Baqiyatallah University of Medical Sciences
Hospital Practices and Research
2476-390X
2476-3918
2
3
2017
09
01
Involvement of Patients in Health Technology Assessment: Further Perspectives for Informing Decision-Makers
58
62
EN
David
Hailey
Department of Computing and Information Technology, University of Wollongong, Wollongong, Australia
dvdhailey@gmail.com
10.15171/hpr.2017.16
Health technology assessment (HTA) is an evaluative process used to inform technology-related policymaking in healthcare. Interest in involving patients in the HTA process is increasing. Patients can provide additional perspectives to those of other groups that are concerned with health technology. Information on patients’ perspectives is preferably obtained through reviews of published studies. Primary research approaches can be used if good quality, published evidence is unavailable. There are good examples of input from patients influencing the scope or preparation of HTA reports and subsequent consideration of these reports by decision-makers. One challenge to achieving effective patient involvement is finding suitable resources for patient organizations and HTA agencies. There is also a need for the further development of methods, for example, for use in rapid evidence reviews. HTA programs and the decision-makers they inform have to make choices about when patient input is appropriate. Such choices will include considering which questions or aspects of a technology requires such input and the expected time lines for assessment.
Health Technology Assessment,Patient Involvement,Decision-making,Outcomes,Challenges
https://www.jhpr.ir/article_49622.html
https://www.jhpr.ir/article_49622_9f2fe94962c07ca30df20a2fc5b46c58.pdf
Baqiyatallah University of Medical Sciences
Hospital Practices and Research
2476-390X
2476-3918
2
3
2017
09
01
Comparison of Fentanyl and Midazolam for the Sedation of Infants Under Mechanical Ventilation; A Randomized Clinical Trial
63
67
EN
Bita
Najafian
0000-0002-4029-1979
Department of Pediatrics, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
dr.najafian@yahoo.com
Bahareh
Esmaeili
Department of Clinical Pharmacy, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran
bahar.es@gmail.com
Mohammad Hossein
Khosravi
0000-0003-0426-5092
Student Research Committee (SRC), Baqiyatallah University of Medical Sciences, Tehran, Iran
dr.mhkhosravi@gmail.com
10.15171/hpr.2017.17
<strong>Background:</strong> Neonatal respiratory distress syndrome (NRDS), a life-threatening pulmonary disorder, involves 1% of all deliveries worldwide. Shallow breathing causes restlessness in infants, which itself affects pulmonary function; thus, sedative medications are used to preserve better pulmonary function. There are different opinions about the benefits and superiority of these drugs.<br /> <strong>Objective:</strong> The study purposed to assess and compare the effects of fentanyl and midazolam on the required time of mechanical ventilation in infants with respiratory distress syndrome (RDS).<br /> <strong>Methods:</strong> In this randomized clinical trial, 60 infants with RDS were randomly allocated to 2 groups (30 infants each); the first group underwent sedation with midazolam (0.1 mg/kg), and the second group received 0.5 mcg/kg of fentanyl during ventilation. The duration of hospitalization, required time of ventilation, drug complications, feeding intolerance, as well as pneumothorax incidence and need for re-intubation were recorded and compared between the 2 groups.<br /> <strong>Results:</strong> Eventually, 60 infants (45 male and 15 female) with a mean gestational age of 37.13±1.22 weeks in the midazolam group and 36.73±1.50 weeks in the fentanyl group underwent analysis (P value=0.449). Infants in the midazolam group had a mean length of stay of 11.96 ± 3.41 days, while mean length of stay was 10.36±3.57 days for infants in the fentanyl group (P value=0.039). Mean duration of mechanical ventilation was 4.6±2.14 days in the midazolam group and 4.06±2.04 days in the fentanyl group (P value=0.252).<br /> <strong>Conclusion:</strong> The findings suggest that midazolam is a more suitable medication for the sedation of infants under mechanical ventilation in comparison with fentanyl; however, its side effects, such as apnea, pneumonia, and seizure, should be considered.
Midazolam,Fentanyl,Respiratory Distress Syndrome,Mechanical Ventilation
https://www.jhpr.ir/article_49776.html
https://www.jhpr.ir/article_49776_1ae5bfd70c7f82b48d48fe6865d365b4.pdf
Baqiyatallah University of Medical Sciences
Hospital Practices and Research
2476-390X
2476-3918
2
3
2017
09
01
Comparison of Estrogen Receptor and Progesterone Receptor in Ductal Carcinoma and Lobular Carcinoma With Regard to Age Prevalence
68
71
EN
Seyed Morteza
Mousavi Naeini
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
morteza.mousavi@bmsu.ac.ir
Shaban
Mehrvarz
0000-0002-4401-5859
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
mehrvarz@bmsu.ac.ir
Ali Mohammad
Madahian
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
mohammad.madahian@bmsu.ac.ir
Shahram
Manoochehry
0000-0002-0424-1763
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
shahram.manoochehry@yahoo.com
Hamid Reza
Rasouli
0000-0003-2793-624X
Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
hr.rasouli64@gmail.com
10.15171/hpr.2017.18
<strong>Background:</strong> Breast cancer is one of the most common women’s cancers, and the number of cases is increasing worldwide.<br /> <strong>Objective:</strong> The current study compared invasive lobular carcinoma (ILC) and invasive ductal carcinoma with regard to the prevalence of estrogen receptor (ER), progesterone receptor (PR), and age prevalence.<br /> <strong>Methods:</strong> This cross-sectional study recruited 225 women diagnosed with invasive ductal or lobular carcinoma who were admitted to the Department of Surgery of Baqiyatallah hospital between March 2014 and March 2015. The ER and PR levels reported were based on the pathologists’ interpretation of assay results; both ER and PR were estimated to be positive when immunoperoxidase staining of the tumor cell nucleus was more than 10%.<br /> <strong>Results:</strong> The most common malignancy was invasive ductal carcinoma found in 213 patients (94.7%) with a mean age of 49.30 ± 12.25 years (0.706). The most common subtype of invasive ductal carcinoma was NOS (82.6%); patients of this type had a mean age of 49.68 ± 12.27 years. Among patients with infiltrative ductal carcinoma (IDC), 129 (60.6%) of them were ER positive. In patients with ILC, 11 cases (91.7%) were ER positive (P < 0.03). Among the patients who had IDC, 107 (50.2%) of them were PR positive. Also, 6 patients who had ILC (50.0%) were ER positive (P < 0.98).<br /> <strong>Conclusion:</strong> The results of this study indicate that the age prevalence of breast cancer in Iran is about 10 years sooner than the rest of the world. In addition, the prevalence rates of positive estrogen and progesterone receptors were lower in this study than in the majority of other studies, and these 2 features worsen the prognosis in the treatment of Iranian patients.
Estrogen Receptor,Progesterone Receptor,Ductal carcinoma,Lobular Carcinoma Cancer
https://www.jhpr.ir/article_49123.html
https://www.jhpr.ir/article_49123_b21ee75cc19531f0ff7503a4d853b241.pdf
Baqiyatallah University of Medical Sciences
Hospital Practices and Research
2476-390X
2476-3918
2
3
2017
09
01
Nurses’ Perception of Organisational Justice and its Effect on Bullying Behaviour in the Hospitals of Turkey
72
78
EN
Hanım
Seyrek
Ankara Numune Research and Education Hospital, Ankara, Turkey
hanimdincer@gmail.com
Dilek
Ekici
0000-0002-8401-4172
Nursing Department, Health Science Faculty, Gazi University, Ankara, Turkey
docdrdilekekici@gmail.com
10.15171/hpr.2017.19
<strong>Background:</strong> The ‘Organizational Justice’ concept is used in order to determine whether the administrator is fair to his personnel or not. It is said that those who get bullied are usually terrorized, annoyed, excluded, belittled, deprived of resources, isolated and prevented from claiming rights.<br /> <strong>Objective:</strong> The purpose of this study is to determine nurses’ perception of organizational justice and its effect on the bullying behaviour they are exposed to.<br /> <strong>Methods:</strong> The cross-sectional study was conducted on nurses at a university hospital and a private hospital in Ankara. In this regard, 250 nurses who had been serving in their respective hospitals for 6 months participated in the study. The variables were measured under 2 categories: bullying and perception of organizational justice. A simple regression analysis was carried out in order to determine the bullying behaviour which causes the nurses’ justice perceptions.<br /> <strong>Results:</strong> According to the survey, the nurses are most likely to perceive injustice in the area of distributional justice. Results revealed that the ratio of nurses who were exposed to bullying in the workplace was 28%. There was a significant and negative relation between the nurses’ distributional justice perception and the bullying they were exposed to.<br /> <strong>Conclusion:</strong> The employees whose organizational justice perceptions are low, display a threatening and negative behaviour towards their colleagues and the institution. They feel themselves to be threatened when they think that they can’t communicate with upper management respectfully and also when they believe that their managers are unjust in performance assessment, in assessing salaries and promotion.
Nurses,Justice,Behaviour,Bullying
https://www.jhpr.ir/article_49796.html
https://www.jhpr.ir/article_49796_07cc2aac738dbe9e041f815b2f6babf7.pdf
Baqiyatallah University of Medical Sciences
Hospital Practices and Research
2476-390X
2476-3918
2
3
2017
09
01
Endophthalmitis in the Tertiary Referral Center in Iran; Etiology and Causative Organisms
79
83
EN
Hamidreza
Torabi
0000-0001-9316-3949
Department of Ophthalmology, Baqiyatallah University of Medical Sciences, Tehran, Iran
dr_hamidrezatorabi@yahoo.com
Mohammad
Riazi Esfahani
0000-0002-9409-2836
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
riazifahimi@yahoo.com
Seyed-Ali
Tabatabai
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
ntavakoli2018@gmail.com
10.15171/hpr.2017.20
<strong>Background:</strong> Endophthalmitis is a severe and sight-threatening complication of ocular surgery or ocular trauma. The identification of common types and causative organisms is essential for prevention and management.<br /> <strong>Objective:</strong> The current study describes the prevalence of various types of endophthalmitis and the causative microbiological spectrum of each type treated in the Tertiary Referral Center in Iran.<br /> <strong>Methods:</strong> All cases of endophthalmitis admitted to the Emergency Department of Farabi Eye hospital (Tehran, Iran) between July 2013 and December 2014 were included in this study. The patients’ demographic data, type of endophthalmitis, aqueous or vitreous culture results, and treatment methods were recorded.<br /> <strong>Results:</strong> From 108 presumed endophthalmitis cases, post-operative endophthalmitis (68.5%) was the most frequent type followed by post-traumatic (25%), bleb-associated (4.6%), and endogenous (1.9%) types. Streptococcus viridians (37.5%) was the most common isolated organism in post-operative cases. In post-traumatic endophthalmitis patients, the most frequent causative organism was Staphylococcus epidermidis (70%).<br /> <strong>Conclusion:</strong> Many studies from other countries have reported that S. epidermidis is the leading cause of endophthalmitis after either intraocular surgeries or open-globe injuries, but the current study has shown that S. viridians is the most common isolated organism in post-operative endophthalmitis.
Endophthalmitis,Post-Cataract Endophthalmitis,Posttraumatic Endophthalmitis,Bleb-Associated Endophthalmitis,Vitreous Culture
https://www.jhpr.ir/article_49236.html
https://www.jhpr.ir/article_49236_f2dcada7817a81c07a6cab2e024f19ef.pdf
Baqiyatallah University of Medical Sciences
Hospital Practices and Research
2476-390X
2476-3918
2
3
2017
09
01
Nursing Workloads and Psychological Empowerment in Hospitals: Structural Equations Modeling
84
89
EN
Parvin
Ebrahimi
0000-0003-2150-864X
Health Management and Economics Research Centre, Iran University of Medical Sciences, Tehran, Iran
parvin_eb@yahoo.com
Zainab
Malmoon
Department of Health Services Administration, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
zemalmoon@gmail.com
Rouhollah
Zaboli
0000-0002-6512-7278
Department of Health Administration, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
rouhollah.zaboli@gmail.com
10.15171/hpr.2017.21
<strong>Background:</strong> The high workload of nurses in hospitals has been identified as a patient safety and worker stress problem. Psychological empowerment is a motivational concept demonstrated in four dimensions: meaning, competence, self-determination, and impact.<br /> <strong>Objective:</strong> This study investigated the relationship between nurses’ workloads and psychological empowerment using structural equations modeling (SEM).<br /> <strong>Methods:</strong> This descriptive correlation study was conducted using SEM. The study was conducted at 17 public hospitals affiliated with Iran University of Medical Sciences (IUMS) in the city of Tehran. The population study was nurses employed in critical care departments. Two questionnaires were used to gather data: the NASA and the Psychological Empowerment Questionnaires. Differences in categorical variables were analyzed using one-way analysis of variance (ANOVA). Confirmatory factor analyses were used to confirm the relationships between latent variables and indicator variables; SEM was used to find the direct and indirect effects of nurse’s workload on psychological empowerment. Data analyses were performed using SPSS 18, and all models were tested in LISREL 8.8.<br /> <strong>Results:</strong> Correlations among indicators of nurse’s workload showed that highest correlations were performances (0.61), and the highest correlations among psychological empowerment were competence (0.03). The overall correlations among nursing workloads and psychological empowerment were 0.74. The proposed structural model fit was acceptable (χ2 = 525.5, df = 89, RMSEA = 0.13, GFI = 0.91).<br /> <strong>Conclusion:</strong> Increasing the workload of nurses in hospitals will better engage the nurses and allow them to face new problems they encounter in their jobs.
Workload,Nurses,Power,Hospitals
https://www.jhpr.ir/article_49237.html
https://www.jhpr.ir/article_49237_bd4a9bdd510c12dd80ef0459c56c3611.pdf
Baqiyatallah University of Medical Sciences
Hospital Practices and Research
2476-390X
2476-3918
2
3
2017
09
01
Clinical Implications of Congenital Absence of Circumflex Coronary Artery
90
92
EN
Ahmet
Karabulut
Department of Cardiology, School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey
drkarabulut@yahoo.com
10.15171/hpr.2017.22
<strong>Introduction:</strong> Coronary artery anomalies are rare clinical entities reported in 0.6% to 5.6% of diagnostic coronary angiographies. Anomalous origins of coronary arteries from distal segments are rarely reported. Presented herein is a coronary anomaly in which the circumflex artery (CX) originated as a continuation of the posterolateral branch of the right coronary artery (RCA) with separate left anterior descending (LAD) artery origination from the left sinus of Valsalva. The clinical presentation of such a rare anomaly is discussed, and the current literature regarding the congenital absence of CX is reviewed.<br /> <strong>Case Presentation</strong>: A 66-year-old male presented with angina pectoris. Coronary angiography revealed critical stenosis in the mid segment of the LAD artery and an anomalous origin of CX artery from the distal RCA. The CX was coursing as a continuation of the posterolateral branch of the RCA. Coronary angioplasty and stent deployment was performed for the LAD lesion, and the patient was discharged with medical therapy. The patient did not report recurrent anginal symptoms under medical therapy.<br /> <strong>Conclusion:</strong> The congenital absence of the circumflex coronary artery is a rare coronary anomaly. The clinical presentation may vary, though most cases are asymptomatic during diagnosis. Such cases require close clinical follow-up since they entertain a future risk for being symptomatic, especially in the setting of atherosclerotic disease.
Coronary Vessel Anomalies,Incidence,Symptom Assessment,Prognosis
https://www.jhpr.ir/article_49888.html
https://www.jhpr.ir/article_49888_3211a233cce5161a490712df6754d925.pdf