Internal Medicine and Medical Investigation Journal (IMMINV)
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Study perception of hospital safety sign and related factors
Full text linkBackground: the safety signs are used as one of the methods of notification and warning to the staff regarding the type and intensity of existing hazards in the workplace.
Objective: this study aimed to investigate perception of the Hospital safety signs and comparison with ISO and ANSI standard also survey relationship between variables such as age, gender, and work experience and education level with perception of the signs.
Methods: This analytical-descriptive study was done in 2016. Tools include a standard questionnaire (ISO 9186-1) and criteria of safety signs (ANSIZ535.3). The sample included 200 non-monochromatic employees working in two hospitals of Bushehr City. Stratified - Random sampling method was used, then, obtained data were analyzed using SPSS-16 software.
Results: the overall mean of perception in the two studied hospitals was 61.04% ± 25.74. The highest and lowest levels of perception were respectively related to the sign "no smoking"(97.5%) and "stretcher to carry injured" (11.5%). 11 and 5 of signs cannot be reached to limit of acceptable perception base on ISO and ANSI. also In 11 case (91%), the level of personnel perception was higher than clients. Result also showed which, in most cases, there was no significant relationship between perception and gender, age, education, experience and type of sample (p<0.05).
Conclusions: the results showed that perception patterns of signs are different. Assessing perception of signs show a moderate level of perception in accordance with ISO and ANSI standard, with regard to less than the standard limit “Risk of biological substances” and “Stretcher to carry injured “safety signs, redesigning this sign is needed. The results showed that type of sample and gender was not an effective factor on safety signs perception
Comparison of knee angles in two-dimensional and three-dimensional EOS imaging in patients with total knee arthroplasty
No full textBackground: Stand-alone radiological images (Weight-Bearing) are commonly used to measure alignment in coronal and sagittal planes. Although its proportions and angles may not be correct, it shows us the vertical and horizontal divergence.
Aim: In the present study, considering the ability of the EOS device to investigate angles in 3D, we investigated and compared the angular difference in 2D and 3D preoperative imaging in total knee arthroplasty.
Material and Methods: The present study is a cross-sectional analytical study. In this study, 50 patients with knee osteoarthritis who underwent knee replacement before EOS imaging of their lower extremities were enrolled. After obtaining patients' demographic data, the EOS was made from the hip, knee, and ankle area. The following angles (such as Varos and Valgus Knee angle, LDFA, mMPTA, and JLCA) in patients were reviewed and recorded once by an expert with the PACS software system, preoperatively. Then the data were analyzed by SPSS ver 21.
Results: The results showed that there was a correlation between the angle of varus, LDFA, MPTA, and JLCA in two-dimensional and three-dimensional images (P-Value <0. 001), indicating that two-dimensional and three-dimensional EOS imaging is not different in examining mentioned angles.
Conclusion: From this study, it can be concluded that the use of 3D imaging is not preferable to two-dimensional imaging, and measurements of angles in each of these two methods are almost identical
Study of Klebsiella pneumonia Antibiotic-Resistance of K1 and K2 Serotypes in Nosocomial infections with Hospital Origin
Full text linkKlebsiella Pneumonia are the most pollutants of the hospital origin. The aim of this study was to determine the antibiotic resistance pattern of Klebsiella pneumonia in two serotypes K1 and K2 from samples Collected with urinary tract infections and burn injuries in Kermanshah of Iran. This study was performed on 140 samples collected from hospitals in Kermanshah for a period of 6 months. After confirmation of bacteria by phenotypic method, genotyping was done by PCR of rmpA2 and magA1 genes. Subsequently, Antibiotic Resistance Pattern was evaluated according to the CLSI 2017 regimen using 6 types of antibiotic disks. The results of genotype determination showed that 76% of the samples were related to K1 serotype and 24% of the samples were related to K2 serotype. Also, among the samples taken from the 35 urine, K1 showed an 80% prevalence (28 samples) and 20% were related to k2. Of the 35 samples examined from burn injuries, 71% of the samples were related to K1 and 29% related to K2. The antibiogram results showed that the samples of K1 positive were resistant to Onloxacin and Nitrofurantoin antibiotics and sensitive to Ceftoxime and limit to Ceftriaxone antibiotics. The interface has the Trimethoprim and Cefazolin antibiotics. Also, K2 serotype is susceptible to Ceftoxime and resistant to Nitrofurantoin and intermediate mode for Cefazolin, Forloxacin and Trimethoprim antibiotics. Additionally, the resistance k1 serotype is higher than k2. In both samples of urine and burn in the studied population, the prevalence of serotype k1 was higher and in both groups, the most resistant to antibiotics were Nitrofurantoin and onloxacin. Also, the most commonly used antibiotics that are recommended are Cefotaxime and Ceftriaxone, and resistant antibiotics that should be used less than Nitrofurantoin and Onloxacin
Corona virus pandemic and health system management in uncertainty
No full textThe health system of any country needs to enact new policies and reform the previous policies in order to respond to the changing needs of society and to increase productivity, quality, and equity. Uncertainty in the real world is undeniable, and it becomes more serious in the logistics of crisis and medical emergencies
Cutaneous kaposi sarcoma during treatment with steroids and rituximab for pemphigus foliaceus
Full text linkPemphigus foliaceus (PF) is an autoimmune disease with bullous manifestations on the surface of the skin that requires long-term administration of immunosuppressive medications. Kaposi’s sarcoma (KS) is one of the diseases that manifest in people with innate or acquired immune systems deficiency with the direct involvement of HHV-8 and causes polypoid skin lesions. This study was conducted on a 78-year-old man with a history of PF treated with immunosuppressive drugs. In this patient, a secondary polypoid lesion had been created around the anus and the results of pathological tests had confirmed the KS
Evaluating the Prognosis Value of White Blood Cell Count in Congestive Heart Failure
No full textIntroduction: Congestive heart failure (CHF) is a condition of heart muscle weakness and ventricular dysfunction that leads to fatigue and dyspnea. Currently, more than 5 million people are suffering from CHF worldwide. There are so many prognostic factors for identifying high-risk patients but lately, researchers have focused on some new factors such as inflammatory markers, natriuretic peptide, and leukocytosis. So in this study, we aimed to evaluate prognostic effects of complete blood count (CBC) findings especially white blood cell (WBC) on the prognosis of CHF during hospitalization and 6 months after discharge in CHF patients. Materials/Methods: This retrospective cohort study was done in Rasoul Akram Hospital of Tehran September 2017 until September 2019. Information such as demographic ones, CBC, blood sugar, triacylglycerol & cholesterol, sodium, and potassium in the first test after hospitalization were collected. Complications after 6 months of discharge were defined as death, readmitting to the hospital because of myocardial infarction, angina, or heart attack, and Need a kind of mechanical therapy such as a pacemaker. Statistical significance was considered at p < 0.05. Results: The means and SD of age were 70±14. 65 patients (55.6%) of 117 ones suffered from hypertension and 48 patients (41%) had diabetes mellitus. The means and SD of hemoglobin and hematocrit of patients were 11.6±2.1 and 36.1±6., the amount of WBC, hemoglobin, hematocrits, and platelets has no significant differences between short term and long term events. Conclusion: WBC count has no correlation with CHF outcomes and it can not be used as a prognostic value
Does SARS-CoV2 infection increase hyperglycemia risk? Case series and review
No full textIntroduction
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has been observed to cause serious complications and higher mortality in patients with type 2 diabetes mellitus (DM). Conversely, new-onset diabetes and metabolic complications of pre-existing diabetes (including DKA and hyperosmolarity) have also been seen in patients with COVID-19.
Materials and Methods
We report a series of 7 patients with mean age of 30.71+/-1.38 years. Our series included 2 female patients. None of our patients had any underlying known comorbidity. All patients were RT PCR positive for SARS-Cov2. All patients had lymphopenia at presentation and raised inflammatory markers. All patients received IV steroids (methylprednisolone) for 5 days and subsequently oral. All patients improved with no major complication except one patient developed hyperglycemia on day 3 of institution of steroids. His Hba1c was suggestive of prediabetic status (6.1%). No other treatment related complication was observed.
Discussion
Given the capability of COVID-19 to trigger an intense inflammatory response, it has been challenging to disentangle whether hyperglycemia in COVID-19 is a cause or a consequence of severe disease. Some authors have hypothesized a potential diabetogenic effect of COVID-19, in addition to the well-recognized stress-induced hyperglycemia associated with critical illnesses. However, we observed that not all patients had hyperglycemia despite receiving steroids at the same dose and for the same duration.
Conclusion
We postulate that the combination of SARS-CoV2 infection and steroids impairs the glucose metabolism resulting in hyperglycemia only in patients who have underlying risk factors for the same.
 
Brain Eating Amoeba: Alarming Rise of Naegleriasis in Pakistan
No full textNaegleriasis also known as primary amoebic meningoencephalitis (PAM) is a fulminant brain infection is caused by a single-celled, ameboflagellate known as Naegleria fowleri. Naegleria fowleri has been difficult to eradicate since its growth is typically found in bodies of warm freshwater, unchlorinated, piped water, swimming pools and moist soil. This letter focuses on characteristics and route of spread of infection caused by Naegleria Fowleri and preventative measures that can be taken to limit its spread. A thorough literature review was performed to identify different route of spread of Naegleria Fowleri infection and specific measures that should be taken to limit its spread. We found that Naegleria follows a nasal route of infection, migrating along the olfactory nerve, through the cribriform plate into the brain where it evokes a substantial immune response causing a widespread inflammation, hemorrhage and necrosis eventually leading to death. The at-risk population includes individuals associated with swimming, diving and water skiing in freshwater and poorly chlorinated swimming pools and individuals performing ablution. Therefore, specific measures should be taken to limit the spread of Naegleria Fowleri infection which includes education and awareness of the public as well as of the health professionals regarding Naegleriasis and its preventative measures
Fetal pulmonary fibrosis due to Hermanski-Pudlak syndrome (HPS): a rare case report with open lung biopsy findings
No full textHermanski-Pudlak Syndrome (HPS) is an extremely rare autosomal recessive disorder. Albinism, bleeding diathesis and other associated complications are the main manifestations of HSP. Here we report a 56-year-old woman who was referred with gradually increasing dyspnea. She had a past history of coughing, epistaxis, gums bleeding, easy bruising and severe sunburn in normal sun exposure. Her blood oxygen saturation was 87% in room air. Physical examination revealed oculocutaneous albinism, strabismus, horizontal nystagmus and fine inspiratory crackle. Laboratory studies showed prolonged partial thromboplastin time and PaO2 value of 39 mmHg. There was a reticulonodular pattern in chest radiography. Open lung biopsy confirmed the diagnosis of pulmonary fibrosis. Although the patient had been treated with Pirfenidone, she died because of respiratory failure. Although HPS is a rare syndrome, finding more about the pathophysiology of HPS and also developing new methods of treatment is indisputable
A Longitudinal Flap of Vena Cava in Live Donor a Safe Option for Adding Elongation at Least 10mm in Vein of Right Kidney
Full text linkIntroduction: To treat chronic kidney, kidney transplantation is the most efficient way especially when donor is alive, in such a way that survival tie can be increased in the best possible way. In this regard, major problem is short renal vein resulting in thrombosis. To elongate the vein length, there is a technique that we report in this study. Materials and Methods: The technique of interest is that at the time of dissection of vena cava and renal vein, it should be tried to put vein of vena cava 1cm above and 1cm below of renal vein. In addition, the kidney must be placed in right iliac of kidney done. Results: Patients discharged in good condition after two days. In our cases, there was no tension in the site of anastomosis showing safe condition. Conclusion: Longitudinal flap of vena cava accompanied by a suitable cuff can increase about I cm length of renal vein