فهرست مطالب ladan ghadami

Two major difficulties in critical care are muscle weakness and malnutrition. Their prevalence in critically ill patients is about 30-50% during hospital stays, and they can also affect routine patient life after discharge, even leading to recurrent infection and death. Metabolic responses to injury have specific effects on metabolic phases in patients.

This study is a randomized, double-blind, clinical trial on critically ill patients in two groups. Both groups were checked for metabolic markers and demographic characteristics during admission and before discharge. In the nandrolone group, 25mg of nandrolone (IM) was injected weekly for three weeks. In the control group, normal saline was used as a placebo. To assess metabolic responses, albumin, total protein, and testosterone levels were checked, in addition to static measures such as cross-sections of rectus femur and mid-upper arm circumference.

There were no significant differences in SOFA and APACHE 2 scores, PSA, ESR, CRP, and PTC levels between the two groups (p<0.05). Results also showed no significant differences between the mean of length of hospital stay, serum albumin, total protein, hemoglobin, testosterone, and HDL between the two groups (p<0.05). LDL and TG had P-values of 0.01 and 0.012, respectively. MUAC and sonographic findings of rectus femoris muscle were better in the case group (P-values 0.008 and 0.012).

Nandrolone had no significant effects on metabolic markers in critically ill patients, except for TG and LDL. The changes in muscle characteristics were significant. However, more study is needed to assess muscular power.

The outbreak of new pathogens or the resurgence of pathogens that have already spread is a serious challenge to public health. Coronavirus is a pathogen that seems to invade the human respiratory system in the first place. Coronaviruses form a large family and are so called because of the presence of crown like cristae on their surface.

This is a cross‑sectional, descriptive study conducted to assess the status of patients with COVID‑19 who were hospitalized in an educational hospital. For this purpose, 142 patients hospitalized in this hospital were followed up 2 weeks after discharge and were inquired about the symptoms they had upon admission to the hospital, the number of hospitalization days, the history of underlying disease, and so on. Descriptive data analysis was done with the SPSS software version 22.

The findings of this research showed that overweight or obese people (about 66%) is more likely to contract the disease. It also seems that older people (37.3% older than 60 years old) and those with a history of diseases (69.6%) such as diabetes, high blood pressure, or heart disease are more prone to COVID‑19. The most common symptoms of COVID‑19 patients included fever (64.5%), shortness of breath (67.4%), and dry cough (50.4%).

it seems that high risk group (obese people, old people, and people with a history of disease) is more likely to be infect with coronavirus so they should more careful than others. Another important issue is that policy‑makers must play an active role in public awareness of dangers of COVID‑19 and ways to prevent it.

The purpose of this study was to investigate the effects of delay in the operation and counseling on postoperative complications and mortality rates in elderly patients.

The present study was a descriptive cross-sectional research. Population of this study was the entire elderly hospitalized patients who aged over 55 years for emergency orthopedic surgeries in a teaching hospital in Tehran. Surgery delays were then determined after examining the checklists, and the relationship between the variables and surgery delays, number of preoperative counseling, complications, and mortality rate was evaluated. Data were analyzed using the Mann–Whitney U-test and Pearson correlation coefficient in SPSS 18 at a 0.05 significance level.

Overall, 89.9% of the patients had counseling. The average hospitalization days were 5 days until surgery, and the standard deviation was 0.50. The mean counseling number was 5.5. The relationship between number of counseling and surgical delays was significant. Delay in surgery in this age group, mortality, and the chances of death have become 2.7 times more than who had not a surgical delay. No significant relationship was observed between surgery delay and the incidence of Deep Venous Thrombosis (P = 0.102), postoperative sepsis and Myocardial Infarction (P = 0.337), embolism (P = 0.505), and postoperative Cerebrovascular Accident (P = 0.153).

The delay in surgery in the elderly causes an increase in mortality. Considering the findings of this study and the importance of emergency orthopedic surgeries in the elderly, to reduce the surgical delays and the mortality rate in the elderly, the establishment of a surgical team for elderly patients in hospitals is recommended.

Accreditation is a comprehensive and supportive model for assessing hospital performance. The present study aimed to assess the methodology of scoring hospital accreditation standards in Iran.
This research is a qualitative study in 2017. The main scope was to interview the experts in the area of policy and accreditation of hospitals in Iran. Accordingly, semi-structured interviews were conducted with 25 experts and hospital accreditation assessors. A framework analysis was used to analyze qualitative data.
In this study, six subjects were identified as the key factors influencing the hospital accreditation method. Standards Classification, Scoring, Weighting, Overall Score Ranking, Role of Assessors, Evaluation Method. In the current method, the overall score did not determine the difference between hospitals. Weighting was not clearly specified. The executive steps which were guidelines of implementation were scored. The decision making methods of the assessors were not the same, and the assessments were mandatory and not carried out by an independent organization.
In the area of classification of standards and the method of scoring and weighting in the current accreditation evaluation, there needs to be changes. Required measurable elements in the accreditation standards will be eliminated. The precondition for entering the accreditation process will be to obtain the necessary permits before accreditation. It is suggested that the Likert scale be used for scoring. It’s recommended that the weight of patient safety standards must be considered more.