[Effect of simulated training course on preparedness of nurses to do pre-hospital triage]

Introduction: The key to successful management of large number of victims with limited resources is triage, which without preparedness of nurses seem to be impossible

The aim of this study was to determine the effect of simulated training course on preparedness of nurses to do pre-hospital triage at Razi psychiatric hospital

Materials and Methods: This is a quasi-experimental study on 60 nurses in Razi psychiatric hospital who according to the inclusion criteria and randomly divided into two experimental and control groups equally by 30. The study tools developed by the researcher included [Knowledge of Disaster Triage Test] that contains 30 questions of four-choice

The [Accuracy of Disaster Triage Test] also contains 30 questions with four-choice. Face validity and content validity has been evaluated

Reliability were evaluated using Cronbach's alpha for the [Knowledge of Disaster Triage Test] 0.75 and for the [Accuracy of Disaster Triage Test] 0.78. A day workshop [Disaster Triage Simulation Method] was arranged for intervention group and two groups were assessed by study tools before and after intervention. Data were analyzed using SPSS/16

Findings: The mean score of nurses preparedness regarding triage training [Knowledge and accuracy] in the intervention group were significantly different before and after the intervention [p<0.001]

The mean difference of nurses preparedness triage training [Knowledge and accuracy] there were significantly different between the two groups respectfully [p<0.001]

Conclusion: The results of the study showed, using the simulation method on triage training improved the nurses preparedness to do disaster triage. Therefore it is recommended to do this training program for nurses' to improve their preparedness for disaster triage

investigation on the efficacy of hemodialysis in Vali-e-Asr hospital of Arak city based on urea kinetic model in year 2003

End stage renal disease [ESRD] is a major health problem and each year the number of patients is increasing. If the disease becomes irreversible, patients must always be hemodialyzed. Since mortality rate will increase due to inadequate dialysis, determining the efficacy of hemodialysis and improving its quality is very important. The main goal of this research is investigating the efficiency of hemodialysis. This is a cross-sectional analytical study which was conducted on 103 people who were under dialysis treatment in the Vali-e-Asr hospital of Arak in year 2003. Weight, blood pressure [before and after dialyze], time of dialysis, BUN and Cr before dialysis and 5 minutes after turning of the pump and before the second dialysis were measured. Data was analyzed by T test and Pearson correlation. The mean of KT/V was 0.58 +/- 0.1; normal protein catabolic rate [nPCR], 0.36 +/- 0.11 g/kg per day and time average concentration of urea [TAG], 43.3 +/- 14 mg/d; which had a significant difference with standard measures [p<0.05]. KT/V was 0.49 +/- 0.18 and 0.47 +/- 0.10 for men and women respectively which was significantly different [p<0.03]. There was a positive and linear relationship between education level and TAG, KT/V and number of dialysis per week. Regarding the low efficiency of hemodialysis in 80% of patients and lower levels of hemodialysis efficacy indicators in comparison to standard measures, periodic assessment and also investigating the reasons of low efficacy of hemodialysis is recommended

[ effect of clinical research center, on clinical researches of Arak University of medical science]

Performing correct research in different aspects of community as well as medical sciences can be a way to resolve many problems. In order to create a systematic knowledge of research method in academic members of Arak University of medical science and enabling them in providing proposals and performing researches, a clinical research center was developed. This study is done to investigate the effect of this center on improving clinical researches in the University. This is a HSR, before and after, interventional study in which, clinical academic members of Arak University of medical science were evaluated. First the information of the pre intervention period was gathered [jan2002-jan2004]. Then the intervention was done in the form of development a research center in Vali-Asr hospital, performing serial research workshops, research conferences, research consultations and planning data bases during a 2 years period. Again data was gathered and then compared to those of pre intervention period. The comparison of pre and post intervention periods showed that in pre intervention period from 38 proposals 30 and in post intervention period from 89 proposals 76 were approved by research committee of the University. In the two pre and post intervention periods 14 [46.6%] and 50 [65.8%] of accepted proposals were clinical respectively. Also from the view point of quality, 11 and 15 proposals were HSR, 2 and 22 clinical trials and 8 and 8 descriptive, respectively. The number of published articles in first period was 45 and in second 84. Presented articles in internal and external congresses were 33 and 59 in the two periods overally, which 25 and 51 articles were presented in the country and 8 and 8 in abroad congresses, respectively. Regarding the results it seems developing research center in this University and other similar Universities can have a significant effect on the process of clinical researches

Two case reports of emphysematous cystitis in two diabetic patients with related literature review

Emphysematous cystitis is a rare form of acute infection of the bladder is which most cases are seen in diabetic patients. Most infections are due to E.coli and Klebsiella species. Predisposing factors are diabetes mellitus, recurrent urinary tract infections, bladder outlet obstruction and neurogenic bladder. CT-scan is the most sensitive method of diagnosis that detects air whithin intramular of bladder that is pathogonomonic of the disease. In this case report we reported two cases of emphysematous cystitis. The first case was a 73 years old diabetic woman who was admitted due to acute renal failure after cholecystectomy. During hospitalization, after remission of renal function, she developed fever, abdominal pain, hematuria and progressive abdominal distention. In physical examination she had generalized abdominal tenderness with dominance in the lower abdomen without rebound tenderness which with observation of air in intramural bladder by CT-scan, diagnosis of emphysematous cystitis was confirmed and the patient was treated and improved. The second case was a 37 years old diabetic woman. She was refered to the hospital because of nausea, recurrent vomiting and abdominal pain. In physical examination she had severe hypotention, generalized abdominal tenderness that was dominant in the lower abdomen and abdominal mass in suprapubic area. Suspicious to emphysematous cystitis, pelvic CT-scan was ordered. By observation of air in intramural bladder, emphysematous cystitis was confirmed. Patient was treated with antibiotic, insertion of fouly catheter and was improved. Undiagnosing or delaying in initiating appropriate treatment can lead to peritonitis secondary to intraperitoneal perforation of the bladder, septisemia and ultimately death of the patient. Timely diagnosis and aggressive therapy are important for the survival of these patients