Payavard Salamat

Study of Compliance with the Guidelines for Registration and Labeling of Anesthesia Drugs in the Operating Room

Shaqayeq Taghizadeh

Background and Aim: One of the basic principles in the safety of drug therapy for patients is the correct registration and labeling of anesthetic drugs, which can lead to the reduction of drug errors, the increase of drug and patient safety, the reduction of drug consumption and the environment, and the optimization of hospital costs.
Materials and Methods: This descriptive-analytical and cross-sectional research was conducted in February 2022 in the operating rooms of Iran University of Medical Sciences hospitals. The participants included 177 Anesthesia experts working in the hospitals’ operating rooms, who were included in the study by census method. The data was collected using the checklist for evaluating anesthetic drug registration and labeling guidelines and analyzed using SPSS software and one-way ANOVA, Fisher, and Pearson correlation coefficient statistical tests. The significance level was considered P value < 0.05.
Results: The average compliance with the guidelines for registration and labeling of anesthetic drugs in all hospitals was 3.559 out of the total score of 16. The average adherence to guidelines in 8 hospitals was significantly different from each other (P < 0.001). Hazrat Ali Asghar Hospital had the highest compliance rate, averaging 10.333 out of 16. Firouzgar and Shahid Akbarabadi hospitals were in the next rank, averaging 10.11 and 6.65, respectively. There was a negative and significant correlation between the level of compliance with the guidelines and the average work experience and age of the experts (P=0/17); However, gender did not significantly correlate with the degree of adherence to the guidelines(P=0/596).
Conclusion: According to the obtained results, compliance with the guidelines for registration and labeling of anesthetic drugs in most hospitals was assessed as weak and at an unfavorable level. Considering the importance of this issue in reducing medication errors and increasing patient safety, it is necessary to use empowerment and retraining courses for Anesthesia experts according to the latest guidelines.

Evaluation of the Knowledge, Awareness, Attitude, and Performance of Radiographers regarding Adherence to Radiation Protection Principles in Iran

Masoud Jabbari

Background and Aim: X-ray radiation, besides its useful applications in the diagnosis and treatment of diseases, also has harmful effects. With the increasing demand for various radiographs and X-ray imaging, radiation protection for radiographers is of particular importance. In this regard, a study was conducted to examine the level of awareness, attitude, and performance of radiographers in Iran with regards to the effects of ionizing radiation and protective methods against them.
Materials and Methods: In this descriptive-analytical study, based on a census, the awareness, attitude, and performance of radiographers in 52 cities in Iran were examined by using a questionnaire. Data from 847 radiographers were collected. Finally, the data were analyzed using t-test and analysis of variance through SPSS statistical software.
Results: Out of the total distributed questionnaires (748 items), 531 questionnaires were completely filled by radiation workers. In the present study, 46% were male and 53% were female, with average scores related to the awareness, attitude, and performance of radiographers in the field of radiation protection being 59.9, 69.4, and 43.54, respectively. There was no statistically significant difference (P<0.05) between the awareness levels of individuals who had undergone refresher training (24.3%) and those who had not. Radiographers’ knowledge of specialized information such as the principle of As Low as Reasonably Available (ALARA) (68.5%), Bucky factor (65.5%), and heel effect (61%), alongside the relationship between source-to-skin distance and radiation intensity (71%), was at a moderate level.
Conclusion: The poor performance of radiologists in this study is not solely attributed to functional deficiencies but sometimes also involves the institutionalization of incorrect principles. These weaknesses and shortcomings are undoubtedly the result of inadequate supervision and erroneous modeling over a long period. If not addressed, they will undoubtedly have irreparable destructive consequences in the future, especially with the increasing advancement of diagnostic radiology methods.

Automatic Spelling Correction in Persian Sonography Text with Neural Networks

Amid Khatibi Bardsiri

Background and Aim: Medical reports and electronic health records are critically important for diagnosis, treatment, patient protection, and medical research. Correcting spelling errors in medical texts is essential to ensure accurate interpretation of information. This research was conducted to automatically correct spelling mistakes in Persian medical texts using neural networks.
Material and Methods: In this study, which was conducted in 2023, a computational model based on artificial intelligence neural networks and dual embedding techniques was developed using Python in a Windows environment. The dual embedding model was fine-tuned for correcting spelling errors in Persian sonography texts. The proposed model employs various techniques for automatic error detection, including dictionary lookup approach and contextual similarity coefficients. Furthermore, features specific to text processing, such as Edit-Distance, along with similarity coefficients, were utilized to automatically select the most appropriate substitute for a misspelled word. The training and testing data for the current model were sourced from a collection of sonography texts from the Imam Khomeini Hospital’s sonography clinic in Tehran.
Results: The proposed model which is based on artificial neural networks, leverages a novel dualembedding architecture to select the best candidate words for correcting both non-word and real-word errors. According to the evaluation results on Persian sonography text, the proposed model achieved an F-Measure accuracy of 90.5% in detecting real-word errors. Furthermore, it demonstrated an impressive 90% accuracy in automatically correcting these real-word errors. Additionally, the model exhibited a strong performance, achieving 90.8% accuracy in correcting non-word errors.
Conclusion: Based on the evaluation results, the proposed method is robust against various changes in word forms and can effectively manage a wide range of morphological and semantic errors, including replacements, transpositions, insertions, and deletions in medical texts. The integration of EditDistance with textual similarity coefficients extracted from the dual embedding model significantly enhanced the accuracy of spelling corrections in Persian sonography texts, ensuring greater validity of such documents. The authors believe that the proposed model represents a significant advancement in the detection and correction of spelling errors in Persian sonography texts.

Design and Developing of Health Information Behavior Questionnaire

Bahram Peymannia

Background and Aim: The term “information behavior,” with an emphasis on health and hygiene, refers to purposeful actions taken to satisfy informational needs related to health. The objective of the current research is to develop and validate a questionnaire on information behavior, with a focus on health and hygiene information.
Materials and Methods: This study was a quantitative research conducted with a tool design approach. Initially, a questionnaire for measuring this behavior was prepared using instrument design methods. The basis for extracting the factors of the present questionnaire has been argumentation and logical repetition. In other words, the researcher, in line with the background of these factors and their repetition in the sources, used them as influential factors in the questionnaire construction. After confirming the content and structural validity, the modified questionnaire was distributed among 238 patients with multiple sclerosis. The sample selection.
was done using the available sampling method. Then, the data were analyzed using exploratory and confirmatory factor analysis. The internal consistency of the data was calculated using Cronbach’s alpha. The collected data were analyzed using descriptive and inferential statistical methods with the help of SPSS and AMOS software.
Results: The content validity of the questionnaire was evaluated with the opinion of 20 experts in information behavior. The reliability of the health information behavior questionnaire was adequate and satisfactory with the overall Cronbach’s alpha coefficient of 0.78 and the Cronbach’s alpha coefficient of the components between 0.71 and 0.94. In order to factor analysis, the sampling adequacy index and the value of Bartlett’s Crowley test were calculated, and all 29 items were statistically significant; which confirms the factorization of the correlation matrix. In the exploratory factor analysis, five factors (avoidance of information), the second factor (need for information), the third factor (exposure to information), the fourth factor (seeking information), and the fifth factor (use of information) were obtained. The indicators of confirmatory factor analysis showed the validity of the proposed structure. The results of the structural equation model test showed that the fit indices were favorable and also indicated the fit of the presented model in the MS patient population.
Conclusion: The obtained results demonstrated that health information behavior in this questionnaire encompasses five factors: information needs, information-seeking behavior, information avoidance, information use, and information confrontation, which were confirmed. The designed scale for assessing health information behavior in the Iranian community has been evaluated and is recommended for use in measuring health information behavior effectively.

Comparing the Efficiency of Hospitals in Western Iran Before and After the Covid-19 Pandemic Using the Pabon Lasso Model

Jamil Sadeghifar

Background and Aim: There is limited evidence about the effect of the corona disease epidemic on the efficiency of hospitals in Iran. This study was conducted with the aim of investigating the effect of the Covid-19 epidemic on the productivity of public hospitals in Ilam province.
Materials and Methods: This retrospective descriptive research has investigated the performance of 9 hospitals in Ilam province during a four-year period(1397-1400) based on the Pabon Lasso graphic model. The desired data were extracted from the HIS system of the hospitals and the key performance indicators of BOR, BTR and ALOS were calculated. The Pabon Lasso diagram was drawn with Excel software.
Results: The results showed that the bed occupancy percentage in teaching hospitals is significantly higher than non-teaching hospitals (P<0.05). Based on the results, the percentage of bed occupancy and the rate of bed rotation after the covid 19 pandemic has decreased significantly (P<0.05). The average length of the stay of patients also increased after the pandemic (P<0.05). Overall evaluation of hospital efficiency based on the Pabén Lasso model shows that the frequency of hospitals located in Nakara district has decreased from 4 hospitals before the pandemic to 3 hospitals, although hospitals in Kara district have not changed during this period.
Conclusion: Most of the researched hospitals, especially non-teaching hospitals, have low bed occupancy. Weakness in the service delivery chain, especially diagnostic services and specialized and super-specialized services, is one of the main reasons for this situation. Moving towards a change in the way hospitals are managed and having more flexibility in the structure and implementation in the short term and prioritizing large hospitals with a complete chain of services can lead to a way out of the current inefficient situation.

Oncolytics, Cancer-Fighting Viruses from Past to Future: A Literature Review

Mehdi Totonchi

Background and Aim: Oncolytic viruses, as novel and advanced tools in the field of treating various types of cancer, have played a very important role in medical developments. The term “oncolytic” refers to the ability of these viruses to destroy and damage cancer cells while preserving the surrounding healthy cells.
Materials and Methods: To conduct this study, a total of 270 initial results were collected through searching in the PubMed, Scopus, and Google Scholar databases from 2012 to 2024. The primary researcher reviewed 68 relevant articles, extracted and summarized the contents, and finally compiled the findings.
Results: The findings from this review study demonstrate that cancer cells possess distinct characteristics that differentiate them from normal cells, including continuous growth signaling, resistance to anti-growth signaling, evasion of apoptosis, increased angiogenesis, and invasion into other body parts. Oncolytic viruses utilize these distinctive features to selectively target and infect cancer cells. Most oncolytic viruses directly eliminate host tumor cells, resulting in viral replication and induction of host antiviral responses. Moreover, these viruses can destroy cancer cells through the production of specific proteins. The cytotoxic potential of oncolytic viruses depends on viral type, genetic manipulation, optimal virus dosage for injection, natural and induced viral tropism, and cancer cell sensitivity to various forms of cell death. The mechanism driving the selective replication of oncolytic viruses in cancer cells likely relates to defects in signaling pathways specific to tumor cells. Phase III clinical trials have demonstrated significant improvements in the treatment outcomes of various cancers, including head and neck cancer, melanoma, glioblastoma, and bladder cancer, through the use of H101 (Oncorine), T-Vec, ECHO-7, and Teserpaturev (Delytact) viruses.
Conclusion: Oncolytic viruses are constructed from various types of viruses and are currently being evaluated in laboratory, preclinical, and clinical stages. The use of these viruses for the treatment of cancer as a new and targeted approach has been proposed, which requires further investigation and achievement of more precise mechanisms for their better performance.

Solutions for Preventing Patient Falls in Hospitals: A Scoping Review

Hojjat Rahmani

Background and Aim: Patient falls are common in hospitals, leading to financial loss and potential harm to patients, staff, and the organization. They can often be prevented with proper planning. This study aims to identify strategies to prevent patient falls and provide evidence to develop safety initiatives.
Materials and Methods: Our review used the Arksey and O’Malley scoping review model to identify strategies for preventing patient falls. We conducted searches with relevant keywords in the PubMed and Web of Science databases until May 25, 2024. In the final stage, we consulted with 18 experts using the Delphi method to gather their opinions. The data were analyzed using the thematic analysis method.
Results: Out of the 4202 studies initially found, 19 articles were chosen. The solutions to prevent patient falls can be grouped into six general categories: planning (which includes quality improvement programs, establishment of patient safety culture, patient fall prevention guidelines and programs), physical space (involving patient room design and the location of treatment staff), equipment (such as monitoring and alarms, pressure sensors, and standard beds), human resources (including communication networks between nurses and other treatment staff, as well as factors like self-efficacy and responsiveness of nurses, and their motivation and job satisfaction), training (covering education and patient participation, training of nurses and treatment staff, and electronic training), and control of executive processes (involving evaluation of risk factors and process control). The highest level of agreement among the members was on the equipment dimension (9.76), and the lowest was on the human resources dimension (8.65).
Conclusion: Patient falls are a common safety concern in hospitals and can be prevented with proper planning. Each hospital should use a combination of prevention methods tailored to its specific conditions.

The Effect of a Period of Circuit Resistance Training on Serum Level of Apelin, Vaspin, and Blood Pressure in Elderly Men with Hypertension

Amir Rashid Lamir

Background and Aim: Adipokines imbalance causes pathological effects on this system. Exercise interventions can play an important role in regulating the secretion of adipokines. This study aimed to investigate the effect of 12 weeks of resistance training on the serum level of apelin, vaspin, and blood pressure in elderly men with hypertension.
Materials and Methods: In this quasi-experimental study, 24 elderly men with high blood pressure were selected purposefully and based on the inclusion criteria and were randomly assigned to resistance training (N=12) and control (N=12) groups. The participants of the resistance training group performed resistance training for 12 weeks and three days a week. At the beginning and end of the study, blood samples were collected to measure the serum level of apelin and vaspin. Data analysis was performed using SPSS version 24 software with dependent and independent t-tests at a significant level of less than 0.05.
Results: After 12 weeks of resistance training, there was a significant decrease in the serum level of apelin (P=0.002), vaspin (P=0.01), systolic blood pressure (P<0.001), and diastolic blood pressure (P<0.001) as compared to the pre-test. In addition, a significant difference was observed between the two experimental and control groups in the serum level of apelin (p=0.001), vaspin (P=0.001), systolic blood pressure (P<0.001), and diastolic blood pressure (P<0.001).
Conclusion: It seems 12 weeks of resistance training can improve systolic and diastolic blood pressure and regulate the secretion of adipokines apelin and vaspin in elderly men with high blood pressure.