Journal Of Patient safety and quality improvement
Volume:6 Issue: 3, Summer 2018

The aim of this study was comparison of anxiety disorders symptoms and related transdiagnostic factors in individuals with cancer and healthy individuals. In a causal-comparative study, 30 individual with cancer and 30 normal individual were selected by available sampling method. The groups were matched in demographic characteristics whit together. The participates completed Generalized Anxiety Disorder 7-item (GAD-7) scale (2006), severity measure for panic disorder-adult (2013), Social Phobia Inventory (2000), cognitive avoidance questionnaire (2008), intolerance of uncertainty scale (1994), metacognition questionnaire (2004), acceptance and action questionnaire-II (2011) and cognitive emotion regulation questionnaire (2006). Data were analyzed by SPSS22 software, using univariate analysis of variance (ANOVA). The significance level was 0.05. The results showed that there is significant difference between two groups in generalized anxiety and panic symptoms (P<0.05). However, there isn't significant difference in social anxiety symptoms (P>0.05). Also, there is significant difference between two groups in all transdiagnostic factors (P<0.05). Individual with cancerexperience more intensity of anxiety disorders symptoms and relatedtransdiagnostic factors.

To investigate the value of procalcitonin (PCT) in lobar and non-lobar pneumonia in children. 80 children with pneumonia were included. 20 healthy children were selected as control. Lobar and non-lobar pneumonia were recognized. The serum level of C reactive protein (CRP), erythrocyte sedimentation rate (ESR), leukocytes and PCT were measured. Statistical analysis was performed using SPSS windows program. Among the 80 children 39 cases (48.75%) were female and 41 cases (51.25%) were male with the average of 17.29±2.43 months. 7 patients (8.75%) were diagnosed with lobar pneumonia. Cough, tachypnea and Crackles were more common symptoms in lobar pneumonic patients. Leukocytosis (more than 15000/microliter) was more prominent in pneumonic patients versus control as well as lobar pneumonia versus non-lobar (p<0.05). The CRP with 3+ level was prominent in lobar pneumonic patients (p=0.02). The mean of ESR in lobar group was higher than non-lobar group (p=0.001). The PCT level of 2ng/mL could consider as cut off point of lobar and non-lobar pneumonia. The PCT level of 0.5ng/mL could consider as cut off point between pneumonic and healthy children. Serum level of PCT is higher in lobar pneumonia than non-lobar pneumonia in children with cut off point of 2ng/mL.

Patient safety care is directly affected by the training that the health care students during their academic period. There is inadequate information about the attitude of the students on this important issue in Iran. This study aimed to determine the attitude of Iranian nursing, midwifery, anesthesiology and operating room students toward patient safety. This cross-sectional study was carried out between March and July 2017 and involved 168 university students (response rate: 92.85%) who were entered in the research by stratified sampling. A valid and reliable questionnaire was used to gather the patient safety attitude of students. Data were analyzed using the SPSS, Version 16, using descriptive and analytical statistics. The mean age of the participants was 24 ± 21.17. Most of the students (57.7%) had positive attitudes towards patient safety, while 42.3% had negative attitudes. According to the results, the mean score of the students on patient safety differed based on the course of study (F=3.07, df=3, p=.03). The association between gender and semester with the attitude of the students was not significant (p>.05). The findings revealed that Iranian paramedical students had inadequate attitude on patient safety. It is recommended to improve the attitude of the students using suitable training programs during academic education.

Burns have impacts include medical, psychological, economic and social that involve patients and health care system. Epidemiologic factors of burns vary in different societies. While the effects of some burn variables on mortality rate, in similar circumstances, are expected to be universal. The present study was carried out to analyze the epidemiology, mortality, and current etiological factors of burn injuries. This cross-sectional study was conducted during a period of 6 years (from 2010 to 2015). Data were obtained by analysis of the medical records of patients hospitalized in the Imam Reza Burn Center in Mashhad, Iran. The data were recorded by the nurses and staffs in the burn ward. In our study, 1334 in-hospital burn patients were recorded. The mean age was 27 ± 5.67 years. The most common Mechanism of burn was flame. The multivariable logistic regression modeling revealed, the most important risk factor of patient mortality were length of stay (LOS) (OR=1.009(95% CI: 1.001-1.018), age OR=0.9(95% CI: 0.96-0.97), sex OR=0.4(95% CI: 0.3-0.5), percentage of burn regarding body surface (BBS) OR=0.9(95% CI: 0.93-0.94),degree of burns OR=0.9(95% CI: 0.89-0.98). The results of our study revealed a high incidence of burns among >20 years old. Implement prevention programs should be designed for focusing chiefly on the domestic environment and the kinds of risks to which children are exposed in their everyday routine and parents, should also be educated about how to supply entertainment that would keep children away from risks.

As a multi-faceted system, the physician-patient relationship is more complicated than a mutual relationship at the turn of the third millennium. This process positively affects the quality of healthcare services provided. This research intends to determine the relationship status of the physicians and the patients in hospitals affiliated with Tehran University of Medical Sciences in 2015-2016. This was a descriptive-analytical, cross-sectional study conducted on 185 patients who had been selected purposively, being hospitalized in 2 public and 2 private hospitals affiliated with TUMS. Patient-Doctor Relationship Questionnaire was employed as the research instrument. In addition to face and content validity, the reliability of the instrument was confirmed via administration of Alpha Cronbach, Test-Retest and Interclass Correlation Coefficient. For data analysis, SPSS software was used, for absolute and relative frequency the descriptive results were employed while Kolmogrov-Smirnov, Pearson, and Anova test were administered for analytical results. Physician-patient relationships were revealed to be relatively desirable and desirable in studied hospitals, although this showed to be better in private hospitals compared to public hospitals. Also, there was observed a significant relation between physician-patient relationship status with patient’s age, educational background, physician’s gender, and educational level. Physician-patient relationship improvement in public hospitals could contribute to the success and sustainability of Health Care Overhaul Plan in Iran. Therefore, providing communication skills training, observation of patients’ rights and medical ethics by the physicians, especially by younger and less experienced physicians as well as medical assistants and medical students is recommended.

Ectopic pregnancy (EP) is considered a common disease worldwide. This study is intended to present a case report of ectopic pregnancy presented with syncope, a rare symptom.
Case: A 31 years old woman presented in emergency department of an academic trauma center with the chief complaint of head trauma. She was suffering of severe headache following falling down because of syncope. In prices exam she had unstable vital signs and was complaining of abdominal pain and tenderness. Routine laboratory tests including β-hCG, head CT scan, complete abdominal and abdominopelvic sonography were ordered for the patient. Results showed positive β-hCG and abundant free fluid in the abdominal cavity in sonography. After approval of ruptured ectopic pregnancy diagnosis, patient underwent laparotomy, salpingectomy and cystectomy.

Rupture of the posterior urethra is a rather uncommon finding in patients with pelvic trauma. It is usually accompanied by pelvic fractures. Herein, we report the case of a 27-year-old man with isolated rupture of the posterior urethra –without pelvic fracture- after falling. The patient was successfully treated with primary suprapubic cystostomy and delayed urethral reconstruction surgery, after which he was discharged in good condition with no urologic complication. The consensus on these cases is either to perform an early realignment or to do late reconstructive surgery.

first seizure is an unpleasant experience, the underlying cause and probability of recurrence is critical for the patient.
Case: A 72 years old female was brought to our emergency department with a complaint of first seizure. Her daughter stated that she had had a tonic colonic generalized seizure that lasted about 10 seconds. She was complaining of a headache at the time of arrival in the ED, and the seizure had ended. The physical examination was normal and she had no past medical history. Spiral axial brain CT scanning demonstrated a sharp, round lesion with peripheral calcification near the pineal gland which compressed the third ventricle. Multiple nodules with fat density were seen in the subarachnoid space. Phenytoin was started for seizure prophylaxis and a neurosurgery consultation was requested. Tumor was completely reacted. This is a rare case of dermoid cyst near the pineal which compressed the third ventricle and caused midline shift and hydrocephaly. The cause of seizure may be the cyst rupturing. Complete cyst resection is the preferred treatment.