This study aimed to determine the sustainability criteria of the beekeeping industry in Iran, which was performed using three-stage classical Delphi technique. The participants were 32 experts in beekeeping industry who were purposefully selected using the snowball sampling method. The criteria identified, after three Delphi stages, consisted of 70 items, which were categorized into 13 general criteria and into four economic, environmental, social, and institutional dimensions. The general criteria were presented in the form of a conceptual model, including: farmers' environmental behavior quality, beekeepers' environmental behavior quality, the quality of marketing and sales of beekeeping productions, productivity and performance improvement, amount of monetization from pollinations' right, the amount of monetization of byproducts and value added, employment rate and job stability, the level of social development of stakeholders, the quality of the role-playing of non-governmental stakeholders, the quality of extension and education new sciences and technologies to stakeholders, comprehensiveness of laws and programs, quality of role-playing of stakeholder non-governmental organizations, and the quality of the roleplaying of governmental institutions stakeholder. Using them, a comprehensive perception of the necessary criteria for the sustainability of Iran's beekeeping industry can be obtained and a comprehensive program can be designed for its implementation.
Purpose: We aim to review our experience of transperitoneal laparoscopic ureterolithotomy (TPLU) for proximal ureteric stone more than 15 mm. Patients and methods: Between June 2017 to December 2020, sixty patients with a history of unsuccessful Extracorporeal shock wave lithotripsy (ESWL) and/or failed ureteroscopy for impacted ureteral calculi more than 15 mm who accepted TPLU were enrolled in our study. The patients' demographic information and post-treatment results were gathered and analyzed, retrospectively. Results: The patients' mean age was 46.25 ± 12.56 years. The mean size of the stone was 20.11 ± 4.76 mm. 37 (61.7%) patients had severe hydronephrosis (HDN) and 46 (76.7%) stones were radio-opaque. Almost all of the patients underwent TPLU by a single urologist. The mean operation time was 72.86 ± 6.07 minutes without intraoperative complication (only 3 stones had upward migration to the pyelocaliceal system). The main operative blood loss was 88.86 ml. The average length of stay in the hospital was 45.8 ± 8.11 hours. The stone free rate (SFR) at discharge was 57 (95%). The overall complication rate was 27 (45%). Regarding early complications, fever was found in 8 (13.3%) patients, and 3 patients (5%) had paralytic ileus. The rate of urine leak was 8.3%, and 8 (13.3%) patients required blood transfusions. In multivariate analysis, the multiple stones, bigger stone in size, incomplete SFR, longer duration of hospital admission, and severe HDN were associated with a high early complication rate (p = 0.05, 0.04, < 001, 0.03, and 0.01, respectively). Conclusions: TPLU is a harmless option for managing proximal ureteric stone as a primary procedure or salvage procedure with good outcomes and acceptable complication rates.
Background: Canceling surgery imposes the high cost of the healthcare provider system and wasted many energy and time from the patient and the care team. Objectives: This study examined the extent and reasons of canceling of surgeries in one of the hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Methods: This was a descriptive-applied study. In order to get the number of operations from April 2018 to March 2020, the hospital used HIS software and then extracted the reasons from the operating room office and the quality improvement office in the hospital. Data were analyzed by SPSS version 21 software. Results: Among 8654 planned surgeries, 0.9% were cancelled. The highest frequency of surgical cancellation is associated with general surgery, and the highest rate of surgical cancellation is associated with the ENT specialty. The highest cancellation rate was 1.82% in August 2018 and 2.87% in February 2019. The lack of preparation of patients and patients did not require surgery was the main and worst reason for discontinuing surgery, respectively. Conclusion: The lack of clinical preparation of the patient was the main reason for the cancellation. Therefore, pre-surgery patient evaluation can help solve this problem, make the operating room more effective, and increase patient satisfaction.
IntroductionThere are different methods of urethroplasty in hypospadias. The present study aimed to compare the repair of the urethral plate by single vs. double layer suturing.Material and methodsFifteen male rabbits were assigned to the control, single layer, and double layer urethral plate suturing groups (n = 5). Experimental hypospadias was induced in the second and third groups and the urethral plates were sutured. After two weeks, the penis was dissected out and underwent histopathological processing. Stereological studies were applied to obtain quantitative histological data regarding the structure of the urethra and the related part of the corpus spongiosum.ResultsVolume density of the urethral epithelium (the fraction of unit volume of the urethra occupied by its epithelium) was higher in the single layer suturing group when compared to the double layer or control groups (p <0.01). Additionally, the volume density of the urethral lumen (the fraction of the corpus spongiosum that is occupied by the urethral lumen) in the single versus the double layer suturing groups was respectively 2.4 and 2 folds higher than that in the control group (p <0.01). Besides, the volume density of the lumen was significantly higher in the single layer suturing when compared to the double layer suturing group (p <0.01). However, no significant difference was observed among the study groups regarding the volume density of the collagen and vessels in the incised site of the penis which implied that the fraction of the urethra and surrounding corpus spongiosum was occupied by collagen and vessels.ConclusionsUrethral plate repair by the single layer suturing method could be accompanied by higher epithelialization and wider lumen in the rabbit model of hypospadias.
Background: The importance of timing lies on providing services, identifying the current status of service delivery, and determining the workload to improve productivity of the organization and the level of satisfaction of service providers and recipients. The aim of this study is to investigate the timing of patient's workflow, in order to identify the current state of service delivery, and determine the workload in the imaging ward of Shahid Rahnemoun hospital in Yazd. Methods: The present study was descriptive-analytical and cross-sectional-observational, which was conducted in 2021. The sample included 1287 images or graphs from the imaging ward of Shahid Rahnemoun Hospital, during a period of 3 months and during different shifts (morning, evening and night). They were selected using the Krejcie-Morgan method. Frequency, percentage, means, and standard deviation were used to evaluate descriptive statistics. Results: Results of the study showed that the maximum and minimum mean time calculated for each service was related to the service of hospitalized patients in the radiology unit (22:50 minutes) and operating room patients (2:16 minutes), respectively. Also, the maximum and minimum working hours spent for all services obtained were related to the inpatients in the radiology unit (67747 minutes) and outpatients in the ultrasound unit (243 minutes), respectively. Conclusion: The timing and workmetry of the activities performed in the hospital's imaging ward, gave the authors a view of the current situation of the workforce and the amount of work done by the imaging ward.
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