Hibernation of the Conduction System and Atrioventricular Block Reversibility Following Revascularization in Patients without Acute Coronary Syndrome.

Although myocardial infarction (MI) is a reversible cause of atrioventricular (AV) block, the association of ischemia other than MI with AV block is unclear. The purpose of this study is to investigate this relationship. Among patients nominated for pacemaker implantation due to AV block in two centers from 2017-2020, 120 patients with significant coronary artery disease (CAD) in angiography were included in the study. Patients were divided into two equal groups based on their CAD treatment approach: drug therapy and revascularization. Coronary lesions were divided into three types based on location: left anterior descending artery (type 1), dominant coronary with AV node branch (type 2), and a combination of both (type 3). After coronary disease treatment, all patients were followed up with for 14 months, and AV block reversibility was assessed. There were 7 cases of block reversibility in the revascularization group (11.7%) and 1 case in the medical group (1.7%), which differed significantly (P = .02). A history of acute coronary syndrome, smoking, opium use, chronic kidney disease, hypertension, age, sex, and chronic obstructive pulmonary disease were not significantly associated with reversible block. Also, the type of coronary obstruction had no significant relationship with block reversibility (P = .3, .5, and .8 for type 1, type 2, and type 3, respectively). Hibernation due to ischemia can be a reversible cause of an AV blockage. Therefore, it is recommended that significant coronary artery lesions be revascularized before pacemaker implantation.

The Effect of Maternal-Foetal Attachment-Based Training Programme on Maternal Mental Health Following an Unintended Pregnancy.

INTRODUCTION: Unintended pregnancy is a risk factor for less maternal-fetal attachment (MFA) and low levels of psychological well-being. This study was conducted to determine the effect of an MFA-based training programme on maternal anxiety, depression and worries following an unintended pregnancy. METHODS: This randomised clinical trial was conducted on 68 women with an unintended pregnancy in north of  Iran during 2018-2019. Participants were allocated to the trained and control groups through simple randomisation. The trained group received the MFA-based training for three 90-min sessions. Demographic questionnaire, London measure of unplanned pregnancy, Cranley's MFA scale, Edinburgh postnatal depression, Spielberger anxiety and prenatal distress questionnaires were used. Data were analysed by descriptive statistics, chi square, Fisher's exact test, independent and paired-samples t-tests, Mann-Whitney U, analysis of covariance, and multivariate analysis of variance. RESULTS: After the intervention, the mean MFA, anxiety and depression scores were not significantly different between the trained and control groups Worry was significantly decreased in the trained group (p = 0.001) and increased in the control group (p = 0.03). DISCUSSION: Although the MFA-based training could not significantly improve MFA, maternal anxiety and depression, it has been effective on worry in women with the unintended pregnancies.

Awareness and Observance of Patient Rights from the Perspective of Iranian Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: Recipients of healthcare services have rights, which must be acknowledged and protected. Such rights include observance of acceptable patient physical, mental, spiritual, and social needs guided by commonly accepted rules and regulations. The objective of this study was to conduct a systematic review and meta-analysis of awareness rates and observance of patient rights in Iran from the perspective of the patient. METHODS: In this study, various references such as Medline (PubMed), Scopus, Scientific Information Database (SID), Google scholar, Magiran, and IranMedex were searched (from August to December 2015). Heterogeneity was assessed using the Q statistic. English and Persian search keywords and combinations included terms such as "patient bill of rights, patient rights, Iranian patient bill of rights, and Persian patient rights." A meta-analysis of the primary search sources was accomplished using STATA (version 11.0). RESULTS: Initial review included 20 articles of which 12 assessed observance rates of patient rights and three described service awareness rates of recipients concerning their personal rights. Five articles covered both topics and had an estimated 54.2% coverage based on the results of meta-analysis and the random-effects model with the heterogeneity. CONCLUSION: An Observance rate of patient bills of rights was considered somewhat adequate. However, contradictions in findings noted in this study suggest deficiencies do exist and need to be resolved. There appears a need to better describe and increase awareness rates of healthcare services by patients concerning their own bill of rights.

Patients' Expectations and Perceptions of Service Quality in the Selected Hospitals.

BACKGROUND: Hospital's success depends on patients' expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients' perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. MATERIALS AND METHODS: This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive - analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. RESULTS: The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients' perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The Kruskal-Wallis test, the difference observed in these three hospitals were significant. CONCLUSION: The results showed that patients' expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed that necessary for managers and relevant authorities to plan and pay special attention to this important issue.

Epidemiologic Investigation of Dysentery in North of Iran: Use of Geographic Information System (GIS).

INTRODUCTION: Dysentery is an intestinal inflammation which is created by the microorganisms attacking intestine mucus. Knowing the prevalence of this disease in different societies paves the way for programming and providing treatment and preventive measures. The main purpose of this study is to investigate the epidemiologic pattern and geographical distribution of dysentery based on GIS. METHOD: This was a cross-sectional and analytical study. The dysentery cases were gathered from the section of contagious diseases in health chancellery of Mazandaran University of medical sciences through a checklist during the years 2008 to 2013. In order to analyze the data, we made use of chi-square test. Then, the GIS software was used to recognize the geographical distribution of the disease. FINDINGS: There was reported about 653 cases affected by dysentery and the disease proportion was equal for both men and women. Most of the persons with dysentery was city dwellers. The highest rate of incidents was reported to be in Fereidunkenar in 2011, and the disease was mostly found among farmers, students, and college students. CONCLUSION: Since dysentery is a disease transmitted from water and food, and in this study, it was found out that the disease sources included using polluted water, vegetables, and lack of appropriate personal hygiene. Therefore, it is essential to take into consideration the health issues. Moreover, the suitable conditions of the geographical area which has the highest rate of incident have paved the way for dysentery occurrence. In addition, using geographic information system (GIS) as a visual instrument can help the stakeholders and officials to elaborate on the death trend and recognize the areas for optimal use of the available resources.

Patient's Perception and Expectations of the Quality of Outpatient Services of Imam Khomeini Hospital in Sari City.

BACKGROUND AND PURPOSE: Out-patient department is the gateway to almost all of the hospital services. Providing method of service in this place has an important role in the general impression of the patient of hospital sanitary and treatment services. This research was done with the purpose of studying the perception and expectations of out-patient service receivers of Imam Khomeini Hospital in Sari. MATERIALS AND METHODOLOGY: A cross-sectional study was conducted on those patients in the outpatient service department of Imam Khomeini Hospital who at least have the junior high school degree. 200 people were selected as sample size with Morgan's table. Respondents answered the questionnaire two times. Once they expressed their perception of the provided services and once for their expectations. Therefore, the following expectation scores are obtained. To prove the significance of demographic variables with perception and expectations, the T and Tukey's tests and also to compare different groups the variance analysis test are used. FINDINGS: The mean of age was 25.68± 9.086 (The youngest participant was 16 and the oldest 67 years old). It was observed from the results of the T test there is no significant difference between sex and residential place. It was clear that in perception part; there was a significant difference, at the level of 0.05 significance, in all groups except for responding and behavior, while, in expectation level, no significance in the age of the dimensions except for access. CONCLUSION: Results showed that the satisfaction status of patients in Imam Hospital clinic in Sari is good. Many of the existing shortages can be improved by presenting an accurate and organized program. The present study shows that some service dimensions of patients require being promoted, the most important of which include behavior, accessibility and affordability, physical and responsiveness dimensions.

Analyzing the Dimensions of the Quality of Life in Hepatitis B Patientsusing Confirmatory Factor Analysis.

BACKGROUND & OBJECTIVES: The scope of the quality of life assessment is not widespread in any time like today. Economists, social scientists and politicians look at this topic from the particular approach. The life quality in hepatitis B patients regarding the degree of its progress is considered a major concern in these patients. Thus, the aim of the study was analyzing the dimensions of the life quality of a group of people suffering from hepatitis B in Mazandaran province in 2012. METHODS: This study was done by descriptive, cross-sectional method on 210 (118 women and 92 men) hepatitis B patients that six month have passed from their diagnosis and formation of follow-up form in health centers, using access sampling method at six regions of Mazandaran province.The instruments of the study were the questionnaire of World Health Organization questionnaire (WHOQOL-BREF) and the chronic liver disease questionnaire (CLDQ). For analyzing the data from descriptive statistics and Kolmogrov-Smirnov test, one sample t-test, two stage Confirmatory factor analysis, Spss and Lisrel software has been used. RESULTS: Findings showed that the social relationship dimension with factor loading of 0.81 has the most amount of coefficient of effectiveness; physical health with factor loading of 0.72, mental health with factor loading of 0.63 and environmental health with factor loading of 0.55 have the least amount of coefficient of effectiveness in creating the general life quality of hepatitis B patients. In the quality of life in hepatitis patients, the emotional function with factor loading of 0.76 has the most coefficient of effectiveness, activity dimension with factor loading of 0.67, fatigue with factor loading of 0.47, abdominal syptoms with factor loading of 0.42 and worry with factor loading of 0.32 have the least coeficient of effectivness in making CLDQ domains of hepatit B patients. CONCLUSIONS: The general quality of life in patients had been below average and social relationship and emotional function must be properly investigated and managed in hepatitis B patients in order to improve life quality. WHOQOL-BREF and CLQD proved to be a useful instrument to assess general life quality in patients and can be helpful to find practical strategies to improving life quality in these patients.