Background: Cholesteatomas are benign destructive lesions of the temporal bone that may lead to life-threatening complications. Objectives: This study described the clinical and surgical characteristics of chronic otitis media patients with acquired middle ear cholesteatoma. Methods: Among 1790 patients with chronic otitis media detected during almost 10 years, 449 suffered from cholesteatoma. The clinical features and surgical data were investigated. Results: Among the chronic otitis media patients, 449 (25.0%) cases had cholesteatoma with a mean age of 32.2 ± 16.1 SD years, and 62.8% were male. The most common symptom was otorrhoea (53%), followed by hearing impairment (37.9%). Erosion of the facial nerve canal was observed in 33.1% of patients, dural plate erosion in 4.8% of cases, and labyrinthine fistula in 10.3% of patients. Moreover, ossicular chain erosion was observed with the highest frequency in incus (40%), followed by malleus (33%) and stapes (26%). Amongst the surgically treated patients, 59.3% underwent mastoidectomy with canal wall preservation, 29.7% underwent modified radical mastoidectomy, and radical mastoidectomy was performed in 11% of patients. Conclusions: Cholesteatoma was seen in about a quarter of patients with chronic otitis media. Based on our findings, cholesteatoma can be associated with serious complications such as facial nerve canal erosion (33.1%), dural plate erosion (4.8%), and labyrinthine fistula (10.3%). Regarding the functional importance of the hearing system and the high prevalence of disease complications, middle ear cholesteatoma needs long-term follow-up.
{"title":"Clinical and Surgical Features of Acquired Middle Ear Cholesteatoma: A 10 Years Population-based Study","authors":"B. Barati, Mahboobe Asadi","doi":"10.5812/semj-133899","DOIUrl":"https://doi.org/10.5812/semj-133899","url":null,"abstract":"Background: Cholesteatomas are benign destructive lesions of the temporal bone that may lead to life-threatening complications. Objectives: This study described the clinical and surgical characteristics of chronic otitis media patients with acquired middle ear cholesteatoma. Methods: Among 1790 patients with chronic otitis media detected during almost 10 years, 449 suffered from cholesteatoma. The clinical features and surgical data were investigated. Results: Among the chronic otitis media patients, 449 (25.0%) cases had cholesteatoma with a mean age of 32.2 ± 16.1 SD years, and 62.8% were male. The most common symptom was otorrhoea (53%), followed by hearing impairment (37.9%). Erosion of the facial nerve canal was observed in 33.1% of patients, dural plate erosion in 4.8% of cases, and labyrinthine fistula in 10.3% of patients. Moreover, ossicular chain erosion was observed with the highest frequency in incus (40%), followed by malleus (33%) and stapes (26%). Amongst the surgically treated patients, 59.3% underwent mastoidectomy with canal wall preservation, 29.7% underwent modified radical mastoidectomy, and radical mastoidectomy was performed in 11% of patients. Conclusions: Cholesteatoma was seen in about a quarter of patients with chronic otitis media. Based on our findings, cholesteatoma can be associated with serious complications such as facial nerve canal erosion (33.1%), dural plate erosion (4.8%), and labyrinthine fistula (10.3%). Regarding the functional importance of the hearing system and the high prevalence of disease complications, middle ear cholesteatoma needs long-term follow-up.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84621402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Gharibi, A. Imani, Masoumeh Ebrahimi Tavani, K. Dalal
Background: The importance of improving quality and performance in higher education has led various universities to turn to effective methods of educational evaluation, such as auditing. Objectives: The present study evaluated the academic performance of the Tabriz Faculty of Management and Medical Informatics postgraduate students, an Iranian Center of Excellence in Health Management based on the Tennessee Academic Audit Model. Methods: This descriptive-cross sectional study was conducted in 2019 with the participation of educational managers and faculty members of the same faculties in two phases consisting of self-assessment and external evaluation. After contextualization, the Tennessee comprehensive higher education audit checklist was used. Data were studied descriptively, and the results were reported as frequency (percentage) and mean ± standard deviation. Analysis of variance (ANOVA) and Tukey’s post hoc tests were used to evaluate the significance of the difference in academic performance between the educational groups. t-test was also used to evaluate the difference in performance scores in self-assessment and external evaluation phases. A P-value < 0.05 was considered significant. Results: The participants’ performance in the self-assessment phase was moderate (total score: 5.32), and their performance in the external evaluation phase was weak (total score: 2.75). The best and the worst self-assessment scores were in the dimensions of “overall assessment” and “follow-up of previous academic audits,” respectively. In the external evaluation, the dimensions of “contributions to the program and university goals” and “follow-up of previous academic audits” had the best and worst performance scores, respectively. Conclusions: The results demonstrated that the Tabriz Faculty of Management and Medical Informatics of the Medical School needs to improve in terms of international standards. Therefore, managers and policymakers are required to implement interventions to address this gap.
{"title":"Evaluating Educational Performance of Postgraduate Students Based on the Tennessee Academic Audit Model","authors":"F. Gharibi, A. Imani, Masoumeh Ebrahimi Tavani, K. Dalal","doi":"10.5812/semj-132682","DOIUrl":"https://doi.org/10.5812/semj-132682","url":null,"abstract":"Background: The importance of improving quality and performance in higher education has led various universities to turn to effective methods of educational evaluation, such as auditing. Objectives: The present study evaluated the academic performance of the Tabriz Faculty of Management and Medical Informatics postgraduate students, an Iranian Center of Excellence in Health Management based on the Tennessee Academic Audit Model. Methods: This descriptive-cross sectional study was conducted in 2019 with the participation of educational managers and faculty members of the same faculties in two phases consisting of self-assessment and external evaluation. After contextualization, the Tennessee comprehensive higher education audit checklist was used. Data were studied descriptively, and the results were reported as frequency (percentage) and mean ± standard deviation. Analysis of variance (ANOVA) and Tukey’s post hoc tests were used to evaluate the significance of the difference in academic performance between the educational groups. t-test was also used to evaluate the difference in performance scores in self-assessment and external evaluation phases. A P-value < 0.05 was considered significant. Results: The participants’ performance in the self-assessment phase was moderate (total score: 5.32), and their performance in the external evaluation phase was weak (total score: 2.75). The best and the worst self-assessment scores were in the dimensions of “overall assessment” and “follow-up of previous academic audits,” respectively. In the external evaluation, the dimensions of “contributions to the program and university goals” and “follow-up of previous academic audits” had the best and worst performance scores, respectively. Conclusions: The results demonstrated that the Tabriz Faculty of Management and Medical Informatics of the Medical School needs to improve in terms of international standards. Therefore, managers and policymakers are required to implement interventions to address this gap.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"149 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81681505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Z. Nahardani, N. Memaryan, M. Keshavarzi, F. Hadi, H. Koenig, Marzieh Pashmdarfard
Background: Today, prioritizing the spiritual well-being of medical students holds significant importance in numerous countries worldwide. An educational curriculum serves as a comprehensive written document that delineates educational objectives, content, as well as teaching and assessment methods. Objectives: This study aims to formulate and construct a curriculum for a master's degree program in spiritual health. Methods: The initial phase of this study aims to ascertain the existing state of spiritual health education programs by conducting a thorough literature review. In the subsequent phase, a focus group discussion was conducted with eight experts and scholars to deliberate on the spiritual health curriculum, utilizing Tyler's curriculum development model as a framework. Finally, the nominal group process was employed to reach a consensus among the experts, ensuring the formulation of the final draft. Results: The spiritual health education curriculum was developed following Tyler's curriculum planning framework, encompassing four distinct components. Part one outlines the goals of the spiritual health curriculum, while part two focuses on defining the content of the curriculum. Part three addresses the learning opportunities and strategies for teaching spiritual health within the curriculum. Lastly, part four involves the evaluation process to assess the effectiveness and impact of the spiritual health curriculum. Conclusions: Spiritual health education has been recommended in various references. Recognizing discipline as spiritual health has fostered the growth of spiritual concepts in the healthcare environment, bringing attention to the needs of patients.
{"title":"Development of a Spiritual Health Curriculum: An Applied Study in Iran","authors":"S. Z. Nahardani, N. Memaryan, M. Keshavarzi, F. Hadi, H. Koenig, Marzieh Pashmdarfard","doi":"10.5812/semj-130784","DOIUrl":"https://doi.org/10.5812/semj-130784","url":null,"abstract":"Background: Today, prioritizing the spiritual well-being of medical students holds significant importance in numerous countries worldwide. An educational curriculum serves as a comprehensive written document that delineates educational objectives, content, as well as teaching and assessment methods. Objectives: This study aims to formulate and construct a curriculum for a master's degree program in spiritual health. Methods: The initial phase of this study aims to ascertain the existing state of spiritual health education programs by conducting a thorough literature review. In the subsequent phase, a focus group discussion was conducted with eight experts and scholars to deliberate on the spiritual health curriculum, utilizing Tyler's curriculum development model as a framework. Finally, the nominal group process was employed to reach a consensus among the experts, ensuring the formulation of the final draft. Results: The spiritual health education curriculum was developed following Tyler's curriculum planning framework, encompassing four distinct components. Part one outlines the goals of the spiritual health curriculum, while part two focuses on defining the content of the curriculum. Part three addresses the learning opportunities and strategies for teaching spiritual health within the curriculum. Lastly, part four involves the evaluation process to assess the effectiveness and impact of the spiritual health curriculum. Conclusions: Spiritual health education has been recommended in various references. Recognizing discipline as spiritual health has fostered the growth of spiritual concepts in the healthcare environment, bringing attention to the needs of patients.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"256 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78990311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masoumeh Albooghobeish, Vahid Saidkhani, K. Ahmadi Angali, Mehran Farzaneh
Background: Clinical decision-making and self-efficacy are essential parts of nurses' professional work, which includes information analysis, and proper implementation of decisions in the clinical field. Objectives: The present study investigated the perspectives of anesthesia nursing students on clinical decision-making and clinical self-efficacy skills. Methods: This cross-sectional study was done on 70 undergraduate anesthesia nursing students at Jundishapur University of Medical Sciences in Ahvaz, Iran, in 2021, who were recruited through the census method. The required data were collected using a questionnaire containing demographics, clinical decision-making, and self-efficacy in clinical performance. The collected data were analyzed in SPSS 16 using the chi-square test, Mann-Whitney U test, and Kruskal Wallis test at a statistical significance of 0.05. Results: Mean age of students was 21.70 ± 1.06 years. The median score of all students' perceptions of clinical decision-making was 66.5 ± 6. Moreover, 60% of the students had a weak perception of clinical decision-making (systematic analytical). The median clinical self-efficacy score of all students was 87.50 ± 22. Also, 51.4% of the students had a moderate level of clinical self-efficacy. Conclusions: There is insufficient perception of clinical decision-making and clinical self-efficacy among anesthesia nursing students at Jundishapur University of Medical Sciences in Ahvaz. Therefore, it is recommended to pay more attention to the curricula and educational programs in order to promote students' perceptions.
{"title":"Clinical Decision-Making and Self-Efficacy Skills in Anesthesiology Nursing Students: A Cross-Sectional Study","authors":"Masoumeh Albooghobeish, Vahid Saidkhani, K. Ahmadi Angali, Mehran Farzaneh","doi":"10.5812/semj-134178","DOIUrl":"https://doi.org/10.5812/semj-134178","url":null,"abstract":"Background: Clinical decision-making and self-efficacy are essential parts of nurses' professional work, which includes information analysis, and proper implementation of decisions in the clinical field. Objectives: The present study investigated the perspectives of anesthesia nursing students on clinical decision-making and clinical self-efficacy skills. Methods: This cross-sectional study was done on 70 undergraduate anesthesia nursing students at Jundishapur University of Medical Sciences in Ahvaz, Iran, in 2021, who were recruited through the census method. The required data were collected using a questionnaire containing demographics, clinical decision-making, and self-efficacy in clinical performance. The collected data were analyzed in SPSS 16 using the chi-square test, Mann-Whitney U test, and Kruskal Wallis test at a statistical significance of 0.05. Results: Mean age of students was 21.70 ± 1.06 years. The median score of all students' perceptions of clinical decision-making was 66.5 ± 6. Moreover, 60% of the students had a weak perception of clinical decision-making (systematic analytical). The median clinical self-efficacy score of all students was 87.50 ± 22. Also, 51.4% of the students had a moderate level of clinical self-efficacy. Conclusions: There is insufficient perception of clinical decision-making and clinical self-efficacy among anesthesia nursing students at Jundishapur University of Medical Sciences in Ahvaz. Therefore, it is recommended to pay more attention to the curricula and educational programs in order to promote students' perceptions.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85265968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Rashidi, F. Amiri, Fahime Abaforush, Z. Mehraban, M. Pouladzadeh, A. Sedaghat
Background: The coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities are a great global concern. Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with COVID-19. Objectives: This study examined the frequency of BM, newly diagnosed hyperglycemia, and their impacts on hospitalized patients with COVID-19. Methods: This retrospective study examined 810 medical records of PCR-confirmed COVID-19 patients admitted to Razi Hospital, Ahvaz, Iran. The clinical presentations, severity, and impacts of COVID-19 were compared between patients with and without DM. Disease severity was determined based on the NEWS2 scoring system. Results: This study included 810 medical records of COVID-19 patients, of whom 326 had pre-existing DM, and 484 were non-DM. The rates of diabetes and newly diagnosed hyperglycemia were 40.2% and 11.2%, respectively. The most common underlying diseases were hypertension (35.3%), ischemic heart disease (17.9%), and chronic kidney disease (11.9%), which were higher in people with diabetes than non-diabetics. The rate of acute kidney injury was higher in patients with diabetes than in non-diabetics (30.7% vs. 19.2%; P < 0.001) and in patients with severe COVID-19 than in those whose disease was not severe (27.8% vs. 21.5%; P = 0.04). The rates of severe COVID-19 (46.3% vs. 34.7%; P = 0.093), ICU admission (40.7% vs. 27.4%; P = 0.012), and mortality (18.5% vs. 10.5%; P = 0.079) were higher in patients with newly diagnosed hyperglycemia than in euglycemic patients. Conclusions: This study showed that COVID-19 infection is linked with newly diagnosed hyperglycemia and pre-existing DM, both associated with severe COVID-19, more need for ICU admission, and mortality.
背景:2019冠状病毒病(COVID-19)大流行及其相关发病率是全球关注的焦点。糖尿病(DM)与COVID-19患者的不良临床结果和高死亡率相关。目的:本研究探讨BM、新诊断高血糖的发生频率及其对住院COVID-19患者的影响。方法:回顾性分析了伊朗阿瓦士Razi医院收治的810例pcr确诊的COVID-19患者的病历。比较合并和非糖尿病患者的临床表现、严重程度和影响。根据NEWS2评分系统确定疾病严重程度。结果:本研究纳入810例COVID-19患者病历，其中已有糖尿病326例，非糖尿病484例。糖尿病和新诊断高血糖的发生率分别为40.2%和11.2%。最常见的基础疾病是高血压(35.3%)、缺血性心脏病(17.9%)和慢性肾脏疾病(11.9%)，糖尿病患者的发病率高于非糖尿病患者。糖尿病患者的急性肾损伤发生率高于非糖尿病患者(30.7% vs. 19.2%;P < 0.001)，重症COVID-19患者的患病率高于非重症患者(27.8% vs. 21.5%;P = 0.04)。重症肺炎发生率(46.3% vs. 34.7%;P = 0.093)， ICU住院率(40.7% vs. 27.4%;P = 0.012)，死亡率(18.5% vs. 10.5%;P = 0.079)，新诊断为高血糖的患者比正常血糖的患者高。结论:本研究显示，COVID-19感染与新诊断的高血糖和既往存在的糖尿病有关，两者都与严重的COVID-19、更多的ICU住院需求和死亡率相关。
{"title":"Frequency of Diabetes Mellitus and Newly Diagnosed Hyperglycemia and Their Impacts on Hospitalized COVID-19 Patients","authors":"H. Rashidi, F. Amiri, Fahime Abaforush, Z. Mehraban, M. Pouladzadeh, A. Sedaghat","doi":"10.5812/semj-130154","DOIUrl":"https://doi.org/10.5812/semj-130154","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities are a great global concern. Diabetes mellitus (DM) is associated with adverse clinical outcomes and high mortality in patients with COVID-19. Objectives: This study examined the frequency of BM, newly diagnosed hyperglycemia, and their impacts on hospitalized patients with COVID-19. Methods: This retrospective study examined 810 medical records of PCR-confirmed COVID-19 patients admitted to Razi Hospital, Ahvaz, Iran. The clinical presentations, severity, and impacts of COVID-19 were compared between patients with and without DM. Disease severity was determined based on the NEWS2 scoring system. Results: This study included 810 medical records of COVID-19 patients, of whom 326 had pre-existing DM, and 484 were non-DM. The rates of diabetes and newly diagnosed hyperglycemia were 40.2% and 11.2%, respectively. The most common underlying diseases were hypertension (35.3%), ischemic heart disease (17.9%), and chronic kidney disease (11.9%), which were higher in people with diabetes than non-diabetics. The rate of acute kidney injury was higher in patients with diabetes than in non-diabetics (30.7% vs. 19.2%; P < 0.001) and in patients with severe COVID-19 than in those whose disease was not severe (27.8% vs. 21.5%; P = 0.04). The rates of severe COVID-19 (46.3% vs. 34.7%; P = 0.093), ICU admission (40.7% vs. 27.4%; P = 0.012), and mortality (18.5% vs. 10.5%; P = 0.079) were higher in patients with newly diagnosed hyperglycemia than in euglycemic patients. Conclusions: This study showed that COVID-19 infection is linked with newly diagnosed hyperglycemia and pre-existing DM, both associated with severe COVID-19, more need for ICU admission, and mortality.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86741076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seyedeh Azam Pourhoseini, S. Niroumand, A. Akbari, Masoumeh Mirteimouri, F. Akhlaghi, Nayyereh Taheri, Neda Davaryari
Background: Abortion is the medical or surgical termination of pregnancy before the 20th week. However, dilation and curettage have been associated with hazards such as uterine rupture, heavy bleeding, and infection. Therefore, in recent decades, pharmacological therapies have become more widely accepted. Objectives: This research compared the medical abortion success rates of misoprostol/letrozole versus misoprostol/placebo. Methods: This randomized clinical study was conducted at Mashhad University of Medical Sciences hospitals between 2018 and 2019, involving pregnant women who were candidates for medical abortion. The study population was divided into two groups based on whether they had undergone cesarean section (CS). Each group was randomly assigned to either a control or an intervention group. In the CS group, there were 52 patients in the intervention group and 52 in the control group. The control group received a regimen of misoprostol and placebo, while the intervention group received a combination of misoprostol and letrozole. Results: There was no statistically significant difference in age (31.59 ± 5.6 vs. 31.06 ± 4.6, P value = 0.605), gestational age by ultrasound (11.20 ± 3.3 vs. 10.29 ± 2.6, P value = 0.135), or blood pressure between the control and intervention groups. However, the analysis showed a statistically significant difference in the rate of complete abortion (12 (23.5%) vs. 28 (54.9%), P value = 0.001) between the two groups. In the non-CS group, there was a significant difference in age between the control and intervention groups. The study analyses also revealed a significant difference in the rate of complete abortion between the two groups (24 (46.2%) vs. 36 (72.0%), P value = 0.008). Conclusions: Letrozole is recommended in combination with misoprostol for medical abortions because it increases the likelihood of complete abortion and reduces the duration of the abortion process.
{"title":"Comparing the Effects of Misoprostol/Letrozole and Misoprostol/Placebo on Medical Abortion Success Rate: A Randomized Clinical Trial","authors":"Seyedeh Azam Pourhoseini, S. Niroumand, A. Akbari, Masoumeh Mirteimouri, F. Akhlaghi, Nayyereh Taheri, Neda Davaryari","doi":"10.5812/semj-131460","DOIUrl":"https://doi.org/10.5812/semj-131460","url":null,"abstract":"Background: Abortion is the medical or surgical termination of pregnancy before the 20th week. However, dilation and curettage have been associated with hazards such as uterine rupture, heavy bleeding, and infection. Therefore, in recent decades, pharmacological therapies have become more widely accepted. Objectives: This research compared the medical abortion success rates of misoprostol/letrozole versus misoprostol/placebo. Methods: This randomized clinical study was conducted at Mashhad University of Medical Sciences hospitals between 2018 and 2019, involving pregnant women who were candidates for medical abortion. The study population was divided into two groups based on whether they had undergone cesarean section (CS). Each group was randomly assigned to either a control or an intervention group. In the CS group, there were 52 patients in the intervention group and 52 in the control group. The control group received a regimen of misoprostol and placebo, while the intervention group received a combination of misoprostol and letrozole. Results: There was no statistically significant difference in age (31.59 ± 5.6 vs. 31.06 ± 4.6, P value = 0.605), gestational age by ultrasound (11.20 ± 3.3 vs. 10.29 ± 2.6, P value = 0.135), or blood pressure between the control and intervention groups. However, the analysis showed a statistically significant difference in the rate of complete abortion (12 (23.5%) vs. 28 (54.9%), P value = 0.001) between the two groups. In the non-CS group, there was a significant difference in age between the control and intervention groups. The study analyses also revealed a significant difference in the rate of complete abortion between the two groups (24 (46.2%) vs. 36 (72.0%), P value = 0.008). Conclusions: Letrozole is recommended in combination with misoprostol for medical abortions because it increases the likelihood of complete abortion and reduces the duration of the abortion process.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82355615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leila Nemati-Anaraki, Rasoul Ayazi Balan, M. Roudbari, H. Hamidi, Nadia Saniee
Background: Librarians need to provide innovative services to different target groups. Objectives: This study aimed to determine the innovation status in the central libraries of Iranian medical universities. Methods: This cross-sectional study was conducted in 2020. The study population consisted of 67 managers of the central libraries in Iranian medical universities. Data were collected using a researcher-made questionnaire whose validity was confirmed by experts; its reliability was also confirmed with an alpha coefficient of 0.98. The data analysis was performed with descriptive and inferential statistics using SPSS version 24 software. Results: The mean innovation score in the studied libraries was 3.5 ± 0.74 in the dimension of organizational innovation and 3.2 ± 0.73 in service innovation, both of which were relatively desirable. However, the innovation level in the technological dimension was 2.7 ± 0.54, which was a relatively unfavorable situation. There were no significant relationships between gender (P = 0.88, 0.16, 0.17), age (P = 0.287, 0.708, 0.981), education degree (P = 0.561, 0.943, 0.935), work experience (P = 0.284, 0.656, 0.782), and education level (P = 0.605, 0.122, 0.033) and the types of innovation in medical libraries. Conclusions: In the digital era, libraries need to focus on innovation, redefine their plans, do strategic planning to change their roles, and take practical steps to provide services for their users’ needs.
{"title":"Status of Innovation in Central Libraries of Iranian Medical Universities","authors":"Leila Nemati-Anaraki, Rasoul Ayazi Balan, M. Roudbari, H. Hamidi, Nadia Saniee","doi":"10.5812/semj-134022","DOIUrl":"https://doi.org/10.5812/semj-134022","url":null,"abstract":"Background: Librarians need to provide innovative services to different target groups. Objectives: This study aimed to determine the innovation status in the central libraries of Iranian medical universities. Methods: This cross-sectional study was conducted in 2020. The study population consisted of 67 managers of the central libraries in Iranian medical universities. Data were collected using a researcher-made questionnaire whose validity was confirmed by experts; its reliability was also confirmed with an alpha coefficient of 0.98. The data analysis was performed with descriptive and inferential statistics using SPSS version 24 software. Results: The mean innovation score in the studied libraries was 3.5 ± 0.74 in the dimension of organizational innovation and 3.2 ± 0.73 in service innovation, both of which were relatively desirable. However, the innovation level in the technological dimension was 2.7 ± 0.54, which was a relatively unfavorable situation. There were no significant relationships between gender (P = 0.88, 0.16, 0.17), age (P = 0.287, 0.708, 0.981), education degree (P = 0.561, 0.943, 0.935), work experience (P = 0.284, 0.656, 0.782), and education level (P = 0.605, 0.122, 0.033) and the types of innovation in medical libraries. Conclusions: In the digital era, libraries need to focus on innovation, redefine their plans, do strategic planning to change their roles, and take practical steps to provide services for their users’ needs.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75335694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seyed Hasan Golboei Mousavi, Narjes Ahmadian, Mahbubeh Chahkandi, Amin Farhadi, B. Sajadinejad
Background: This study aimed to investigate the epidemiology of basal cell carcinoma (BCC) and the probability of having another lesion in patients diagnosed with BCC. Methods: This descriptive-analytical study was conducted from 2015 to 2017, based on the data from patients with definitive diagnoses of BCC in two university hospitals in Birjand. In this study, 85 patients with BCC were selected based on pre-defined inclusion criteria and then divided into two groups, including single and subsequent asynchronous lesions in another anatomic area. In this study, the information was collected by census method from diagnosed patients two years after surgery. The subsequent lesions in other anatomical areas were investigated, then tumor risk factors were compared in the two groups. Results: The mean age of the patients was 67.83 ± 12.29, and the youngest and the oldest patients were 38 and 92 years old, respectively. Among the studied patients, 75.3% had a history of sun exposure. The most common occupations of the patients were farmer, rancher, and housekeeper. Head and neck regions were involved in 96.5%. The patients with subsequent asynchronous BCC in another facial skin region were 10.6% (CI95: 4.06 - 17.14). These patients have been subject to several simultaneous risk factors in their medical history; most of them were farmers older than 65 years. Two patients experienced three lesions in three different anatomical regions at different times. There was no statically significant difference between the two groups regarding mean age (P = 0.47), gender (P = 0.73), pathologic subtype (P = 0.06), and other risk factors (P > 0.05). Conclusions: This study confirms the likelihood of having a subsequent lesion in other anatomical regions in patients diagnosed with BCC. Patients with a history of BCC require prolonged follow-up because of the probability of new BCC developing.
{"title":"An Epidemiology Study and Risk of Subsequent Basal Cell Carcinoma, A 5-year Retrospective Investigation","authors":"Seyed Hasan Golboei Mousavi, Narjes Ahmadian, Mahbubeh Chahkandi, Amin Farhadi, B. Sajadinejad","doi":"10.5812/semj-132185","DOIUrl":"https://doi.org/10.5812/semj-132185","url":null,"abstract":"Background: This study aimed to investigate the epidemiology of basal cell carcinoma (BCC) and the probability of having another lesion in patients diagnosed with BCC. Methods: This descriptive-analytical study was conducted from 2015 to 2017, based on the data from patients with definitive diagnoses of BCC in two university hospitals in Birjand. In this study, 85 patients with BCC were selected based on pre-defined inclusion criteria and then divided into two groups, including single and subsequent asynchronous lesions in another anatomic area. In this study, the information was collected by census method from diagnosed patients two years after surgery. The subsequent lesions in other anatomical areas were investigated, then tumor risk factors were compared in the two groups. Results: The mean age of the patients was 67.83 ± 12.29, and the youngest and the oldest patients were 38 and 92 years old, respectively. Among the studied patients, 75.3% had a history of sun exposure. The most common occupations of the patients were farmer, rancher, and housekeeper. Head and neck regions were involved in 96.5%. The patients with subsequent asynchronous BCC in another facial skin region were 10.6% (CI95: 4.06 - 17.14). These patients have been subject to several simultaneous risk factors in their medical history; most of them were farmers older than 65 years. Two patients experienced three lesions in three different anatomical regions at different times. There was no statically significant difference between the two groups regarding mean age (P = 0.47), gender (P = 0.73), pathologic subtype (P = 0.06), and other risk factors (P > 0.05). Conclusions: This study confirms the likelihood of having a subsequent lesion in other anatomical regions in patients diagnosed with BCC. Patients with a history of BCC require prolonged follow-up because of the probability of new BCC developing.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78974276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Masoumi, M. Rezai, A. Dehghani, Shahindokht Hasanpor, Sayyed Kasra Fatemi
Background: National indicators have been defined for the satisfaction and efficiency of emergency services and for evaluating their functionality. These indicators enlighten strengths and areas where improvements can help improve emergency ward quality. Objectives: This study assessed the knowledge of medical specialists and their experiences, especially concerning the effects of these protocols. Methods: This qualitative study was conducted in 2019 in the emergency departments of hospitals affiliated with the Iran University of Medical Sciences. During semi-structured interviews with 20 professors of emergency medicine in 2019, their experiences regarding the effects of these indicators on providing emergency services were evaluated. The data were collected until saturation. All interviews were recorded with the participant’s permission and then transcribed verbatim and analyzed by content analysis method, and their semantic codes were extracted. Results: By analyzing the interviews, 14 subcategories, and four main categories were obtained. Categories and subcategories consisted of providing services to patients (with three subcategories: Improving the quality of medical services, waiting time reduction, and increasing satisfaction), improving emergency efficiency and performance (with five subcategories: Improving conditions, services, communication improvement, resource management, and facilities and equipment), accreditation (with three subcategories: Performance improvement, management and planning, and service quality improvement), and proposed indicators (with three subcategories: Time, capacity, and resources). Conclusions: The recognition of emergency medicine specialists in hospital emergencies is below average, which can affect the manner of providing health services and upgrading national indicators. With more and more familiarity of emergency medicine specialists with the indicators, a step can be taken to improve the status of hospital emergencies, thus determining patients’ tasks faster, reducing the length of stay in the emergency department, increasing patient satisfaction, and improving the performance of the emergency department.
{"title":"Emergency Medicine Specialists’ Knowledge of Hospital Emergency Department Indicators and Their Role in Patient Treatment: A Qualitative Study","authors":"G. Masoumi, M. Rezai, A. Dehghani, Shahindokht Hasanpor, Sayyed Kasra Fatemi","doi":"10.5812/semj-130697","DOIUrl":"https://doi.org/10.5812/semj-130697","url":null,"abstract":"Background: National indicators have been defined for the satisfaction and efficiency of emergency services and for evaluating their functionality. These indicators enlighten strengths and areas where improvements can help improve emergency ward quality. Objectives: This study assessed the knowledge of medical specialists and their experiences, especially concerning the effects of these protocols. Methods: This qualitative study was conducted in 2019 in the emergency departments of hospitals affiliated with the Iran University of Medical Sciences. During semi-structured interviews with 20 professors of emergency medicine in 2019, their experiences regarding the effects of these indicators on providing emergency services were evaluated. The data were collected until saturation. All interviews were recorded with the participant’s permission and then transcribed verbatim and analyzed by content analysis method, and their semantic codes were extracted. Results: By analyzing the interviews, 14 subcategories, and four main categories were obtained. Categories and subcategories consisted of providing services to patients (with three subcategories: Improving the quality of medical services, waiting time reduction, and increasing satisfaction), improving emergency efficiency and performance (with five subcategories: Improving conditions, services, communication improvement, resource management, and facilities and equipment), accreditation (with three subcategories: Performance improvement, management and planning, and service quality improvement), and proposed indicators (with three subcategories: Time, capacity, and resources). Conclusions: The recognition of emergency medicine specialists in hospital emergencies is below average, which can affect the manner of providing health services and upgrading national indicators. With more and more familiarity of emergency medicine specialists with the indicators, a step can be taken to improve the status of hospital emergencies, thus determining patients’ tasks faster, reducing the length of stay in the emergency department, increasing patient satisfaction, and improving the performance of the emergency department.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87833707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Farnoush Azizi, B. Honarvar, Z. Molazem, A. Kazemi, Banafsheh Tehranineshat
Background: Nurses who are occupied in emergency departments play a critical role in health services provision and patient care. Considering the importance of providing appropriate and immediate care in emergency departments, nurses need to acquire sufficient skills and up-to-date knowledge. Objectives: This study aimed to identify the educational needs of nurses working in the emergency department and explore strategies to meet challenges against the elimination of these needs. Methods: This qualitative study was conducted using a content analysis approach. This study selected the emergency departments of two large educational hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, southern Iran. This study was conducted on 15 emergency department nurses selected via purposive sampling with maximum variation within January 2020 and March 2021.The data were collected by performing 15 in-depth, semi-structured interviews (11 face-to-face and 4 telephone interviews due to the coronavirus disease 2019 pandemic) and making field notes. Then, the recorded interviews were transcribed verbatim and analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. The consolidated criteria for reporting qualitative studies (COREQ) was used to report the findings of this study. Results: Three main themes, namely the need for comprehensive and continuous education, challenges of managing educational needs, and strategies to meet educational needs, were extracted following data analysis. Conclusions: Clarifying the educational needs of nurses and exploring strategies to solve these challenges can be effective by providing continuous practical training and adopting effective teaching-learning strategies to promote nurses’ education and improve their performance in clinical skills. Accordingly, the provision of appropriate infrastructure for mobile health applications and utilization of mobile-based educational applications in emergency departments have to be taken into account by hospital managers and health policymakers.
{"title":"Investigating Emergency Department Nurses’ Educational Needs and Exploring Strategies to Meet Challenges Against Management of These Needs: A Qualitative Study","authors":"Farnoush Azizi, B. Honarvar, Z. Molazem, A. Kazemi, Banafsheh Tehranineshat","doi":"10.5812/semj-122875","DOIUrl":"https://doi.org/10.5812/semj-122875","url":null,"abstract":"Background: Nurses who are occupied in emergency departments play a critical role in health services provision and patient care. Considering the importance of providing appropriate and immediate care in emergency departments, nurses need to acquire sufficient skills and up-to-date knowledge. Objectives: This study aimed to identify the educational needs of nurses working in the emergency department and explore strategies to meet challenges against the elimination of these needs. Methods: This qualitative study was conducted using a content analysis approach. This study selected the emergency departments of two large educational hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, southern Iran. This study was conducted on 15 emergency department nurses selected via purposive sampling with maximum variation within January 2020 and March 2021.The data were collected by performing 15 in-depth, semi-structured interviews (11 face-to-face and 4 telephone interviews due to the coronavirus disease 2019 pandemic) and making field notes. Then, the recorded interviews were transcribed verbatim and analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. The consolidated criteria for reporting qualitative studies (COREQ) was used to report the findings of this study. Results: Three main themes, namely the need for comprehensive and continuous education, challenges of managing educational needs, and strategies to meet educational needs, were extracted following data analysis. Conclusions: Clarifying the educational needs of nurses and exploring strategies to solve these challenges can be effective by providing continuous practical training and adopting effective teaching-learning strategies to promote nurses’ education and improve their performance in clinical skills. Accordingly, the provision of appropriate infrastructure for mobile health applications and utilization of mobile-based educational applications in emergency departments have to be taken into account by hospital managers and health policymakers.","PeriodicalId":39157,"journal":{"name":"Shiraz E Medical Journal","volume":"80 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87466525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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