Triple-A syndrome, also known as Allgrove syndrome, is a rare autosomal recessive disorder. The 3 features of this syndrome are achalasia, adrenal insufficiency, and alacrima. Achalasia could be the first manifestation of the triple-A syndrome; however, its etiology is unclear. Alacrima is generally asymptomatic but can be detected by obtaining patient history. Although adrenal insufficiency could have manifestations such as asthenia, it might be wrongly diagnosed as muscle fatigue. Vitamin D and calcium supplements are usually prescribed for the prevention of osteoporosis. Neurologic manifestations could be present in adults. In some individuals with this disorder, genetic examination indicates mutations in both alleles of the AAAS gene, which encodes a special 546-amino-acid protein designated ALADIN, and in chromosome 12q13. The genetic cause of the triple A syndrome in some patients who do not have an identified mutation is unknown. While very few such cases have been reported till date, one such case was presented to us as an edentulous child.
Adrenal Insufficiency ; Adult ; Alleles ; Asthenia ; Calcium ; Child* ; Esophageal Achalasia ; Humans ; Muscle Fatigue ; Neurologic Manifestations ; Osteoporosis ; Vitamin D

PURPOSE: The purpose of this research was to evaluate the amount of reosseointegration after counter torquing (reverse torque) and transposing the installed implants at different times. MATERIALS AND METHODS: This study was done on ten tibiae of five cross-bred dogs. At the first day one implant was installed in each tibia. After one week half of the implants were randomly counter torqued (1WCT) and the other half were explanted and reimplanted in a new juxtaposition site (transposed)(1WT). At the same time three new implants were installed in each dog, one of them was considered as one week control (1WC) and remaining two as 8 week groups (8WCT&8WT). After eight weeks the 1WCT and 1WT implants were loosened by counter torque and the quantity of needed force for liberation was measured with the digital device (BGI). At the same time one implant was installed in each dog as eight week control (8WC) and the same protocol was repeated for 8 week groups after another 8 weeks. RESULTS: All implants were osseointegrated. Mean quantities of osseointegration in case groups indicated better amounts rather than control groups. CONCLUSION: Counter torque or transposition of the installed implants one week or eight weeks after the implantation did lead to osseointegration.
Animals ; Dogs* ; Osseointegration ; Tibia* ; Torque*

OBJECTIVES: This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016. METHODS: A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses. RESULTS: The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001). CONCLUSIONS: Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.
Hospitals, Teaching* ; Humans ; Iran* ; Male ; Medication Errors* ; Methods ; Nurse Administrators ; Nursing Staff ; Patient Safety ; Prevalence*

OBJECTIVES: This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016.METHODS: A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses.RESULTS: The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001).CONCLUSIONS: Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.
Hospitals, Teaching ; Humans ; Iran ; Male ; Medication Errors ; Methods ; Nurse Administrators ; Nursing Staff ; Patient Safety ; Prevalence