ACTA MEDICA IRANICA

Assessing the Safety Level of Hospitalized Patients: Analyzing Patient Activities

2025-02-04T08:12:56+00:00

One of the important issues in health care systems that affect safety-related behaviors and reduce medical errors is to improve the safety level of the hospitalized patients. Patient safety, especially non-therapeutic safety, is crucial in providing the hospital services. Any shortcoming in this regard can be life threatening. The aim of this study was to evaluate the level of safety of the hospitalized patients by analyzing the patient's activities. In the present study, all activities of the hospitalized patients were considered as one job, and the occupational safety analysis technique was used. For this purpose, all the activities of hospitalized patients from the time of entering the hospital to the time of leaving the hospital were identified and by forming a team of specialists in the field of patient care, a list of all possible risks in different stages of patient activities was determined. To assess the risk, the risk matrix model, which is one of the risk assessment models, was used. The risk assessment process was used considering the probability and severity of the risks, as well as the effects of risk. The severity of risk was divided into 4 categories and the probability of risk into 5 levels. In the matrix, the number 1 indicates the lowest risk, and the number 20 indicates the highest risk. Experts' opinions were used to rank the risk, and finally the risk level of the identified hazards was determined before and after the control measures. The results showed that the risks in 6 stages for the patient include the patient entering the hospital, patient admission in the ward, patient entry into the room, hospitalization in the room, patient transfer for medical and diagnostic purposes and patient discharge from the hospital. There are a total of 79 potential hazards. All the risks assigned to the patient had a score above 12 at the time of the risk assessment; however, providing control-preventive measures reduced the level of risk at all stages significantly, according to the re-evaluating of the potential risks. The results showed that by managing the four types of risks "Struck against", "Fall to below", "Fall same level", "Struck by", which are among the most important risks that threaten the hospitalized patients, more than 50% of potential risks is reduced. The findings showed that the recurrence and severity of risk and, consequently, the level of risk identified in different stages of hospitalization are different. Therefore, improving the level of management and prioritization and providing the controlling and the suggested solutions, which are the main management tasks in a hospital, can improve the safety of the hospitalized patients. It is recommended that hospital managers consider the Occupational Safety Analysis Technique, known also as the Patient Safety Analysis Technique, to identify potential risks of the hospitalized patients.

A Study on the Role of LPA and ATX in Breast Cancer in Iraq

2025-02-04T08:12:54+00:00

Breast cancer is the most common malignancy among women and a leading cause of cancer-related mortality. Early detection is crucial for improving treatment outcomes. This study investigates the roles of lysophosphatidic acid (LPA) and autotaxin (ATX) in the early diagnosis of breast cancer among Iraqi women. A case-control study was conducted involving 75 women diagnosed with breast cancer and 75 healthy controls. Blood samples were collected, and biochemical parameters, including LPA and ATX levels, were measured using the ELISA technique. Statistical analyses were performed with SPSS version 24, and receiver operating characteristic (ROC) analysis was used to evaluate diagnostic capabilities. The majority of breast cancer patients were aged 50-59 years (33.3%). Histologically, invasive ductal carcinoma was the most prevalent subtype (82.6%). Biochemical analysis revealed significant differences in alanine aminotransferase, total serum bilirubin, and alkaline phosphatase levels between patients and controls. LPA levels were significantly elevated in the patient group (868.48±142.11 pg/ml) compared to controls (212.01±54.94 pg/ml), while ATX levels were also higher (2252.20±399.46 pg/ml vs. 951.40±209.21 pg/ml). ROC analysis indicated that both LPA and ATX exhibited high diagnostic sensitivity (98%) and specificity (100%). In Iraqi women, elevated serum levels of LPA and ATX may serve as potential diagnostic biomarkers for breast cancer, highlighting their role in disease progression. Further studies are warranted to explore their clinical applications in breast cancer diagnosis and management

Investigating the Insights of Nursing Students About Clinical Pharmacology Courses

2025-02-04T08:12:51+00:00

Nursing education, requires critical attention to the science of pharmacology as well as employment of the relevant clinical skills. Therefore, the present study intends to investigate the insights of nursing students about clinical pharmacology courses. This cross-sectional descriptive study was performed on a community consisted of all nursing students who selected their clinical pharmacology course. The researcher-built questionnaire was the tool for collecting the data. Descriptive (percentage, mean and standard deviation) and analytical (t-test and Mann-Whitney non-parametric test) statistics were utilized to analyze the data using SPSS-22. The ethical considerations of the research were observed. Based on the findings, the variables of gender and the pharmacology grade achieved in the second semester predicted the level of satisfaction with clinical pharmacology course among the students as well as studying about the medicines before starting the internship. Regarding the relative satisfaction in this study, 85% of the students found the applications employed for learning clinical pharmacology contents effective to boost their skills and knowledge so that it would be recommended to use the novel educational methods for better learning of the course.

The Role of Platelet-Rich Plasma (PRP) in Enhancing IVF Success in Women With Ovarian Insufficiency: A Cohort Study

2025-02-04T08:12:49+00:00

- Ovarian insufficiency is a significant cause of infertility in women, with limited effective treatment options. Platelet-Rich Plasma (PRP), rich in concentrated growth factors, has shown regenerative potential in various medical fields. However, its efficacy as an adjunct in infertility treatment, particularly in women with ovarian insufficiency, remains unclear. This study investigates whether PRP administration improves the success of IVF cycles in this specific population. This cohort study followed women with ovarian insufficiency undergoing IVF at a fertility center. Participants were divided into two groups: the intervention group, which received PRP alongside the standard IVF protocol, and the control group, which received only the standard protocol. Data collected included patient demographics, hormonal levels, number and quality of retrieved oocytes, fertilization rates, embryo quality, and pregnancy outcomes. The primary outcome was IVF success, defined by clinical pregnancy rates. Secondary outcomes included hormonal changes, oocyte quality, and embryo development. Statistical analysis utilized descriptive statistics, chi-square tests, and t-tests to compare outcomes between groups. PRP administration led to significant reductions in FSH levels (P<0.001) and marked increases in AMH levels and antral follicle count (AFC) (P=0.001 and P<0.001, respectively). The number of oocytes, mature MII oocytes, and Grade A embryos also improved significantly (P ranging from 0.004 to 0.017). Although the increase in Grade B embryos was not statistically significant, it was higher post-PRP. Chemical pregnancies occurred in 25% of participants, with 20.83% resulting in clinical pregnancies, including 2.1% spontaneous pregnancies. PRP significantly enhanced ovarian reserve markers (FSH, AMH, AFC), oocyte quality, and embryo development, translating into improved fertility outcomes. The findings suggest that with longer follow-up and larger sample sizes, PRP could be validated as a promising adjunctive therapy for women with ovarian insufficiency undergoing IVF. These results align with prior research and highlight PRP’s potential to advance reproductive outcomes in this challenging patient population.

Elements of Success After Metatarsectomy Healing of Neuropathic Diabetic Foot Ulcers

2025-02-04T08:12:58+00:00

Diabetic foot ulcer (DFU) is one of the most significant and destructive complications in diabetic patients. It is not only the main cause of patients' foot amputation but is also related to their mortality rate. The aim of this study was to evaluate the results of metatarsectomy in the recovery of diabetic-resistant foot neuropathic wounds to evaluate its clinical effectiveness. This quasi-experimental, before-and-after study was done on 16 diabetic patients with refractory neuropathic ulcers, who were referred to the vascular surgery ward undergoing metatarsectomy. Patients were followed up for two weeks, one month, and three months after surgery and were evaluated for complete recovery, partial recovery, and no response. Of 16 diabetic patients with 16 refractory diabetics plantar fasciitis, 12 (75%) were male and 4 (25%) were female. The mean age of patients was 56.63. There were 5 patients with type 1 diabetes and 11 patients with type 2 diabetes. 10 patients (62.5%) had the underlying non-diabetic disease. 50% of patients had had a history of amputation. The mean duration of diabetes in 16 patients was 18.06 years. All wounds healed completely with an average healing time of 4 months (100% epithelialization). The results of the present study demonstrate that metatarsectomy can be used as a primary technique for offloading in the treatment of diabetic-resistant neuropathic wounds in the soul instead of non-surgical methods. The results prove that this method with a high recovery rate and significant clinical effectiveness can be used as an effective method in the first line of treatment of diabetic-resistant neuropathic wounds of the sole.

Evaluation of Anti-Cancer, Pro-Apoptotic, and Anti-Metastatic Effects of Synthetic Analogue Compound 2-Imino-7-Methoxy-4-(4-fluorophenyl)-2H-1,3-Thiazino [3,2-a] Benzimidazole on Pancreatic PaCa-2 and Melanoma A375 Cancer Cells

2025-02-04T08:12:48+00:00

Synthetic compounds are widely used in cancer drug discovery. Chemotherapies aim to inhibit proliferation and induce apoptosis however, they have limitations. This study aims to explore in vitro anti-proliferative, pro-apoptotic, and anti-metastatic effects of 2-imino-7-methoxy-4-(4-fluorophenyl)-2h-1,3-thiazine [3,2-a] benzimidazole against pancreatic and melanoma cancer cell lines. Cell viability assays were conducted using Alamar blue assay. Caspase 3/7 activation was evaluated using caspase-Glo® 3/7 substrate reagent. Gene expression was analyzed using conventional polymerase chain reaction (PCR). Cell migration was assessed using wound healing. Alamar blue assay showed that the molecule studied exhibited antiproliferative activity on both the PaCa-2 and A375 cell lines, however, with higher cytotoxicity on PaCa-2 which suggests that it is cell-line dependent. Caspase 3/7 activity was upregulated in PaCa-2 and downregulated in A375, suggesting caspase-dependent and caspase-independent cell death, respectively. p53 and Bax were upregulated on both cell lines which suggests that the compound might have induced apoptosis and autophagy. Wound healing showed a decreased cell migration on both cell lines an important stage of metastasis. The study suggests that the study molecule can be a promising chemotherapeutic agent in the development of new anticancer drugs.

Pericardial Involvement in Hereditary Hemorrhagic Telangiectasia

2025-02-04T08:12:46+00:00

Hereditary haemorrhagic telangiectasia is a rare disease characterized by cutaneo-mucous and visceral arteriovenous malformations. Cardiac involvement is uncommon and was presented primarily by hyper-output heart failure. Hemorrhagic pericardial effusion, although is extremely rare, can occur during HHT. We report the case of a 48-years-old woman which was hospitalized in 2015 in internal medicine department, Sfax, Tunisia in 2015 for anicteric cholestasis. She noticed a personnel and familial history of recurrent epistaxis. Biologic findings revealed anemia and moderate cholestasis. Viral investigations and immunologic tests were negative. Abdominal tomography showed multiple arterio-venous shunts of the liver. Liver involvement due to Rendu Osler Weber disease was retained. She was treated by ferrous iron, but she was lost to follow up. She was presented in February 2021, with severe anemia (5 g/dL). Physical examination revealed signs of global heart failure. Biological investigations found anemia, inflammatory biological syndrome, cytolysis and cholestasis. Heart ultrasound revealed an abundant pericardial effusion. Only 500cc of hemorrhagic fluid could be aspirated before the needle became blocked. Unfortunately, one week after, re-accumulation of pericardial fluid and worsening occurred. She underwent a partial surgical pericardial excision with pleuropericardial opening. Analysis of the fluid ruled out any infectious cause of this effusion. Histological examination confirmed the vascular dysplasia with signs of hemorrhage and inflammation. The patient was discharged 1 month after surgery with no other bleeding episodes. For her anemia, she received a transfusion of red blood cells. Then, the patient was treated by iron treatment.

A Case Report of Gastric Diverticulum-An Uncommon Cause of Dyspepsia

2025-02-04T08:12:44+00:00

Gastric diverticulum is a rare anatomic abnormality which resulted from abnormal outpouching of the stomach wall. It is known to cause symptoms from asymptomatic to life threatening conditions. The management mainly depends on the severity of the disease and the size of the diverticulum and there is no specific treatment for an asymptomatic patient. We reported a case of 58-year-old gentleman who presented with dyspepsia secondary to gastric diverticulum. The diagnosis was made based on medical history and an outpatient Oesophagogastroduodenoscopy (OGDS). Patient was treated non surgically with proton pump inhibitors and prokinetics.