Epidemiology and Statistics
yalda ravanshad; Mohadese Golsorkhi; elham Bakhtiari; aghil lollah keykhosravi; anoush azarfar; malihe shoja; mohamad behazin; sahar ravanshad; alireza ghodsi
Volume 28, Issue 2 , May and June 2021, , Pages 183-188
Abstract
Introduction: The patient’s self-discharge from the hospital is a process in which the patient leaves the hospital voluntarily without completing the course of treatment, despite medical advice, and can indicate patient dissatisfaction and a significant challenge for health system managers. This ...
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Introduction: The patient’s self-discharge from the hospital is a process in which the patient leaves the hospital voluntarily without completing the course of treatment, despite medical advice, and can indicate patient dissatisfaction and a significant challenge for health system managers. This study was conducted to investigate the causes and consequences of a patient's self-discharge from Dr. Sheikh Hospital as a referral center in the northeast of Iran.
Material and Method: All patients who were discharged with the personal consent from the hospital with personal consent between October 2014 and March 2015 were included in the study. A checklist was used to collect data. The patients' outcome was completed by telephone a week later. Finally, SPSS statistical software was used to evaluate the results.
Results: Totally, 51 patients were included in this study. The leading causes of discharge with personal consent were including dissatisfaction with the physician and medical staff in 23 patients (45.1%), home care preference in 12 patients (23.5%), distance from the hospital in 5 patients (9.8%), teaching at the hospital in 3 patients (،5.9), the high cost of treatment in 3 patients (9 5.9), the overcrowding of the hospital in 3 patients (9 5.9) and the lack of specialist or diagnostic and therapeutic devices in 2 patients (3.9%). Also, in the study of patients' outcome, 21 patients (41.1%) referred to the doctor again, 18 patients (35.3%) continued treatment at home, 9 patients (17.7%) were readmitted and 2 patients (3.9%) died.
Conclusion: The most common cause of discharge with personal consent was dissatisfaction from the treatment team. Given that 3.9% of patients have died and a large number of patients have been re-referred to the doctor and be readmitted, it seems that justifying patients to refrain from self-discharge is in the patient's best interest.
Mohammad Esmaeeli; Anoush Azarfar; Aghilollah Keykhosravi; Mahbobeh Nematshahi; Yalda Ravanshad; Ahmad Delbari; Effat SheykhBaheddin zadeh
Volume 20, Issue 5 , March and April 2014, , Pages 597-602
Abstract
Aims: Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately.
Hyperuricemia is a feature of several pathologies and requires ...
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Aims: Acute kidney injury (AKI) is characterized by a reversible increase in the blood concentration of creatinine and nitrogenous waste products and by the inability of the kidney to regulate fluid and electrolyte homeostasis appropriately.
Hyperuricemia is a feature of several pathologies and requires an appropriate and often early treatment, owing to the severe consequences that it may cause. A rapid and massive raise of uric acid, mainly damage the kidney.. Rasburicase, compared to allopurinol, results in more rapid reduction of uric acid and prevent its accumulation in patients with hematologic malignancy with hyperuricemia and AKI.
Methods: We evaluated the efficacy of rasburicase (0.15 mg/kg) administered as single dose in 15 patient with AKI in sheikh hospital, Mashhad University of medical Sciences. Beside conventional therapy, infusion of Rasburicase in 50cc normal saline in30 minute intravenously was done and all adverse reaction was treated.
Before injection of Rasburicase and 1st, 3nd and 7rd day after it urea, creatinine, uric acid and urine output were determined and compared.
Results: Within first 24 hour, the levels of serum uric acid in all patients decreased dramatically. there was a significant improvement in estimated GFR and urine output. Urea and creatinine level decreased from Day 0 to Day 7 but there was no difference between creatinine before treatment and 1st day.
Conclusion: Rasburicase is effective for management of hyperuricemia and uremia in AKI Patients