Background: Diabetic foot ulcers (DFUs) are common problems in diabetes. One of the most important factors affecting the quality of diabetes care is knowledge and practice. The current study aimed at determining the knowledge and practice of patients with diabetes regarding the prevention and care of DFUs. Methods: The current analytical, cross sectional study was conducted in Guilan Province (north of Iran) on 375 patients registered in the medical records as type 2 diabetes mellitus. Demographic characteristics, knowledge, and practice of participants were recorded in a questionnaire during face-to-face interviews conducted by the researcher. Descriptive and inferential statistics were performed using SPSS version18. Results: The mean score of knowledge was 8.63 ± 2.5 out of 15, indicating that the majority of participants had a poor knowledge (84.8%). The mean practice score was 7.6 ± 2.5 out of 15, indicating that a half of them had poor performance (49.6%). There was a significant and direct correlation between knowledge and practice. Knowledge level, place of residence, marital status, and history of admission due to diabetic foot were predictors of practice score. Conclusions: According to the low level of knowledge and practice in patients with diabetes regarding the prevention and care of DFUs, and considering the significant relationship of some demographics of patients with knowledge and practice scores, a targeted educational program is needed to promote knowledge of patients with diabetes.
A Double-J stent may be used for ureteral injury because of a gynecologic procedure. Intravascular migration of a Double-J stent into the inferior vena cava as an uncommon complication of ureteral stent placement is reported. Percutaneous removal of the migrated stent was performed through the left femoral vein under angiographic and fluoroscopic guidance.
BackgroundTrauma, especially chest and abdominal trauma are increasing due to the growing number of vehicles on the roads, which leads to an increased incidence of road accidents. Urbanization, industrialization and additional problems are the other associated factors which accelerate this phenomenon. A better understanding of the etiology and pattern of such injuries can help to improve the management and ultimate the outcomes of these patients.ObjectivesThis study aimed to evaluate the patients with chest and abdominal trauma hospitalized in the surgery ward of Poursina teaching hospital, Guilan, Iran.Patients and MethodsIn this cross-sectional study, the data of all chest and abdominal trauma patients hospitalized in the surgery ward of Poursina teaching hospital were collected from March 2011 to March 2012. Information about age, gender, injured areas, type of injury (penetrating or blunt), etiology of the injury, accident location (urban or rural) and patients' discharge outcomes were collected by a questionnaire.ResultsIn total, 211 patients with a mean age of 34.1 ± 1.68 years was entered into the study. The most common cause of trauma was traffic accidents (51.7%). Among patients with chest trauma, 45 cases (35.4%) had penetrating injuries and 82 cases (64.6%) blunt lesions. The prevalence of chest injuries was 35.5% and rib fractures 26.5%. In chest injuries, the prevalence of hemothorax was 65.3%, pneumothorax 2.7%, lung contusion 4% and emphysema 1.3%, respectively. There were 24 cases (27.9%) with abdominal trauma which had penetrating lesions and 62 cases (72.1%) with blunt lesions. The most common lesions in patients with penetrating abdominal injuries were spleen (24.2%) and liver (12.1%) lesions. The outcomes of the patients were as follow: 95.7% recovery and 4.3% death. The majority of deaths were observed among road traffic victims (77.7%).ConclusionsConsidering the fact that road-related accidents are quite predictable and controllable; therefore, the quality promotion of traumatic patients' care, and the road safety should be noted as problems associated with public health.
Background
Hydatid cysts are fluid-filled sacs containing immature forms of parastic tapeworms of the genus Echinococcus. The most prevalent and serious complication of hydatid disease is intrabiliary rupture, also known as cystobiliary fistulae. In this study, a sporadic case of biliary obstruction, cholangitis, and septicemia is described secondary to hydatid cyst rupture into the common bile duct and intraperitoneal cavity.
Case presentation
A 21-year-old Iranian man was admitted to the emergency ward with 5 days of serious sickness and a history of right upper quadrant abdominal pain, fatigue, fever, icterus, vomiting, and no appetite. In the physical examination, abdominal tenderness was detected in all four quadrants and in the scleral icterus. Abdominal ultrasound revealed intrahepatic and extrahepatic biliary duct dilation. Gallbladder wall thickening was normal but was very dilated, and large unilocular intact hepatic cysts were detected in segment IV and another one segment II which had detached laminated membranes and was a ruptured or complicated liver cyst.
Conclusion
Intrabiliary perforation of the liver hydatid cyst is an infrequent event but has severe consequences. Therefore, when patients complain of abdominal pain, fever, peritonitis, decreased appetite, and jaundice, a differential diagnosis of hydatid disease needs to be taken into consideration. Early diagnosis of complications and aggressive treatments, such as endoscopic retrograde cholangiopancreatography and surgery, are vital.
Objective: The present study aimed to investigate the frequency and antibiotic susceptibility pattern of Gram-negative bacteria (GNB) isolated from surgical site infections (SSIs) in the North of Iran. Results: This cross-sectional study conducted over a two-year period during 2018-2020 on all cases of SSIs who had a positive culture for a GNB. Standard microbiological tests were followed for the bacterial isolation and identification. Antimicrobial susceptibility profiles were determined using disk diffusion method. During the study period, a total of 78 nonduplicated GNB isolated from SSIs. The most prevalent surgical procedures were fracture fixation (37.2%), and tissue debridement (23.1%). Klebsiella isolates showed the highest isolation rate (29.5%) followed by Enterobacter (28.2%), and Acinetobacter (16.7%). Antibiotic susceptibility results showed that Acinetobacter isolates were almost resistant to all of the tested antibiotics, except gentamicin, co-trimoxazole, and meropenem. Enterobacteriaceae isolates showed the lowest resistance against amikacin, co-trimoxazole, and imipenem. Overall, 49 (62.8%) of isolates were multiple drug-resistant (MDR). In summary, a remarkable rate of MDR isolates which showed an increasing trend during recent years is a serious alarm for the management of SSIs caused by GNB. Moreover, the results of regional assessments, provide good epidemiological background for comparing our situation with other regions.
Here, a new strategy of ultra‐broadband monostatic and bistatic radar cross‐section reduction (RCSR) was theoretically investigated. A circular configuration of perforated dielectrics, as the coating layer, was designed to have full control on the bistatic RCS signatures of flat metallic objects. Using the proposed phase cancellation method, a customised level of bistatic RCSR (BRR) as well as operating frequency bandwidth were interpretively achieved. The presented study offered a robust and straightforward RCSR technique which does not rely on conventional blind optimisations. The coating layer was capable of reducing the monostatic and BRR of >10 dB in a broad frequency range from 8.3 to 23.1 GHz (BW = 94%). The results were significantly improved compared to those of preceding researches. Besides, unlike the preceding researches, the performance of the designed coating layer was analytically justified under TE and TM polarisations of oblique incidences. A good agreement was observed between numerical simulations and theoretical predictions, confirming the polarisation‐independent feature of the designed stealth coating layer for incident angles up to 60∘. These superior performances and the flexibility of design guarantee the applicability of the proposed RCSR approach for various stealth applications.
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