stone samples so it may have a role in formation of kidney stone, although it should be more clarified in future studies.

The Effect of Stretching Exercises on Severity of Restless Legs Syndrome in Patients on Hemodialysis.

BackgroundThe restless legs syndrome is a sensorimotor disorder that is very common in patients on hemodialysis. Due to pharmacological treatments which have their own side effects, nowadays, studies have turned to non-pharmacological treatments.ObjectivesThe present study aims to assess the effect of stretching exercises on the severity of restless legs syndrome in patients on hemodialysis.Patients and MethodsThis clinical trial study was conducted on 33 patients who had been identified using diagnostic criteria from the hemodialysis ward of Hasheminejad Hospital in Tehran. Participants were randomly divided into the intervention group (n = 17) and control group (n = 16). Stretching exercises were performed on legs during the dialysis for half an hour, three times a week for 8 weeks in intervention group. Data were collected by using the international restless legs syndrome study group scale.ResultsThe results showed that the majority of participants were suffering from moderate restless legs syndrome. The symptom severity of this syndrome meaningfully changed eight weeks after intervention in the intervention group compared to the control group (P < 0.001).ConclusionsThe results highlighted the significance of training and performing the stretching exercises during dialysis for the purpose of improving restless legs syndrome symptoms and the quality of care of hemodialysis patients.

Impact of morphine use in reducing the need for CT scan in patients with cervical spine trauma: a double blinded randomized clinical trial.

BackgroundCervical spine trauma occurs mostly among young males due to falls and car accidents. The CT scan technology is replacing radiography in many medical clinics as it is very capable in detecting subtle cervical spine injuries. However, the use of CT scan for routine screening in patients with cervical spine trauma remains controversial due to its radiation risks and relatively high cost.ObjectiveThe focus of this research was on using morphine in patients with cervical spine trauma. The objective was to determine the ability of morphine to reduce the number of patients in need of CT scans.MethodsThis double-blinded randomized clinical trial study was conducted from April 2014 to March 2015 in Hasheminejad Hospital in Mashhad, Iran. We enrolled 67 patients with cervical spine trauma and normal radiography in the study. They were divided randomly into two groups (groups A and B), where group A received intravenous morphine, and group B received a placebo. We measured the pain scores in both groups before giving the medication and 10 minutes afterwards using a visual analog scale (VAS).ResultsAs a result of receiving morphine, the patients in group A had significantly lower pain than group B (p-value < 0.001). The average pain score in group A was reduced by 43% versus 23% in group B. However, the most pain reduction was in those in group A with a normal CT scan. The pain score of these patients dropped by 52%.ConclusionsThe findings of this study suggest that patients with a normal radiography may be discharged with a cervical collar without a need for a CT scan if morphine reduces their pain. This is because the pain in these patients stem from the muscles and non-bony structures in the cervical spine area. Clinical trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2013100214872N1FundingThe authors received no financial support for the research or for the publication of this article.

Assessing the Frequency and Antibiotic Susceptibility Pattern of Isolated Bacteria from Septicemic Hemodialysis Patients

Introduction: Septicemia is one of the main causes of morbidity and mortality worldwide that increases the hospitalization time and also raises the cost for patients. The current study aimed to evaluate the frequency and antimicrobial susceptibility profiles of blood culture isolates from the hemodialysis patients referred to Hasheminejad Hospital in Tehran, Iran.Methods: In this retrospective cross-sectional study the records of 1090 patients who undergone hemodialysis in Hasheminejad Hospital Urinary Tract and Kidney Center between 2012 and 2013 were evaluated. At least two Blood samples from each patients were collected under sterile conditions and was injected into blood culture bottles. After 1, 3, 5 and 7 days, samples were cultured in sheep blood agar (BA), chocolate agar and eosin methylene blue agar (EMB). Disc diffusion on Muller Hinton Agar (HIMEDIA, India) was performed to define the susceptibility. Spss software version 20 was used to analyze the data.Results: From 1090 patients 186 subjects had positive blood culture from them 121 were male and 65 were female. The most frequent isolated species are as follow respectively: coagulase positive Staphylococcus 68 (37%), Escherichia coli 47 (26%), Pseudomonas aeruginosa 25 (14%), Streptococcus Group D 22 (12%), Coagulase-negative Staphylococcus 13 (7%), Streptococcus group A 4 (2%), Klebsiella 2 (1%), and Bacillus 1 (1%). Gram negative bacteria were mostly sensitive to nitrofurantoin, amikacin, and ciprofloxacin. In addition, gram positive bacteria were mostly sensitive to vancomycin, amikacin, cefotaxime, ciprofloxacin, imidazole, colistin, erythromycin, and oflatoxin.Conclusion: The result of the current study determined the most prevalent bacteria that are responsible for septicemia in Tehran, Iran, and the most effective antimicrobials for treatment of septicemia in this area which could help physicians to select a proper antibiotics for initial antimicrobial therapy.

The Survey of Affecting Factors on Employees' Creativity and Innovation from the perspective of Personnel of the Hashemi nejad Hospital in Tehran: 2011

The Survey of Affecting Factors on Employees' Creativity and Innovation from the perspective of Personnel of the Hashemi nejad Hospital in Tehran: 2011

OP-073 Neutrophil to Lymphocyte Ratio is Increased in Patients with Rheumatic Mitral Valve Disease

Accuracy of Malcoaptation Area in Aortic Regurgitation for Evaluation of Aortic Regurgitation Severity. Fariba Bayat, Erfan Naghshbandi, Niloufar Samiei, Mehdi Nazmdeh, Saeed Nateghi, Amirsaeed Karimi. Cardiovascular Research Center.Shahid Beheshti University of Medical Sciences, Tehran, Iran; Cardiovascular Research Center of Rajaee Hospital, Tehran, Iran; Emergency Deparment of Hasheminejad Hospital, Tehran, Iran. Figure. Subject: The measurement of malcoaptation Surface Area assessed by trans-esophageal echocardiography has been introduced to differentiate severity of Aortic regurgitation(AR), but its value has not been accurately determined. The present study aimed to determine the accuracy of malcoaptation area in Aortic Regurgitation for evaluation of AR severity. Methods: In this cross-sectional study, 88 patients with aortic regurgitation referred to our hospital in 2013 were assessed. These patients were randomly selected from all patients who undergoing transthoracic echocardiography and then were assessed by trans-esophageal echocardiography for further assessment of the status of aortic valve regarding Malcoaptation Surface Area. Results: According to the area under the ROC curve analysis, the accuracy of Malcoaptation Surface Area for detection of severe aortic regurgitation was 97% that in cutoff point of 0.3 yielded a sensitive of 80.0% and a specificity of 100% for discriminating severe aortic regurgitation. The accuracy of Malcoaptation Surface Area for detection of mild aortic regurgitation was 96% so the cutoff point of 0.1 for Malcoaptation Surface Area yielded a sensitive of 89.7% and a specificity of 98.3%. Considering a range of 0.1 to 0.3 for Malcoaptation Surface Area yielded a sensitive of 96.6% and a specificity of 84.7% for discriminating moderate aortic regurgitation. Conclusion: Malcoaptation Surface Area is a reliable index for evaluation of AR severity, with the defined cut off points.

OP-072 Accuracy of Malcoaptation Area in Aortic Regurgitation for Evaluation of Aortic Regurgitation Severity

Accuracy of Malcoaptation Area in Aortic Regurgitation for Evaluation of Aortic Regurgitation Severity. Fariba Bayat, Erfan Naghshbandi, Niloufar Samiei, Mehdi Nazmdeh, Saeed Nateghi, Amirsaeed Karimi. Cardiovascular Research Center.Shahid Beheshti University of Medical Sciences, Tehran, Iran; Cardiovascular Research Center of Rajaee Hospital, Tehran, Iran; Emergency Deparment of Hasheminejad Hospital, Tehran, Iran. Figure. Subject: The measurement of malcoaptation Surface Area assessed by trans-esophageal echocardiography has been introduced to differentiate severity of Aortic regurgitation(AR), but its value has not been accurately determined. The present study aimed to determine the accuracy of malcoaptation area in Aortic Regurgitation for evaluation of AR severity. Methods: In this cross-sectional study, 88 patients with aortic regurgitation referred to our hospital in 2013 were assessed. These patients were randomly selected from all patients who undergoing transthoracic echocardiography and then were assessed by trans-esophageal echocardiography for further assessment of the status of aortic valve regarding Malcoaptation Surface Area. Results: According to the area under the ROC curve analysis, the accuracy of Malcoaptation Surface Area for detection of severe aortic regurgitation was 97% that in cutoff point of 0.3 yielded a sensitive of 80.0% and a specificity of 100% for discriminating severe aortic regurgitation. The accuracy of Malcoaptation Surface Area for detection of mild aortic regurgitation was 96% so the cutoff point of 0.1 for Malcoaptation Surface Area yielded a sensitive of 89.7% and a specificity of 98.3%. Considering a range of 0.1 to 0.3 for Malcoaptation Surface Area yielded a sensitive of 96.6% and a specificity of 84.7% for discriminating moderate aortic regurgitation. Conclusion: Malcoaptation Surface Area is a reliable index for evaluation of AR severity, with the defined cut off points.

Recognition and Ranking Critical Success Factors of Business Intelligence in Hospitals - Case Study: Hasheminejad Hospital

Business Intelligence, not as a tool of a product but as a new approach is propounded in organizations to make tough decisions in business as shortly as possible. Hospital managers often need business intelligence in their fiscal, operational, and clinical reports and indices. The main goal of recognition and ranking CSF is implementation of a business intelligent system in hospitals to increase success factor of application of business intelligence in health and treatment sector. This paper is an application and descriptive-analytical one, in which we use questionnaires to gather data and we used SPSS and LISREL to analyze them. Its statistical society is managers and personnel of Hasheminejad hospital and case studies are selected by Cochran formula. The findings show that all three organizational, process, and technological factors equally affect implementation of business intelligence based on Yeoh & Koronis approach, where the assumptions are based upon it. The proposed model for CSFs of business intelligence in hospitals include: declaring perspective, goals and strategies, development of human and financial resources, clarification of organizational culture, documentation and process mature, management support, etc. Business intelligence implementation is affected by different components. Center of Hasheminejad hospital BI system as a leader in providing quality health care, partially succeeded to take advantage of the benefits the organization in passing the information revolution but the development of this system to achieve intelligent hospital and its certainty is a high priority, thus it can`t be said that the hospital-wide BI system is quite favorable. In this regard, it can be concluded that Hasheminejad hospital requires practical model for business intelligence systems development.

Relationship between spiritual well-being and quality of life in nurses

Background and objectives: spiritual well-being coordinate the dimensions of life together. Quality of life can be influenced by emotional - psychological and occupational factors. This study investigated the relationship between Spiritual Well-being and quality of life in nurses. Methods and Materials: This descriptive analytical research was conducted on 93 nurses at Hashemi Nejad Hospital in Mashhad. SF36 quality of life and SWBS Spiritual Well-being questionnaire were used. The collected data were analyzed in SPSS 15 using Chi-square, independent T Test, Fisher's exact test, pearson correlation coefficient, Stepwise multiple regression and logistic regression. Results: the mean age of under research Persons was 32/52 ± 7/2. Mean score of Quality of life and Spiritual Well-being were 64.38±17.84 and 94.3±16 . Multiple regression analysis showed that the Spiritual Well-being have a significantly association with quality of life. Logistic regression test showed that with 10 points to Spiritual Well-being, the odds ratio (OR) Good quality of life was 1/781. Conclusion: High level of Spiritual Well-being in under research nurses was associated with good quality of life.

Studying preparedness in teaching hospitals affiliated to Iran University of Medical Sciences, 2006

PurposeHospitals are all required to be prepared against crisis, while according to studies, most hospitals are not prepared enough to encounter disaster problems. Therefore, each hospital should have an established programme to face earthquake and other catastrophes. This paper aims to investigate this issue.Design/methodology/approachThis descriptive study was carried out in teaching hospitals of Iran University of Medical Sciences. Data collection was done using a checklist including general information, as well as information on demography, security, supplies and equipment, evacuation and communication. This procedure was done through observation and interview with hospital managers, etc. and the data were analyzed by SPSS software.FindingsIn the hospitals four dimensions of planning were studied and the following mean scores were obtained. On security, Hazrat Rasul hospital scored the highest (88.4) while Navab Safavi, Haftome Tir and Ali Asghar hospitals scored the lowest (51.4). On supplies and equipment, Navab Safavi and Haftome Tir hospitals obtained the highest score (66.6) and Hasheminejad, Shafa Yahyaeian, Firoozgar and Hazrat Rasul hospitals got the lowest score (60.0). On evacuation, Hazrat Rasul and Haftome Tir hospitals scored the highest and lowest respectively (64.2), (47.0). On communication, Hasheminejad hospital scored the highest (63.2) while Firoozgar hospital scored the lowest (36.6). In general from among ten hospitals under study the most and the least prepared hospitals were Hazrat Rasul and Navab Safavi respectively (65.65), (54.3).Originality/valueThe paper shows that most hospitals under study were not prepared enough against crisis and communication is found to be the weakest aspect although it is regarded as a basic principle in planning. Hazrat Rasul hospital was well prepared against crisis due to its disaster plan.