International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - 4(5), March, 2012

Pages: 111-117

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STUDY OF OBSERVING THE STANDARDS AND SECURITY PRINCIPLES IN DIAGNOSTIC
RADIOLOGICAL CENTERS IN SISTAN AND BALUCHESTAN HOSPITALS, IRAN

Author: Mohammad Javad Keikhai Farzaneh, Mojtaba Vardian, Mahdi Shirin Shandiz, Baharan Namayeshi, Mohammad zarei

Category: Healthcare

Abstract:Background and Objective: Due to the fact that outfitting and establishing a radiological
center has many costs and the technologies related to this equipment are continually developing and progressing, taking into consideration and observing the international standards of these centers are necessary and is led to increased efficiency and useful lifetime of the apparatuses and economy in economic costs. This article aims to study the condition of diagnostic radiological parts of Sistan and Baluchestan hospitals and its comparison with the standards determined for these centers through national and international organizations like ICRU1, NCRP2 and ICRP3. Materials and Methods: In this descriptive study, the condition of
physiological atmosphere, the condition of personal protection apparatuses of radiographers
and patients as well as the status of radiography apparatuses has been studies using a threepartite questionnaire. In the next stage, the collected data have been through questionnaire, dosimeter and thermometer compared to the standard amounts and the qualitative and quantitative statuses of the radiographic centers has also been analyzed. Findings: The results achieved in this study indicate that the compatibility mean of the status quo with the international standards is 58 percent. In addition, none of these radiological centers are provided with standard darkroom and sufficient alarming signs and there was no archives regarding personnel protected from radiation in 44 percents of his center. Radiographic rooms have some defects and problems in 50% and lack of radiation leakage in 64%. Conclusion: According to the results achieved and the significant differences between
international standards and the condition of the centers under study, applying the periodic
monitoring and regularly quality control programs are necessary.

Keywords: Sistan and Baluchestan, Radiography Standards, Radiation Protection, Radiology.

Full Text:

INTRODUCTION
Radiography is one of the most significant methods to diagnose many diseases and the effective use of this technology is made possible only through observing the standards. Hence, taking into consideration the current condition in radiographic centers and its comparison with standards such as ICRU, NCRP and ICRP is a key factor to be assured about the appropriate function this apparatuses. On the other hand, the radiographic center is the most expensive one in each medical center and the investment made in this center is more than the one in other centers in such a way that the measures taken for being radiation protection, ionized air conditioning, the purchase and installment of the radiographic apparatuses and also providing the required physical atmosphere to different imaging apparatuses imposed much costs to the medical center, especially that the biological effects of the radiation are emphasized for the radiographers, patients and entourages(1). According to the reports issued, more than 80% of the referents to hospitals have a kind of radiography and the problem in giving services in these centers in one hand caused an inappropriate radiography being presented and the necessity to be repeated, and also it is led to an inappropriate diagnosis and or lack of diagnosis on the other hand which is resulted to the lack of patient?s health being endangered (2). On the other hand, if the protective principles are not observed and inappropriate radiographies are made, the ionizing radiation using in these centers put the personnel and patients health in danger (3). The studies performed in 51 public and private centers in Tehran showed that this center has many problems in terms of the issues related to radiological personnel, 89%, the radiographic room 82%, protective coverings, 77% and radiation leakage 37% (4). On the other hand, quality control of radiological apparatuses is one of the most significant methods to diagnose the current problems in such a way that applying the quality control programs in some centers in Iran is led to the employees and patient?s dose be reduced more than 70 % on average and concurrently the quality of radiographic images are significantly increased (4). Finally existing some problems such as lack of uniformity of X-ray field, the failure of collimator in appropriate adjusting the field of view, lack of conformity between the optical field and Xray field, lack of observing the radiation protection principles, lack of providing film and appropriate drug, lack of using radiation protection especially for children, lack of appropriate filtration of the apparatus and the defect of various parts of emerging and fixing apparatus are led to irreparable damages being made to the personnel and patient?s health (5,6). Therefore, according to the necessity mentioned, this study aims to take into consideration the amount and type of defects in radiological centers of Sistan and Baluchestan?s hospitals and a final result being presented to resolve this problem.

MATERIALS AND METHODS
The criteria being studied in this article have been divided into four groups as follows:

1- The condition of radiographic room and control room in terms of dimensions, light, radiation leakage, Cast conditioning ( height, condition, Cast), the condition of entrance door(position,height, being locked from inside) and warning posters for pregnant women, the danger of exposure (number, type and the place being installed), exposure Red Light, conservative equipments, loudspeaker, the distance of the tube from control room, the size of lead glass, height and position of lead glass to the X-ray room, flooring condition and walls ( safety shield) (2,3,7,14,16,18).

2- The condition of radiographic rooms in terms of the type and duration of the apparatus, the keys to move tube in different directions, the keys to move radiography bench, film sync, the function of grid, the condition of tube elbow and the condition of fluoroscopy (8,9,10,11).

3- The condition of darkroom in terms of entrance door, dimensions, the place and position related to radiographic room, light leakage, inner construction in terms of light reflection, ventilator ( power and anti-light), the lamp of the darkroom (the type of filter, the distance from the film and the power of lamp), film inbox ( light leakage), the preparation of drug, the required lighting, the fixing and emerging apparatus (type and duration), the condition of emerging and fixing pomp, the warmer of emerging and fixing apparatus, the rollers, the store to preserve drugs and no radiating films (light, moisture and ventilation)(12,13,15,17).

4- The condition of dosimeter of radiographic centers in terms of the number of dosimeters, using dosimeters, controlling the beige films, the medical brochures of the personnel employed in the center, periodic experiments, the one who is responsible for the center?s physical health, the applications of lead shields (lead coverings, lead glasses, Thyroid shied shields, Gonad shield, lead glasses, lead gloves) (2,3,7,14,16,18). At the final stage, the information related to the condition of physical atmospheres, the condition of radiographic apparatuses, the personnel information and the equipments for personnel and patient?s protection were collected by referring to the radiological centers. To perform the dosimetery, the one named DIADOS E made in PTW manufacture calibrated for the X-rays with 40 kvp to 150 kvp was used. In addition, a thermometer with measurement range of - 10 to 150 degrees centigrade and ±1 accuracy was used to check the temperature of emerging and fixing medicine. A building meter was also used to measure the dimensions.

Findings
The condition of 9 radiological centers, both educational and non-educational, was examined in this study, the number of studies apparatuses were 21 ones in which 5 apparatuses were useless and out of service. The functional duration of the apparatuses was 1 to 32 years with the mean functional duration of 10 years. The results of this study indicate that the condition of radiographic rooms, compared to the defined standards on average was 50% (figure 1), the condition of radiological apparatuses 77% (figure 2), the condition of control room was 65% (figure 3) and the condition of darkroom was 44% (figure 4) and the dosimeter condition and personnel protection was 52% (figure 5).

In performed studies, it was observed that the condition of side rooms are desirable in 25% compared to defined standards. In addition, the results of applied studies of radiological centers showed that 44% of the concerned centers have more than 20% of radiation leakage. On the other hand, none of the studied centers have the required maintaining equipment and hardware of radiological centers. The results achieved showed that 66% of darkrooms in radiological centers are defected with observable light leakage and there is no lamp system in the darkroom. On the other hand, 55% of the centers under study had not appropriate emergence and fixation temperature in a standard condition which indicates the inappropriate condition of emerging and fixing apparatuses. In addition, 53% of Casts are defected in all hospitals in terms of appropriate efficiency. 77% of the radiological centers have direct fluoroscopic problems and only 33% of the hospitals are provided with thyroid shield, Gonad shield, lead glasses and lead coverings. Concerning the sign alarms, 55% of the hospitals under study were in an appropriate condition in terms of exposure danger lamp, the warning poster of pregnant women and also the poster of exposure danger. The condition of radiological centers regarding controlling the exposure personnel shows that 44% of radiographic centers were bereft of medical brochure and the periodic experiment results of the personnel. Furthermore, 33% of the studied radiological centers did not choose a person responsible for medical physics to supervise and follow the cases related to personnel protection and periodic control.

DISCUSSION
The study of the findings achieved in this study indicates this reality that the radiological centers have not been controlled and supervised in an organized way. On the other hand, the results obtained show that only 33% of the hospitals are provided with thyroid and Gonad shield and lead glasses and coverings, which this amount is unpromising given the fact that these apparatuses are essential for the protection of children and adolescents against the radiation. This study also indicate that quality control of radiological apparatuses are essential for optimizing the radiological centers and also preventing from the economical resources being wasted away.

References:

1. Douglas J. Simpkin. Evaluation of NCRP No. 49 assumptions on workloads and use factors in diagnostic Radiology Facilities. Medical physics. 1996; 23(4):577-584.

2. Keane BE, Tikhonov KB. Manual of Radiation Protection in Hospitals and General Practice. WHO.1995; 3(2):190- 197.

3. Benjamin R. Archer. History of the shielding of Diagnostic X-ray Facilities. Health physics .1995; 69(5): 750-758.

4. Said dabbaghzadeh,et al. investigating the Security Principles of radiography centers.Hakim journal.2002;5(1):23-30

5. Johan B,Tony P. Chesney's Radiographic Imaging. Black wolf. 1997; 20(3):72-78.

6. Douglas J. simpkin. A General solution to the shielding of medical x and y Rays by the NCRP Report No .49 methods. Health physics. 1987; 52, (4):431-436.

7. B.R.Archer , j.i. Thomby , S.C Bushong. Diagnostic X-ray shielding design Based on and Empirical Model of photon Attenuation. Health physics. 1983; 44(5): 507- 517.

8. E.lynn McGuire .A revised schema for performing diagnostic X-ray shielding calculations. Health physics. 1986; 50(1): 99-105.

9. Douglas j. simpkin. Shielding a Spectrum of Workloads in Diagnostic Radiology. Health physics. 1991; 61(2): 259-261.

10. Douglas J. simpkin. Fitting Parameters for medical diagnostic x-ray transmission data. Health physics. 1988; 54(3): 345- 347.

11. Douglas J.simpkin.Transmission of scatter radiation from computed tomography (CT) scanners determined by a Monte Carlo calculation. Health physics. 1989; 52(2): 211-229.

12. Rehani MM, Arun Kumar LS, Berry M. Quality assurance in diagnostic radiology. lnd 1 Radiol Imag. 1992;4(2): 43-119. 13.

13.Manton DJ, Roebuck EJ, Fordham GL. Building and Extending a Radiology Department. London Royal Society of Medicine Servine. 1988; 41(3): 63-79.

14. Simone P, Radiation Protection in the X-ray Department. Butter worth Heinemann. 1994; 15(2): 53-97.

15. Boothroyd AE, Russell JGB. The lead apron: room for improvement.BJR. 1987; 60(1): 203-207. 16.

16.Moores BM, Stieve FE, Eriskat H, et al. Technical and Physical Parameters for Quality Assurance in Medical Diagnostic Radiology Tolerances, Limiting Values and Appropriate Measuring Methods. London British Institute of Radiology. 1989; 18(2): 45- 56.

17. Douglas j. simpkhn. Shielding Requirements for Mammography. Health physics.1987; 53(3): 267-279.

18. National Council on Radiation Protection.Medical X-ray and Gammaray Protection for Energies up to 10 MeV; Equipment Design and Use. NCRP Report.1968; 33(1): 22-35.

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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

A study by Dorothy Ebere Adimora et al. entitled \"Remediation for Effects of Domestic Violence on Psychological well-being, Depression and Suicide among Women During COVID-19 Pandemic: A Cross-cultural Study of Nigeria and Spain\" is awarded Best Article of Vol 14 issue 23
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
A study by Saurabh Suvidha entitled \"A Case of Mucoid Degeneration of Uterine Fibroid with Hydrosalphinx and Ovarian Cyst\" is awarded Best article of Vol 14 issue 21
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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
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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
A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
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A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
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A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
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A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
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
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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
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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
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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
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
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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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