Evaluation of hospital information systems of the teaching hospitals affiliated to Shiraz University of Medical Sciences, based on the American College of Physicians Criteria

Introduction: Hospital information system [HIS] is a computerized system used for management of hospital information as an electronic device and has an indispensible role in the field of qualified healthcare services. Nevertheless, compared to other industrial and commercial systems, this information system is lagged in using the information technology and applying the controlling standards for satisfying the customers. Therefore, the present study aimed to evaluate HIS, identify its strength and weak points, and improve it in the teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran

Method: The present descriptive, cross-sectional study was conducted in the 8 teaching hospitals of Shiraz University of Medical Sciences which used HIS in 2011. The study data were collected through interview and direct observation using the criteria of American Physician College check-list. Finally, SPSS statistical software was used to analyze the data through descriptive statistics

Results: The study results showed that laboratory and medical records had respectively the most%43.5 and the least%21.03 conformity to the criteria of American College of Physicians. Also, Faghihi and Zeinabiye hospitals respectively had the most%41.8 and the least%25.2 conformity to the American College of Physicians' criteria. In pharmacy, data entrance mechanism and presentation of reports had complete conformity to the scales of American College of Physicians, while drug interactions showed no conformity. In laboratory, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had%87.5 conformity. The possibility of receiving information from centers out of laboratory had no conformity to the desired criteria. In the radiology department, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had%87.5 conformity. Besides, the possibility of receiving information from centers out of radiology department had%25 conformity. In medical records department, data entrance mechanism had complete conformity to the criteria and data storage, files format, and the process of providing backup had%75 conformity

Conclusion: The final conformity of HIS in the study hospitals showed that the total mean of the system was less than%50 and weak. Therefore, further studies are required to be conducted throughout the country; so that various providers will be able to evaluate the presented systems regarding compatibility and interoperability

Prevalence of coronary artery diseases risk factors in Sari-Iran [2005-10]

Coronary artery diseases are one of the main causes of mortality and morbidity. This study was done to determine the prevalence of risk factors for coronary artery diseases in patients referred to angiography center in Sari, Northern Iran. This descriptive study was performed on 2540 patients referred to angiography center in Sari city, northern Iran, during 2005-10. Risk factors including diabetes, hypertension, hyperlipidemia, smoking, Family history, CRP and also ECG changes, type and number of involved artery and the severity of vascular involvement were recorded for each patient. Hypertension, hyperlipidemia, diabetes, smoking were seen in 40.8%, 40.5%, 29.1%, 12.5% of patients, respectively. Positive family history and CRP were found in 10% and 3.4% of the patients, respectively. 23.8% of patients had abnormal ECG. One, two and three vessel diseases were observed in 26.5%, 48.3%, 48.3% of cases, respectively. Left anterior descending artery constriction was seen in 75.8% and 80.4% of males and females, respectively. A significant relationship was found between diabetes and left coronary circumflex [P<0.04] and left anterior descending artery [P<0.03] constriction. Diabetes, hypertension, hyperlipidemia, smoking, family history, abnormal ECG are among the risk factors of coronary artery diseases in this area

[Antimicrobial effect of Citrus aurantifolia extract on Enterococcus faecalis within the dentinal tubules in the presence of smear layer]

Instrumentation of the root canals results in formation of smear layer which covers the dentinal tubules. In infected teeth, it is ideal to achieve a material that has the ability to remove the smear layer besides antimicrobial activity. Therefore, this study was designed to evaluate the antimicrobial effect of Citrus aurantifolia extracts [lime juice and rind extract] on Enterococcus faecalis within dentinal tubules in the presence of smear layer. One-hundred and forty dentin tubes were prepared from bovine incisors. After removal the smear layer, the specimens were infected with Enterococcus faecalis. Then, the smear layer was reformed. Test solutions were used as the irrigants in study groups as follows: group 1: 5.25% NaOCl; group 2: 17% EDTA; group 3: NaOCl+EDTA; group 4: Lime juice; group 5: ethanolic rind extract of C.aurantifolia; group 6: 96% ethanol. Dentin chips were collected from inner and outer layers of dentinal walls and optical density was measured. The data were analyzed using one-way ANOVA and Tamphane tests. In outer layer of dentin, the efficacy of rind extract was less than that of NaOCl+EDTA [P<0.05]. Also Lime juice was less effective than EDTA, NaOCl and NaOCl+EDTA [P<0.05]. In inner layer of dentin, Lime juice was significantly less effective than NaOCl and NaOCl+EDTA [P<0.05]. The efficacy of rind extract was less than that of NaOCl + EDTA [P<0.05]. In the presence of smear layer, the antimicrobial activity of Lime juice was less than that of NaOCl but the efficacy of rind extract was similar to that of NaOCl

[Survey of relationship between serum procalcitonin and infectious diseases]

Procalcitonin is prohormone of calcitonin and is made 116 amino acids. The normal value of procalcitonin is less than 0.5 ng/ml, that if this amount exceeds, infection is indicated. This poly-peptide is a marker for the diagnosis of primary infection. Increased amounts of procalcitonin is associated with infection; especially bacterial infections. 32 patients with liver cirrhosis and 16 healthy controls enrolled in this study were. Serum PCT levels in these subjects was measured. PCT level was measured by semi-quantitative method. Patient group included 23 males and nine females with mean age of 45 years and SD= 17.44 years, the control group included 11 males and 5 females with mean age of 46 years and SD=15.5 years.The statistical analysis showed that there was significant difference between PCT levels in patients and controls [P<0.05].Furthermore PCT levels was significantly higher in cirrhotic patients with hepatitisec background. Since these patients had no symptoms of infection and were hospitalized for endoscopy test and the PCT test was positive in 78.1% of cirrhotic patients, whereas this ratio was 25% in the control group, the patients probably were infected and should be under proper treatment

Hearing loss in acquired hypopthyroidism

Both clinical and laboratory evidence confirm that hearing loss can result from congenital and acquired hypothyroidism. There is a confirmed correlation between congenital hypothyroidism and hearing loss, but significant controversy still surrounds the association between acquired hypothyroidism and hearing loss.The aim of this study was to evaluate this relationship. Fifty patients with confirmed primary hypothyroidism, were studied and compared with 50 age- and sex- matched controls. All patients were evaluated in the hypothyroidism state before treatment with thyroxine. Auditory assessments included: Toutine ENT examinations, speech reception threshold, pure tone audiometry, speech discrimination score, acoustic reflex and tympanometery The hearing thresholds in all frequencies in both ears of the case group were higher than in controls. Also hearing loss frequencies, i.e. 2000, 4000, 8000 dB in the left and 4000, 8000 dB in the right ears in the case group, were higher than in controls. Hearing loss was symmetric, sensory neural and mild to moderate. Mean speech reception threshold in the right and left ears in the case group were 15 and 15.1 respectively and in controls, 10.6 dB for both the right and left ears. Mean speech discrimination score in the right and left ears in the case group was 97 and in the control group was 99 dB Results demonstrate a strong correlation between acquired primary hypothyroidism and hearing loss

Neutrophil function [innate immunity] during Ramadan

Fasting during the month of Ramadan is one of the essential religious practices of Muslims. The aim of this study was to evaluate opsonisation, phagocytosis, and nitroblue tetrazolium [NBT] reduction by white blood cells in normal, healthy, male subjects under nonfasting [before Ramadan] and fasting [after Ramadan] conditions. In this study, 13 Muslim men, aged 28-54 years, whose health was confirmed by health application forms, gave blood samples one week before the beginning of the holy month of Ramadan and during the last week of Ramadan. Blood samples were tested for neutrophil phagocytosis, serum opsonisation power, and NBT reduction. Despite a decline in the neutrophil phagocytic index and serum opsonisation index, the percentage of neutrophils participating in phagocytosis increased with fasting. In addition, there was an increase in the percentage of neutrophils demonstrating NBT reduction. Although there was a decrease in opsonisation of the serum, the increased percentage of opsonisation compensated for this defect. This study demonstrates the beneficial effect of fasting during Ramadan on neutrophil phagocytic function

Antibacterial substantivity of carvacrol and sodium hypochlorite in infected bovine root dentin

Various methods commonly used for cleaning and shaping root canals have not been successful in completely eradicating bacteria due to anatomic complexity and root canals irregularities. Disinfecting the canals with intracanal irrigants in addition to proper cleaning and shaping can produce a successful outcome. Antimicrobials with sustained antibacterial activity would be desirable for irrigation. The purpose of this study was to compare the antimicrobial substantivity of Carvacrol and 5.25% NaOCl in infected bovine root dentin. One hundred and twenty dentin tubes prepared from bovine incisors were infected in vitro for 14 days with Enterococcus [E] faecalis. The specimens were divided into four groups including 1] Carvacrol, 2] NaOCl, 3] infected dentin tubes [positive control]; and 4] sterile dentin tubes [negative control]. Dentin chips were collected at five intervals [days 0, 1, 3, 7 and 28] using round burs with sequentially increasing diameters [which includes five layers of dentin] into Brain Heart Infusion [BHI] broth. In order to compare the pre- and post-irrigation antimicrobial activity of the irrigants the colony-forming units [CFU] were counted and classified as 'CFU-before' and 'CFU-after'. After culturing, the number of CFU with the various experimental time and dentinal layers was recounted. Two-way ANOVA test was used to analyze the effects of time and materials. One-way ANOVA and supplemental Tukey HSD test were used for pair comparison.CFU was significantly reduced in NaOCl group when compared to all other experimental groups [P < 0.05]. The substantivity of NaOCl was significantly greater than Carvacrol. Further studies are required to investigate and approve Carvacrol as a final irrigant

effect of intravenous tranexamic acid on blood loss in lumbar hernial disc resection under inhalation and total intravenous anesthesia

Tranexamic acid is a synthetic antifibrinolytic drug that reduces bleeding and transfusion requirements in cardiac surgery and total knee arthroplasty. In this study, we evaluated the efficacy of the prophylactic tranexamic acid on intraoperative bleeding in patients undergoing lumbar hernial dics resection. Eighty patients in ASA class I and II were randomized into 4 groups. In group 1, anesthesia was achieved by total intravenous anaesthesia and also the administration of tranexamic acid. The other groups were group 2, anesthetized by total intravenous anaesthesia without tranexamic acid; group 3, anesthetized by halothane and the administration of tranexamic acid and group 4, anesthetized by halothane without tranexamic acid. Blood loss and surgeon's satisfaction were registered. The amount of blood loss in group 1 was 267.1 177.3 ml; in group 2: 656 411.6 ml; in group 3: 357 307.2 ml and in group 4: 550 406.7 ml. The least bleeding was recorded in group 1 which had a significant difference with groups 2 and 4 for which tranexamic acid was not administered. Blood loss in groups 2 and 4 was more or less similar with no significant difference. The surgeon's highest satisfaction was with group 1. No complications were recorded in the 4 groups. We concluded that administration of prophylactic tranexamic acid in patients undergoing hernial disc resection has the potential to reduce intraoperative bleeding and improving visualization of the surgical field especially when administered with total intravenous anesthesia

Effect of Ramadan on neutrophil's respiratory burst [innate immunity] and circulating immune complex

The aim of this study was to investigate the effects of Ramadan fasting on neutrophil's respiratory burst and circulating immune complex [CIC] level. The effects of Ramadan fasting on neutrophil's respiratory burst and CIC was studied in 21 normal young fasting Muslim individuals using standardized chemiluminescence and poly ethylene glycol methods respectively, the results obtained and statistically analysed. It was shown that in 11 cases out of 21 [52%] both of the chemiluminescence [CL] activity and CIC levels measured before and after Ramadan fasting were in normal range in spite of a insignificant decrease or increase in CL activity or CIC level. Therefore, the changes of the immunological parameters were not significant and the levels remained in the range of normal. In four cases out of 21 [24%], the CL activity and CIC levels were higher than normal range measured just before Ramadan, however after month of Ramadan the CL activity and CIC level decreased reaching to the normal level of these parameters. In four cases out of 21 [24%] there were an increase in CL activity and CIC levels after Ramadan fasting. There were no significant changes of CL activity of circulating neutrophils and CIC levels comparing the results obtained before and after Ramadan. More over there was a good correlation between these two immunological parameters measured in the present study

role of aspergilus in patients with chronic allergic rhinosinusitis

Allergic Rhinosinusitis is one of the most common problems that make people refer to rhinolaryngology clinics, spending a lot of money for the treatment. The antigens from the growth of fungi in sinus cavity causes allergic manifestation and resistance to the treatment. The objective of this study was to evaluate any relationship between chronic rhinosinositis and the allergic symptoms concerning certain fungi. This is a sectional case-control study on 60 patients who referred to the rhinolaryngology clinics of Bahman 22nd and Imam Reza hospitals. 30 patients with chronic rhinosinositis and allergic symptoms like rhinorea, sneezing, nasal itching were selected for the study as the case group and the other 30 patients with chronic rhinosinousitis without the allergic symptoms as the control group After CT scan evaluation, all the patients were sent to the Endoscopic Department Of Imam Reza Hospital. The endoscopic samples obtained under general or local anesthesia were prepared from maxillary sinuses and were sent for culturing [Saboro Agar] and pathologic evaluations. Positive fungal culture was found in 26.7% of the subjects with both chronic sinusitis and allergy. The frequency rate of such finding was significantly more than that of the control group [4.7%]. The most frequent fungus was found to be aspergilus. There was a significant correlation between the fungi and the allergic symptoms in certain seasons [e.g. 44% positive culture in summer]. The frequency of asthma in the subjects with positive culture for aspergilus was 60% that was significantly more than the control group. The number of the subjects that showed palor of Mucosa during the endoscopy [25%] revealed fungal involvement which was significantly more than the control group [4.17%]. Based on the findings of this study, fungi are one of the causes of chronic allergic rhinosinusitis. Therefore, an evaluation of fungal infection in all of the patients with chronic rhinosinusitis and allergic symptoms is recommended

correlation between vitiligo and hearing losse

To determine the correlation between vitiligo and hearing loss. Fifty patients with active vitiligo and forty healthy subjects were included in this case control study. Pure tone thresholds were determined at frequencies between 250 and 8000Hz. We compared the results in control and patients group by use of chi-square test. M/F ratio was 10:40 in the patients group and 10:30 in the control group. Mean age in patients and control groups was 22 and 22.6 years old respectively. The mean hearing threshold in patients was 19.5 +/- 5.7 and 10 +/- 5.7 in control groups. High frequency sensor neural hearing loss was seen in 19 out of 50 patients [38%], whereas no hearing loss was observed in the control group [X[2]=19.26, P<0.001]. Bilateral, right ear and left ear involvement were 63.1%, 26.3% and 10.6% respectively. Statistical difference between bilateral and unilateral involvement was significant [P<0.05]. No conductive hearing loss was seen in the control and patients groups. Vitiligo, Which is a type of pigmentary disorder, seems to be an effective factor in hearing loss. The mechanism for this condition might be the absence of the preventive function of melanin - containing cells in the inner ear

[A retrospective evaluation of epidemiologic and clinical parameters in Myeloma patients]

Myeloma is a hematologic malignancy in which there is monoclonal proliferation of bone marrow plasma cells that produce abnormal proteins. Reviewing the medical records of patients admitted to Dr.Shariati and Imam Khomeini Hospitals of Tehran University of Medical Sciences from 199 1-2000, we assessed distribution of epidemiologic and clinical parameters of patients with Myeloma and for each parameter we evaluated the missed data percentage as an index of active data collection. Among the epidemiologic parameters only age and sex had no missing data. For smoking, missing data were 22.9% and in other parameters there were more than 90% missing data. For clinical parameters, missing data percentages were between 46.2% and 93.1%. Establishing a documented system for object oriented data collection based on specific epidemiologic and clinical parameters is essential for optimum prevention and management of Myeloma

Studying the staffs job satisfaction in admission unit of training hospitals affiliated with Shiraz University of Medical Sciences

Job satisfaction is one of the key factors affecting professional success which, in turn, allows an organization to achieve its objectives. And ultimately it can result in individual and social health. Thus, managers are highly concerned with factors affecting job satisfaction. In this study, it was decided to investigate factors determining the staffs job satisfaction. It was a descriptive analytic study in which data were collected by a standard questionnaire in nine training hospitals affiliated with Shiraz University of Medical Sciences in 1380. The questionnaire was given to fifty people working in admission unit. The data were analyzed by t-test, kruskal-wallis, pearson correlation and one way ANOVA. Findings of the study revealed that there was a significant relationship between sex and job satisfaction on the one hand and promotion and salary on the other. There was also statistically meaningful relationship between organizational position and job satisfaction. In order to increase the productivity in admission units, the staffs job satisfaction must be fulfilled. In addition, by reducing the gap between different social classes and achieving a logical distinction in exploiting economic and social rights, we can make organizational objectives closer to staffs expected tasks

histologic evaluation on tissue reaction to three implanted materials [MTA, root MTA and Portland cement Type I] in the mandible of cats

Statement of Problem: Nowadays Mineral Trioxide aggregate [MTA] is widely used for root end fillings, pulp capping, perforation repair and other endodontic treatments. Investigations have shown similar physical and chemical properties for Portland cement and Root MTA with those described for MTA

Purpose: The aim of this in vitro study was to evaluate the tissue reaction to implanted MTA, Portland cement and Root MTA in the mandible of cats

Materials and Methods: Under asepsis condition and general anesthesia, a mucoperiosteal flap, following the application of local anesthesia, was elevated to expose mandibular symphysis. Two small holes in both sides of mandible were drilled. MTA, Portland cement and Root MTA were mixed according to the manufacturers, recommendation and placed in bony cavities. In positive control group, the test material was Zinc oxide powder plus tricresoformalin. In negative control group, the bony cavities were left untreated. After 3, 6 and 12 weeks, the animals were sacrificed and the mandibular sections were prepared for histologic examination under light microscope. The presence and thickness of inflammation, presence of fibrosis capsule, the severity of fibrosis and bone formation were investigated. The data were submitted to Exact Fisher test, chi square test and Kruskal Wallis test for statistical analysis

Results: No statistically significant differences were found in the degree of inflammation, presence of fibrotic capsule, severity of fibrosis and inflammation thickness between Root MTA, Portland cement and MTA [P>0.05]. There was no statistical difference in bone formation between MTA and Portland cement [P>0.05]. However, bone formation was not found in any of the Root MTA specimens and the observed tissue was exclusively of fibrosis type

Conclusion: The physical and histological results observed with MTA are similar to those of Root MTA and Portland cement. Additionally, all of these three materials are biocompatible. However, in order to replace Root MTA and Portland cement type I as less expensive and suitable substitutes for MTA, more longer- term studies with larger number of samples are suggested

Peripheral O2 Saturation change in adenotonsillar hypertrophy

One of the obstructive complications of Waldeyer's ring hypertrophy is changing in Arterial O2 saturation which could result in serious complications such as corpulmonal and hypertension and even sudden infant death syndrome. Because this complication is common we decided to study it. In this analytic cohort study forty patients who were admitted for Adenotonsilecomy in Mashhad University hospitals at ENT Departments were selected, and their changing O2 saturation studies were recorded with pulseoxymeter along the one hour normal sleep. This change was compared with a control group. The result shows that there is a significant difference between the two groups