Journal of

Backgound: Approximately half of the diabetics population type 2 are not aware of their disease .Lack of awareness can lead to development of diabetes and increase cost of treatment. The aim of this survey was to determine the level of population awareness in Bushehr port in south of Iran in Bushehr prov­ince.

Methods: In this cross-sectional study, 719 subjects (417 male and 302 female) aged over 18 years old, without diabetes and inhabitant in Bushehr port in 2005 were assessed. Multi-stage random simple sampling was used. A 39 question questionnaire was used with validity checked by researchers in Yazd Diabetes Research Center and reliability alpha-cronbach=75%.The data were analyzed with independ­ent t-test, pearson correlation coefficient , ANOVA and Multiple Logistic Regression models by SPSS package ver. 10.05.

Results: Mean and SD of scores of subjects knowledge levels were 16.96 and 6.29, respectively. The levels of males' awareness rate was more than females' (P=0.001). There was indirect relation between subjects awareness and their age (r=-0.203, P=0.001) and direct relation between awareness and the level of education (P=0.01, r=0.07).The mean of awareness scores was not similar between singles and married (P=0.042). Awareness regarding fundamental diabetes disease, primary symptoms, early com­pli­ca­tions, delay complications, diet awareness was low and concerning controlling methods of diabetes was high.

Conclusion: Awareness in relation to fundamental and complications of diabetes disease was low, so the people need more education about diabetes.

Background: In recent years lots have been done for hospital automation but this non harmonized ac­tions leads to different software usage and entrance of different data into the system when partly is not useful . In this way, usage of soft wares in medical records specialty in the high loaded reception and recording will decrease defect in registration and storage of medical data. Using computerized system which cover applied soft wares could decrease many problems in medical data records. Any research in medical record area needs to be fed with data there fore it should be to use and evaluation of comput­erized systems. 

Method: This cross sectional study was conducted in reception and recording department teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran, using check list and direct collection of the data in the hospital. We used descriptive statistics tools to analysis the data.

Results: Specialized hospital and general hospital use computerized system for medical record with percents of 49.06% and 40.73% respectively .search of the input data and output data were considered as 66.7%.

Conclusion: The usage of automation in reception and recording departments of TUMS hospitals was low and even the operating system was not capable to register the patients data. Even though a few humble of systems in medical records awards were set which would be the source of some problems is saving and processing the data.

Background: Study of the attitudes of health information management experts in health systems could be regarded in order to maximize utilization of information. The research reported here aimed to study of attitudes of medical records departments in Iran about mechanisms of development of health care system information technology.

Material and method: A cross- sectional research was developed by a questionnaire to study the atti­tudes of medical records departments of 17 universities by mail in Iran. 49 of them completed the questionnaire and returned it to us. Therefore the response rate was 70 percent. The data were saved by SPSS software and analyzed by statistical method.

Results: Faculty members of universities of medical sciences believe that the must hindrances of de­velopment of electronic health records in Iran are low budget and lack of standards.

Conclusion: Utilization of health information management experts attitudes could be assured the im­provement of health care information technology.

Background and aim:Blood cells have an important role in human healthy, so their shapes and numbers are defined as human healthy indexes. These factors are measured by cell counter machines. Presenting a high quality report according to cell counters output is dependant on their operational accuracy. Therefore it was necessary to do a study on quality control of blood cell counter machines in selective medical laboratories of Tehran.

Method of study:This study was an experimental type in selective medical laboratories of Tehran. "Brittin method" was used as a general method for 6 selective machines over WBC, RBC, Hb, HCT, MCV, MCH and MCHC. In this method red blood cells index stability with EDTA, in 4^oC for 24 hour is assessed. Data was collected before and after quality controls and finally data analysis was done by T- student (paired samples T test) method and SPSS software.

Results:Using Brittin method showed all selective machines had significant differences before and after quality control in one or more quality factors (P-value< 0.05).

Conclusion:Quality control can show inaccuracy in cell counter machines output and finally inaccuracy over patient blood tests. By this subject we can have high quality diagnosis. This study showed parameters producing errors are error in sample volume, biological factors, error in concentration and using bad solutions.

Introduction and objectives: Despite the advances in the control of food-borne diseases, still one of the dilemmas in the health of most societies and a matter of concern for health authorities is food poi­soning and food-borne diseases by unsafe foods.

Materials and methods: In total 390 samples, including 195 samples of raw kebabs and hamburgers and 195 samples of the cooked ones were gathered from shops, sampling raw and cooked meat at the same time, and they were sent to the laboratory for testing, over a period of one year. The methods used for the tests were based on the Iranian National Standard procedures, numbers 356 and 2394.

Results: All the cooked specimens had bacterial contamination in acceptable standard levels and there­fore were considered consumable. From the 165 raw kebab samples, 90 samples (54.5%) were con­sumable but 75 samples (45.5%) were not fit for consumption, where from 30 raw hamburger samples, 22 samples (73.3%) were consumable and 8 (26.7%) were inconsumable. In serological evaluations, Thompson serotype had the highest prevalence in kebab and hamburger samples.

Conclusion: The results of present study show that there is no reason for concern in consuming cooked kebabs.

Introduction: Corticosteroids decrease side effects after noncardiac elective surgery. The aim of this study was to determine the prophylactic effects of IV dexamethasone (6mg×2) in preventing side ef­fects after cardiac surgery.

Methods and Materials: In a randomized, double blinded, placebo-controlled study 184 ASA physical status I or Il patients ranging 40-82 undergoing coronary revascularization surgery were enrolled in Imam Khomeini Hospital, medial sciences university of Tehran.
Dexamethasone (6mg/mL) or saline (1mL) was administered after the just before surgery and a second dose of the same study drug was given on the morning after surgery.  The patients were assessed at 24 and 48h intervals after surgery as well as at the time of hospital discharge, to determine the incidence and severity of postoperative side effects.

Results: Dexamethasone significantly reduced the incidences of nausea (P=0.034) and vomiting on the first postoperative day (P=0.005). In addition, dexamethasone significantly improves appetite on the first postoperative day (P=0.005). The corticosteroid decreased the incidences of atrial fibrillation AF (P=0.018) in the postoperative period. However, the corticosteroid failed to decrease the incidences postoperative pain.

Conclusion: dexamethasone (12 mg in divided doses) is suggested in reducing nausea and vomiting, decreases of atrial fibrillation and improving appetite after cardiac surgery.

Background: With due attention to the prevalence of thalassemia in Iran and patients' importunate needs for blood intake, this study aimed to inspect contaminations due to repeated blood transfusion which does not sift in blood donation. One such contamination is cytomegalovirus infection, which is an important pathogen in immunosuppressive patients or receivers of transplanted organs.

Methods: This cross sectional study was conducted on 311 thalassemia patients under age of 15 yr who was receiving blood from Hospitals in Tehran and Noorabad Mamasani repeatedly. To determine active infection (presence of IgM antibodies) of cytomegalovirus, ELISA method was used. In addi­tion, 225 healthy people under age of 15 yr were studied as testified group and finally all data were analyzed using SPSS ver. 11.5.

Results: 12.9 % of patients were positive from the view point of active infection. Regional separation of patients showed that the patients resided in Tehran are more contaminated to this virus than patients of other cities.

Conclusion: The range of cytomegalovirus active infection in thalassemia patients is high. One reason might be the infected blood intake or immunosuppressant (weakness of immune system) in patients, there­fore immunity care of these patients and negative serologic blood intake with respect to and also he­matic parents (parents with the same blood) are important.

Background: Septicemia is a life threatening status and needs rapid antibiotic treatment. Enterobacteri­acea are one of the most important causes of septicemia. So this study is therefore aimed to evaluate antibiotic sus­ceptibility of enterobacteriacea isolates in blood cultures in Shariati Hospital, Tehran, Iran.

Methods: This retrospective study was performed on 138 patients with positive blood culture in Shariati Hospital, Tehran, Iran in 2004, using disk diffusion and Macfarland standard. 

Results: Prevalence of isolated enterobacteriacea was respectively E. coli (n=74, 53.6%), Klebsiella (n=37, 26.8%), Enterobacter (n=21, 15.2%), Citrobacter (n=4, 2.9%), Salmonella paratyphi (n=1, 0.7%) and Proteus mirabilis (n=1, 0.7%). The most antibiotic susceptibility among enterobacteriaceaes was ciprofloxacin (60.4%), cloramphenicol (56.8 %) and gentamycin (49.3%). The most antibiotic re­sistance were seen among cephalotine (78%), cotrimoxazole (62.3 %) and ceftriaxon (57.5 %).

Conclusions: Due to dissimilarity between antibiotic consumption in laboratories and hospitals, it seems that to reach more proper conclusions and choosing better strategy for antibiotic consumption, cooperation should be between laboratories and physicians, plus synergism between drug prescription and antibiotic discs in laboratories.

 Background and Aim:To assess of human force and population's programming at high level, is very important that we know rates and characteristics of population. Growth of population has direct relationship with fertility rate of women in community. To control of population and arrive to index of N.R.R.(Net reproduction rate) equal to one ,each family must be has one or tow children .Thus ,in families that they have more over tow children, we must be search about factors affected and attempt to reduce of population's growth , until arrive to a stationary population.

Materials and Methods: The cross-sectional study upon 500 women that are married and have 45 years old and more in Bushehr. Tow-stage random sampling was used in this study. First, Bushehr divided into 23 hypothesis blocks of 1000 households and thus, 20 points from each of blocks were selected by chance. Also, from each of 20 pointes, 25 families were selected by chance. In this study, a questionnaire was used for collecting of data, that questioners were asked of chief of households. The data was analyzed with SPSS package version 13. To find relationship between variables together and with response variable , was used kendall's tau test and chi-square for trend test. The multiple-logistic regression was used to find factors affected on parity progression ratios.

Results: In this study 181 persons(36.2%) of women had illiterate, 229 persons(45.8%) had primary education and 90 persons(18%) of them had high and more education .The age of the first marriage of 456 persons(91.2 %)  of women were under 25 years old and the age of the first pregnancy of 196(39.2 %) of them were under 20 years old. Probability of arrive to the first child in Bushehr was equal 0.98,and probability of arrive to second, thirst and fourth children was equal 0.92,0.81 and 0.72 respectively. This study shows that the factor like the age of the first marriage of women has a negative effect on PPR (parity progression ratio) from zero to one child, and the factors like the women's education and having a dead child have a positive effect on it. The results indicate that the factor like having a dead child has increasing effect on PPR from one to tow children, and the factors like the women's education, the age of the first pregnancy and marriage have a decreasing effect on it. In this research it is observed that having a dead child has a positive effect on PPR from tow to three children, and the factors like the age of the first pregnancy and marriage, education of women and their husbands have a negative effect on PPR from tow to three children. Also it is observed that sexually and having a dead child has increasing effect on PPR from three to four children, and the factors like, the women's education, job and education of husband , and the age of the first pregnancy of  women have decreasing effect on PPR from three to four children.

Conclusion: The results indicate that probability of arrive to third and fourth children are high. Thus it is show the controlling of family planning in Bushehr dose not good carry out within families belong lately decades.

Background and Aim: Yersinia enterocolitica is a Gram-negative bacterium which its strains are involved in human diseases. To differentiate among pathogenic and non-pathogenic types, tests such as Congo Red absorption, Crystal Violet, and Calcium Dependency test are used. These tests are based on existence of 70-75 kb plasmids and sometimes, with respect to plasmids instability, we will face false negative results. Therefore, by setting up a methodology based on stable chromosomal genes of pathogenic agent we can overcome this hurdle. The goal of this survey was comparison among routine and molecular diagnostic approaches in the identification of Y. enterocolitica pathogenic strains.

Materials and Methods: Some Gram-negative bacteria from family Enterobacteriacea and some Y.  enterocolitica strains isolated of human beings and environment were evaluated.

Results: Obtained results showed that 4 Y. enterocolitica strains isolated of human beings were PCR positive while PCR results of environmental strains, one human strain and non-Yersinia strains were negative.

Conclusion: The mentioned approach can be used as a method to differentiate among pathogenic and non-pathogenic strains of Y. enterocolitica.

 Background and Aim:There are a number of successful examples of hydatid cyst control, achieved on a national or regional scale in different countries. The earliest successful program was that in Iceland initiated nearly 143 years ago when cystic hydatid disease was recognized as affecting approximately one of every six Icelanders. With a continuous campaign, by the 1950_s hydatidosis was considered eradicated from Iceland. Prior to 1970, in Cyprus, hydatid cysts were routinely found in the lungs and livers of the majority of mature sheep, cattle, goats and pigs, and people believed that hydatid cysts were normal part of the anatomy of infected hosts. By performing a 15-year plan aiming to eradication of the disease, infection prevalence of dog and sheep reduced to zero and 0.11%, respectively and from 1981 to 1985, only a single case of human infection was diagnosed. Elimination of stray dogs was the key element in above remarkably successful program. During the first year of the campaign more than 18000 stray and ownerless dogs were killed.

Conclusion:In Xinjiang Province of China, a control program during 1990-1995 resulted in a dramatic decrease in the infection rate in dogs (from 14.8% down to zero) and sheep (from 73/8% down to 1.4%). In this control program, 16000 dogs and herdsman dogs were given the drug praziquantel for five years. There are also other successful examples of hydatid cyst control in Spain (La Rioja), Australia (Tasmania), Chile, and NewZealand.

Background and Aim: Ever-increasing development of access to appropriate software and hardware for e-learning especially development of worldwide web has suggested new horizons for educational institutes. It is much important in medical sciences, because Medical Sciences deal with the health of human beings. Since beside issues related to education, research and information production, appropriate treatment of the patients is possible through having up to date and new information as well. For this reason Medical Sciences utilize information technology as soon as possible in order to prepare essential information for physicians quickly. This article discusses the role of e-learning in Medical Sciences universities.

Materials and Methods: in this literature review article, gathering information has been done by using paper and paperless documents related to the topic.

Results: For implementing of e-learning in Medical Sciences organization there should be some infra-structures, standards and skills which are to be noted prior to commencing e-learning. These     infra-structures, standards and skills play a special role in successful implementation of e-learning.

Conclusion: Regarding the advantages of e-learning naturally possesses, there is no doubt in necessity of developing Medical Sciences e-learning. But the ways of efficient access to this sort of education is much more important. So, it is recommended that by comparing the existing process in the world and using the experiences of prominent countries in this field, the most appropriate method be chosen and applied.

Background and Aim: The human bowel contains a large and dynamic bacterial population (more than 500 species of bacteria). Some intestinal bacteria such as Streptococcus bovis , Enterococcus and Bacteroides fragilis have previously been suggested to be implicated in the promotion of colon carcinogenesis probably through the conversion of mutagen metabolites.

Materials and Methods: Thirty patients with colorectal cancer confirmed by colonoscopy examination and pathological survey were evaluated. Thirty healthy people who matched by sex and age with patient group were identified. Fecal samples were collected from patient and control groups were cultured in specific and non-specific culture media (aerobic and nonaerobic situations).Organisms isolated by microbial and biochemical pathways.

Results: S. bovis was predominant fecal microbial flora in nine (39.1%) patients and six (26.1%) of control group (P=0.657). Entrococcus was predominant fecal microbial flora in 6 (26.1%) patients and 2 (8.7%) of control group (P=0.657). B. fragillis was predominant fecal microbial flora in 8 (21.7%) patients and 2 (5.4%) of control group (P= 0.062).

Conclusion: Our results by fisher statistical analysis show that the incidences of fecal S. bovis, Enterococcus and B. fragilis in colorectal cancer were not significantly higher than health people.

Background and Aim: Aging is a physiological process that is an unavoidable property of life. Decline in some dimensions of aging such as activity, income, health care and changes in life style are associated with increased risk of physical and mental health disorders. The aim of this study was to investigate the association between living areas and the demographic characteristics of elderly people in Tehran.

Materials and Methods: A cross - sectional / analytical study was conducted. The sample was consisted of 5600 elderly people and data was collected by using a questionnaire All analyses were undertaken using SPSS (Version 11.5).

Results: The results of this study showed that more 50% of subjects were illiterate and 30.5% of the were in schooling level. 62% of them reported at least one disease. We found significant differences between residences of north and south regions of Tehran for many of investigated variables.

Conclusion: These findings indicated that we need to pay more attention to elderly status specially those who are living in southern region.

Background and Aim: Symptoms of the "Darkroom Disease" amongst X-ray personnel are well reported. In this study, radiographers have been compared to physiotherapists to see if there is any link between the occurrences of symptoms with processing chemicals. The aim of this study was to find the prevalence of these symptoms amongst radiographers.

Materials and methods: Sixty nine radiographers from 13 hospitals of Tehran Medical School University were compared with 72 physiotherapists from those hospitals. Respondents were asked to identify, by means of questionnaire, any of the symptoms like dermatitis, sore throat, allergy, shortness of breath etc., described as "Darkroom Disease" from which they suffer.

Results: Data provided by this work demonstrated that radiographers suffered more from shortness of breath (P=0.013 & for men P=0.045), nausea (men P=0.049), and physiotherapists suffered more from catarrh (P= 0.044 & for men P=0.046), as well as joint pain (men P=0.04).

Conclusion: The results from this preliminary work suggests that there is a link between using the processing chemicals and incidence of these symptoms like shortness of breath, nausea among radiographers (P< 0.05), and it seems that the incidence of dermatitis and the history of this disease are linked.

Background and aim: One of the most important technological advancements for monitoring patients -- especially in anesthesia, recovery, and Intensive Care stages -- is pulse oximetry which can measure the oxygen saturation of arterial blood (spo2) and show hypoxemia before it is clinically observable. Therefore, it is necessary for the individuals who are responsible for treating and taking care of patients in critical stages to have sufficient knowledge about it. If they lack the required knowledge, they should be trained using appropriate methods.

Materials and methods: Upon referring to the ORs and the ICUs, a questionnaire was distributed among the medical and paramedical staff (doctors, nurses, anesthesia technicians, etc.) to assess their knowledge of pulse oximetry. The questionnaire had a part for demographic data and 20 true/false items and was to be filled in by the subjects in 15 minutes. After the data were collected and analyzed, the subjects' level of knowledge about pulse oximetry was assessed in terms of age, sex, academic degree, their experience with the device, and how they had obtained information about pulse oximetry. The variable was measured on a 0-20 scale. The subjects would get one point for every correct response and the total number of correct responses would constitute each individual's score.

Results: The results of the study show that only 15.8% of the participants had a high level of knowledge of pulse oximetry. The figure was 61% for those having medium-level knowledge and 23.2% for the individuals with low knowledge. In other words, for the optimal use of the device, 84.2% of the subjects need training. The results also indicate that the subjects' level of knowledge is positively related to their sex, academic degree, and how they acquired their knowledge. In fact, female subjects, paramedical staff, and those who had obtained information from colleagues and the companies selling the device had a lower level of knowledge needed for using the device properly. However, no statistically significant difference was found between the subjects' knowledge of pulse oximetry and their age and experience with the device.

Conclusion: Based on the findings, it is necessary for the female members of paramedical staff to be trained in classes and/or be provided with pamphlets on the issue. 

Conflict management is a kind of management which could be administered the organization with the best ways and create balance between organization and staffs and  eliminates the conflict. Generally , conflict management is the process of conflict roles recognition between intergroups and intragroups and use of conflict techniques for eliminate or simulate conflict for organizational effectiveness.
This research is aimed to introduce conflict management and how to use its strategies to modify this phenomenon.
This research shows that organizational conflict have both instructive and destructive results. Managers should use conflict management in every organization. Most conflict management strategy used to control conflict is collaboration between managers and staffs. Conflict management has important role to make managers successful . Although, a minimum of conflict is appropriate in every organization but no managers agree with anarchism in his organization

Background and Aim: Surveying faculty members can prove beneficial in the assessment of the university's performance in various domains, and the design and planning of suitable interventions. The current study assesses faculty members' opinions on the university's development programs.

Materials and Methods: One hundred and forty nine individuals completed the questionnaire in this cross-sectional study that was done through systematic sampling. The questionnaire covered demographic questions, professional specifications, faculty promotion criteria, sabbatical leaves, faculty participation in short-term educational programs, being in contact with graduates, recruiting foreign students, distant learning, processes involving research proposal approval, rewards and encouragement policies, faculty participation in health care management and distribution of budget among schools and hospitals.

Results: 71.8% of participants were male. The mean numbers of years of service in the university was 14.2 with a standard deviation of 7.5. Most participants were satisfied with the current status of promotion, processes involving research proposal approval and their participation in short-term educational programs. However most were not happy with the current status of sabbatical leaves.

Conclusion: Surveying through the methodical approach is a valuable tool in guiding senior university directors and its repetition and continuity can strengthen faculty participation and assess changing procedures.

Background and Aim: Systematized Nomenclature of Medicine systems are the important supportive for electronic health record in registration and retrieval of data. Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) is the most comprehensive language and then the consistency of exchanged data across health care providers and finally the high effectiveness of health care.

Materials and Methods : This research is a descriptive - comparative study and has been done in certain time section. Ideally , it have been used the descriptive - comparative method for studying of selective countries.

Results : Findings of this study show that American and England countries have accepted the SNOMED CT with application in all clinical activities and Australia country is evaluating this system and is using older versions of SNOMED only in pathologic applications now. Study shows that SNOMED CT structure is complex and based of concept (clinical concept) and contains two fundamental parts : 1) content of SNOMED CT core (concepts , descriptions and relations) that are always constant 2) content of out of SNOMED CT core (mappings or relation with systems and local extensions) that according to health and management needs and native terms of country are different. Such a structure executes in different software applications.

Conclusion : SNOMED CT structure in America and England countries has been compared and with attention to similarities (content of SNOMED CT core) and differences (content of out of SNOMED CT core : cross mappings and local extensions) , a basic SNOMED CT structure has been provided for Iran. Because of SNOMED CT in Australia is under development, researcher has studied its evolution and execution process in this country and has provided an appropriate structural pattern for Iran.

Background and Aim: Currently in most hospitals medical mission and medical  documents secession don't be notified  about any disciplines in the framework of documenting medical data and in parallel the document makers will be overshadowed by non-executing these principles qualitatively and quantitatively(1).

Materials and Methods: The above study is a sectional one that describes the situation of recording informational items in the surgical special sheets. In order to collect information collect information from considered sheets, it has been used of 1040 files of hospitalized because of surgery operation in the under study hospitals.

Results: The results of the study showed that 67.5% and 53.4% of informational items have not been recorded in nte sheets General and special hospitals. In the operation report sheet more informational items has been recorded in proportion to others which amounts to 59.9%. Informational items related to the tests in the pre operation care sheet, complementary information in the operation report sheets, and after surgery care and observed side-effects in the anesthesia sheet have the most non recording information.

Conclusion: The situation of recording informational items in the surgical special sheets in contrast to previous studied samples is not desirable. Regarding to the importance of these sheets and their position in relation to the information recorded in them, it is necessary to take needed measures to remove the factors that result in non recording the informational items.