Hospital In North Of Iran Research Articles

Factors Related to Neonatal Mortality at Discharge Among Premature Neonates in a Tertiary Care Hospital in North of Iran

Factors Related to Neonatal Mortality at Discharge Among Premature Neonates in a Tertiary Care Hospital in North of Iran

Comorbidities affecting re-admission and survival in COVID-19: Application of joint frailty model.

One of the common concerns of healthcare systems is the potential for re-admission of COVID-19 patients. In addition to adding costs to the healthcare system, re-admissions also endanger patient safety. Recognizing the factors that influence re-admission, can help provide appropriate and optimal health care. The aim of this study was to assess comorbidities that affect re-admission and survival in COVID-19 patients using a joint frailty model. This historical cohort study was done using data of patients with COVID-19 who were re-hospitalized more than twice in a referral hospital in North of Iran. We used the joint frailty model to investigate prognostic factors of survival and recurrence, simultaneously using R version 3.5.1 (library "frailtypack"). P-values less than 0.05 were considered as statistically significant. A total of 112 patients with mean (SD) age of 63.76 (14.58) years old were recruited into the study. Forty-eight (42.9%) patients died in which 53.83% of them were re-admitted for a second time. Using adjusted joint model, the hazard of re-admission increased with cancer (Hazard ratio (HR) = 1.92) and hyperlipidemia (HR = 1.22). Furthermore, the hazard of death increased with hyperlipidemia (HR = 4.05) followed by age (HR = 1.76) and cancer (HR = 1.64). It Also decreased with lung disease (HR = 0.11), hypothyroidism (HR = 0.32), and hypertension (HR = 0.97). Considering the correlation between re-admission and mortality in the joint frailty model, malignancy and hyperlipidemia increased the risk of both re-admission and mortality. Moreover, lung disease probably due to the use of corticosteroids, was a protective factor against both mortality and re-admission.

Placenta accreta outcomes and risk factors in a referral hospital in north of Iran: A case control study.

Placenta accreta syndrome (PAS) may led to heavy blood loss and maternal death. Here we analyzed the main risk factors of PAS+ pregnancies and its complications in a referral hospital in the north of Iran. In a case control study, all pregnant women with PAS referred to our department during 2016 till 2021 were enrolled and divided in two groups case (PAS+) and control (PAS-) based on preoperative imaging, intraoperative findings, and pathological reports. The sociodemographic features and neonatal-maternal outcomes also were recorded. The most frequent reason for cesarean (C/S) was repeated C/S (62.9%, 56/89). A significant difference showed up in the time lag between previous C/S and the present delivery (p < 0.001) which shows that when the time distance is longer, the risk of PAS rises (OR: 1.01 [95% CI: 1.003-1.017]). Also, a positive history of prior abortion and elective type of previous C/S were related to PAS+ pregnancies. Our other finding showed that PAS+ pregnancies will end in lower gestational age and have a longer duration of operation and hospitalization, heavy blood transfusion, and hysterectomy. Also, PAS+ pregnancies were not related to poor neonatal outcomes. It seems that, in addition to repeated C/S as a strong risk factor, previous abortion is a forgotten key which leads to incomplete evacuation or damage the endometrial-myometrial layers.

The Frequency of Septal Abscess and Underlying Factors in Affected Patients in a Referral Hospital in North of Iran

The Frequency of Septal Abscess and Underlying Factors in Affected Patients in a Referral Hospital in North of Iran

The effect of communication using Peplau's theory on satisfaction with nursing care in hospitalized older adults in cardiac intensive care unit: A quasi-experimental study.

Patient satisfaction helps healthcare organizations to improve their quality level and nurse-patient relationship is effective in increasing satisfaction. The aim of this study was to determine the effect of communication using Peplau's theory on satisfaction with nursing care in hospitalized older adults' patients in cardiac intensive care unit. This quasi-experimental study was conducted by available sampling method on 78 hospitalized older adults (39 interventions, 39 control) in cardiac intensive care unit of Guilan hospitals in north of Iran in 2021. In the intervention group, Peplau's communication theory (four stages of orientation, identification, exploitation, and resolution) was implemented and the control group received routine care. At the time of discharge, patient satisfaction questionnaire of quality of nursing care was completed for both groups. Data were analyzed through descriptive and inferential statistics (independent t test, Chi-square test). The mean score of nursing satisfaction in the intervention group (5.4 ± 93.0) was significantly higher than the control group (6.8 ± 75.7) (t (64) = 11.54, P < 0.001, d = 2.84). In other words, the mean satisfaction scores of nursing care in the intervention group were 17.4 units (95% confidence interval: 14.4-20.4) more than the control group. Using Peplau's communication theory in the care of hospitalized older adults in cardiac intensive care unit can lead to improvement of satisfaction, so it is suggested to use this communication method in the care of these patients to improve the level of satisfaction, quality of care, and functional independence.

Genetic Cassettes Profiling of Class I Integron and Antimicrobial Susceptibility Profiles Among Pseudomonas aeruginosa Isolates Collected from Patients in North of Iran

Background: Pseudomonas aeruginosa is an opportunistic nosocomial bacterium, especially in infection wards and among patients with burns. The present study addressed the molecular investigation of the gene cassettes of Class I integrin (intI) and its relationship with multiple drug resistance in clinical samples of P. aeruginosa isolated from Babol hospitals in north of Iran. Objectives: This study aimed to detect the frequency of intI and gene cassettes in the clinical isolates of P. aeruginosa. Methods: In this study, from 75 clinical samples, 30 strains were identified using specific biochemical methods. After determining antibiotic susceptibility using disk diffusion and agar dilution, the frequency of the intI gene and its gene cassettes were determined using the polymerase chain reaction (PCR) method. Results: The highest resistance rate was observed for cefotaxime, ampicillin, and nitrofurantoin using disk diffusion and agar dilution methods. The molecular analyses revealed that 60% of the isolates had the intI genes. The frequency of the aadB, dfrA1, and bla-OXA30 genes were 61, 66, and 33%, respectively. Conclusions: The high resistance of Pseudomonas isolates is due to the presence of intI and its gene cassettes. Considering their high resistance to cefotaxime, gentamicin, ampicillin, and imipenem in hospitals, selecting appropriate drugs or generally changing the treatment course for patients is possible to prevent the spread of resistance inducing genes and the development of nosocomial infections.

The Effect of Orange Blossom Aromatherapy on the Physiological Parameters and Anxiety of Patients undergoing angiography

Background: Invasive diagnostic tests such as angiography cause stress and anxiety in patient and most of them experience relatively high levels of anxiety. Objectives: The aim of this study was to evaluate the effect of aromatherapy on anxety and physiologic parameters of patients undergoing angiography. Materials and Methods: This clinical trial was performed in the angiography department of Heshmat hospital in north of Iran. Eighty patients with anxiety score of above 43 were randomly assigned into two groups of aromatherapy and placebo groups. Fifteen minutes Before and then angiography, the physiologic parameter and anxiety of the patients were measured, and the intervention group sniffed three drops of essential oil of orange blossom for three minutes. Results: In the intervention group, there was no significant difference between the mean score of the manifest and hidden anxiety and the physiological indices before and after the intervention. The adjusted post-intervention values showed that systolic and diastolic blood pressure in the control group were significantly lower than intervention group (P&lt;0.001). The mean reduction of systolic blood pressure in the intervention and control group was 3% and 13%, respectively. The mean diastolic blood pressure reduction was 2% vs 7% in the intervention and control group, respectively. Conclusion: This study revealed no significant effect of aromatherapy on anxiety of the patients undergoing angiography. Among physiologic parameter, systolic and diastolic blood pressure significantly reduced after intervention.

Extended-spectrum beta-lactamases detection and prevalence of blaTEM gene in clinical isolates of Klebsiella pneumoniae from hospitals in North of Iran

Klebsiella pneumoniae is a member of the Enterobacteriaceae family which plays an important role in creating various infections in the community. These strains are resistant to multiple β-lactam antibiotics due to the production of β-lactamases enzyme (ESBL). The purpose of this study was to assess the phenotypic and genotypic characteristics of ESBL-producing K. pneumoniae strains from clinical specimens in three hospitals in Mazandaran, Iran. In this cross-sectional study, K. pneumoniae samples (N = 100) were identified from different clinical specimens after standard biochemical and microbiological tests. Disc agar diffusion test was applied for antibiotic-resistant examinations. Phenotypic detection of ESBL-producing isolates was performed using mixed disk method. The presence of blaTEM gene was investigated in ESBL-producing isolates using PCR method. The ESBL test analysis was positive for 40 isolates (40%) of K. pneumoniae. The prevalence of blaTEM gene in ESBL-producing K. pneumoniae isolates was 55%. Tetracycline, tobramycin, and ampicillin were the most active antibiotics against K. pneumoniae isolates, showing 85%, 81% and 73% sensitivity, respectively. The highest antibiotic resistance in isolated K. pneumoniae was found for ceftriaxone (48%) and cefotaxime (46%) antibiotics. There was a significant correlation between ESBL production and K. pneumoniae isolates resistance to cefotaxime (p = 0.000), ceftazidime (p = 0.001), ciprofloxacin (p = 0.001), tobramycin (p = 0.044), and ceftriaxone (p = 0.000). The prevalence of ESBL-producing K. pneumoniae was high and increasing. The high prevalence of blaTEM gene in these isolates may be a reason for their pathogenesis and multiple-antibiotic resistance. Therefore, there is a need to develop the strategies to manage antibiotic resistance in these isolates.

Septorhinoplasty with and without Nasal Packing:A Comparative Study from North of Iran

Septorhinoplasty are the most common nose surgical procedures widely used the world over. The main aim of this study was comparing the results of septorhinoplasty with and without nasal packing. This case control interventional study was conducted on patients who underwent septorhinoplasty in an ENT university hospital in north of Iran. Two separate groups, with or without nasal tampon (each group consisted of 35 patients) were includedin the study. Open surgical approach for repairment was executed for all and nasal packing (ie. tetracycline impregnated mesh, that was removed after 48 hours) for 35 patients inserted postoperatively.Patients were studied in three time periodsfor pain (using Visual Analogue Scale) and other postoperative signs and symptoms and convenience and overall satisfaction. No significant difference for postoperative bleeding, ecchymosis, hematoma and rhinorrhea was founded between the groups (pE�?0.05), but there was a significant difference in short-term outcomes in terms of convenience (p=0.006), edema two days after surgery (p= 0.001), right side and left side edema (p=0.002). The overall satisfaction was significantly higher in patients without nasal packing (p= 0.002). In assessment of the pain rate one week after surgery, there was no significant difference in various age and sex groups (pE�?0.05). Based on our 8indings routine nasal packing is not working well in septo-rhinoplasty cases and it is recommended to be avoided in these patients.

Eco-capability role in healthcare facility’s performance

PurposeWith the exponential growth of problems linked to the natural environment, healthcare facilities are increasingly faced with ecological challenges in their operations. In this regard, they progressively need to improve their environmental performance like other industries in recent years. Applying the natural-resource-based view (NRBV) and dynamic capabilities literature, the purpose of this paper is to investigate this eco-capability which fully leverages human, relationship, and technology resources.Design/methodology/approachApplying the NRBV and dynamic capabilities literature, this paper investigates this eco-capability which fully leverages human, relationship, and technology resources. Using survey data from staffs across 15 hospitals in north of Iran, researchers estimated a latent moderated structural model that provides support for these three resource components.FindingsResults obtained from structural equation analysis revealed that human, technology, and relationship resources have positive impact on eco-capability. Also eco-capability has positive impact on market and financial performance and the perceived quality of the hospital’s offering.Research limitations/implicationsAs the model consist just of three kinds of resources, future studies could include examining the effect of additional resources and other internal and external factors on eco-capability.Practical implicationsThis paper includes suggestions for facility’s managers to develop environmental strategy in three areas: human, technology, and relationship resources.Originality/valueThe role of eco-resources has been used only rarely to investigate organization capability and performance. This paper includes suggestions for facility’s managers to develop environmental strategy in three areas: human, technology, and relationship resources.

Prophylactic antibiotics prescription in ear, nose, throat and ophthalmologic procedures; an Iranian university hospital situational analysis

Introduction:Different prophylactic methods are introduced to prevent surgical site Infection. This study was conducted to evaluatesituation of prophylactic antibiotics (PA) usage in an Iranian university hospital.Aims:A cross sectional study.Methods:This study obtained data from 1010 patients’ medical files in 2015. These patients were admitted to a university otolaryngology (ENT) and ophthalmology hospital in north of Iran. Data from ordered prophylactic antibiotics considering induction time, type of antibiotic, duration of use, dosage amount and intervals was obtained to compare with international and national guidelines. Data analysis was performed by using Chi-square test at significance level of 95%.Results:402 (39.8%) patients were male and 608 (60.2%) ones were female. Mean age and standard deviation was 41.8±22.3 years old, and most participants were in 20-39 years of age. Ophthalmic and ENT related procedure was respectively conducted for 41.7% and 58.3% of patients. Septorhinoplasty and phacoemulsification were the commonest procedures. Totally 999 (98.9%) people received prophylactic antibiotics. Intravenous Cefazolin (for ENT procedures) and topical eye drop of Chloramphenicol 0.5% were prescribed mostly. We found poor accommodation between antibiotic use and guidelines for prophylaxis, mostly in case of duration of apply.Conclusion:Ordered prophylactic antibiotics is not as need as prescribed. Also, accommodation between prescription of antibiotics and available scientific guidelines was improper in this study.

Emergence of Extensively Drug Resistant Acinetobacter baumannii-Encoding Integrons and Extended-Spectrum Beta-Lactamase Genes Isolated from Ventilator-Associated Pneumonia Patients

Background: Acinetobacter baumannii has increasingly become one of the most common pathogens causing ventilator-associated pneumonia (VAP). Objectives: In the present study, we aimed to assess the presence of extended-spectrum beta-lactamase (ESBL) and integron genes in A. baumannii isolates from VAP patients in the intensive care units (ICUs) of 18 hospitals in North of Iran. Methods: All patients, who were ventilated for at least 48 hours, were assessed daily for VAP. The minimum inhibitory concentrations were determined according to the standard protocol by the clinical and laboratory standards institute (CLSI). ESBL-producing A. baumannii was detected, using the double-disk synergy test. ESBL-positive A. baumannii isolates were screened for CTX, VEB, GES, SHV, int1, and int2 genes, using polymerase chain reaction (PCR) amplification. Results: In total, 29 out of 205 patients with nosocomial infections, admitted to ICUs during 2014 - 2015, showed VAP caused by ESBL-producing A. baumannii. A total of 19 (65.51%) strains were extensively drug resistant (XDR). As the findings revealed, the rates of imipenem and colistin resistance were 55.2% and 34.5%, respectively. The prevalence of CTX, VEB, and SHV genes in ESBL-producing A. baumannii was 34.5%, 17.2%, and 96.6%, respectively. Also, 79.3% of the isolates had class 1 integrons, while 10.3% contained class 2 integrons. Conclusions: Presence of integrons in A. baumannii has been considerably associated with ESBL genes. The high rate of SHV and int1 genes highlights the necessity of avoiding aminoglycosides for empirical therapy. Although colistin was the most sensitive antibiotic in XDR strains in our region, due to the presence of patients with A. baumannii in ICUs, colistin resistance screening should be performed before empirical therapy for VAP, even for those without prior exposure to this antibiotic.

Sex Disparities in Elderly Trauma in Northern Iran

Introduction: Trauma is currently the ninth cause of mortality in the elderly. Several factors may have an impact on the outcomes after trauma in the elderly including background disease, sex, trauma severity, and age. The aim of this study was to understand the sex differences about trauma in this growing population. Methods: In a cross-sectional study, the records of all the traumatic injured people above 60 years of age who were admitted to a main center of trauma hospital in north of Iran in 2012 were studied. Demographic data, characteristics of road traffic incidents, and in-hospital medical profiles were derived. The analysis of data was done by using theχ 2 test and T test with SPSS Ver. 18 software. A P value of < 0.05 was considered statistically significant. Results: One thousand and eight-hundred thirty injured elderly patients were admitted during the study period. This amount accounted for 10.5% of the total injured. In this study 56.3% of victims were male with the mean age of 70.84±8.16 years in comparison to 71.65±8.59 years in women (P < 0.05). Sex differences were seen in Glasgow coma scale, place, mechanism of trauma, anatomical part injured, and in-hospital death rate (P < 0.05). Outdoor trauma was more prevalent in men and indoor trauma in women. The mechanisms causing trauma in both sexes were slipping and road traffic accidents, respectively. In men, head and neck were the most common anatomical sites injured, while most women suffered from injuries to the upper extremities. Conclusions: It seems that elderly men are more at risk of severe injury with a higher mortality rate in comparison to elderly women

Effect of Selenium on Ischemia-Reperfusion Injury in the Coronary Artery Bypass Graft Surgery: A Clinical Trial Study

Background: In patients with coronary artery stenosis, coronary artery bypass graft surgery (CABG) is the most effective strategy to limit infarct size and improving outcomes. However, the rapid restoring of blood flow to the tissue can paradoxically induce cardiac damage. This phenomenon termed as myocardial ischemic/reperfusion (I/R) injury which is exacerbated under cardiopulmonary bypass (CPB) and is the cause of poor clinical outcomes. Therefore, it is essential to search for novel strategies with further cardio protective effects. Objectives: In the current study, we investigated the effects of selenium (Se) administration on I/R injury in CABG patients. Methods: This randomized double-blind clinical trial was conducted in the department of cardiac surgery of a university hospital in North of Iran from May 2015 to September 2015. One hundred and ten patients undergoing an elective isolated CABG surgery were divided into two groups using randomized fixed quadripartite blocks. They received either intravenous Se before induction of anesthesia, or normal saline as placebo. Cardiac troponin I (CTnI) and creatine kinase-MB (CKMB) were measured as biomarkers at four measurement point times, before the intervention (T0), at 6, 12, 24 and 48 hours after the surgery (T1-T4). Results: Finally, data from 104 patients were analyzed, the Se (n = 53) and control (n = 51) groups. There was no significant difference between the two groups regarding the baseline characteristics. In both groups CPB caused a markedly increase in CKMB and CTnI plasma concentrations compared to the baseline (P = 0.0001). Based on CKMB, there was no significant difference between the two groups at any point times, T0 (P = 0.357), T1 (P = 0.751), T2 (P = 0.46), T3 (P = 0.16) and T4 (P = 0.053). According to CTnI, there was just a significant difference between the two groups at T1 (P = 0.011) but not at T2 (P = 0.116), T3 (P = 0.09) and T4 (P = 0.634). No adverse effect was recorded linked to our intervention. Conclusions: Selenium can alleviate I/R injury in short time. Further well-planned trials are needed to find the optimized administration method to achieve the most beneficial effects to the patients.

Factors Associated with the Length of First Time Hospitalization in a Referral Psychiatric Hospital in North of Iran

Factors Associated with the Length of First Time Hospitalization in a Referral Psychiatric Hospital in North of Iran

Evaluation of prophylactic antibiotic administration in general surgery division of a teaching hospital in north of Iran

Evaluation of prophylactic antibiotic administration in general surgery division of a teaching hospital in north of Iran

Comparing the Mental Health and Hope between Radiotherapy and Chemotherapy Patients

Mental health and hope are of great importance in cancerous patients’ compatibility and their improvement process and nurses, family members and related persons to the patients are required to get acquainted to these variables and the relationship among them. For this reason, this study is conducted to compare the mental health and hope between radiotherapy and chemotherapy patients (Man and woman). This study is descriptive with causal-comparative design. The sample included (100) cancerous patients (50 radiotherapy and 50 chemotherapy) who referred to Shahid Rajaee Hospital in Babolsar (the only specialized hospital in north of Iran) in (2012), and were selected by the random sampling method. Data are gathered by use of two questionnaires of Schneider Hope and mental health (6HQ-28). Data were analysed by use of descriptive statistic t-test with (0.05%) level of significant. The results indicated that there is no meaningful relationship between mental health and hope in radiotherapy patients, but in chemotherapy patients mental health and hope in men were more than women and chemotherapy women are more vulnerable in mental health and hope so they require more supports; therefore, the nurses and other related persons are advised to insist more on multilateral supports which have a great impact on augmenting the level of mental health and hope and consequently improving treatment process of patients. Besides, hospitals could initiate apalliative care centre by the presence of the psychologists for consultation and conducting training courses for patients.

Preparedness of Hospitals in North of Iran to Deal With Disasters

IntroductionPreparedness of hospital has a major impact on their optimal and satisfactory performance. This study aimed to investigate the preparedness of the hospitals to deal with disasters.Case PresentationThis cross-sectional study was carried in 2011 and all of the hospitals which were located in the northern areas of Iran were investigated through the census method. The data collection instruments were self-administered Managers’ Awareness Questionnaire (40 items) and a 141-item checklist. The mean percentage score of hospitals in management of the unanticipated disasters program in the hospital was good. The mean score of managers’ awareness of the hospital status was moderate. With the increase in managers’ awareness, the preparedness of the hospitals significantly increased (r = 0.73, P < 0.001).ConclusionsThe findings showed the moderate preparedness of the hospitals in the Northern provinces to deal with disasters.

Health Care Violence and Abuse towards Nurses in Hospitals in North of Iran

Aim:In the current survey, we explored the prevalence of verbal and physical abuse against the nurses in different hospitals of north of Iran.Methods:We performed a cross-sectional survey. Nurses were interviewed using a standardized questionnaire (Staff Observation Scale Revised (SOAS-R)). The sample covered 400 participants from 5 hospitals of Mazandaran University of medical sciences, Sari, Iran.Results:The sampling size involved 271 participants (271 forms from 400 forms (sampling population) were filled completely) including 193 female (71.2%) and 78 male (28.8%) participants. 79 (29.1%) participants experienced physical abuse and 260 (95.9%) participants were abused verbally. It was noted that in 35 cases (44.3%) the patients were the source of physical abuse and in 44 cases (55.6%) the members of patients’ family were the source. In 79 (30.3%) cases the patients were the source of verbal violence and in 139 (53.4%) cases the members of patients’ family were the source and in 42 (16.1%) cases coworkers were the sources.Conclusion:Verbal abuse was a common type of violence in our study in north of Iran. There is a requirement to increase awareness about this significant problem among health care workers.