Serous otitis or otitis media with effusion is one of the common diseases which if left untreated can lead to complications like tympanic membrane atrophy, cholesteatoma formation, behavioural changes, osteonecrosis and sensori - nueral deafness. One of the treatment options for serous otitis is VT placement which has its own complications like ottorhea, perforation and tympano - sclerosis. The rejection time of VT is closely related to the location of the VENTILATION tube. The complications arising due to VT placement are related to the time period since placement of the tube, social status of the patient, age, personal hygiene including prevention of water entry into the affected ear, etc. This prospective analytical survey with a one year follow up was carried out on children suffering from serous otitis who had been operated (VT placement) during the first half of 1378 at Shahid Rahnemom Hospital. Most of the VT rejections in all age groups occurred about 7-9 months after the operation but no significant difference was observed between the age groups. In the study determining the relation between gender and VT rejection time (P.V= 0.536), it was realized that the maximum number of VT rejections were between 3-6 months after the operation (47.7%) of which 44.3% was seen in boys and 51.9% in girls, thus, no significant difference was observed between the two sexes (P.V=0.691). 33.9% of the total had ottorhea. 35.1 % sclerosis, and 3.4% had a perforation. 27.6% of the patients had no complications. 7.7% of those patients who had a VT in the anterosuperior compartment of the tympanic membrane had a perforation, while only 2.7% of those who had a VT in the postero – interior compartment had a perforation. Age and gender have no effect on VT rejection time. The probability of a VT remaining in place is more in Shepherd type VENTILATION tubes than Richard type VT. VENTILATION tubes placed in the antero - inferior quadrant are rejected earlier than those placed in the antero - superior quadrant. In the population under study, perforation is the least occurring complication in all age groups. There is on significant difference in the complications arising in either gender.      

Background: Pulmonary embolism (PE) is a blockage in one of the pulmonary arteries. VENTILATION/Perfusion (V/Q) scan is one the diagnostic methods of PE in pregnant women. It is necessary to investigate fetal dose and compare it with recommended values. The aim of this study was to determine the fetal dose in V/Q scan using Monte Carlo simulation. Methods: An adult pregnant woman phantom and all her displaced organs were used for simulation. Source organs were defined for each of the radiopharmaceuticals used in two lung VENTILATION and perfusion scans, including lung and bladder for 133Xe, 81mKr, and technetium diethylene-triamine-pentaacetate aerosol (99mTc-DTPA-aerosol) for lung VENTILATION scan, and lung, bladder, and liver for 99mTc-technetium macroaggregated albumin (MAA) for lung perfusion scan. Fetal dose was determined and evaluated using the simulation output after calculations. Findings: For 99mTc-MAA at prescription dose of 200 MBq, fetal dose was found to be 1. 01 mGy, maximum fetal dose was 1. 97 mGy, and both of them were more than the values recommended by International Commission on Radiological Protection (ICRP). For 99mTc-DTPA, fetal and maximum doses were below 1 mGy, and for 133Xe and 81mKr, fetal dose was negligible. Conclusion: It is concluded that considering higher dose to the fetus (200 MBq of 99mTc-MAA), if the pregnant woman scan is needed, her awareness must be done.

The surgical site infection (SSI) is one of the most important infectious problems in hospitals which may be happened in 2. 6% of all surgeries. According to the literature, the primary source of SSI is the flakes released from the exposed skin of surgical staffs or patients. It is well known that appropriate VENTILATION strategy is the most effective way to control bacteria-carrying airborne particles responsible for SSI. In this research, the effect of the most dominant design parameter, namely inlet air velocity, on the ultra-clean VENTILATION (UVC) systems performance is evaluated in detail using the computational fluid dynamics (CFD). The results show an optimum value for the inlet air velocity which is mainly due to formation of a thermal plume over the wound tissue. This thermal plume protects the wound from contaminants deposition like a shield and may be disturbed at too high inlet air velocity. In addition, the effect of critical factors including the particle size the wound temperature, the operating lights boundary condition, and the existence of fixed and removable partitions on the optimum inlet air velocity is also investigated and discussed extensively.

Background: High-frequency oscillatory VENTILATION (HFOV) has been shown to result in less lung injury. HFOV is also used in critically ill newborns when conventional mechanical VENTILATION (CV) fails, especially in units with lack of nitric oxide (NO) and extracorporeal membrane oxygenation. Objectives: There are no recent data on the response of newborns to rescue HFOV (rHFOV) in the literature. The aim of this study was to evaluate the risk factors that affect the response to rHFOV in newborns who had CV failure in respiratory support. Methods: Newborns who still had a respiratory failure in case of CV and switched to rHFOV were grouped as survived and died. The characteristics of the patients such as birth weight (BW), gestational age (GA), and disease, in addition to ventilator settings, arterial blood gas analysis, VENTILATION duration, and side effects were compared between the groups. Results: 84 patients with a mean GA of 32. 1  5. 3 weeks and a mean BW of 1901  1135 g were enrolled in the study. The patients were switched to rHFOV at median 28. 5 hours of life. Infants who died had lower BW (1345 935 g vs. 2557 1035 g, P = 0. 0001) and lower GA (31. 7  4. 9 weeks vs. 34. 8  4. 4 weeks, P = 0. 03) in comparison with infants who survived. Prematurity (OR: 7. 73, 95% CI: 2. 1-24. 7, P = 0. 001) and having BW < 1500 g (OR: 7. 02, 95% CI: 2. 6-18. 6, P < 0. 001) increased mortality significantly. Cut-off values for BW and GA were found to be 1875 g and 32. 5 weeks with 75% sensitivity and 78% specificity. There were no differences in the initial VENTILATION settings between the groups and no correlation between the side effects such as intraventricular hemorrhage, retinopathy of prematurity, and bronchopulmonary dysplasia could be demonstrated with the duration of rHFOV. Conclusions: rHFOV in case of CV failure is more effective in patients with greater GA andBW, independent of the disease and initial rescue ventilator settings.

BACKGROUND: Endotracheal or tracheostomy tube in mechanically ventilated patients disturb verbal communication with others. Therefore, patients are frustrated of requesting for their needs or problems related to artificial breathing. Therefore investigating self-experiences of these patients can be applied in providing them with a better care by clinical personnel.METHODS: This is a qualitative phenomenological survey. The study population was patients who were mechanically ventilated at least for one time and were more than 12 years old. Data were collected during five months by deep interview and then were analyzed by Collizi's seven–stage method.RESULTS: The findings of this research were classified in 139 codes and 3 categories as: 1) Interpersonal experiences, 2) Extra personal experiences and 3) Intrapersonal experiences.CONCLUSION: Mechanically ventilated patients tolerate many stressors, which many of them are externally sustained. Better care will reduce these stressors, and make it easier for the patients to get along with the artificial breathing. Meanwhile some pleasure experiences had been mentioned by patients in this study.

Variability of tidal volume and respiratory rate in normally breathing man has long been demonstrated [1]. However because of lack of knowledge and technology primary ventilators could only deliver a fixed tidal volume in a fixed rate the so called volume controlled VENTILATION (VCV). VCV was volume preset time triggered and cycled and there was no synchronization with patient’s breaths. At that time ventiltory management was associated with serious lung damage caused by ventilator [2-3]. Today that is referred as ventilator induced lung injury.  …