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Showing 13 results for Amouzeshi
Ali Asghar Moinipoor, Mohammad Abbasi, Ahmad Amouzeshi, Jamil Esfahanizadeh, Shahram Amini,
Volume 1, Issue 1 (October 2013)
Introduction: Deep sternal wound infection is a rare but serious complication after cardiac surgery that can increase mortality and morbidity. The aim of this study was to investigate the incidence and causative germs of deep sternal wound infection following cardiac surgery.
Methods: Data were collected retrospectively from patients who underwent different cardiac surgeries including coronary artery bypass grafting and valvular heart surgeries between July 2010 and October 2012 at a teaching hospital in the north east of Iran. Patients with a deep sternal wound infection (DSWI) were defined based on clinical findings and culture results of the wound. The patients were tracked for the development of DSWI and causative germs and sensitivity were identified according to the microbiological studies.
Results: 4621 patients underwent different cardiac surgeries during the study period. There were 82 cases (1.77%) of DSWI with mean age of 53.93 years and male to female ratio of 47:35 with mortality rate of 10.9%. The most common germs in order of decreasing frequency included Klebsiella, Pseudomonas, Staphylococus Coagulase Negative, Acinetobacter, Staphylocciaureus, Escherichia coli, methicillin resistant Staphylocciaureus, Providenciarettgeri, and Obligatory anaerobe Streptococus.
Conclusions: We conclude that DSWI remains a rare but devastating complication and is associated with significant comorbidity, increased hospital mortality, and reduced long-term survival with gram negative rods as the most common pathogens.
Mostafa Mehrabi Bahar, Mohammad Reza Motie, Ahmad Amouzeshi, Hossein Razavian, Alireza Rezapanah, Elena Saremi,
Volume 1, Issue 1 (October 2013)
Torsion of the gallbladder is a relatively rare surgical disease which mimics acute cholecystitis' symptoms that usually would not be respondable to medical therapies. The torsion would mostly be diagnosed intra-operatively. Cholecystectomy is the treatment of choice. In general in our centre, General Surgery department, Imam Reza hospital, Mashhad, Iran, since 1986 over 14000 cholecystectomies have been performed and 3 cases with an underlying cause of gallbladder torsion are documented. The relative literatures reviewed so then the presentation, paraclinical findings, and the treatment of gallbladder volvulus are discussed. Gallbladder volvulus: Review of the literature and report of three cases.
Hoda Khoshdel, Ahmad Amouzeshi, Zahra Amouzeshi, Zahra Unesi,
Volume 2, Issue 1 (March 2014)
ntroduction: Electrocautery device is one of the most widely used electronic devices in operating rooms despite its advantages in operations, production risks such as the halo of smoke above the operating position. The smoke with hazardous substances,cause to transmitting HIV, HPV and hepatitis and complications such as respiratory distress, nausea and vomiting, eye irritation, headache, and so on The purpose of the present study was to determine Surgical Team' Knowledge of electrocautery smoke complications in the Educational hospitals in Birjand, 2011. Methods: In this descriptive and cross-sectional study Surgical Team in Birjand Educational hospitals who were available were selected. After ensuring that they were content with and cooperate in the study, a researcher designed questionnaire was filled. The questionnaire included demographic questions (4 items) and knowledge questions (21 items) of electrocautery smoke complications. The obtained data was analyzed by SPSS software (V: 16), using Kruskal-Wallis and Mann-Whitney at the significant level P<0.05. Results: Mean score Surgical Team ' knowledge of electrocautery smoke complications were 9.0±4.88 (of the total 21 points) that is, 57% of them had low knowledge of electrocautery smoke complications. Conclusions: Given the low level of knowledge about electrocautery smoke complications in Surgical Team, planning to enhance their knowledge through workshops and continuing education programs and training is essential.
Masome Abdoli, Zahra Amouzeshi, Mohamad Hosein Nakhaee,
Volume 2, Issue 1 (March 2014)
Introduction: A growing number of children around the world are being born by surgical delivery, or cesarean section. Concerns about the steep increase in cesarean deliveries have been raised because of the possibility that surgical delivery is associated with greater maternal and infant mortality and morbidity than vaginal delivery. The purpose of the present study was to determine Prevalence of cesarean section and related causes of in women referring to Vali-e-Asr and tamin -e-ejtemaee hospitals in Birjand, 2010.
Methods: In this descriptive study, which cross-sectionally was carried out, 293 pregnant women referring to Vali-e-Asr and tamin -e-ejtemaee hospitals were studied. A questionnaire in 2 portions was filled out at mothers’ bed, in delivery room, operation room, and women's ward. The obtained data was analyzed by SPSS software, using chi square test at the significant level P<0/05.
Results: From 293 pregnant women in this study 147 (50.2%) had a normal delivery and 146 (49.8%) by Cesarean. The most common causes for caesarean were cephalopelvic disproportion (22.4%), malpresentation (21.7%) and Failure to progress (16.8%).
Conclusions: In this study, the prevalence of caesarean section is more than the WHO standard. In order decrease the number of unnecessary cesarean, teaching the young pregnant mothers about the disadvantages of cesarean is necessary.
Shahnaz Tabiee, Zahra Amouzeshi, Seyyed Abolfazl Vagharseyyedin,
Volume 2, Issue 2 (September 2014)
Introduction: As a key member of the healthcare workforce, nurses play an important role in patient care. N ursing care performance, especially sterilization, is of significant importance in provision of health and prevention of complications such as hospital infections. This study aimed to investigate nurses’ performance concerning sterilization while performing nursing techniques in ICU wards of educational hospitals affiliated to Birjand University of Medical Sciences.
Methods: In this descriptive-analytic study, 36 nurses working in the ICU ward were selected by census method. A researcher-made observational checklist with three choices for each item was designed to check the sterilization techniques used by nurses in terms of obtaining intravenous (IV) access (10 items), suctioning of the endotracheal tube (7 items), and dressing (8 items).For each technique, a total score of≥75% was considered as good, between 50-75% as moderate, and <50% as poor performance. Content validity was used to confirm the validity of the checklist, and Cronbach’s alpha was calculated 0.67 to confirm its reliability. Data were analyzed in SPSS (version 16) using independent t-test at the significant level of P<0.05.
Results: Mean score in the suction technique (out of 21) was 15.3±0.88 for which 8.3% of participants had good and 91.7% had moderate performance. As for the dressing technique, the mean score (out of 24) was 18.1±0.68 for which 46.4% of participants had good and 53.6% had moderate performance. Mean score in the obtaining IV access (out of 30) was 18.64±1.03 for which 100% of participants had moderate performance. No poor technical performance was observed, nor was there a Significant differences between the participants’ demographics and their performance.
Conclusions: Nurses’ performance concerning sterilization techniques used in the ICU wards was moderate. Considering the results, periodic re-education programs are suggested to improve nurses’ performance.
Toba Kazemi, Ahmad Amouzeshi, Nahid Borna, Gholam Reza Sharifzadeh, Zahra Amouzeshi,
Volume 2, Issue 2 (September 2014)
Introduction: Causes of death vary globally, and they depend regionally on lifestyle and socio-cultural factors. The purpose of this study was to determine accident-related mortality in Southern Khorasan Province, Iran, in the year 2010.
Methods: This descriptive-analytical study involved all the death cases in the year 2010 in Southern Khorasan. The data were collected from the death registration system, and were classified and analyzed according to the codes of the 10th revision of the International Classification of Deaths (ICD).
Results: From among the 3,792 deaths in 2010, n=633 (16.7%) were accident-related. Of accident-related deaths, 73.6% (n=450) of the deceased persons were male. The highest rate of mortality belonged to Summer (July 23 to Aug 22) (n=203 32.1%). The median age in accident-related deaths was 36.6±21.9 years with the minimum age of 5 days and maximum age of 92 years. The leading cause of mortality was traffic accidents (52.1%) and violence (18%). The median age of the deceased women in accidents was significantly higher than men (P<0.048) and in rural persons more than urban people (P=0.02), with Surgical complications as the least frequent cause of death.
Conclusions: Since road traffic accidents rank first in accident-related mortality, it is recommended to have measures to improve road safety as well as quality and safety of vehicles, and to establish strict rules for those who disobey traffic rules.
Mohsen Taghavi Shavazi, Ahmad Amouzeshi, Toba Kazemi, Alireza Ehsanbakhsh,
Volume 3, Issue 3 (10-2015)
Aortic coarctation is a rare but dangerous condition. Presence of aortic dissection in addition to coarctation is significantly rarer and more life-threatening. Here, we present a case of acute inferior MI due to aortic dissection complicating a native aortic coarctation.
A 17-year-old boy was admitted to our emergency department due to severe chest pain and loss of consciousness. His electrocardiogram showed ST elevations in Inferior leads proposing an inferior MI. Further evaluations revealed that the patient had been suffering from an underling aortic coarctation complicated by an acute aortic dissection.
For every young person with symptoms of acute coronary syndrome, aortic dissection should be considered as a potentially fatal differential diagnosis. Coexistence of aortic coarctation, as an underling and exacerbating factor, should be assessed using appropriate imaging modalities whenever suspected.
Ahmad Amouzeshi, Seyedeh Masome Hosseini, Abbas Javadi, Fateme Norozian, Nazanin Zamanian, Yahya Mohammadi, Somaye Jomefourjan, Zahra Amouzeshi, Mahmoud Kohan,
Volume 3, Issue 3 (10-2015)
Introduction: Anxiety and depression are among major problems encountered by most patients after cardiac surgery. They can have serious consequences for patients’ quality of life, physical and psychological morbidity, and follow-up treatments. Accordingly, the present study was conducted to determine the status of depression and the associated factors in coronary artery bypass grafting (CABG) patients hospitalized in cardiac surgery ward of Imam Reza Hospital of Mashhad in 2013.
Methods: The current investigation is a descriptive, cross-sectional study for which all patients undergoing CABG surgery were selected using the census method. The subjects included inpatients hospitalized in Imam Reza (AS) Hospital of Mashhad from April 2013 to March 2014. The data was collected using the demographic characteristics form as well as Beck Depression Inventory (BDI-II). Analysis of data was conducted with SPSS (version 16) using paired t-test, independent t-test, ANOVA and Pearson correlation coefficient. The significance level was set at P<0.05.
Results: The mean score of depression after cardiac surgery was 31.5±10.60 and 29.3±10.55 for male and female patients, respectively. From among the patients, 64.4% suffered from severe depression after surgery, while 32.1% had moderate depression. No statistically significant relationship was found between age, sex, marital status, employment status, and education level on the one hand and post-operative depression score on the other hand.
Conclusions: As regards the high rates of pre-surgical and post-surgical depression in patients undergoing CABG, effective communication with patients and patient training are recommended as critical components of nursing care to reduce depression.
Zahra Amouzeshi, Narges Soltani, Narjes Khatoon Taheri, Majid Zare Bidaki, Seyed Ali Reza Mousavi, - Manizhe Nasirizade, Farzaneh Safajou,
Volume 4, Issue 1 (2-2016)
Introduction: The use of e-learning and computer-aided methods is rapidly on the rise in medical and nursing education. Therefore, given the conflicting findings and lack of systematic clinical trials on comparison of the effects of e-learning and traditional methods in nursing education, this study aimed to assess the effects of offline e-Learning on cognitive learning (levels of knowledge, comprehension, and application) in the Fluid and Electrolyte Imbalances course among nursing students.
Methods: This is a quasi-experimental study with a two-group, post-test-only design. A total of 52 third-semester nursing students were selected by convenience sampling method. Course contents were presented during 6 weeks by lecture and question and answer (Q & A) in the traditional learning group and by offline e-Learning in the second group. Afterwards, the students’ cognitive learning (knowledge, comprehension, and application) was assessed using a 23-item questionnaire on Fluid and Electrolyte Imbalances course. The obtained data were analyzed in SPSS (version 16) using Mann-Whitney, t-test, Chi-square, Fisher's Exact Test, and analysis of two-way variance. The significant level was considered as P < 0.05.
Results: The mean score of cognitive learning was significantly higher in the traditional learning group (14.1±1.9) than in the e-learning group (12.4±2.2) (P=0.006). The difference was also significant in the domain of knowledge (P<0.001), but insignificant in comprehension (P=0.097) and application (P=0.892) domains.
Conclusions: According to the results, the method of teaching e-learning, alongside traditional teaching method is recommended.
Ahmad Amouzeshi, Mahtab Dolatabadi, Samaneh Nakhaee, Mahmood Hosseinzadeh Maleki, Omid Mehrpour,
Volume 5, Issue 1 (10-2017)
Introduction: Opium addiction is a social and health problem in many parts of the world, including Iran. The exact effects of this substance on the cardiovascular system and postoperative complications are not clear And the results of studies in this regard are also contradictory, Therefore, the present study aims to compare short-term mortality After coronary artery bypass surgery In two groups Opium consumer And non-consumer was done.
Methods: This cross-sectional study was performed on 194 patients who were hospitalized during September 2013 to September 2015 In Valiasr Hospital of Birjand, they were under CABG operations conducted. In this study, short-term mortality)Hospital and a month After discharge) Through existing records And phone calls were reviewed. All data were analyzed by SPSS 22 software and analyzed using descriptive and inferential statistics.
Results: Of the 194 patients who had undergone surgery twenty-three patients (12.2%) used opioid Among them, In the form of Inhaler, 13 patients (56.5%) orally And 3 patients (13%) was a combination of orally and inhaled. In general, there is a case of mortality during surgery And 7 cases (77.77%) of mortality occurred in the Hospital ward. During the one month follow up, There was a death case. Among the non-addicted patients164 case were alive and 7 died And among addicted patients as well 22 cases were alive And there was a death case. Finally, the results showed, No statistically significant difference between the mortality after surgery, Blood lipids, and diabetes, In two groups Opium consumer And non-consume(p>0/05). But hypertension in the non-addicted group was significantly higher (p <0.05).
Conclusions: Based on the results of this study, there was no significant relationship between opioid dependence and short-term mortality in patients after CABG surgery. Due to low sample size and cross-sectional study, The design of cognitive studies with higher sample sizes seems to be necessary in order to discover causal relationships.
Habibollah Rezaei, Shahram Shayan, Zahra Amouzeshi, Amrollah Roozbehi, Jafar Nikbakht, Bahareh Bahmanbijari, Amin Beigzadeh,
Volume 5, Issue 1 (10-2017)
Introduction: The health system development plan is currently one of the most fundamental changes in Iran. The purpose of this study was to determine the amount of attention to the components of change in health Development plan from the Viewpoint of staff in Al-Zahra hospital in Isfahan and Afzalipour hospital in Kerman in 2015.
Methods: In this quasi-experimental study , the staff of Al-Zahra hospital in Isfahan and Afzalipour hospital in Kerman were selected by convenience sampling method. Data were collected using a researcher-made questionnaire and its validity and reliability were taken into account. Data were analyzed by SPSS version 21 and two-way multivariate analysis of covariance was used as appropriate at a significant level of p <0.05.
Results: The average rate of attention to the components of change in three factors namely "support and planning", "training and counseling", and efficiency" Were respectively 3.93±0.63, 2.91±0.86 and 2.3±0.69. The overall mean of attention to change components was 2.83±2.52.
Conclusions: The mean of the total score showed that less attention has been paid to the components of change in the Health Development Plan. We suggest conducting a national survey to identify faulty components and elements in order to take corrective measures.
Mahmoud Kohan, Mehdi Bagheri, Zahra Amouzeshi,
Volume 6, Issue 2 (8-2018)
Structured surgical training is vital to ensure that the next generation of surgeons is equipped with the skills necessary to guarantee safe patient care, as well as the skills required to ensure effective ongoing professional development. Numerous instructional strategies and educational approaches, which are commonly used in the operating room, have recently been described in the literature. The aim of this review article is to highlight current teaching methods for training surgical residents in the operating theatre. A literature search on the current teaching methods for training surgical residents in the operating room was carried out using PubMed, Scopus, Google Scholar, ScienceDirect, and ERIC databases between the years 1990 and 2018, and selected articles were retrieved. This review demonstrates that most surgical training programs make use of a variety of teaching methods and models for training surgical residents in the operating room, including the apprenticeship model, the BID model, the Zwisch model, the one-minute preceptor, Koens et al.’s model, and Morbidity and Mortality Meetings. Effective use of these novel educational tools by surgical educators may serve to improve the quality and efficiency of intraoperative resident education.
Ali Rajabpour Sanati, Ahmad Amouzeshi, Ali Mohammad Pourbagher Shahri,
Volume 6, Issue 2 (8-2018)
As you know physical and mental wellness of physicians and nurses, as the main role in the treatment of patients, in conditions such as burnout, compassion fatigue, depression, and poor work-life balance, is one of the top priorities in the U.S.A. National Academy of Medicine (1-4).
Although healthcare team members are generally known as a caregiver to others; their high workload commonly lead to lack of enough self-care, which ultimately can result in medical errors.
Medical errors are known as the third leading cause of death in the U.S.A. accounting for approximately 50 percent of deaths in hospitalized patients (5, 6).
In Iran, due to the absence of a comprehensive system for registration of medical errors, no precise statistics are available. However, by different social and economic factors, the prevalence of medical errors is higher than reports from global standards and scientific data (7).
Systematic review studies showed that poor wellbeing and moderate to high levels of burnout were significantly related to medical errors (5, 6).
Studies also indicated that work shifts longer than 12 hours per day or 40 hours per week were significantly associated with the occurrence of medical errors (8-12).
On the other hand, the unhealthy work environment of staff causes noxious effects on the wellbeing of the health team and ultimately leads to increased occurrence of medical errors (4).
Considering the above-mentioned issues and in line with this fact that a comprehensive study of effective variables on environmental conditions, physical and mental wellbeing of health team members, especially surgeons and surgery wards nurses, has not been conducted in Iran yet, it is suggested that providing and conducting encouraging programs for authors can disseminate studies in this field. Therefore, with a meta-analysis study of gathered data, necessary approaches and actions to identify and resolve these factors and obstacles can be achieved, which can successfully result in decreasing medical errors rate.