emergency medical center مرکز اورژانس پزشکی
in a natural disaster such as an earthquake,very often due to the extensive number of severe injuries,demands for blood units sharply increase in emergency hospitals.regarding such a problem,we propose a new robust two-stage multi-period stochastic model for the blood supply network design with the consideration of a possible natural disaster.the demand for blood units from different types and their derivatives including plasma and platelets are uncertain variables.as a novel contribution,the possibility of transfusion of one blood type as well as its derivatives to other types based on the medical requirements is considered in the optimization model.the pertinent network consists of three layers including the donated areas,the collection blood centers,and the transfusion blood center,which is usually a governmental organization.the model is also constructed for considering a likely earthquake in tehran (the capital of islamic republic of iran) using a professional report prepared in the year 1999 and also updated in a next research work.the scenarios for the demands of blood units and their derivatives are generated based on these reports.the mathematical model is implemented and assessed in a proper way using the simulation method.© 2017 springer science+business media new york
background: the international committee of the red cross supports a worldwide program of prosthetic fitting and rehabilitation.in this context,a prosthetic foot was developed and widely distributed in least developed countries.study design: prospective,randomized,double-blind,controlled study.objective: to compare patient satisfaction and energy expenditure during ambulation between a low-cost prosthetic foot designed with a polypropylene keel (cr-equipements™ solid ankle cushion heel,international committee of the red cross) to a well-recognized solid ankle cushion heel foot with a wooden keel (solid ankle cushion heel foot,otto bock).methods: a total of 15 participants with unilateral transtibial amputation were evaluated using the two prosthetic feet in a randomized prospective double-blind crossover study.main outcomes were patient satisfaction questionnaires (satisfaction with prosthesis questionnaire and prosthetic foot satisfaction) and energy expenditure (oxygen consumption—ml/kg/min,oxygen cost—ml/kg/m,and heart rate—bpm).results: there were no significant differences between the two prosthetic feet for satisfaction and energy expenditure.conclusion: the low-cost solid ankle cushion heel foot with polypropylene keel provides comparable satisfaction and similar energy expenditure as the solid ankle cushion heel foot with wooden keel.clinical relevance: the results of this study support the application and widespread use of the cr-equipements™ solid ankle cushion heel foot.from a cost-effectiveness standpoint,patients are well satisfied and exhibit similar outcomes at a substantially lower cost.© 2016,© the international society for prosthetics and orthotics 2016.
introduction: this was a report of uterocutaneous fistula as a rare complication of expectant management of placenta increta,and a review of the literature.case presentation: a 38-year-old pregnant woman in her third term of pregnancy was operated on in a secondary hospital in arak (a city located in the center of iran) in april 2015.as a result of placenta incereta,the attached placenta was left in the uterus.on the 38th day,she was referred to our tertiary care hospital due to intermittent fever and bleeding.more examinations by mri and hystrosalpingography revealed uterocutaneous fistula.she was operated on again,and surgical findings indicated coexistent uterine necrosis and uterocutaneous fistula.conclusions: this case was the first reported morbidity of fistula in the uterocutaneous pathway.© 2017,iranian red crescent medical journal.
studies show that by the course of time,the number of natural disasters such as earthquakes is increasing.therefore,developing a model for locating distribution centers and relief goods distribution systems in disaster times,along with appropriately locating health centers with the ease of access for transferring the casualties and saving their lives,is among the most essential concerns in relief logistics.considering these two subjects,simultaneously,results in an increase in the quality of service in disaster zones.in this study,a multi-objective programming model is developed for locating relief goods distribution centers and health centers along with distributing relief goods and transferring the casualties to health centers,with pre/post-disaster budget constraints for goods and casualties logistics.for a better modelling of the reality,the uncertainties in demand,supply,and cost parameters are included in the model.also,facility failure (e.g.relief distribution centers,health centers,hospitals and supply points failure) due to earthquakes is considered.the proposed model maximizes the response level to medical needs of the casualties,while targeting the justly distribution of relief goods and minimizing the total costs of preparedness and response phases.in order to handle the uncertainties,the robust optimization approach is utilized.the model is solved with ε – constraint method.for the large sized form,the mogasa algorithm is proposed,and the results are compared to those of the nsgaii algorithm.then the validity and efficiency of the proposed algorithm is explored based on the results of both the proposed and exact methods.© 2017 elsevier ltd