Iranian Red Crescent Medical Journal Iranian Red Crescent Medical Journal Iran Red Crescent Med J http://www.ircmj.com 2074-1804 2074-1812 10.5812/ircmj en jalali 2017 5 26 gregorian 2017 5 26 17 5
en 26082851 10.5812/ircmj.21509 Introducing an Outcome Expectation Questionnaire and Its Psychometric Properties Regarding Leisure Time Physical Activity for Iranian Male Adolescent Introducing an Outcome Expectation Questionnaire and Its Psychometric Properties Regarding Leisure Time Physical Activity for Iranian Male Adolescent research-article research-article Conclusions

This study provided evidence regarding the reliability and validity of the Iranian male adolescent outcome expectation about leisure time physical activity (IMAO-PAC) and illustrated that this new questionnaire can be used to measure the perceived exercise benefits among target group in observational and interventional studies.

Background

Outcome expectation (OE) is known as a psychosocial determinant of leisure time physical activity (LTPA). Despite importance of this construct evaluation, there is no evidence of special questionnaire for measuring OE in Persian speaking Iranian male adolescents.

Objectives

This article reports development and psychometric evaluation process of a specific questionnaire that evaluates OE about LTPA among Iranian male adolescents.

Materials and Methods

Literature review and group discussions were used to select 26 items of this questionnaire based on 3 dimensions of OE (self-evaluation, social expectancy, and physical expectancy). All Participants (n = 720) were divided into two groups randomly after evaluating comprehensibility, face and content validity, and items analysis. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were separately operated on one of these groups for evaluation of the construct validity of questionnaire. The reliability of the questionnaire was estimated by the Cronbach α.

Results

EFA extracted 3 main factors explained 45.80%, 10.31%, and 7.51% of OE variance, respectively. Almost all fit indexes in CFA were acceptable (CMIN = 107.39, CMIN/DF = 2.619, CFI = 0.938, PCFI = 0.699, RMSEA = 0.067, PCLOSE = 0.034). Finally 11 items remained in the questionnaire, which showed excellent reliability on main study (α = 0.85).

Conclusions

This study provided evidence regarding the reliability and validity of the Iranian male adolescent outcome expectation about leisure time physical activity (IMAO-PAC) and illustrated that this new questionnaire can be used to measure the perceived exercise benefits among target group in observational and interventional studies.

Background

Outcome expectation (OE) is known as a psychosocial determinant of leisure time physical activity (LTPA). Despite importance of this construct evaluation, there is no evidence of special questionnaire for measuring OE in Persian speaking Iranian male adolescents.

Objectives

This article reports development and psychometric evaluation process of a specific questionnaire that evaluates OE about LTPA among Iranian male adolescents.

Materials and Methods

Literature review and group discussions were used to select 26 items of this questionnaire based on 3 dimensions of OE (self-evaluation, social expectancy, and physical expectancy). All Participants (n = 720) were divided into two groups randomly after evaluating comprehensibility, face and content validity, and items analysis. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were separately operated on one of these groups for evaluation of the construct validity of questionnaire. The reliability of the questionnaire was estimated by the Cronbach α.

Results

EFA extracted 3 main factors explained 45.80%, 10.31%, and 7.51% of OE variance, respectively. Almost all fit indexes in CFA were acceptable (CMIN = 107.39, CMIN/DF = 2.619, CFI = 0.938, PCFI = 0.699, RMSEA = 0.067, PCLOSE = 0.034). Finally 11 items remained in the questionnaire, which showed excellent reliability on main study (α = 0.85).

Exercise;Adolescent;Questionnaires;Reproducibility of Results;Cognition;Iran Exercise;Adolescent;Questionnaires;Reproducibility of Results;Cognition;Iran http://www.ircmj.com/index.php?page=article&article_id=21509 Mohammad Hadi Abasi Mohammad Hadi Abasi Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR Iran Ahmad Ali Eslami Ahmad Ali Eslami Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-3137922652 Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Health Education and Promotion, School of Public Health, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-3137922652 Fatemeh Rakhshani Fatemeh Rakhshani Department of Health Education and Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Department of Health Education and Promotion, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 26082849 10.5812/ircmj.17(5)2015.18373 Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial research-article research-article Background

One of the strategies for a good outcome and pain free childbearing is to design the delivery room.

Objectives

The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women.

Patients and Methods

This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation.

Results

The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants’ intervention vs. 66% of control participants had perinea laceration (P = 0.041).

Conclusions

According to the findings of the present study, distracting senses in snoezelen room decreases mother’s pain intensity, the length of labor, and incidence of episiotomy.

Background

One of the strategies for a good outcome and pain free childbearing is to design the delivery room.

Objectives

The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women.

Patients and Methods

This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation.

Results

The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants’ intervention vs. 66% of control participants had perinea laceration (P = 0.041).

Conclusions

According to the findings of the present study, distracting senses in snoezelen room decreases mother’s pain intensity, the length of labor, and incidence of episiotomy.

Snoezelen Room;Perinea Laceration;Childbirth;Labor Onset;Labor Pain Snoezelen Room;Perinea Laceration;Childbirth;Labor Onset;Labor Pain http://www.ircmj.com/index.php?page=article&article_id=18373 Mansoureh Jamshidi Manesh Mansoureh Jamshidi Manesh Department of Reproductive Health, Shahroud University of Medical Sciences, Shahoud, Iran Department of Reproductive Health, Shahroud University of Medical Sciences, Shahoud, Iran Mahnaz Kalati Mahnaz Kalati Labor and Childbirth Ward, Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, IR Iran; Labor and Childbirth Ward, Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, IR Iran Labor and Childbirth Ward, Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, IR Iran; Labor and Childbirth Ward, Akbar Abadi Hospital, Iran University of Medical Sciences, Tehran, IR Iran Fatemeh Hosseini Fatemeh Hosseini Department of Biostatistics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, IR Iran Department of Biostatistics, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, IR Iran
en 10.5812/ircmj.17(5)2015.18320 Unscheduled Return Visits and Leaving the Chest Pain Unit Against Medical Advice Unscheduled Return Visits and Leaving the Chest Pain Unit Against Medical Advice research-article research-article Conclusions

Considering that the most frequent reason for our URVs was patient-related factors, where all cases had left the CPU Against Medical Advice (AMA) during their first attendance, we recommend that further appropriate strategies be devised to prevent leaving against medical advice.

Results

Patient-related factors accounted for most 72 hours URVs (49%). Multivariable analysis revealed that in our CPU, leaving Against medical advice was the most important predictor for 72 hours URVs (P value < 0.001). Additionally, male sex, history of hypertension, first-visit disposition to observation unit and age were the other factors associated with URVs.

Background

Rate of Unscheduled Return Visits (URVs) to the Emergency Department has been considered as a key indicator for evaluating the quality of the Emergency Department care for decades. A higher rate of URVs can have a negative impact on the quality of health care. Investigations of the reasons for these returns have indicated that many of these visits can be preventable.

Objectives

Given that there are no clear findings about the frequency and reasons for 72 hours URVs to the Chest Pain Unit (CPU), in the present study, we investigated the causes of 72 hours URVs to our CPU in order to find out the inadequacies, and propose preventive strategies.

Patients and Methods

This research was a single-center retrospective case control study in the setting of CPU of Tehran Heart Center (a 460-bed, tertiary-care teaching hospital), Tehran, Iran. The medical records of the patients who were presented to our CPU with the chief complaint of chest pain between December 28th, 2010 and February 28th, 2011 were reviewed. Of the 6247 eligible patients, forty-nine URVs that fulfilled our criteria were identified. The control group consisted of 196 patients who did not return to the Emergency Department during our study period.

Conclusions

Considering that the most frequent reason for our URVs was patient-related factors, where all cases had left the CPU Against Medical Advice (AMA) during their first attendance, we recommend that further appropriate strategies be devised to prevent leaving against medical advice.

Results

Patient-related factors accounted for most 72 hours URVs (49%). Multivariable analysis revealed that in our CPU, leaving Against medical advice was the most important predictor for 72 hours URVs (P value < 0.001). Additionally, male sex, history of hypertension, first-visit disposition to observation unit and age were the other factors associated with URVs.

Background

Rate of Unscheduled Return Visits (URVs) to the Emergency Department has been considered as a key indicator for evaluating the quality of the Emergency Department care for decades. A higher rate of URVs can have a negative impact on the quality of health care. Investigations of the reasons for these returns have indicated that many of these visits can be preventable.

Objectives

Given that there are no clear findings about the frequency and reasons for 72 hours URVs to the Chest Pain Unit (CPU), in the present study, we investigated the causes of 72 hours URVs to our CPU in order to find out the inadequacies, and propose preventive strategies.

Patients and Methods

This research was a single-center retrospective case control study in the setting of CPU of Tehran Heart Center (a 460-bed, tertiary-care teaching hospital), Tehran, Iran. The medical records of the patients who were presented to our CPU with the chief complaint of chest pain between December 28th, 2010 and February 28th, 2011 were reviewed. Of the 6247 eligible patients, forty-nine URVs that fulfilled our criteria were identified. The control group consisted of 196 patients who did not return to the Emergency Department during our study period.

Chest Pain;Against Medical Advice;Return Visits Chest Pain;Against Medical Advice;Return Visits http://www.ircmj.com/index.php?page=article&article_id=18320 Yaser Jenab Yaser Jenab General Cardiology Department, Tehran University of Medical Sciences, Tehran, IR Iran; General Cardiology Department, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188029256, Fax: +98-2188029256 General Cardiology Department, Tehran University of Medical Sciences, Tehran, IR Iran; General Cardiology Department, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188029256, Fax: +98-2188029256 Shima Haghani Shima Haghani Clinical Research Department, Tehran University of Medical Sciences, Tehran, IR Iran Clinical Research Department, Tehran University of Medical Sciences, Tehran, IR Iran Arash Jalali Arash Jalali Clinical Research Department, Tehran University of Medical Sciences, Tehran, IR Iran Clinical Research Department, Tehran University of Medical Sciences, Tehran, IR Iran Farzad Darabi Farzad Darabi Clinical Research Department, Tehran University of Medical Sciences, Tehran, IR Iran Clinical Research Department, Tehran University of Medical Sciences, Tehran, IR Iran
en 26082846 10.5812/ircmj.17(5)2015.17594 Dietary Patterns of Young Females and Their Association With Waist Circumference as a Health Index in Northwest of Iran, 2007 Dietary Patterns of Young Females and Their Association With Waist Circumference as a Health Index in Northwest of Iran, 2007 research-article research-article Conclusions

The current study findings suggest that the Iranian Central Obesity Making Dietary Pattern is directly associated with waist circumference (marker of central obesity), while lacto vegetarian dietary pattern is reversely associated with weight, waist circumference and BMI. Special obesity pattern in Iranian young females can be justified by Iranian Central Obesity Making Dietary Pattern”.

Background

Despite the higher prevalence of overweight and obesity among young people in western countries, the 50th and 95th percentile ranks for waist circumference in the Iranian young Females are higher than those of the western ones.

Objectives

Identifying major dietary patterns in Iranian young females, which associate with central obesity, can probably explain the difference between Iranian young females’ pattern and those of their western peers regarding obesity.

Patients and Methods

In the current cross-sectional study, a total of 257 young females aged 11 - 15 years old from Talaat Intelligent Guidance School, Tabriz, Iran (2007) were selected for the study using non-probability simple sampling method. Then, usual dietary intakes of all subjects were evaluated by a food frequency questionnaire and anthropometric measurements such as weight, height, waist circumference, and Body Mass Index (BMI) using the standard protocols. Data were analyzed by inferential statistics (One-way ANOVA, Tukey test for Post-Hoc Analysis, Chi-square test, age-adjusted means, analysis of covariance with Bonferroni correction, correlation and partial correlation) by SPSS software.

Results

In the current study, six major dietary patterns were extracted using factor analysis method. Before and after controlling the age, subjects in the upper tertile of the Iranian Central Obesity Making Dietary Pattern (rich in cruciferous vegetables, green leafy vegetables, soft drinks, tomatoes, other vegetables and vegetable oils) had larger waist circumference in comparison with the ones in the lower tertile (before controlling for age: 64.2 ± 9 vs. 61.6 ± 7 P = 0.03; after: 64.5 ± 0.8 vs. 61.5 ± 0.8, P = 0.009). However in lacto vegetarian dietary pattern (rich in legumes, potato, other vegetables, dough, high-fat dairy products and margarine), individuals in the upper tertile had significantly lower weight, waist circumference and body mass index (BMI) in comparison with the ones in the lower tertile (weight: 44.9 ± 9.3 vs. 51.4 ± 10.6, P < 0.01; WC: 59.9 ± 8 vs. 64 ± 7.9, P < 0.01; BMI: 18.6 ± 3.1 vs. 20.6 ± 3.5, P < 0.01).

Conclusions

The current study findings suggest that the Iranian Central Obesity Making Dietary Pattern is directly associated with waist circumference (marker of central obesity), while lacto vegetarian dietary pattern is reversely associated with weight, waist circumference and BMI. Special obesity pattern in Iranian young females can be justified by Iranian Central Obesity Making Dietary Pattern”.

Background

Despite the higher prevalence of overweight and obesity among young people in western countries, the 50th and 95th percentile ranks for waist circumference in the Iranian young Females are higher than those of the western ones.

Objectives

Identifying major dietary patterns in Iranian young females, which associate with central obesity, can probably explain the difference between Iranian young females’ pattern and those of their western peers regarding obesity.

Patients and Methods

In the current cross-sectional study, a total of 257 young females aged 11 - 15 years old from Talaat Intelligent Guidance School, Tabriz, Iran (2007) were selected for the study using non-probability simple sampling method. Then, usual dietary intakes of all subjects were evaluated by a food frequency questionnaire and anthropometric measurements such as weight, height, waist circumference, and Body Mass Index (BMI) using the standard protocols. Data were analyzed by inferential statistics (One-way ANOVA, Tukey test for Post-Hoc Analysis, Chi-square test, age-adjusted means, analysis of covariance with Bonferroni correction, correlation and partial correlation) by SPSS software.

Results

In the current study, six major dietary patterns were extracted using factor analysis method. Before and after controlling the age, subjects in the upper tertile of the Iranian Central Obesity Making Dietary Pattern (rich in cruciferous vegetables, green leafy vegetables, soft drinks, tomatoes, other vegetables and vegetable oils) had larger waist circumference in comparison with the ones in the lower tertile (before controlling for age: 64.2 ± 9 vs. 61.6 ± 7 P = 0.03; after: 64.5 ± 0.8 vs. 61.5 ± 0.8, P = 0.009). However in lacto vegetarian dietary pattern (rich in legumes, potato, other vegetables, dough, high-fat dairy products and margarine), individuals in the upper tertile had significantly lower weight, waist circumference and body mass index (BMI) in comparison with the ones in the lower tertile (weight: 44.9 ± 9.3 vs. 51.4 ± 10.6, P < 0.01; WC: 59.9 ± 8 vs. 64 ± 7.9, P < 0.01; BMI: 18.6 ± 3.1 vs. 20.6 ± 3.5, P < 0.01).

Adolescent;Diet;Anthropometry;Iran Adolescent;Diet;Anthropometry;Iran http://www.ircmj.com/index.php?page=article&article_id=17594 Mohammad Alizadeh Mohammad Alizadeh Food and Beverages Safety Research Center, Department of Nutrition, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, IR Iran Food and Beverages Safety Research Center, Department of Nutrition, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, IR Iran Alireza Didarloo Alireza Didarloo Social Determinants of Health Research Center, Department of Health and Preventive Medicine, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, IR Iran; Social Determinants of Health Research Center, Department of Health and Preventive Medicine, Faculty of Medicine, Urmia University of Medical Sciences, P. O. Box: 57561-15111, Urmia, IR Iran. Tel: +98-4412752372, Fax: +98-4412780800 Social Determinants of Health Research Center, Department of Health and Preventive Medicine, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, IR Iran; Social Determinants of Health Research Center, Department of Health and Preventive Medicine, Faculty of Medicine, Urmia University of Medical Sciences, P. O. Box: 57561-15111, Urmia, IR Iran. Tel: +98-4412752372, Fax: +98-4412780800 Ahmad Esmaillzadeh Ahmad Esmaillzadeh Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran
en 26082852 10.5812/ircmj.17(5)2015.21934 Intestinal Obstruction Due to Idiopathic Sclerosing Encapsulating Peritonitis: A Case Report Intestinal Obstruction Due to Idiopathic Sclerosing Encapsulating Peritonitis: A Case Report case-report case-report Conclusions

Despite advances in radiological techniques, the exact diagnosis in many cases is still made according to intraoperative findings and histopathological properties of the excised membrane. While some cases of SEP remain asymptomatic for years, most cases are characterized by recurrent bouts of acute, subacute or chronic intestinal obstruction. To our knowledge, the case presented here is the oldest patient with idiopathic SEP in the literature.

Introduction

Sclerosing encapsulating peritonitis (SEP) is characterized by partial or complete encasement of small intestine by a thick fibrocollagenous membrane. Depending on underlying causes, SEP is divided into primary and secondary forms. Idiopathic SEP is also called idiopathic or abdominal cocoon syndrome. Herein we presented a case of idiopathic SEP.

Case Presentation

A 90-year-old male patient presented to our emergency department with signs and symptoms of intestinal obstruction and dehydration. Physical examination findings, patient's age and plain abdominal radiography were consistent with tumoral obstruction or viscus perforation. Explorative laparotomy revealed a fibrous capsule encasing intestines as well as dense adhesions between intestinal loops. Since the overall condition of the patient was not well enough to allow a wide dissection and membrane excision, the operation was terminated after performing a limited loop ileostomy. Unfortunately, the patient was lost due to organ failure at the postoperative period.

Conclusions

Despite advances in radiological techniques, the exact diagnosis in many cases is still made according to intraoperative findings and histopathological properties of the excised membrane. While some cases of SEP remain asymptomatic for years, most cases are characterized by recurrent bouts of acute, subacute or chronic intestinal obstruction. To our knowledge, the case presented here is the oldest patient with idiopathic SEP in the literature.

Introduction

Sclerosing encapsulating peritonitis (SEP) is characterized by partial or complete encasement of small intestine by a thick fibrocollagenous membrane. Depending on underlying causes, SEP is divided into primary and secondary forms. Idiopathic SEP is also called idiopathic or abdominal cocoon syndrome. Herein we presented a case of idiopathic SEP.

Case Presentation

A 90-year-old male patient presented to our emergency department with signs and symptoms of intestinal obstruction and dehydration. Physical examination findings, patient's age and plain abdominal radiography were consistent with tumoral obstruction or viscus perforation. Explorative laparotomy revealed a fibrous capsule encasing intestines as well as dense adhesions between intestinal loops. Since the overall condition of the patient was not well enough to allow a wide dissection and membrane excision, the operation was terminated after performing a limited loop ileostomy. Unfortunately, the patient was lost due to organ failure at the postoperative period.

Intestinal Obstruction;Encapsulating Peritoneal Sclerosis;Abdomen Intestinal Obstruction;Encapsulating Peritoneal Sclerosis;Abdomen http://www.ircmj.com/index.php?page=article&article_id=21934 Ridvan Yavuz Ridvan Yavuz Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey Sami Akbulut Sami Akbulut Department of Surgery, Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey; Department of Surgery, Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey. Tel: +90-4223410660, Fax: +90-4223410036 Department of Surgery, Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey; Department of Surgery, Liver Transplant Institute, Faculty of Medicine, Inonu University, Malatya, Turkey. Tel: +90-4223410660, Fax: +90-4223410036 Mehmet Babur Mehmet Babur Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey Firat Demircan Firat Demircan Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey
en 26082855 10.5812/ircmj.17(5)2015.28090 17-Year-Delayed Fistula Formation After Elective Spinal Instrumentation: A Case Report 17-Year-Delayed Fistula Formation After Elective Spinal Instrumentation: A Case Report case-report case-report Conclusions

Late inflammation may occur around spinal instruments and results in cutaneous fistula formation. After oral or intravenous antibiotic treatment, total device extraction is the cornerstone of treatment.

Case Presentation

Here we report an unusual 17-year delayed fistula formation after primary spinal instrumentation due to spinal trauma. He was admitted to Ghaem General Hospital, a chief referral center, Mashhad, North-East of Iran in August 2014. The patient underwent hardware removal surgery with antibiotic therapy as a definitive treatment.

Introduction

A late-developing infection after an uneventful initial spinal instrumentation procedure is rare. Delayed infection and new fistula formation have been reported from a few months to 13 years. Here we report an unusual 17-year-delayed fistula formation after primary spinal instrumentation. The patient underwent hardware removal surgery with antibiotic therapy as a definitive treatment.

Conclusions

Late inflammation may occur around spinal instruments and results in cutaneous fistula formation. After oral or intravenous antibiotic treatment, total device extraction is the cornerstone of treatment.

Case Presentation

Here we report an unusual 17-year delayed fistula formation after primary spinal instrumentation due to spinal trauma. He was admitted to Ghaem General Hospital, a chief referral center, Mashhad, North-East of Iran in August 2014. The patient underwent hardware removal surgery with antibiotic therapy as a definitive treatment.

Introduction

A late-developing infection after an uneventful initial spinal instrumentation procedure is rare. Delayed infection and new fistula formation have been reported from a few months to 13 years. Here we report an unusual 17-year-delayed fistula formation after primary spinal instrumentation. The patient underwent hardware removal surgery with antibiotic therapy as a definitive treatment.

Delayed;Fistula;Instrumentation Delayed;Fistula;Instrumentation http://www.ircmj.com/index.php?page=article&article_id=28090 Hamid Etemadrezaei Hamid Etemadrezaei Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran Samira Zabihyan Samira Zabihyan Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran Aidin Shakeri Aidin Shakeri Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran Babak Ganjeifar Babak Ganjeifar Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran; Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran. Tel: + 98-5138012613, Fax: + 98-5138413493 Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran; Department of Neurological Surgery, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran. Tel: + 98-5138012613, Fax: + 98-5138413493
en 26082848 10.5812/ircmj.17(5)2015.18342 Coexistence of Obstructive Sleep Apnea and Superior Vena Cava Syndromes Due to Substernal Goitre in a Patient With Respiratory Failure: A Case Report Coexistence of Obstructive Sleep Apnea and Superior Vena Cava Syndromes Due to Substernal Goitre in a Patient With Respiratory Failure: A Case Report case-report case-report Conclusions

Our case showed that if the respiratory failure occurred due to substernal goiter and SVCS, we would need to investigate the coexistence of OSAS and SVCS.

Case Presentation

We presented the clinical course and treatment of acute respiratory failure (ARF) developed in a patient with SVCS and OSAS due to substernal goiter. After treatment of ARF with invasive mechanical ventilation, weaning and total thyroidectomy were successfully performed through collar incision and median sternotomy without complications.

Introduction

Substernal goiter may rarely cause superior vena cava syndrome (SVCS) owing to venous compression, and cause acute respiratory failure due to tracheal compression. Obstructive sleep apnea syndrome (OSAS) may rarely occur when there is a narrowing of upper airway by edema and vascular congestion resulting from SVCS.

Conclusions

Our case showed that if the respiratory failure occurred due to substernal goiter and SVCS, we would need to investigate the coexistence of OSAS and SVCS.

Case Presentation

We presented the clinical course and treatment of acute respiratory failure (ARF) developed in a patient with SVCS and OSAS due to substernal goiter. After treatment of ARF with invasive mechanical ventilation, weaning and total thyroidectomy were successfully performed through collar incision and median sternotomy without complications.

Introduction

Substernal goiter may rarely cause superior vena cava syndrome (SVCS) owing to venous compression, and cause acute respiratory failure due to tracheal compression. Obstructive sleep apnea syndrome (OSAS) may rarely occur when there is a narrowing of upper airway by edema and vascular congestion resulting from SVCS.

Substernal Goiter;Superior Vena Cava Syndrome;Apneas, Sleep;Respiratory Failure Substernal Goiter;Superior Vena Cava Syndrome;Apneas, Sleep;Respiratory Failure http://www.ircmj.com/index.php?page=article&article_id=18342 Mehtap Tunc Mehtap Tunc Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey; Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.Tel: +90-3123825582, Fax: +90-3124817783 Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey; Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.Tel: +90-3123825582, Fax: +90-3124817783 Hilal Sazak Hilal Sazak Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey Bulent Karlilar Bulent Karlilar Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey Fatma Ulus Fatma Ulus Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey Department of Anesthesiology and Reanimation, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey Irfan Tastepe Irfan Tastepe Department of Thoracic Surgery, Gazi University Medical Faculty, Ankara, Turkey Department of Thoracic Surgery, Gazi University Medical Faculty, Ankara, Turkey
en 26082850 10.5812/ircmj.17(5)2015.19000 A Comparison of Organizational Climate and Nurses’ Intention to Leave Among Excellence Awarded Hospitals and Other Hospitals in 2013 A Comparison of Organizational Climate and Nurses’ Intention to Leave Among Excellence Awarded Hospitals and Other Hospitals in 2013 research-article research-article Conclusions

Performing quality improvement pattern such as organization’s excellence plan improves organizational climate of healthcare sectors, it can reduce nurses’ intentions to leave and retain human resources.

Background

Human resource is the most important factor of performance, success and better revelation of excellence goals of each organization. By performing excellence plan, healthcare organizations improve their organizational climate and play a valuable role in retaining nurses and improving the quality of their services to patients.

Objectives

The aim of this study was to compare hospital organizational climate and intention to leave among working nurses in hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences.

Patients and Methods

This was a cross-sectional descriptive comparison study. Its population included 248 nurses of the hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences in Iran selected by random sampling. The used instrument had three parts: the first part was related to personal characteristics, the second part was the Munn’s organizational climate questionnaire and the third part was Hinshaw’s questionnaire of “anticipated turnover scale”. Data was analyzed using SPSS software, version 17 and indices of descriptive statistics and inferential statistics.

Results

The results of the mean and standard deviation for organizational climate and intention to leave in both performing and non-performing hospitals of the organizational excellence plan were respectively (65.28 ± 19.31 and 56.42 ± 21.36) and (33.64 ± 5.58 and 35.59 ± 4.94). Independent T test revealed a significant difference between the mean scores for organizational climate in both performing and non-performing hospitals, and also a significant difference between the mean scores for intention to leave in both performing and non-performing hospitals (P = 0.004). Moreover, Pearson Correlation test showed a reverse significant correlation between organizational climate and intention to leave in performing hospitals of the organizational excellence plan (r = -0.337) and non-performing hospitals (r = -0.282) (P = 0.001).

Conclusions

Performing quality improvement pattern such as organization’s excellence plan improves organizational climate of healthcare sectors, it can reduce nurses’ intentions to leave and retain human resources.

Background

Human resource is the most important factor of performance, success and better revelation of excellence goals of each organization. By performing excellence plan, healthcare organizations improve their organizational climate and play a valuable role in retaining nurses and improving the quality of their services to patients.

Objectives

The aim of this study was to compare hospital organizational climate and intention to leave among working nurses in hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences.

Patients and Methods

This was a cross-sectional descriptive comparison study. Its population included 248 nurses of the hospitals performing the excellence plan and other hospitals of Tehran University of Medical Sciences in Iran selected by random sampling. The used instrument had three parts: the first part was related to personal characteristics, the second part was the Munn’s organizational climate questionnaire and the third part was Hinshaw’s questionnaire of “anticipated turnover scale”. Data was analyzed using SPSS software, version 17 and indices of descriptive statistics and inferential statistics.

Results

The results of the mean and standard deviation for organizational climate and intention to leave in both performing and non-performing hospitals of the organizational excellence plan were respectively (65.28 ± 19.31 and 56.42 ± 21.36) and (33.64 ± 5.58 and 35.59 ± 4.94). Independent T test revealed a significant difference between the mean scores for organizational climate in both performing and non-performing hospitals, and also a significant difference between the mean scores for intention to leave in both performing and non-performing hospitals (P = 0.004). Moreover, Pearson Correlation test showed a reverse significant correlation between organizational climate and intention to leave in performing hospitals of the organizational excellence plan (r = -0.337) and non-performing hospitals (r = -0.282) (P = 0.001).

Organizational Culture;Climate;Intention;Attitude;Total Quality Management;Nurses Organizational Culture;Climate;Intention;Attitude;Total Quality Management;Nurses http://www.ircmj.com/index.php?page=article&article_id=19000 Maryam Mohamadzadeh Nojehdehi Maryam Mohamadzadeh Nojehdehi School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR Iran School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR Iran Mansoureh Ashgholi Farahani Mansoureh Ashgholi Farahani Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, IR Iran; Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, IR Iran. Tel:+98-2143651616 Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, IR Iran; Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, IR Iran. Tel:+98-2143651616 Forough Rafii Forough Rafii Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, IR Iran Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, IR Iran Nasser Bahrani Nasser Bahrani Statistical Consultant at University of Tehran and Iran Civil Aviation Technology College, Tehran, IR Iran Statistical Consultant at University of Tehran and Iran Civil Aviation Technology College, Tehran, IR Iran
en 26082854 10.5812/ircmj.17(5)2015.27676 Depression and Quality of Life in Patients With Type 2 Diabetes Depression and Quality of Life in Patients With Type 2 Diabetes research-article research-article Objectives

This study aimed to investigate the relation between depression and quality of life in patients with diabetes.

Patients and Methods

This is a cross sectional survey. Subjects were selected from 330 eligible people referred to the only diabetes clinic in Gorgan City during 6 months, using systematic random sampling. Beak Depression questionnaire and the brief questioner with 26 questions recommended by the World Health Organization (WHOQOL-BREF) were used to measure depression and quality of life, respectively. Data were analyzed through descriptive methods, Chi-square, Independent t test and linear regression model using SPSS16; moreover, P value < 0.05 was considered as significant.

Results

In total, 330 patients with diabetes (35.5 % male and 64.5% women) were studied. The mean and standard deviation of their age and years involved with diabetes were 50.6 ± 9.0 and 5.4 ± 4.5 years, respectively. Range of age was 25 - 75 years, as well. The prevalence of depression in all patients with diabetes was 58.2% (124 mild, 56 medium, and 12 with severe depression). Hypertension was 13.9% more in diabetic patients with depression (P value < 0.001) and physical activity in 24.7% of the cases was less with a meaningful difference (P value = 0.01). The mean and standard deviation of quality of life in diabetic patients with and without depression was 50.7 ± 14 and 60.5 ± 13.3, respectively that was significant in two groups (P < 0.0001).

Conclusions

The prevalence of depression is high in patients with diabetes and has a considerable impact on the consequences of diabetes and quality of life too.

Background

Frequency of mood disorders in patients with chronic diseases, especially diabetes and its effects on life quality are dramatically increasing.

Objectives

This study aimed to investigate the relation between depression and quality of life in patients with diabetes.

Patients and Methods

This is a cross sectional survey. Subjects were selected from 330 eligible people referred to the only diabetes clinic in Gorgan City during 6 months, using systematic random sampling. Beak Depression questionnaire and the brief questioner with 26 questions recommended by the World Health Organization (WHOQOL-BREF) were used to measure depression and quality of life, respectively. Data were analyzed through descriptive methods, Chi-square, Independent t test and linear regression model using SPSS16; moreover, P value < 0.05 was considered as significant.

Results

In total, 330 patients with diabetes (35.5 % male and 64.5% women) were studied. The mean and standard deviation of their age and years involved with diabetes were 50.6 ± 9.0 and 5.4 ± 4.5 years, respectively. Range of age was 25 - 75 years, as well. The prevalence of depression in all patients with diabetes was 58.2% (124 mild, 56 medium, and 12 with severe depression). Hypertension was 13.9% more in diabetic patients with depression (P value < 0.001) and physical activity in 24.7% of the cases was less with a meaningful difference (P value = 0.01). The mean and standard deviation of quality of life in diabetic patients with and without depression was 50.7 ± 14 and 60.5 ± 13.3, respectively that was significant in two groups (P < 0.0001).

Conclusions

The prevalence of depression is high in patients with diabetes and has a considerable impact on the consequences of diabetes and quality of life too.

Background

Frequency of mood disorders in patients with chronic diseases, especially diabetes and its effects on life quality are dramatically increasing.

Type 2 Diabetes Mellitus;Quality of Life;Depression Type 2 Diabetes Mellitus;Quality of Life;Depression http://www.ircmj.com/index.php?page=article&article_id=27676 Firooze Derakhshanpour Firooze Derakhshanpour Golestan Psychiatric Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran Golestan Psychiatric Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran Mohammad Ali Vakili Mohammad Ali Vakili Department of Health and Social Medicine, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran; Department of Health and Social Medicine, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran. Tel: +98-1732421221, Fax: +98-1732421657 Department of Health and Social Medicine, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran; Department of Health and Social Medicine, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran. Tel: +98-1732421221, Fax: +98-1732421657 Maryam Farsinia Maryam Farsinia Golestan University of Medical Sciences, Gorgan, IR Iran Golestan University of Medical Sciences, Gorgan, IR Iran Kamal Mirkarimi Kamal Mirkarimi Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, IR Iran
en 26082853 10.5812/ircmj.17(5)2015.24779 Isolation and Molecular Detection of Gram Negative Bacteria Causing Urinary Tract Infection in Patients Referred to Shahrekord Hospitals, Iran Isolation and Molecular Detection of Gram Negative Bacteria Causing Urinary Tract Infection in Patients Referred to Shahrekord Hospitals, Iran research-article research-article Conclusions

Our findings implied that a wide range of bacteria could be involved in creating urinary tract infection in patients referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord, Iran. Regardless of age, sex and the use of catheter, a wide range of bacteria could be involved in urinary tract infections.

Patients and Methods

In this cross-sectional study 147 urine samples of patients (urine test results were positive for UTIs) were examined during April to September 2013. A total of 147 urine samples of patients with clinical symptoms of UTI who had been referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord (Iran), were collected and processed immediately for laboratory analysis.

Results

Escherichia coli was identified as the most common causative agent of UTIs (51.70% of total isolates in both sexes), followed by Klebsiella pneumoniae (K. Pneumoniae) (16.32%). Frequency of Proteus spp., Acinetobacter spp., Entrobacter spp., Citrobacter spp., Pseudomonas aeruginosa (P. aeruginosa) and Providencia spp. was 10.88%, 6.12%, 5.44%, 4.08%, 3.40% and 2.04%, respectively. Statistical analysis by Fisher exact test showed that there was no significant relationship between the type of bacteria and gender (P > 0.05). Chi square test showed that there was no significant relationship between the type of bacteria and the use of catheter and age group (P > 0.05). However, there was a significant relationship between the type of bacteria and the history of hospitalization (P > 0.05).

Objectives

The purpose of this study was to determine the incidence and variety of the causative microbial agents of UTIs in patients who had referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord, Iran.

Background

Urinary Tract Infections (UTI), and their complications, cause serious health problems, which affect millions of people every year. Infections of the urinary tract are the second most common type of infection in the body and approximately 20% of women are especially prone to UTIs for reasons not yet well understood. Urinary Tract Infections in men are not as common as in women yet can be very serious when they do occur. Accurate identification of bacterial isolates is an essential task of the clinical microbiology laboratory.

Conclusions

Our findings implied that a wide range of bacteria could be involved in creating urinary tract infection in patients referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord, Iran. Regardless of age, sex and the use of catheter, a wide range of bacteria could be involved in urinary tract infections.

Patients and Methods

In this cross-sectional study 147 urine samples of patients (urine test results were positive for UTIs) were examined during April to September 2013. A total of 147 urine samples of patients with clinical symptoms of UTI who had been referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord (Iran), were collected and processed immediately for laboratory analysis.

Results

Escherichia coli was identified as the most common causative agent of UTIs (51.70% of total isolates in both sexes), followed by Klebsiella pneumoniae (K. Pneumoniae) (16.32%). Frequency of Proteus spp., Acinetobacter spp., Entrobacter spp., Citrobacter spp., Pseudomonas aeruginosa (P. aeruginosa) and Providencia spp. was 10.88%, 6.12%, 5.44%, 4.08%, 3.40% and 2.04%, respectively. Statistical analysis by Fisher exact test showed that there was no significant relationship between the type of bacteria and gender (P > 0.05). Chi square test showed that there was no significant relationship between the type of bacteria and the use of catheter and age group (P > 0.05). However, there was a significant relationship between the type of bacteria and the history of hospitalization (P > 0.05).

Objectives

The purpose of this study was to determine the incidence and variety of the causative microbial agents of UTIs in patients who had referred to a medical laboratory of Kashani and Hajar hospital in Shahrekord, Iran.

Background

Urinary Tract Infections (UTI), and their complications, cause serious health problems, which affect millions of people every year. Infections of the urinary tract are the second most common type of infection in the body and approximately 20% of women are especially prone to UTIs for reasons not yet well understood. Urinary Tract Infections in men are not as common as in women yet can be very serious when they do occur. Accurate identification of bacterial isolates is an essential task of the clinical microbiology laboratory.

Gram-Negative Bacteria;Isolation;Molecular Detection;Urinary Tract Infections Gram-Negative Bacteria;Isolation;Molecular Detection;Urinary Tract Infections http://www.ircmj.com/index.php?page=article&article_id=24779 Elahe Tajbakhsh Elahe Tajbakhsh Department of Microbiology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran; Department of Microbiology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran. Tel: +98-9131841012, Fax: +98-3833361060 Department of Microbiology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran; Department of Microbiology, Faculty of Basic Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran. Tel: +98-9131841012, Fax: +98-3833361060 Sara Tajbakhsh Sara Tajbakhsh School of Nursing, Shahrekord University of Medical Sciences, Shahrekord, IR Iran School of Nursing, Shahrekord University of Medical Sciences, Shahrekord, IR Iran Faham Khamesipour Faham Khamesipour Young Researchers and Elite Club, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran; Faculty of Veterinary Medicine, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran Young Researchers and Elite Club, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran; Faculty of Veterinary Medicine, Shahrekord Branch, Islamic Azad University, Shahrekord, IR Iran