International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(8), April, 2012

Pages: 185-188

Date of Publication: 25-Apr-2012


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STUDY OF THE REASONS OF THE RADIOGRAPHIC IMAGES REPETITION IN SISTAN AND BALUCHESTAN'S TREATMENT CENTERS

Author: Mohammad Javad Keikhai Farzaneh, Reza Afzalipour, Mojtaba Vardian, Mahdi Shirin Shandiz, Mohammad zarei

Category: Healthcare

Abstract:Background and Objective: the repetition of radiographic images causes increased dose of the patients and personnel, reduced life of the equipment and wasting the national capitals away. By identifying the percentage of the repetition of radiographic images and the factors associated with it, we can significantly make help to reducing the dose of patients, increase the useful life of the equipment, increase the efficiency of personnel, reduce the dose of personnel and make economy in national costs. Materials and Methods: in this descriptive study, the radiographic images had been collected for 3 months from nine governmental hospitals in the province of Sistan and Baluchestan and also the reasons why the radiographic images were not accepted by the experts resident in that center was studied. In this study, the reasons of the repetition of radiographic images were studied as follows: error in exposure conditions, error in positioning the patient, lack of adoption between radiation center and cast center, inappropriate choosing of the film size, movement of the patient, the error resulted from radiography equipment, error in the process of fixation and emergence, lack of appropriate choosing of the radiation point on the limb and other cases. Findings: Of the 34287 films used in nine treatment center, 4434 films were repeated and the overall percentages of the repetition of radiographic images were 12.9% which the maximum percentage of the repetition of radiographic images was in Amiralmomenin Hospital in Zabol
(26.9%) and the minimum percentage was related to Nabiakram Hospital in Zahedan (6.7%). Of the factors related to the repetition of radiographic images, the maximum percentage of repetition was related to the high radiation condition (3.22%) and the minimum amount was related to inappropriate choosing of the film size (0.21%). The percentage of other factors comprised of choosing the radiation condition (2.38%), error in radiation center (1.88%), error in equipment performance (0.61%), error in the patient's positioning (0.61%), movement of the patient (0.33%), darkroom (1.57%) and other factors (2.08%). Conclusion : The percentage of the repetition of radiographic images in governmental hospitals in Sistan and Baluchestan province are in acceptable level in comparison with the statistics issued in other centers,
the percentage of the repetition of radiographic images can be significantly reduced and the national capitals can be prevented to be wasted away through taking the measures such as regular quality control of X-ray equipments , training the less experienced personnel and designing the methods of appropriate choosing of radiation condition.

Keywords: radiography, film, darkroom, radiation condition, radiographic images, Sistan and Baluchestan

Full Text:

INTRODUCTION
Due to the fact that X-ray is frequently applied to diagnose diseases and to reduce the patient‘s dose and prevent from wasting the national capitals away, studying the amount and factors resulted in the repetition of radiographic images are an unavoidable necessity so that inappropriate using of X-ray generators causes the over-exposure of patients and personnel in radiology department which is contrary to the ALARA (As Low As Reasonably Achievable) principle (1). On the other hand, the repetition of radiographic images causes increased amount of time in giving services to patients, the patient‘s dissatisfaction, reduced useful life of the equipment and wasting the national capitals away. Therefore, the factors which are led to the repetition of radiographic images in treatment centers should be taken into consideration and the re-exposure of the patient should be prevented as much as possible. The significant factors of the repetition radiographic images are as follows: the inappropriate radiation factors, the error in the apparatus‘s performance, movement of the patient, error in the film size, lack of adoption of the radiation center and cast center, lack of appropriate adoption of radiation point on the limb, etc. (2,3). It has been attempted in this study that the amount of the repetition of radiographic images are taken into consideration as well as the most significant factors affecting on the repetition of images be identified in order to the appropriate guidelines be presented to reduce the repetition of radiographic images, and consequently reduce the costs imposed on the treatment center.

MATERIALS AND METHODS
In this descriptive design, the radiographic images were collected for three months and have been studied by observation as such as according to the overall number of the accepted patients and the number of applied films, repetition fraction was calculated according to the equation below:

Ri=Ai/(Ai+Bi) Which in this equation:
Ri: fraction of repetition in radiographic center Ai: total number of repeated films
Bi: total number of accepted films

In the next stage, to determine the factors related to the repetition of radiographic images, the form of data collection was designed and some of the most common factors in the repetition of radiographic images have been written down as below:

1- Error in radiation condition which is led to creating a complete dark or white image and this error can be investigated having seen the image.

2- Error in patient‘s positioning which can be investigated by observing the image with asymmetrical zooming or lack of complete seeing of the concerned limb.

3- Lack of appropriate choosing of the radiation point on the limb and lack of adoption of radiation center with cast center which this error can be investigated with seeing the image.

4- Inappropriate choosing of the film size.

5- Patient movement, which this error causes the fading and lack of clarity of the image

6- Error resulted from the equipment which can be investigated by studying an image with two projections in a film and seeing the image of the patient in the experiments which several radiography are performed to follow up the performance of the limb.

7- The changes in the appearance of the image in darkroom which this error can be studied by observing the image, because it can be clearly seen by inappropriate washing of the film or dislodging the film‘s emulsion due to the roller‘s failure. 8- Other factors which can be involved such as artifact, error in performing the demanded radiography, etc. In the next stage radiographic images are investigated by the experts in radiology in each hospital and will be involved in the special form according to the above definition. Finally, after complete the related forms, the repetition of radiography images, absolute frequency, relative frequency and frequency percentage for the factors related with according to the mentioned cases are determined and the objectives of the plan have been realized.

FINDINGS AND DISCUSSION
During performing this design, 34287 films were used in the concerned hospital. Table 1 shows the percentage of repetition of radiographic images in the concerned hospitals.

Due to the fact that the range of the percentage of radiography images repetition in several studies has been indicated between 0.9% to 27.6% (4-9), it can be said that the percentage of the repetition in governmental hospitals of Sistan and Baluchestan province are in an acceptable range. This study indicated that high radiation condition and inappropriate choosing of film size are the most and least possible causes for repetition, respectively. Amiralmomenin hospital of zabol and Nabi -Akram Hospital of Zahedan have the most and least percentage of repetition, respectively. In the studies performed by Nixon (7) and Morgan (9), error in positioning has been indicated as the most significant cause in the repetition of radiographic images, while in the current study, patent positioning and performance error of the equipment are both in sixth grade. The admission statistics in Imamkhomeyni of Zabol and Khatam of iranshahr Hospitals are higher than other treatment centers and due to the high lifetime of the equipment of Zabol‘s Imamkhomeyni Hospital, providing a new equipment for this hospital is necessary. On the other hand, inappropriate filtration of the equipment in Taminejtemai Hospital of Zahedan causes the percentage of the repetition of radiography images is high in this center. Therefore, the filtration function of this equipment should be corrected. Finally, due to the results obtained in this study, the following measures can be effective in reducing the repetition of radiographic images in governmental hospitals of Sistan and Baluchestan Hospitals: Providing the auxiliary equipment to make limit the regarded limb of the patient, proving the special charts of choosing the radiation condition for the employees who are less experienced, replacing some of the radiography equipments, regular quality control of the equipments and the processors and continuous training of the personnel. The Amiralmomenin Hospital of Zabol also have a high percentage of exposure repetition which talking with the patients before being exposed and the precision of radiologists are necessary to improve the condition.

References:

1. Clark PA, Hogg P. Reject/repeat analysis and the effect prior film viewing has on a department‘s reject/repeat rate. Radiography 2003; 9: 127-137.

2. Ali asgharzadeh A, Mohseni M. Evaluation of repeated radiographic films and its causes in Kashan hospital in 2003. J Feiz 2005; 33(9): 50-56 (Persian).

3. URL:http://www.srp_uk.org/srpcdrom/p4- 7.doc. Accessed Feb 21, 2009.

4. Jadidi M. Quality assessment of the radiography films. J Iran Univ Med Sci 2002; 30(9): 317- 326 (Persian).

5. Peer S, Peer R, Giacomuzzi S.M, Jaschke W. Comparative Reject Analysis in Conventional Film-screen and Digital Storage Phosphor Radiography. Radiat Prot Dosim 2001; 94 (1- 2): 69-71.

6. Lewentant G, Bohndorf K. Analisis of reject X-ray films as a quality assurance element in diagnostic radiology. Rofo 1997; 166: 376- 381.

7. Nixon PP, Thorogood J, Holloway J, Smith NJ. An audit of film rejects and repeats in a department of dental radiology. Br J Radiol 1995; 68: 1304-1307.

8. Al-Malki MA, Abulfaraj W.H, Bhuiyan S.I, Kinsara AA. A study on radiographic repeat rate data of several hospitals in Jeddah. Radiat Prot Dosim 2003; 103: 323-330.

9. Morgan TL, Banks DA, Kagan AR. Radiation therapy port film, a quality assurance study. Int J Radiat Oncol Biol Physics 1998; 42(1):223-227.

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Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

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A study by Muhas C. et al. entitled \"Study on Knowledge & Awareness About Pharmacovigilance Among Pharmacists in South India\" is awarded Best article for Vol 14 issue 22
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A study by Sathyanarayanan AR et al. entitled \"The on-task Attention of Individuals with Autism Spectrum Disorder-An Eye Tracker Study Using Auticare\" is awarded Best article of Vol 14 issue 19
A study by Gupta P. et al. entitled \"A Short Review on \"A Novel Approach in Fast Dissolving Film & their Evaluation Studies\" is awarded Best Article of Vol 14 issue 18.
A study by Shafaque M. et al. entitled \"A Case-Control Study Performed in Karachi on Inflammatory Markers by Ciprofloxacin and CoAmoxicillin in Patients with Chronic Suppurative Otitis Media\" is awarded Best Article of Vol 14 issue 17
A study by Ali Nawaz et al. entitled \"A Comparative Study of Tubeless versus Standard Percutaneous Nephrolithotomy (PCNL) \? A Randomized Controlled Study\" is awarded Best Article for Vol 14 issue 16.
A study by Singh R. et al. entitled \"A Prospective Study to Find the Association of Astigmatism in Patients of Vernal Keratoconjunctivitis (VKC) in a Tertiary Health Care Centre in India (Vindhya Region MP)\" is awarded Best Article for Vol 14 issue 15
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A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
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A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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