Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 Can Hypoxia Induced Pulmonary Hypertension be Treated with a Combination of MgSO4, Alpha Blocker as Well as Angiotensin Converting Enzyme Inhibitor? 1 4 113578 10.30483/RIJM.2018.30 EN Mohammed Omar Galal MD, PhD, MBA, King Faisal Specialist Hospital & RC, Jeddah, Saudi Arabia Journal Article 2017 10 14 Pulmonary hypertension (PHT) has classically been treated with expensive vasodilators. Through the treatment of hypoxia-induced PHT as well as postoperative hypoxia by proxy PHT, possible alternatives in treatment have been discovered. Results of the aforementioned treatments and patient interventions have been discussed in this paper. Medications discussed individually are MgSO4, ACE inhibitors, and alpha blockers as well as their implementation in therapeutic regimens. The conclusions drawn from those largely successful interventions lead to a proposal for the development of an alternative medication for the hypoxia-induced pulmonary hypertension that theoretically would prove to be as inexpensive as it would be effective. Bringing together the results of the aforementioned research, this medication would consist of MgSO4, ACE Inhibitors, and alpha blockers. It is inferred that a triple therapy of the three drugs would allow for synergistic effects and reduce the side effects to a minimum. The goal would be to develop a medication that can be used for all the communities where it is needed, regardless of their medical development or financial flexibility.

https://journal.razavihospital.ir/article_113578_4951bdf59b5798ab123c9df56e4efb91.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 Use of Composite Graft in Patients with Coronary Artery Diseases Concomitant with Porcelain Aorta: A Safe Technique and case series in Severe Aortic Calcification 5 8 113576 10.30483/RIJM.2018.31 EN Mohamad Abbasi Tashnizi Associate Professor of Cardiac Surgery, Department of Cardiac Surgery, Emam Reza hospital, Mashhad University of Medical Science, Mashhad, Iran Seyed Hamid Hoseinikhah Assistant Professor of Cardiac Surgery, Department of Cardiac Surgery, Emam Reza hospital, Mashhad University of Medical Science, Mashhad, Iran Shadi Sarafan Department of Medical Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran Arash Akhavan Rezayat Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Nahid Zirak lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2018 01 27 Background: Surgery in patients with severe calcification of the aorta, also known as “porcelain aorta”, is challenging for cardiac surgeons. In this study, we evaluated the efficacy of composite grafts in avoidance of aortic manipulation among patients with porcelain aorta undergoing coronary artery bypass grafting (CABG). Objectives: The aim of current study was to investigate of use of composite graft in patients with coronary artery diseases concomitant with porclain aorta. Methods: Ten patients among admitted ones for CABG over 3 years showed severe calcification of the aorta. We used a composite graft for revascularization of the target vessel without manipulation of the aorta. In patients with CAD and porcelain aorta, off-pump CABG was applied to avoid cannulation of the aorta. Moreover, a composite graft was used for internal mammary artery (unilateral/bilateral) to avoid partial clamping of the aorta. Results: Among ten patients with the mean age of 72.5 years seven patients were male and 3 were female. The most common risk factors were diabetes (6 patients), hypertension (5 patients), smoking (5 patients), and hyperlipidemia. Four patients had thetwo-vessel disease, while the remaining had thesix-vessel disease. In the intraoperative and postoperative periods, no hemodynamic instability was reported in any of the patients. Similarly, no ischemic complications due to femoral artery cannulation (lower limb ischemia) were reported. Based on the findings, no neurologic complications occurred in the early postoperative period and 12-month follow-up (causing no neurologic deficits). Postoperative evaluation of the grafts via computed tomography showed sufficient patency in all patients. Conclusion: Coronary artery disease, concomitant with severe calcification of the aorta, is a challenging condition for cardiac surgeons, given the higher risk of atheroembolic events and serious morbidity. Although multiple techniques have been described for avoiding manipulation of the aorta in these patients, the composite graft technique may be a simple and safe procedure with reduced risk of cerebrovascular events due to atheroembolism.

https://journal.razavihospital.ir/article_113576_cc4ad606c9e6c2bae7993b642a8d4df9.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 The Effectiveness of Group Reality Therapy on Personal Identity Crisis Improvement with an Emphasis on Life Expectancy 9 13 113579 10.30483/RIJM.2018.33 EN Nasrin Rafaee Saeedi Ph.D of psychology, Ferdowsi University of Mashhad, Mashhad, Iran Ali Mashhadi Ph.D , Associate Professor of Psychology, Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran Bahram-ali Ghanbari Hashemabad Ph.D , Professor of Counseling, Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran Journal Article 2017 11 20 Background: Considering the importance of adolescence and in which identity formation occurs and effects of successful identity on adolescents Life expectancy, one common technique for reduction and resolving identity crisis is to use the reality therapy. Objectives: The present study investigates the effectiveness of group reality therapy approach in reduction of personal identity crisis with emphasis on Life expectancy for the future. Methods: This was a quasi-experimental study, which was carried out by pre-test and post-test with experimental and control group. The statistical population consisted of high school girl students of Mashhad in 2014-2015 educational years. Participants were selected using convenience sampling method. From all grades, two first grades, one second grade and two third grades were randomly selected (totally 125 students). 22 students who answered the personal identity questionnaire and received the highest score, were divided into 2 groups of 11 (experimental and control) using random assignment. The experimental group received 10 sessions of 90-min group reality therapy, while the control group received no therapy. After the completion of therapy, both groups answered the personal identity questionnaire again. Results: The results of ANCOVA test showed that group reality therapy led to reduction of identity crisis in the experimental group (p<0.01). Conclusion: According to the findings, holding training workshops based on group reality therapy for high school students may reduce personal identity crisis with emphasis on Life expectancy for the future.

https://journal.razavihospital.ir/article_113579_a34bdd44597e84efeb911b0bce2e9755.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 Morphometric Characteristics of 1200 Normal Kidneys in Cadavers at the Mashhad Forensic Medicine Center 14 18 113581 10.30483/RIJM.2018.34 EN Shabnam Mohammadi Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Anatomy and Cell Biology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Arya Hedjazi Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran Maryam Sajjadian Mashhad Legal Medicine Research Center, Legal Medicine Organization, Mashhad, Iran Mohsen Rezazadeh Mashhad Legal Medicine Research Center, Legal Medicine Organization, Mashhad, Iran Farhad Moghimian Mashhad Legal Medicine Research Center, Legal Medicine Organization, Mashhad, Iran Maryam Mohammadi Department of Public Health, School of Health, ShahidBeheshti University of Medical Sciences, Tehran, Iran Journal Article 2018 01 08 Background: Kidneys play an important role in excertion of bodily waste and the regulation of water and electrolyte. Currently available sources and books are based on anthropometric characteristics from Western countries. Determining national anthropometric measurements is a research priority in Iran. Based on a recent search, no study has been done on the standard data of kidneys in the Iranian population. Objectives: The present study investigated the morphometrical characteristics of the kidney (length, width, thickness, index, and weight) in an Iranian population. Methods: This cross-sectional study was performed on 604 cadavers (122 females/482 males) with a mean age of 43.86 ± 19.09 years in Mashhad Forensic Medicine Center in 2015. After approval of the Ethical Committee, demographic characterizes of cadavers were recorded. Then, length, width, thickness, index and weight of kidney were measured using a vernier caliber. At the end, data were analyzed using SPSS software. Results: Themean length of the kidney was 11.12 ± 1.73 cm, mean width was 5.09 ± 2.19 cm, mean thickness was 2.60 ± 1.39 cm, kidney index was 2.33 ± 1.62, and mean weight was 143.03 ± 52.97 g. No significant difference was seen in the morphometric values of the kidney between males and females (P>0.05), but a significant correlation was found between the age and body surface area of the cadavers and the length, width, thickness, index, and weight of the studied kidneys (P<0.05). Conclusion: The investigation of the morphologic characteristics of kidney is useful for both surgeons andanatomists. Besides, it provides valuable data on standard kidney sizes in Iranian population.

https://journal.razavihospital.ir/article_113581_a22969f03f6143359defd2dbf0bb6ef2.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 Evaluation of Empathy and Its Related Factors among Students of Nursing and Midwifery School of Mashhad University of Medical Sciences Using Persian Version JSE-HPS 19 23 113580 10.30483/RIJM.2018.35 EN Gholamhosein Zarifnejad Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mahbubeh Abdollahi Ph.D, Assistance professor, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Fatemeh Zahra Karimi Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Ph.D, Assistance professor, Department of Midwifery, School of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran Journal Article 2017 11 30 Background: Empathy and its positive effects are of utmost importance in the relationship between patient and health care providers. Objectives: This study was conducted to determine the level of empathy and its related factors among students of Nursing and Midwifery Faculty of Mashhad University of Medical Sciences in 2016. Methods: In this cross-sectional study, 353 students from the Faculty of Nursing and Midwifery were selected by stratified random sampling. The data collection tool was the Persian version of Scale of Empathy- Health provider student version (SE-HPS) that the validity and reliability of the Persian version have been confirmed. Data was analyzed using SPSS software version 20. Results: The mean total score of empathy among students was 102.76 ± 15.87. Among the 3 subscales of SE-HPS, the highest mean was related to the subscale of Perspective taking (53.41 ± 10.34). The mean scores of the subscales of Compassionate care and Standing in the patient’s shoes were 40.1 ± 7.71 and 9.24 ± 2.93, respectively. The results show that the mean score of empathy was in female students and those whose mothers had college education statistically significanthigher. , The results of linear regression showed that gender, mother's education and field of study are the factors influencing empathy. Conclusion: According to the results of the study about the amount of empathy among students and the role of empathy in improving the quality of service provider relationship with the patient, educational planning seems necessary to strengthen the empathy between students and patients.

https://journal.razavihospital.ir/article_113580_20b51ad1b0e28db6dba01bc5d8c6b0e2.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 Benefit of Inactivated Influenza Vaccine in Infants in Iran: A Community based Randomized Control Trial 24 29 113584 10.30483/RIJM.2018.38 EN Mohammad Khajedaluee MD, Department of Biostatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Kolsum Deldar PhD, Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Shahin Saeedinejat MD-MpH, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Saeid Sasan MD, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2017 11 06 Background: Influenza in infants and young children is a major medical problem which causes excess medical visits, antibiotic prescriptions and hospitalization even in otherwise healthy children. Many of the developed countries have recommended influenza vaccination for all children (>6month old), but the economic benefit of this strategy is not clear especially for developing countries. Objectives: To find the difference in the incidence of influenza-like illness (ILI) and economic cost related to it between TIV vaccinated and non-vaccinated infants in Mashhad, Iran. Methods: This was a community randomized controlled trial which was started in November 2005 and ended up at May 2006. Each of the study and control groups were composed of 500 infants between 6 month and 20 months old who were brought for routine vaccination. The study group was given two doses of TIV; the control group received routine care without any extra intervention. Both groups were followed by monthly telephone calls (up to six months after the vaccination) and were asked about signs and symptoms of flu like illnesses and any cost related to them. SPSS 11.5 was used for statistical analysis, P<0.05 is considered as statistically significant. Results: There was no significant difference in the monthly occurrence of ILI between the vaccinated and non-vaccinated groups (P: 0.06-0.97). The costs related to ILI were similar between vaccine and control groups, except for physicians visit cost in the third month, which was more in the control group (P<0.05). Conclusion: In influenza season of 2005-06, TIV vaccination did not decrease the rate of influenza-like illnesses and was not cost saving in infants (6- 20 months old) in Mashhad.

https://journal.razavihospital.ir/article_113584_d35bfb36d5412af0447453850e3c5e7f.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 Evaluating the Performance of Quality Improvement Team and Their Effect on Service Efficacy Indices in Razavi Subspecialty Hospital 30 34 113583 10.30483/RIJM.2018.39 EN Reza Saeidi Neonatal Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Seyyed Mojtaba Mirjalili Director of Public Relations and Cultural Affairs, Razavi Hospital, Mashhad, Iran Morteza Shayeghi Rad Master of Business Administration in the Field of e-commerce, Payame Noor University, Mashhad, Iran Seyyede Faeghe Mousavi Master of Comparative Literature, Ferdowsi University, Faculty of Literature and Human Sciences Dr. Ali Shariati, Mashhad, Iran Journal Article 2017 10 06 Background: Productivity is one of the main indices in development plans; therefore, the performance of quality improvement team in any hospital that is a step towards the Implementation of a comprehensive quality management may be considered as an appropriate management technique for development of human resources as well as promotion of the hospital efficacy. Objectives: The current study is designed to evaluate the collaborative management method through the performance of quality improvement team in Razavi Hospital. Methods: This study was carried out in Razavi Hospital, Mashhad during 2016 - 2018 focusing on establishment of a collaborative management system and its effect on the hospital service efficacy. It was an interventional and applied research. The target population included all the staff of Razavi Hospital who volunteered to participate the study, and took measures to promote the hospital efficiency after attending the related training workshops. Results: According to the findings, the bed occupancy rate of Razavi Hospital increased from 59.5 percent in 2016 to 62 percent in 2017. Meanwhile, the patient's average length of stay decreased by 2 percent compared with the same period last year. The hospital bed turnover rate also increased from 86.3 times in 2016 to 121 times in 2017. Following the formation of quality improvement team and applying the optimal strategies and methods, especially in medical wards, it was revealed that the patient satisfaction had a significant increase in 2017 comparing to 2016. Furthermore, the job satisfaction (including job promotion, rules and regulations, colleagues, nature of the work, organizational communication and organizational goals) increased by 18.7 percent in 2017 in comparison with 2016 indicating the efficacy improvement at the hospital. Conclusion: Formation of quality improvement team in Razavi Hospital and their activities have led to relative increase in the hospital management efficacy.

https://journal.razavihospital.ir/article_113583_0795811eafec27e813e51718d15f078f.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 Outcome of Coronary Artery Bypass Graft with On-pump Beating-heart Technique 35 37 113582 10.30483/RIJM.2018.40 EN Kambiz Alizadeh Department of Cardiovascular Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Masoomeh Tabari Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Zohreh Rouhandeh Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Azra Izanloo Razavi Cancer Research Center, Razavi Hospital, Imam Reza International University, Mashhad, Iran Journal Article 2018 03 03 Background: This paper intends to evaluate the effects of on-pump beating-heart coronary artery bypass graft (CABG) in patients with coronary artery disease. Studies have shown that this surgical procedure can have acceptable results. Objectives: This study intends to share experiences and results of on-pump beating-heart CABG. Methods: We reported preliminary results related to mortality and morbidity in patients who underwent CABG in the period from 2015 to 2017 in Ghaem hospital, Mashhad, Iran. Results: 80 patients, in the period from 2015to 2017, underwent general anesthesia and on-pump beating-heart CABG surgery was done for them. The average number of grafts was 3.18± 0.474 and two patients died, unfortunately: one during surgery and one in ICU. There were no postoperative myocardial infarctions during the study. None of the patients reported kidney dysfunction. The average length of hospitalization was 4±1.11 days and the mean follow-up of the patients was 6 months. The average ejection fraction (EF) of patients was 43. 28± 9.58. Conclusion: In the last decade there has been a big challenge between using off-pump CABG and on-pump CABG, on-pump beating method could present acceptable and effective results.

https://journal.razavihospital.ir/article_113582_b047da122e56f1d092dcb3a8b46a2647.pdf

Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 6 4 2018 12 30 Left Atrial Mass during Angiography; Myxoma or Haemangioma? A Case Report 38 41 113577 10.30483/RIJM.2018.41 EN Afsoon Fazlinezhad Cardiologist, Cardiology Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Bentolhoda Panjalizadeh Cardiologist, Cardiology Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Akbar Kamali Cardiologist, Cardiology Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Journal Article 2018 02 16 Introduction: Cardiac tumours are rare findings which can be manifested by different clinical features. Most of these tumours have similar imaging findings during the clinical work up of patients presenting with cardiac masses. Myxoma is a common tumour of the left atrium which also has less common differential diagnoses: haemangiomas and angiosarcomas. The final diagnosis of such atumouris made by pathology studies. However, in some cases, surgery to reveal the exact nature of the mass is not possible. Imaging procedures, such as trans-oesophageal echocardiography and cardiac magnetic resonance imaging (MRI), are considered reliable methods for excluding differential diagnoses. Case Presentation: In this report, we will discuss a case of a left atrial mass which was first diagnosed as myxoma in angiography. During further imaging work ups, a cardiac MRI assisted in determining the exact nature and location of the tumour. Conclusion: While myxoma is a common tumour of the left atrium, cardiologists should always consider haemangiomas as a differential diagnosis.

https://journal.razavihospital.ir/article_113577_1c234806c690dd5465d13c7931f63967.pdf