فهرست مطالب
Hospital Practices and Research
Volume:3 Issue: 2, Spring 2018
- تاریخ انتشار: 1397/03/27
- تعداد عناوین: 8
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Pages 37-43Incidence and prognostic relevance of supraventricular arrhythmias were evaluated in nine studies. These studies investigated patients with different forms of pulmonary hypertension. Supraventricular arrhythmias were more often found in patients with group two pulmonary hypertension. Common findings in these patients were elevated right atrial pressure and diameters and reduced tricuspid annular plane systolic excursion (TAPSE). Elevations in other parameters like systolic pulmonary arterial pressure, mean pulmonary arterial pressure, and pulmonary vascular resistance (PVR) were inconsistent. Most of the patients with arrhythmias suffered symptoms and improved after sinus rhythm (SR) was restored. The prognostic relevance of non-sustained ventricular tachycardia was evaluated in only one study. Non-sustained ventricular tachycardia does not seem to be prognostically relevant. Extending Holter electrocardiogram (ECG) monitoring over 24 hours up to 72 hours raises the detection rate of arrhythmias. Ablation of arrhythmias, especially atrial flutter and atrioventricular node reentry tachycardia, is feasible and safe in these patients.Keywords: Pulmonary Hypertension, Arrhythmias, Atrial Flutter, Atrial Fibrillation, Prognostic Relevance
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Pages 44-49BackgroundThe cerebral performance category (CPC) score is widely used in research and quality assurance to assess neurologic outcome following cardiac arrest. However, little is known about the results of the CPC in Turkey.ObjectiveThis study aimed to determine whether the CPC is associated with the initial rhythm and resuscitation time following resuscitation from in-hospital cardiac arrest.MethodsThis study compared the CPCs (CPC 1-2 and CPC 3-4-5) of patients discharged from the hospital after surviving cardiopulmonary arrest (CPA) during a 2-year period between June 2013 and June 2015 (at discharge, and at 6th, 12th, 18th, and 24th months) based on the initial rhythm (asystole/pulseless electrical activity and ventricular fibrillation/pulseless ventricular tachycardia) and resuscitation time (014 min and 1530 min) at the time of arrest.ResultsNo difference was found between CPC 1-2 and CPC 3-4-5 scores at discharge or at 6th, 12th, 18th, and 24th months in terms of the first rhythm and resuscitation time (P > 0.05).ConclusionPatients discharged from the hospital following in-hospital cardiopulmonary resuscitation (CPR) were found to have no difference in 2-year CPC scores with respect to cardiac rhythms and resuscitation durations at the onset of resuscitation.Keywords: Heart Arrest, Cardio, Pulmonary Resuscitation, Neurologic Examination
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Pages 50-58BackgroundOne way to improve hospital food provision is certainly by understanding the management of hospital foodservices, but there is limited detailed information about staff roles in food provision in many hospitals around the world.ObjectiveThe hospital meal experience of patients, a part of the services provided by hospitals, is becoming important. Therefore, the role of various hospital staff members was studied through their behavior, attitudes, and practices so as to understand how the foodservice system works to address patients food consumption.MethodsThis qualitative research used the convenient sampling method. Data was collected by interviewing twenty hospital employees with different job scopes (nurses, doctors, dietitians, foodservice managers, and directors of hospital foodservices) in 6 public hospitals.ResultsThemes such as providing familiar food, food as the motivational factor for consumption, empathy shown by staff, and influences of the eating environment were identified using content analysis.ConclusionThe viewpoints and experiences of key stakeholders facilitated the understanding of various factors involved in the provision of hospital food which affect patients decisions to accept and consume food.Keywords: Dietary Services, Health Personnel, Health Care Quality, Hospitalization, In, Patient
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Pages 59-63BackgroundTuberculous, parapneumonic and traumatic loculated pleural-effusions pose therapeutic challenges due to resultant pleural-thickening and compromised lung-function for life. Tuberculosis is widely prevalent in developing countries, necessitating appropriate, effective, and economical treatment for loculated pleural-effusion to reduce the burden and sequelae.ObjectiveAn uncontrolled and blind before-after intervention study to determine the effectiveness of intrapleural fibrinolytic therapy (IPFT) using urokinase in loculated pleural effusions was conducted at a tertiary-care respiratory center after obtaining approval and written informed consent.MethodsFifty-one patients with loculated pleural effusion were administered with repeated cycles of three doses of 1 Lakh IU of urokinase intrapleurally until complete drainage of pleural fluid. Pre- and post-IPFT clinical and radiological responses were compared using removal of fluid, ultrasound, and chest radiography were compared. The Kolmogorov-Smirnov test and paired t test with significance at a P value less than 0.05 were applied to test statistically significant differences in proportions and means, respectively.ResultsTuberculosis was the most common etiology leading to loculated pleural effusion (80%), and 82.4% of tuberculosis patients required at least two cycles of IPFT. Complete resolution in chest radiograph after IPFT was observed in 80.4% of patients. Chest pain (13.7%) and fever (9.8%) were the most common undesired effects associated with IPFT. A statistically significant reduction in mean intrapleural fluid levels pre- and post-IPFT from 184±81 ml to 67±52 ml was observed.ConclusionIPFT with urokinase is an effective treatment modality in patients with post-tubercular loculated pleural effusions. IPFT has minimal and tolerable undesired effects and prevents sequelae such as pleural thickening and consequent compromise of respiratory function.Keywords: Tuberculosis, Intrapleural Fibrinolytic Therapy, Pleural Effusion, Urokinase
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Pages 64-68BackgroundAlthough all jobs can be stressful, occupational stress is an important issue in jobs that deal with human health. Evidence indicates that nursing is a stressful occupation.ObjectiveThis research evaluated factors affecting occupational stress and strategies for coping with it.MethodsThis cross-sectional descriptive-analytic study was conducted in 2015. The study population comprised all nurses at Shahid Rajaee hospital, from whom 190 nurses were selected by random sampling. Data was collected by questionnaire and analyzed using SPSS software (version 19), Pearson correlation coefficient tests, Mann-Whitney tests, and t tests.ResultsOccupational stress was rated as moderate among the studied nurses. Significant positive correlations were found between occupational stress level and less effective coping method, occupational stress level and work experience level, and ineffective coping methods and age. Moreover, a significant difference was seen between men and women in terms of emotion-focused coping.ConclusionAccording to the research findings, occupational stress was at a moderate level among the studied hospital nurses, indicating that the authorities need to focus on efforts to reduce occupational stress for nurses.Keywords: Occupational Stress, Nurses, Hospital
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Pages 69-70IntroductionDelusion of pregnancy is a bizarre delusion in which one feels s/he is carrying a fetus. The etiology is unknown, but aloneness, masturbation, and stress may precipitate this disorder.Case PresentationWe introduce a young, single man who has delusions of pregnancy. This type of delusion is not a well-known disorder; based on investigated articles, this type of somatic delusion is rare.ConclusionThis was a chronic case, the exact cause and development of which was unknown. We suggest this phenomenon as a novel symptom. No similar case was found in the literature.Keywords: Delusion, pregnancy, Hypochondriacal