Alborz University Medical Journal
Year:2024 | Volume:13 | Issue:2|Papers Count:8

2Background: Superior vena cava (SVC) stenosis is a major cause of vascular access problem and is associated with morbidity and mortality in hemodialysis patients. This study was done to determine the prevalence and risk factors for SVC stenosis in patients on HD by tunneled cuffed catheter (TCC) in Shariati hospital. Methods: All patients on chronic HD with TCC were enrolled in the study. SVC stenosis was defined as diameter reduction more than 50% by CT Angiography. Demographic characteristics including age, gender, BMI, history of diabetes mellitus (DM) were evaluated. Moreover, location of TCC insertion (subclavian, Jugular), duration of catheter carriage, and history of previous catheterization were recorded. Results: This study was done on 40 patients. SVC stenosis was diagnosed in 3 out of 40 (7. 5%) patients. Only one patient was symptomatic and presented with face and neck edema. All 3 patients were female. However, there was no significant correlation between gender of the patients and SVC stenosis. Two of patients with SVC stenosis had history of DM, but we did not find significant relationship between DM and SVC stenosis. SVC stenosis was significantly more common in patients with subclavian catheter in comparison to jugular catheter (P=0. 02). There was significant correlation between duration of catheter carriage and SVC stenosis (P=0. 02). Conclusion: SVC stenosis was not common and it could be asymptomatic. However, we should consider it in patients on HD by TCC. The duration of TCC carriage should be restricted and subclavian catheterization must be avoided.

2Background: Oral complications during and after radiotherapy are common and affect the quality of life. This study was aimed to assess the relationship between underlying factors and oral health related quality of life in head and neck cancer patients undergoing radiotherapy. Methods: This Descriptive-analytical and cross-sectional study was conducted on 85 patients with head and neck cancer referred to the Radiotherapy Center of the Cancer Institute of Imam Khomeini Hospital Complex in Tehran. Sampling was done by "available" sampling method from April to June 2023. Demographic information and information related to the disease were checked in a questionnaire. Also, for the oral health related quality of life, a questionnaire including 26 questions was designed based on the complications and symptoms caused by radiotherapy. Results: There was no significant relationship between age, gender, education, history of smoking or alcohol consumption, smoking or alcohol consumption at the time of completing the questionnaires, type of lesion, week of the radiotherapy course in which the questionnaire was completed, area of ​​malignant lesion and the quality of life questionnaire score. (P>0. 05) There was a significant relationship between occupation, marital status, underlying diseases and the quality of life questionnaire score. (P<0. 05) Conclusion: The results of this article show a general decrease in the quality of life of head and neck cancer patients undergoing radiotherapy. People with a better job status and married people had a higher quality of life, which could be due to better financial and emotional conditions in these people. People with underlying diseases also reported a higher quality of life, which could be due to getting used to the conditions of the disease and starting radiotherapy with a lower quality of life. These results can help in better implementation of care and in providing necessary support for these people.

2Introduction: Self-esteem is one of the essential components in maintaining mental and physical health. Individuals who have positive self-esteem are more flexible and able to accept their strengths and weaknesses. The results of studies have shown that increasing self-esteem leads to increased self-confidence and efficiency in students. The aim of this study is to investigate the relationship between different dimensions of self-esteem and academic performance in students of Alborz University of Medical Sciences. Method: This descriptive-correlational study was conducted among 704 students of Alborz University of Medical Sciences in 2020. Data were collected using Cooper Smith's standard self-esteem questionnaire and demographic characteristics questionnaire. The samples were selected randomly and classified according to the number of students in each field. Students' academic performance was obtained using the cumulative grade point average of the past semesters by self-report method. Data were analyzed using descriptive statistics, Pearson correlation tests and multivariate linear regression. Results: The results showed that the mean and standard deviation of self-esteem in the general dimension was 18. 24 (4. 1), in the social dimension was 5. 03 (1. 79), in the family dimension was 5. 7 (2. 15), and in the academic dimension was 5. 65 (1. 67). Also, there was a significant correlation between academic performance and self-esteem in the general dimension (p < 0. 01, r=0. 12), social dimension (p < 0. 01, r=0. 14), family dimension (p < 0. 01, r=0. 20), and academic dimension (p < 0. 01, r=0. 34). Multiple linear regression results showed that the academic self-esteem dimension had the greatest effect on academic performance, so with other variables constant, on average, with an increase of one unit in academic self-esteem score, academic performance would increase by 37%. Conclusion: The highest correlation between academic self-esteem and academic performance was observed. It is recommended that instructors pay more attention to this dimension of self-esteem in students in order to improve academic performance in classroom and clinical environments.

2background: The present study was conducted to investigate the effectiveness of emotion-oriented schema therapy on death anxiety in nurses with obsessive-compulsive personality traits. methods: This research was practical and semi-experimental (pre-test, post-test, and follow-up) with a control group. The statistical population was nurses working in social security hospitals from 2021. The statistical sample consisted of 13 people in the experimental group and 13 people in the control group from nurses working in the Corona department, who had an average score on the personality questionnaire of the fifth diagnostic statistical guide and Templer's death anxiety. Experiment and control (13 people in each group) were randomly assigned. Templer's death anxiety scale was used to measure the research variable in the pre-and post-treatment stages. The experimental group was treated with emotional schema therapy for 10 sessions of 120 minutes. The control group did not receive treatment. At the end of the treatment period, the post-test was performed. The data were analyzed with the help of SPSS-24 software and by the variance analysis method with repeated measurements.   Result: The results of the analysis showed that this therapeutic intervention reduces the death anxiety of nurses with obsessive-compulsive personality traits working in the Corona ward. P < 0. 01 Conclusion: emotional schema therapy intervention can be one of the effective treatment strategies to improve the death anxiety of nurses with obsessive personality traits. Therefore, holding training courses in this field is recommended.

2Background: studies are trying to differentiate two disorders, Attention deficit/hyperactivity disorder and Sluggish cognitive tempo, due to their similarities. In this regard, the present study was conducted with the aim of comparing self-regulation and substance use tendencies in adolescents with and without symptoms of attention deficit/hyperactivity disorder or sluggish cognitive tempo. Methods: The study was in the frame of Causal Comparative design. The statistical population includes parents and adolescents aged 13 to 17 years with the symptoms of attention-deficit/ hyperactivity disorder, sluggish cognitive tempo and normal adolescents in Karaj in 2022. The method of sampling was available and using it, 150 people (50 with attention deficit/hyperactivity, 50 with sluggish cognitive tempo and 50 normal adolescents) were selected. The tools of data collection were the Rating of Attention deficit hyperactivity disorder, Sluggish Cognitive Tempo Inventory, Adolescent Self-Regulatory Inventory, and Addiction Susceptibility Questionnaire-Adolescent Version. Finally, the data were analyzed using the analysis of variance and Sheffe's post hoc test. Results: The findings showed that the self-regulation scores are respectively and significantly lower in the attention deficit/hyperactivity group, the sluggish cognitive tempo group, and the normal group (p<0. 05). There were no significant differences in the scores of substance use tendency between adolescents with attention-deficit/hyperactivity disorder and with sluggish cognitive tempo,But the difference between the two groups compared to normal adolescents was significant. Conclusion: It can be concluded that adolescents with and without symptoms of attention deficit/hyperactivity disorder or sluggish cognitive tempo are different in terms of self-regulation and substance use tendencies.

2Introduction: The transformation of hospitals into a productive center is one of the most important and fundamental issues in the country's health system, and it requires the attention of managers to make hospitals more productive. Therefore, the aim of the present study is to provide solutions to increase the revenues of Alborz University of Medical Sciences hospitals in order to make the hospitals more efficient. Therefore, the present study was conducted in the hospital in order to identify ways to reduce costs and increase income in hospitals covered by Alborz University of Medical Sciences. Methodology: The present research was conducted in a combined (quantitative and qualitative) manner in two stages. First, the current situation in the hospitals of Alborz University of Medical Sciences was examined in terms of cost and income in 1400. Then, using the panel of experts, solutions were presented to increase income and reduce costs according to the weaknesses and the existing condition of the hospitals. Findings: In terms of cost-income difference per bed, Hospital No. 4 was in a better position. Solutions to reduce costs and increase income were identified based on experts' opinions and divided into 5 groups, including human resource management, financial resource management, energy management, equipment maintenance, outsourcing, and control. Conclusion: According to the investigations carried out and the proposed solutions, hospital managers can use the solutions presented in this study to increase the income in the hospital, according to the different dimensions and angles of the quality of healthcare services and according to the plan and goals of each hospital.

2Background: Examining the rate of leaving with discharge against medical advice (DAMA) despite not completing the treatment process is one of the ways to be aware of patients' satisfaction with the environment and treatment system. Therefore, the study was conducted to investigate the factors affecting emergency department (ED) discharge with personal responsibility of the patient in selected hospitals of Alborz University of Medical Sciences in 2021. Methods: The present study was a descriptive cross-sectional study that was conducted in 2021 in the emergency department of selected hospitals affiliated by Alborz University of Medical Sciences. The sample size included 200 patients leaving ED with personal consent by stratified random method. Data were created by a researcher checklist using descriptive statistics and SPSS24. Results: The most identified reasons for DAMA from the emergency room of the studied hospitals were educational (50%) and attitudinal-emotional (30%),and the least reasons were related to equipment, physical environment and amenities (12%) and Emergency procedures (7%). Conclusion: DAMA can have many undesirable and sometimes irreversible consequences for them, such as death and infection. Planning for training medical students and scheduling the presence of residents and interns in the ED to prevent overcrowding in this department, as well as identifying factors affecting the patient's attitude and feelings, including explaining the treatment process, are recommended.

2Background and objectives: All organizations and companies, whether commercial or administrative, are created by the thoughts and ideas of individuals. Visionary organization, by imagining what the future demands and the role that the organization should play in the future, should be one step ahead of their competitors. Therefore, our goal in this study is to achieve a comprehensive model for Alborz University of Medical Sciences with the approach of a visionary organization. Methods: This research has been done in a sequential mixed method (qualitative and quantitative) in two stages. In the first stage, to identify the factors of the model of visionary organization, the data theorizing method of the foundation was used. The interviewees were 10 senior managers of Alborz University of Medical Sciences who were interviewed according to the theoretical saturation rule. In the second stage, Delphi method was used to determine the importance of indicators. Results: In this study, 72 indicators were identified through axial coding that according to causal conditions, intervening conditions, strategies and consequences were developed and the final model was presented. The Delphi method was used to determine the priority of the factors affecting capacity building for the visionary organization and the importance of the strategies found in the interview. Core values, visionary leadership, network structure, coaching, meritocracy, knowledge-based, religious culture, commitment and risk-taking, fearless goals and empowerment were of paramount importance in creating a visionary organization.     Conclusion: Awareness of the indicators of the visionary organization, and in particular the University of Medical Sciences, helps managers, employees and researchers in the optimal understanding of the visionary organization in order to promote productivity.