rahman ghafari

The current research aims to suggest an open data governance model to improve the administrative health with the establishment of E-government in the tax affairs organization. The objectives are practical using grounded theory for the qualitative analysis. The data were collected through the semi-structured interview. The population of the research was all the high level managers of the tax affairs organization, CEOs and their deputies, tax advisors, professors of economics department, experts and researchers of the information technology, elites in the field of governance and administrative health, and other managers of supervision centers. The sampling was done to reach thick-data for the qualitative analysis, resulting in 12 participants. The data analysis was coded through open, thematic, and selective coding systems. The findings indicated six elements from the grounded theory: 1. Main elements such as shared data-base, responding system, organizational clarity, and technical infrastructures, 2. Interventional condition such as shared elements (domestic and foreign), domestic elements, and foreign elements, 3. Causative elements such as shared elements (indo- and exo-organizational), individual elements, and social elements, 4. Contexts such as indo- and exo-organizational contexts, 5. Strategies such as shared strategies (indo- and exo-organizational), indo-organization elements, and exo-organizational elements, 6. Shared consequences such as shared consequences (indo- and exo-organizational), indo-organizational consequences, and exo-organizational consequences.

Increased competition regarding the employment of students, financial sources, and quality employees has resulted in increased attention to third-generation universities in order to create a set of features and achieving a distinctive brand. Therefore, this study intends to design brand acceptance pattern of entrepreneur university in higher education system.

The mixed method has been used in this research. In the qualitative part, the grounded theory method was used, and in the quantitative part, structural equation modeling was used. Qualitative instrument included interviews with 18 university experts, but the researcher-made questionnaire was used as the quantitative data collection instrument.

Data analysis revealed that 474 initial codes were identified. Then, they were divided into 75 concepts and 26 major categories. Based on the systematic approach by grounded theory method, the identified codes were categorized into six components of casual conditions, basic conditions, intervening factors, strategies, and consequences.

The above-mentioned model leads to the employment of the most quality elements in the competitive market through changing the educational system and creating a positive image. The main consequences of these measures include an advanced military industry, achievement of scientific authority in the Islamic world, and increase in public welfare within the society.

Background and

Cardiovascular diseases are the most common cause of death worldwide. Surgical treatment is one of the main treatment options for cardiac diseases. However, the complications of open heart surgery increase the morbidity and mortality rates and also increase the length of stay in Intensive Care Unit (ICU). The aim of this study was to evaluate the effect of oral glutamine on patient’s outcome.

A clinical trial was performed in 106 patients, candidate for elective open heart surgery who were selected on the basis of study inclusion and exclusion criteria. Patients were randomly assigned to receive either oral glutamine 0.5 g/kg/day (n= 53) or placebo (n= 53) for two days preoperatively until two days postoperatively. SOFA score, EuroSCORE II, length of ICU and hospital stay, and 30 day mortality were measured at several postoperative time points.

Length of hospital stay was found to be significantly different between the two groups and it was significantly lower in the group that had received glutamine (P=0.001). There were no significant differences in SOFA score, EuroSCORE II, length of ICU and 30 day mortality rate between the two groups (P> 0.05).

According to this study, oral glutamine has many benefits and could reduce hospital stay after cardiac surgery.
 
(Clinical Trials Registry Number: IRCT20151109024975N10)

Advances in coronary artery surgery have reduced patient morbidity and mortality. Nevertheless, patients still have to face physical, psychological, and social problems after discharge from hospital.
The objective of this study was to determine the efficacy of Pender’s health promotion model in predicting cardiac surgery patients’ lifestyles in Iran.
This cross-sectional study comprised 220 patients who had undergone coronary artery bypass graft (CABG) surgery in Mazandaran province (Iran) in 2015. The subjects were selected using a simple random sampling method. The data were collected via (1) the health-promoting lifestyle profile II (HPLP II) and (2) a self-designed questionnaire that included two main sections: demographic characteristics and questions based on the health-promoting model constructs.
Spiritual growth (28.77 ± 5.03) and physical activity (15.79 ± 5.08) had the highest and lowest scores in the HPLP II dimensions, respectively. All the health promotion model variables were significant predictors of health-promoting behaviors and explained 69% of the variance in health-promoting behaviors. Three significant predictors were estimated using regression coefficients: behavioral feelings (β = 0.390, P According to the results of the study, health-promoting model-based self-care behaviors can help identify and predict cardiac surgery patients’ lifestyles in Iran. This pattern can be used as a framework for discharge planning and the implementation of educational interventions to improve the lifestyles of CABG patients..

Rumors regarding the nature and influence of social anxiety that can increase productivity and reduce production and social validity Employees, managers, agencies and organizations impair the. In this regard, we expect people who are ethics obligation, understand, analyze and manage rumors, have distinct behaviors. This study aimed to describe concepts such as gossip and review of management practices and control in organizations is moral. Two standard questionnaire (alpha = .82 manage rumors, and .91 to adhere to ethics) among managers, deputies and four senior ministers have been distributed. Results show that the overall correlation between adherence to the Code of Conduct by directors and managing their organizations rumored to exist. Additionally, the findings suggest that education, gender, experience and position in the management and adherence to ethical principles affect rumor.

Background and Infection is one of the most important complications after coronary artery bypass surgery. The purpose of this study was to evaluate the risk factors for infection in these patients. A descriptive prospective study was performed in 986 patients hospitalized in Sari Fatemeh Zahra hospital, Iran 2014-2015. Possible risk factors for infection (before, during and after the surgery) were recorded. Patients were followed up for possible infection until 30 days after surgery. Data was analyzed in SPSS applying t-test and Chi-Square. The p value less than. 05 was considered significant. Totally, 52 patients (5.3%) developed infection including sepsis (28.8%), pneumonia (17.7%), mediastinitis (15.3%) and deep incisional surgical site infection (11.5%). Significant associations were found between developing infection following coronary artery bypass and prolonged use of Foley catheter, the balloon inside the artery during surgery, using internal mammary artery as a graft, left ventricular outputs, high blood pressure in the morning of surgery, days of hospitalization before and after the surgery, duration of intubation after surgery, duration of ICU stay, duration of bypass surgery, high BMI, and reoperation following complications (P> 0.05). In this study, the risk factors during and after the surgery were more responsible for infection after coronary artery bypass surgery compared to preoperative conditions.

Atrial Fibrillation (AF) is a common complication after open heart surgery and is frequently associated with increased hospital stay, complications, and mortality rates. The effect of β-blockers on prevention of supraventricular arrhythmias has been confirmed in several prospective randomized studies.. This clinical trial aimed to compare the preventive effects of carvedilol and metoprolol on occurrence of AF after CABG surgery..Patients and This prospective, double-blind, randomized clinical trial was conducted on 150 patients (55 females, 95 males; mean age: 59 ± 10 years) who underwent CABG surgery. The patients with no contraindication for β-blocker use were randomly divided into two groups of carvedilol and metoprolol Tartarate (n = 75). Treatment with β-blocker was started on the first postoperative day (metoprolol, 25 mg BD; carvedilol, 6.25 mg, BD) and the dosage was regulated according to the patients’ hemodynamic response. All the patients were monitored 5 days after the surgery and incidence of AF and other complications was recorded in both groups.. AF was detected in 18 patients in the carvedilol group and 21 patients in the metoprolol group (P = 0.577). The results of Fisher Exact test showed no significant relationship between the type of the drug and the occurrence of AF (P < 0.05). Nevertheless, the prevalence of AF was higher in the renal failure group. AF was mostly recorded on the second and third days after the surgery. The results showed an association between old age and higher occurrence of AF. AF was recorded in 11 patients (14%) in the metoprolol group and 9 ones (12%) in the carvedilol group, with Left Ventricle Ejection Fraction (LVEF) being between 35% and 45% (P = 0.587). However, no significant difference was found between the two groups in this regard.. In the patients with sufficient ejection fraction, no difference was observed in using carvedilol or metoprolol in prevention of post-CABG AF. Yet, given the anti-oxidant and anti- inflammatory effects of carvedilol, it might be more beneficial in comparison to metoprolol, particularly in the patients with lower ejection fractions or heart failure..

Monitoring of facial nerve function during surgery help surgeons to preserve the nerve during parotid gland surgery. EMG is currently the standard method for monitoring، however، the rates of facial nerve paresis and paralyses are 68-18% and 3%، respectively. The disadvantages of this method are its cost and lack of access to it everywhere. Unipolar alternating electric current stimulation of the facial nerve causes contraction of the muscles and the nerves، and the damage can be avoided. In this study، patients in the years 1388 to 1390 using monopolar electrocautery was undergoing parotidectomy and one month after surgery، the facial nerve injury were examined. During the study period، twenty patients had undergone total or superficial parotid gland resection and one excluded due to facial nerve involvement before surgery. In this study، 19 patients were studied. The mean age of patients participating in this study، 43. 1 ± 13. 9 years and 63. 2% of them (12 cases) were female. A temporary palsy (5. 4%) was observed and there was no paralysis. Due to its availability and low cost، using electrocautery devices compared with standard facial nerve monitoring، EMG، is beneficial and the treatment results are also satisfactory.

Background and

Surgical Site Infection (SSI) is the third leading cause of hospital infections and lead to increased morbidity, mortality and costs after cardiac surgery. The importance of prophylactic antibiotics in cardiac surgery has been proved. The aim of this randomized clinical trial was to compare of two prophylactic antibiotic regimens (cefazolin and cefazolin + Gentamicin) on surgical site infection of CABG patients in Mazandaran Heart Center.

A total of 400 patients, meeting eligibility criteria, were randomly allocated into two equal groups. In the control group the prophylactic regimen consists of Cefazolin 2 g IV before sternal incision followed by 1 g IV every 6 hours for 72 hours. In the intervention group the prophylactic regimen consists of Cefazolin 2 g IV plus Gentamicin 1.5mg/kg IV before sternal incision followed by Cefazolin 1 g IV every 6 hours plus Gentamicin 1.5mg/kg IV every 8 hours for 72 hours. Patients were observed by cardiac surgeon for signs of surgical wound infection at 3, 7, 21 and 30 days after cardiac surgery. Also Creatinine and BUN was measured before, 2th and 4th days after surgery. Data were analyzed by Independent t test, Paired t test, Chi-Square, Fisher and Repeated Measures tests.

392 of 400 patients were examined, 198 patients in control group and 194 patients in intervention group. There was no significant difference between the two groups regarding demographic and clinical variables (P>0.05). After intervention there was no significant difference between the two groups regarding the incidence of infection (P>0.05) but serum level of Creatinine and BUN was significantly higher in intervention group (P<0.05).

With considering to the lack of significant difference in infection rates between two groups and significant increase in serum level of Creatinine and BUN in intervention group, Cefazolin alone is sufficient as a prophylactic antibiotic to prevent surgical site infection of CABG patients.

Primary heart tumors are not common. Âlthough myxoma is the most common tumor of the heart، mitral valve myxoma is extremely rare. The patient is a 55 years old woman who had atypical retrosternal pain، retinal artery emboli and visual deficit. Ïn transesophageal echocardiography a (4x3x3) cm mass was detected in posterior leaflet of mitral valve. The posterior leaflet of mitral valve was totally resected and the mitral valve was successfully replaced with prosthetic mechanical valve. Histopathology result confirmed myxoma.

This research is implemented with the objective to survey course content effect in various academic disciplines such as: various management orientations, medicine, basic sciences, engineering, art and theology, on Tehran University students’ learning style (LS) and spiritual intelligence (SQ or SI). This study used Kolb's learning styles model (1985) which involves four learning styles; abstract conceptualization (AC), reflective observation (RO), active experimentation (AE), concrete experience (CE). The goal of this article is to examine the relationship between measures of SQ among various academic disciplines and their learning styles. Hence, two questionnaires consisting of thirty one questions for SQ evaluation (by alpha %968) and twelve questions for students learning styles measurement (by alpha %87) were used. Our statistic sample included two hundred and twenty five students. Findings of the research show that there is a positive relationship between course contents and LS. Also, the assumption of existing a significant correlation between spiritual intelligence and individual learning style was confirmed. According to the research findings, significant point is that the humanities disciplines, especially management should employ assimilation style to increase power of abstract conceptualization in their learning. But, contents of management lessons are changing in a way that the students.

We evaluated the vascular complications of Intra-aortic balloon pump and risk factors associated with the development of these complications in patients undergoing myocardial revascularization

103 consecutive patients with Intra-aortic balloon pump support were evaluated. Univariate and multivariate analyses were performed to identify risk factors for the development of vascular complications.

Seven (7%) patients developed major and 8 (8%) patients developed minor vascular complications. Ischaemia of the limb, requiring thromboembolectomy, developed in 2 (3%) patients. Mean age of the patients was 59 ± 2 years and 41% of the patients were female. Vascular complications (leg ischemia) were not affected by age. The overall mortality was 44%. Multiple logistic regression analysis revealed duration of intra-aortic balloon pump support, emergency of operation and diabetes as independent risk factors. The duration of intra-aortic balloon pump therapy ranged from 9 hours to 7 days (mean 2 days) and it had a direct linear relation with occurrence of limb ischemia so that the risk was about 16% of patients per 24h (p = 0.055). prevalence of limb ischemia proved to be higher in diabetic patients (p = 0.04). The emergency of operation had clear impact on leg ischemia in patients with intra-aortic balloon pump (p < 0.02).