Iran University of Medical science

Sari, Iran

Iran University of Medical science

Sari, Iran
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Gholamhosseini L.,Iran University of Medical science | Gholamhosseini L.,Aja University of Medical science | Ayatollahi H.,Iran University of Medical science
Health Information Management Journal | Year: 2017

Background: To date, several models have been developed to evaluate e-health readiness in healthcare organisations; however, no specific tool has been designed to assess or measure e-health readiness. Objective: The aim of this research was to design an e-health readiness assessment tool and to apply this tool to two Iranian hospitals to assess their readiness for the implementation of e-health. Method: The study, which was undertaken in 2012, consisted of three phases: (i) review of existing models of e-health; (ii) design of an e-health readiness assessment tool; and (iii) trial of the assessment tool in two Iranian hospitals. Phase 1 consisted of a literature review that informed the development of the tool. In phase 2, we developed an e-health readiness assessment tool with feedback using two questionnaires from 40 employees from two teaching hospitals in Iran. In phase 3, we applied the tool to the same two Iranian teaching hospitals. Participants who completed the questionnaires were from management, health information technology, medical and nursing backgrounds and were familiar with e-health. A purposive sampling method was used to invite them to take part in the study. Data from the questionnaires were analysed using factor analysis and descriptive statistics. Results: Five dimensions and twenty-one indices were selected to be included in the e-health readiness tool. The 5 dimensions and their relative importance were e-health readiness (16%), information and communication technology (ICT) functions (15%), environmental readiness (20%), human resources readiness (29%) and ICT readiness (20%). The total e-health readiness scores for hospital A and hospital B were 0.22 and 0.4, respectively (a score of 1 is the ideal). Conclusion: It is important to assess the e-health readiness of hospitals to save time and money and be able to better prepare for ICT implementations. The e-health readiness assessment tool provides a relatively simple method for assessing hospitals and provides essential information to assist healthcare facilities focus preparations and planning for e-health implementations. © The Author(s) 2016.

AbdollahiFakhim S.,Tabriz University of Medical Sciences | Bayazian G.,Iran University of Medical science | Notash R.,Tabriz University of Medical Sciences
Egyptian Journal of Ear, Nose, Throat and Allied Sciences | Year: 2014

Cleft palate lateral synechia syndrome (CPLS) is a very rare syndrome characterized by a cleft palate, adhesions in the mouth roof, some parts of the tongue or the mouth floor. This is a report of a 12-week-old female infant presented for evaluation of cleft palate, with lateral synechia that caused the inability to fully open the mouth. Release of the synechia was performed without complications. Although some researchers believe CPLS is inherited in an autosomal recessive pattern, our case indicated that a new mutation may cause this situation. Further research is recommended to clearly determine its inheredited and phenotypic variablities. © 2014 .

Naghdi S.,Tehran University of Medical Sciences | Ansari N.N.,Tehran University of Medical Sciences | Mansouri K.,Iran University of Medical science | Hasson S.,Angelo State University
Brain Injury | Year: 2010

Primary objective: To determine the extent to which the Brunnstrom recovery stages of upper limb in hemiparetic stroke patients are correlated to neurophysiological measures and the spasticity measure of Modified Modified Ashworth Scale (MMAS). Research design: A concurrent criterion-related validity study. Interventions: Not applicable. Methods and procedures: Thirty patients (15 men and 15 women; mean ± SD 58.8 ± 11.5 years) with upper limb spasticity after stroke were recruited. Wrist flexor spasticity was rated using the MMAS. The neurophysiological measures were Hslp/Mslp ratio, Hmax/Mmax ratio and Hslp. Main outcomes and results: There was a significant moderate correlation between the Brunnstrom recovery stages and the neurophysiological measures. The Brunnstrom recovery stages were highly correlated to the MMAS scores (r -0.81, p < 0.0001). Conclusions: The Brunnstrom recovery stages are moderately correlated with neurophysiological measures and highly correlated with the MMAS regarding the evaluation of motor recovery in stroke patients. The Brunnstrom recovery stages can be used as a valid test for the assessment of patients with post-stroke hemiplegia. © 2010 Informa UK Ltd. All rights reserved.

Barati M.,Iran University of Medical Science | Bashar F.R.,Tehran University of Medical Sciences | Shahrami R.,Tehran University of Medical Sciences | Zadeh M.H.J.,Tehran University of Medical Sciences | And 2 more authors.
Journal of Critical Care | Year: 2010

Purpose: Early diagnosis and assessment of the systemic inflammatory response to infection are difficult with usual markers (fever, leukocytosis, C-reactive protein [CRP]). Triggering receptor expressed on myeloid cells-1 (TREM-1) expression on phagocytes is up-regulated by microbial products. We studied the ability of soluble TREM-1 (sTREM-1) to identify patients with sepsis. Materials and Methods: Plasma samples were obtained on intensive care unit admission from patients with systemic inflammatory response syndrome for sTREM-1 measurement. Results: Soluble TREM-1, CRP concentrations and erythrocyte sedimentation rate (ESR) were higher in the sepsis group (n = 52) than in the non-infectious systemic inflammatory response syndrome group (n = 43; P = .00, .02, and .001, respectively). Soluble TREM-1, CRP concentrations, white blood cell count and ESR were higher in the sepsis group than in the non SIRS group (n = 37; P = .04, .00, .01, and .00, respectively).In a receiver-operating characteristic curve analysis, ESR, CRP and sTREM-1 had an area under the curve larger than 0.65 (P = .00), in distinguishing between septic and non-infectious SIRS patients. CRP, ESR, sTREM-1 had a sensitivity of 60%, 70% and 70% and a specificity of 60%, 69% and, 60% respectively in diagnosing infection in SIRS. Conclusion: C-reactive protein and ESR performed better than sTREM-1 and white blood cell count in diagnosing infection. © 2010.

Khezri M.B.,Qazvin University of Medical Sciences | Ghasemi J.,Qazvin University of Medical Sciences | Mohammadi N.,Iran University of Medical science
Acta Anaesthesiologica Taiwanica | Year: 2013

Objective Nowadays, conventional analgesic agents, which are widely used for pain relief after cesarean section, provide suboptimal analgesia with occasional serious side effects. We designed a randomized, double-blind, placebo-controlled study to evaluate the analgesic efficacy of intrathecal ketamine added to bupivacaine after cesarean section. Methods Sixty patients scheduled for cesarean section under spinal anesthesia were randomly allocated to one of the two groups to receive either bupivacaine 10 mg combined with 0.1 mg/kg ketamine, or bupivacaine 10 mg combined with 0.5 mL distilled water intrathecally. The time to the first analgesic request, analgesic requirement in the first 24 hours after surgery, onset times of sensory and motor blockades, the durations of sensory and motor blockades, and the incidences of adverse effects such as hypotension, ephedrine requirement, bradycardia, and hypoxemia, were recorded. Results Patients who received ketamine had a significantly prolonged duration of anesthesia compared with those who did not in the control group [95% confidence intervals (CI) 195-217; p = 0.001]. The mean time to the first analgesic request was also significantly longer in ketamine group (95% CI 252.5-275; p < 0.001). The total analgesic consumption in the 24 hours following surgery significantly lessened in the ketamine group compared with that of the control group (95% CI 2-2.5; p < 0.001). The two groups did not differ significantly in intraoperative and postoperative side effects. Conclusion Intrathecal ketamine 0.1 mg/kg co-administered with spinal bupivacaine elongated the time to the first analgesic request and lessened the total analgesic consumption in the first 24 postoperative hours in comparison with bupivacaine alone in the control group following elective cesarean delivery. Copyright © 2013, Taiwan Society of Anesthesiologists. Published by Elsevier Taiwan LLC. All rights reserved.

Ghazaei F.,Iran University of Medical science
American Journal of Physical Medicine and Rehabilitation | Year: 2016

ABSTRACT: Vasculitis is a group of disorders characterized by inflammation and destruction of blood vessels, resulting in ischemic injury to the involved tissue. Sometimes, peripheral neuropathy is one of the first symptoms of systemic vasculitis. Although the classic form of peripheral nervous system vasculitis is mononeuritis multiplex, it can also present as a mononeuritis. In this case report, the patient presented with progressive rapid onset numbness in her right hand for 2 months. She underwent carpal tunnel decompression surgery with initial diagnosis of acute carpal tunnel syndrome but failed to respond to the surgery, and two month later, she presented with foot drop. The final diagnosis was vasculitic mononeuritis multiplex. The present case report demonstrates the importance of identification of median mononeuritis as one of the first presentations of vasculitic disorders and distinction from acute carpal tunnel syndrome. The natural history of many of the systemic vasculitides is rapidly progressive, and they are likely to be fatal without early treatment. In this regard, timely diagnosis of vasculitis is critical because of the vital role of early immunosuppressive therapy in preventing multiorgan damage and decreasing mortality rate. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Falavarjani K.G.,Iran University of Medical science | Modarres M.,Iran University of Medical science
Iranian Journal of Ophthalmology | Year: 2010

Purpose: To review the effectiveness and safety of perioperative injection of bevacizumab in vitrectomy for proliferative diabetic retinopathy (PDR) Methods: A literature search of all English articles from the Medline and Scopus databases was performed. Original articles, case reports and letters were included. Results: Nineteen, 3 and 5 studies reported preoperative, intraoperative and postoperative intravitreal injection of bevacizumab, respectively. There are good evidences that preoperative injection of bevacizumab induces the regression of new vessels, facilitates the surgery and may reduce the incidence of postoperative vitreous hemorrhage in selected eyes. Also, it may decrease the vitreous clear up time for postoperative vitreous hemorrhage. However, the risk of development or progression of tractional retinal detachment (TRD) should be considered. Postoperative complications like the neovascular glaucoma and nonclearing vitreous hemorrhage may be properly managed by intraocular bevacizumab injection. Conclusion: Preoperative intravitreal bevacizumab (IVB) seems to be effective and relatively safe for surgical facility with variable effects on postoperative hemorrhage. Postoperative intravitreal injection may be effective for the treatment of postoperative complications. © 2010 by the Iranian Society of Ophthalmology.

Sheikhtaheri A.,Iran University of Medical science | Farzandipour M.,Kashan University of Medical Sciences
AJOB Primary Research | Year: 2010

Informed consent is regarded as a pillar of medical ethics. The purpose of this study was to evaluate perceptions of the informed consent process prior to surgery. Three hundred elective surgery patients were randomly selected from three teaching hospitals in Kashan, Iran, and asked to complete a questionnaire about four key aspects of the informed consent process: information disclosure, voluntariness, comprehension, and their relationship with physicians. Data were scored and analyzed using univariate and multivariate methods. Based on the responses, the perceived quality of information disclosure (7.96 ± 4.9 out of 18 points), comprehension of the consent form (0.55 ± 1.1 out of 4 points), and voluntariness (1.73 ± 2.1 out of 8 points) were considered to be unacceptable and the perceived quality of the physician-patient relationships (10.6 ± 4.1 out of 14 points) acceptable. Most of the participants (88.7%) reported that they had requested to be informed about the complications of the surgical procedures, including severe complications such as death, but most of them did not receive this information. The most important factors associated with the perceived quality of informed consent were the patient's level of education and type of surgery. In conclusion, practices consistent with the principles of informed consent have not been adequately implemented in the surgical departments of these hospitals in Kashan. To improve current practices, patients should receive more information about the risks and benefits of surgery as well as any available alternatives. Information about the expected length of hospital stay, post-discharge follow-up, and the cost of surgery should also be provided to patients. To improve the perceived quality of the informed consent process, more emphasis should be placed on ensuring that patients receive the requested information in amanner they can comprehend. Redesigning consent forms may be an important step in improving the patients' experience of the informed consent process. © Taylor & Francis Group, LLC.

Dadkhah F.,Iran University of Medical science | Kashanian M.,Iran University of Medical science | Eliasi G.,Iran University of Medical science
Early Human Development | Year: 2010

Objective: To evaluate the pregnancy outcome in pregnancies with threatened abortion (miscarriage). Material and method: A prospective cohort study was performed on 1000 pregnant women.500 women (case group), had a history of vaginal bleeding during the first half of pregnancy and the other 500 women (control group), did not have this history.Both groups of women were monitored from 20. weeks of pregnancy up to delivery. Results: The women of the 2 groups did not have any significant differences according to age, parity or body mass index (BMI).Spontaneous preterm delivery [126 cases (25.2%) vs. 47 cases (9.4%), P=0.001, adj RR=1.4, CI 95%=1.2-1.5], PROM [51 cases (10.2%) vs. 24 cases (4.8%), P=0.02, adj RR=2.1, CI95%=1.2-2.3], placental abruption [20 cases (4%) vs. 7 cases (1.4%) P=0.01, adj RR=1.1, CI 95%=1.01-1.2], were more in the case group.There were no differences between the 2 groups with regard to Preeclampsia, small for gestational age (SGA), and cesarean deliveries.Neonatal weight (in term pregnancies) in the case group was lower than in the control group (3046.4±560.8g vs. 3317.6±432g, P=0.001).There was a significant relationship between the number of bleeding episodes, spontaneous preterm delivery and placental abruption and there was also a significant relationship between the amount of bleeding and placental abruption. Conclusion: Threatened abortion increases the rate of spontaneous preterm delivery, PROM and placental abruption, and decreases the neonatal weight.Therefore threatened abortion indicates a high risk pregnancy and, as such, demands more serious prenatal care. © 2010 Elsevier Ltd.

Fallah S.,Iran University of Medical science | Valinejad Sani F.,Iran University of Medical science | Firoozrai M.,Iran University of Medical science
Contraception | Year: 2011

Background: Experimental evidences suggest that metabolic activation and conversion of oral contraceptive pills (OCPs) to reactive species are responsible for their genotoxicity. The present study was undertaken to investigate the effects of low-dose (LD) OCPs on the activities of erythrocyte antioxidant enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD) in OCP consumers. Study Design: Enzyme activities were assayed spectrophotometrically in 50 healthy women with normal menstrual cycles who served as the control group and 50 women taking LD OCPs. Results: The pooled data obtained for erythrocyte GPX activity in OCP consumers (50.05±14.9 U/g of Hb) was significantly higher (+15.4%, p=.015) than in the control group (42.33±16.31 U/g of Hb), but the same comparison for SOD activity between the control group (83.46±23.97 U/g of Hb) and women receiving OCPs (81.83±23.97 U/g of Hb) showed an insignificant (-2%, p=.699) decrease. The duration of intake of OCPs beyond 36 months had an effect on the magnitude of the increase (+16.2%) and the decrease (-11%) in GPx and SOD activities, respectively. There was a significant and considerable (not significant) correlation between the activities of GPx (p=.039) and SOD (p=.102) with the duration of OCP consumption, respectively. Conclusion: These findings suggested that OCPs may stimulate or reduce the activities of GPx and SOD enzymes, respectively. This may be due to an effect of these pills on bone marrow erythroblast maturation via stimulation or inhibition of the synthesis of new active GPx and SOD molecules or may be a result of the increased frequency of an allele of the GPx and SOD enzymes. It is suggested that these alterations in GPx and SOD activities may be related to their probable protective effects in response to various pathological and physiological properties of OCPs. It seems that probably free radicals produced during metabolism of OCPs provoke the activity of antioxidant enzymes. © 2011 Elsevier Inc.

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