BackgroundTraumatic brain injury (TBI) is a common cause of mortality and disability worldwide. Choosing an appropriate diagnostic tool is critical in early stage for appropriate decision about primary diagnosis, medical care and prognosis.ObjectivesThis study aimed to compare the Glasgow coma scale (GCS), full outline of unresponsiveness (FOUR) and acute physiology and chronic health evaluation (APACHE II) with respect to prediction of the mortality rate of patients with TBI admitted to intensive care unit.Patients and MethodsThis diagnostic study was conducted on 80 patients with TBI in educational hospitals. The scores of APACHE II, GCS and FOUR were recorded during the first 24 hours of admission of patients. In this study, early mortality means the patient death before 14 days and delayed mortality means the patient death 15 days after admitting to hospital. The collected data were analyzed using descriptive and inductive statistics.ResultsThe results showed that the mean age of the patients was 33.80 ± 12.60. From a total of 80 patients with TBI, 16 (20%) were females and 64 (80%) males. The mortality rate was 15 (18.7%). The results showed no significant difference among three tools. In prediction of early mortality, the areas under the curve (AUCs) were 0.92 (CI = 0.95. 0.81 - 0.97), 0.90 (CI = 0.95. 0.74 - 0.94), and 0.96 (CI = 0.95. 0.87 - 0.9) for FOUR, APACHE II and GCS, respectively. In delayed mortality, the AUCs were 0.89 (CI = 0.95. 0.81-0.94), 0.94 (CI = 0.95. 0.74 - 0.97) and 0.90 (CI = 0.95. 0.87 - 0.95) for FOUR, APACHE II and GCS, respectively.ConclusionsConsidering that GCS is easy to use and the FOUR can diagnose a locking syndrome along same values of subscales. These two subscales are superior to APACHI II in prediction of early mortality. Conversation APACHE II is more punctual in the prediction of delayed mortality.
Background: Dissolved air floatation (DAF) is one of the methods has been used for the sludge thickening in wastewater treatment plants. This study aimed to investigate the effects of coagulation and sonication processes as additional configurations on the efficiency of a lab-scale DAF process for thickening of the biological sludge of an industrial wastewater treatment plant in Kashan, Iran. Methods: The required amounts of sludge samples were collected from a wastewater treatment plant and kept at temperature of 4°C. Variables, such as pressure (3, 5, and 7 atm), flotation time (5 and 10 minutes), ultrasonic irradiation power (0, 75, and 150 W), and presence/absence of Fe-based coagulant were considered on a sequencing batch reactor (SBR) included coagulation, flotation, and sonication processes, respectively. Results: The use of ultrasonic waves led to an insignificant increase in the DAF efficiency (P > 0.05), however, the application of coagulant significantly increased the thickening efficiency (P < 0.05). The maximum efficiency of the process was achieved at flotation time of 5 min, pressure of 3 atm, and sonication power of 75 W. Conclusion: According to the results, DAF has a proper efficiency for thickening of biological sludge. Coagulation compared to sonication has a greater effect on the efficiency of the process.
Background & Objective: Schizophrenia is considered as one of the most extreme mental illnesses in the area of psychiatry which is characterized by social and occupational incompetence. Support and care of these patients has always been on the part of families. The imposed burden includes physical, mental, social and economic problems being experienced by caregiver of the family. The present study aimed at investigating the burden experienced by schizophrenic patients at Imam Reza Hospital in the city of Bojnurd. Material & Methods: This is a descriptive-analytical study conducted on 75 family caregivers visiting Imam Reza Hospital. Data collection methods included demographic questionnaire, and Zarit Questionnaire which measured degree of experienced burden by caregivers. Reliability and validity of both questionnaires had already been established. Then, data were fed into SPSS 14 for analysis. Results: 12.2% of caregivers experienced low burden, 36.4% average burden, and 51.5% high burden. The perceived burden among women was significantly higher (P=0.003) than that of men. There was significant relationship (p=0.03) between the obtained score of caregiving and age of caregivers while the relationship between caregiving score and age of patients was not significant (p>0.05) but was negative. Younger patients imposed higher burden on the caregivers. Conclusion: Taking care of schizophrenic patients put immense pressure on family especially on caregivers. Therefore, it can be said that the mental pressure imposed by such patients threatens caregivers' mental health, hence reduction in quality of care and support. Consequently, family centered programs are recommended for decreasing the burden incurred by schizophrenic patients.
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