Journal of

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: 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 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.

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 & Aim : Chronic myeloid leukemia (CML) is a disorder of pluripotential hematopoietic stem cell that is as a myeloproliferative disease and occurs in about 15 percent of all leukemia. Two cell cycle regulatory proteins that function as tumor suppressor are P16INK4A and P14ARF. The origin of these two proteins is a human INK4A-ARF gene locus that located on chromosome 9p21. P16INK4A control retinoblastoma (Rb) and P14ARF control with p53 thought negative feedback. The purposes of this study, this was that whether these genes are preferable use as a factor in prognosis and progression of disease.

Materials and Methods: This research was a Cross sectional study.  The expression of p16INK4A and p14ARF mRNA in about 73 peripheral bloods (PB) Samples were collected from 45 CML patients at different phases of disease were assayed by reverse transcriptase polymerase chain reaction (RT-PCR). 26 samples were from patients at chronic phase before any treatment, 26 samples 3 month after treatment with imatinib, 9 samples in accelerated phase and 12 samples in Blastic phase.

Results. From 45 patients with CML, 33 patients (73%) were men and 12 patients (27%) were women. About 26 samples (35%) were p16INK4A positive and 55 samples (75%) were p14ARF RT-PCR positive. This expression of the two genes at different phases of disease were not statistically significant (p>0.05).

Conclusion: High percentage of the CML patients expressed P14ARF and P16INK4A genes. The expression of these gene at different phases of disease (diagnosis, accelerate, and Blastic phases) was not statistically significant even though, the expression of these genes was higher after the treatment.  The increased expression of these genes was probably because of the Imatinib treatment.

Background and Aim : Creation of knowledge management (KM) and efforts to use it in the university research programs shows the university society activity to enhance intellectual qualities and improve this effectiveness of the universities on the development and advancement in the countries. The objective of present study was to evaluate the status of organizational culture and structure for implantation of KM in the central libraries of the medical science universities in Iran.

Materials and Methods:The present work is an applied research and descriptive-analytic study.  The survey population consisted of 80 people who were directors or managers of 29 central libraries in medical science universities. Data collection method was used based on the questionnaire.  The validity was checked by researchers and reliability Cronbach's alpha (>0.7). The data & information were analyzed with descriptive statistics and independent t-test by SPSS software package ver. 15.

Results: The findings showed that the status of "organizational structure" of KM in these libraries was intermediate, whereas "organizational culture" was in the suitable status. Also in the libraries in which decentralization, revision in knowledge sharing process and Internal Network for knowledge sharing is adopted, higher organizational culture as compared with  other libraries, and have significant differences in them (p<0.05).

Conclusions: The result of present work is a proof for willingness and propensity of the Iranian librarians and their managers in the process of knowledge sharing and utilization of KM is at the proper level. Therefore, the authorities should provide the necessary structures and other complementary backgrounds for the utilization of KM in Iranian university libraries.

Background and Aim: Evaluation is a principle function of management which measure organizational goal attainment and eliminate the problems and modify the policies and procedures. Teachers are the most important educational system inputs and are evaluated with more complexity. There are several evaluation procedures for teachers' evaluation. For example, evaluation of teaching process by students. This research is aimed to conduct faculty members and teachers' opinion about teachers evaluation questionnaires form completed by the students in school of Allied Health Sciences, Tehran University of Medical sciences by the Students.

Materials and Methods: All the teachers and faculty members were selected to collect their opinions about teaching evaluation form. The data were analyzed by Excel and descriptive statistical method.

Result: The research findings showed that most of the faculty members and teachers believed that teachers evaluation questionnaire form is truly designed and conducted.

Discussion and Conclusion: Several universities faculty members and teachers don't believe in teachers evaluation by students, however we think that compound evaluation technical is most appropriate for teachers evaluation.

Background and Aim: The JAK2 is an acquired mutation that is observed in majority of patients with classical Philadelphia-negative Myeloproliferative neoplasms that include polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF). This acquired mutation is characterized by a G to T transversion at nucleotide 1849 in exon 12 of the JAK2 gene, leading to a substitution of valine to phenylalanine at amino acid position 617(V617F) of the JAK2 protein, and result in constitutive JAK2 activation that promotes hypersensitivity to growth factors and cytokines.

Materials and Methods: In this study we evaluated RNA from 58 patients with MPNs and statistical analysis was done with mann whitney test. The mutation detected by AS-PCR. In addition, 3 samples were sequenced in Mille gen company.

Results: 46 patients:86.6%(26/30) of those with polycythemia vera, 53.3% (8/15) of those with essential thrombocythemia,61.5% (8/13) of those with idiopathic myelofibrosis polycythemia vera patient carrying the mutation displayed higher levels of WBC (p=0.03). on the other hand,16 out of 26 JAK2V617F positive patients were female there is a demonstrate correlation between the presence of a mutant allele and female gender. The difference in other groups were not significant.

Discussion and Conclusion: The JAK2V617F mutation has been detected in the vast majority of patients with polycythmia vera (65-95%) and in a lower frequency in patients with essential thrombocythemia (23-57%), idiopathic myelofibrosis (23-57%) and chronic myeloid leukemia 19% (3/16 CML Ph-). Detection of the mutation is helpful in differential diagnosis, prognosis, and prediction of therapeutic response.

Background and Aim: Electronic learning system is a new educational process which designed upon basis of computerized technology, multimedia and processors. It has several potentials and contexts.
To do comparative study and utilizing of successful electronic learning in developed countries could help us to develop this new process in Iran's Universities of  Medical Sciences.

Materials and Methods: This research is developed descriptive comparative study in 2007 - 2008 by using of developed countries universities websites information and 62 references and keywords such as Electronic Educations,Medical Sciences Courses,Commutation Technology, Comparative Study and University in the field of electronic medical sciences. Then, the findings will compare with each developed countries universities and Iran's Universities of Medical Sciences.

Results: The results showed that Manchester and Dekin University have much experience in developing of electronic learning. The Students should be assessed by attendance, online and blended in developed universities.
Degree based courses are only present in South - Africa University, meanwhile single courses and training are present in other universities. Electronic health sciences courses and training are developed much more in compressive with others.

Discussion and Conclusion: The studied universities are different in history of construction, student assessment type, homework presence type, registration procedures, electronic medical education type with each other.
Iran's Universities of Medical Sciences, electronic education have several deficiencies in comparison with developed countries universities. We suggest appropriate technological and cultural infrastructure and use's skill improvement to develop this process in our country's universities of Medical sciences.

Background and Aim: Analysis of efficiency in hospitals, as the most expensive operating unit of the health system, is very important. This costly unit has several departments that one of them is medical records. This study is trying to analyze the efficiency of medical records department for the enhancement of using medical records facilities.

Materials and Methods: In this study, technical, scale and managerial efficiency of medical records department has been studied by data envelopment analysis method, and assuming the scale efficiency variable and the input axis. Information used in this study was the input variables (number of technician personnel and lower and Master of Science personnel and higher), output variables (number of emergency and outpatient and inpatient medical records and the number of filing unit visitors to respond) during 2007-2009.

Results: The average technical efficiency of medical records departments is 84 percent, that indicates there is at least 16 percent capacity for an increase in performance. Average of management and scale Performance in units during the 3 years of study are 95 and 89 percent respectively. Most input surplus is relevant to technician and lower personnel. The average performance of these units in general hospitals is 80 percent and in specialized activities is 92 percent.

Discussion and Conclusion: Relationship between studied indicators in this study with performance medical records departments showed that using such as employee personnel with undergraduate degrees and higher and educated in medical records filed, the use of managers with enough experience in this department and more use of computer systems for unit activities can fill 16 percent capacity of performance improvement in these units.

Background and Aim: The benefits of a unique computerized medical records and communication equipments is utilized to collect, storage, process, extract and relate to patient care information and management information. If this utilization is in accordance with the needs of managers and staff of medical records, many of the nation's health system problems will be dissolved. Information systems in health supply system by compiling, analyzing and publishing data provide utilization of information improve the health of the society. The purpose of this study is to investigate the process of clinical information systems in general hospitals of Tehran University of Medical Sciences based on available clinical information system in these hospitals.

Materials and Methods: This descriptive study is an application study that conducted in order to determine the process of clinical information system in general hospitals of Tehran University of Medical Sciences based on available clinical information in these hospitals. The required data have been collected by a valid and reliable questionnaire. Descriptive statistics were used to analyze data.

Results: With regard to the current condition and the importance of survey of the process of clinical information system in the studied hospitals, the authors provided the desired checklist in general hospitals with studying the related system in America, Australia and England countries, on the basis of country requirements in the form of clinical information system processes. We studied clinical information system processes in departments of admission, filling and retrieving, statistical and coding and also soft wares in this department.

Discussion and Conclusion: It is necessary to create a coordinated and integrated clinical information system with suitable process and empower experts in the field of proper use of data with regard to the position of information system in each organization and its fundamental role in the adoption of accurate policies. We found that relative frequency of clinical information system processes is more than 60% in this department and clinical information system elements was observed 75% in all the departments except admission.

Background and Aim: The study of organizational culture as a managerial tools, is necessary in health care organizations. Hospital administrators should compare present with desired hospitals' organizational culture continuously. This research is aimed to compare the present with desired organizational culture as administrators' view in Tehran University of Medical Sciences' Hospitals.

Materials and Methods: A Cross - Sectional' descriptive and analytical study was conducted among 15 Tehran University of Medical Sciences' Hospitals administrators by a questionnaire including demographic information and 30 questions which determined the approach of TUMS hospitals administrators about current and appropriate organizational culture components. Before the main study, validity and reliability of the questionnaire was performed. The data was collected by SPSS version 15 software and analyzed by Chi-square, Pearson and T tests.

Results: The result of this study showed that leadership was the most and control was the least organizational culture components which observed in present condition.

Discussion and Conclussion: As TUMS hospital administrators' view, all of the hospitals organizational culture components, exception control and communication patterns, are not observed in current status. There is a significant difference between current and appropriate hospital organizational culture components as the administrator's view which impressed on the hospital management system. Therefore, the hospitals administrators are required to do strategic planning to optimize the hospitals organizational cultures.

Background and Aim: Using Hirsch index as an important tool to describe the scientific outputs of researchers has caused some authors to increase their self-imposed parameters, increase, citing themselves. Therefore it is necessary to consider the effect of self-citation on Hirsch index for every author to have better measuring on the quality of researchers scientific production.

Materials and Methods: This research is descriptive method of citation analysis in general and specifically self-citation analysis. The study, are Iranian prolific authors in the field of medicine that have at least 30 documents indexed in Web of Science database between 2004 to 2006. Citations following up was studied till December 2010 Results was analysis using Excel software version 2007.

Results: The average self-citation observed between prolific authors in medical field was 25/89 percent. Hirsch index for 30/77 percent of authors had changed considerably. The authors rating scheme based on Hirsch index was done after removing self - citation so that 38/46 percent of authors decreased to lower level.

Conclusion: Considering that 10 to 30 percent of self-citation can be normal and justified, the status of self-citatin of Iranian prolific authors in medical field is desirable. Also, lower rates of self - citation of these authors doesnot affect Hirsch index.

Background and Aim: Identifying criteria of expert teacher and efforts to strengthen and use them in teaching by teachers will enhance the learning process. In this way, one of the important methods is taking the views of students. This study was conducted to determine the characteristics of an expert teacher for effective teaching from the viewpoints of allied medical students at Tehran University of Medical Science.

Materials and Methods: In this cross-sectional study, 200 BSc of allied medical students at were included employing simple random sampling method. Data collection was done employing a self administrated questionnaire. Validity and reliability of questionnaire was calculated. Data analysis was carried out by t-test and SPSS software.

Results: Some criterias like dominance in the scientific subjects (86.8%), power of expression and transmission the training materials (86.2%), respect for students(85.6%), good mood(85%) and work with ethic and sense of responsibility (84.4%) are important criteria for expert teacher. Furthermore, no significant relationship was found between gender and field of study and the above-mentioned four domains (p> 0/05).

Conclusion: Teaching ability was the most important factor for teaching process from he view of the students which could be paid attecntion in teachers' assessment program.

Background and Aim: One of the most important reasons why organizations are distinguished from one another is the degree of application and implementation of information technology in their organizational activities. In this regard, individual factors contribute considerably to the application of information technology (IT). Such factors include employees' perceptions and attitudes towards information technology and their demographic characteristics which affect the level of information technology acceptance and implementation.

Materials and Methods: In this cross-sectional study, 110 middle managers from teaching hospitals of Tehran University of Medical Sciences (TUMS) were chosen. A structured questionnaire was used as the data collection device and its validity and reliability were confirmed by a pilot study.

Results: Of the participants, 62.9% were males and 37.1% were females. The findings show that there is a statistically significant relationship between perception and making decisions based on the implementation of information technology. However, there was no significant relationship between work experience, education and training on the one hand and IT implementation on the other.

Conclusion: The results show that human factors (perception and decision) have a considerable impact on the implementation of information technology. Top managers and experts should consider the important aspects of human factors and also the factors affecting them.

Background and Aim: The operating room is one of the main units in a hospital, where the most important phase of treatment is performed. Due to the physical properties, use of gases, and different electric devices in the operating room, the safety of both the patients and the staff should be considered carefully. This study aims to estimate the safety standards of the operating rooms in ‎Tehran University Hospitals and to provide solutions to the existing problems.

Materials and Methods: This is a descriptive, cross-sectional study conducted in the operating rooms of TUMS hospitals. The research instrument was a checklist used by interviewers while observing the place. The safety standards were studied in terms of physical environment, protection against fire‎, personnel safety, patients' safety, and infection control. The data were analyzed by SPSS software.

Results: The overall safety of the operating rooms of TUMS hospitals was found to be 84.9 percent. The figures for infection control and personnel safety, however, were lower.

Conclusion: The operating rooms of Tehran University of Medical Sciences hospitals were studied in terms of five safety standards. Considering the physical environment, fire protection, and patient safety, they were quite safe but as to infection control they were relatively safe. However, they were found to be unsafe regarding the safety of their staff. Tehran Heart Center with an overall safety of 97.5% for its operating rooms can be considered as a model for the other TUMS treatment centers.

Background and Aim: Micro RNAs are a group of small non-coding RNAs which play an important role in multiple processes such as proliferation, differentiation, apoptosis, and cancer. Recent studies indicate that mir-210 is overexpressed into erythroid linage during the differentiation of hematopoietic precursor. The main goal of the present study is to investigate the influence of mir-210 on the pattern of expression in hemoglobin gamma chain.

Materials and Methods: First, K562 cell line was cultured in RPMI1640 media. Then, pre-miR-210 was transferred into K562 cell line by lipofectamin. Finally, the alterations in the pattern of gamma chain expression were analyzed in days 7 and 14 by RT-PCR and real time PCR technique.

Results: It was demonstrated that the overexpression of mir-210 in K562 cell line would lead to a 25-fold increase in the expression of gamma chain in comparison with the control group. Data analysis revealed that the change in the pattern of hemoglobin gamma chain expression was meaningful (p<0.002).

Conclusion: Based on these data, overexpression of mir-210 can lead to a significant increase in the production of gamma chain. Therefore, more studies in the field may reveal the fact that an increase in mir-210 can be a suitable goal in the improvement of sickle cell anemia and β-thalassemia.

Background and Aim: The use of electronic operations in health care industry has many positive points such as health care quality improvement, reduction in costs, and increased efficiency. Besides talking about the concept of Mobile Commerce (M-Commerce) as well as its benefits and challenges, the present article presents suitable approaches to benefit more from this new technology in the field of health, especially in the private sector.

Materials and Methods: This review article was performed based on a literature review and a search through such valid sites as Science Direct, Emerald, and Magiran, and also an advanced search in Google. In this paper, the researchers studied national and international documents about the application of communication and IT tools -- particularly mobile and wireless tools, E-commerce, and M-commerce -- from 1996 to 2011.

Results: E-business can be considered as one of the subsets of E-Health, and M-commerce as one of the E-business models is a very useful tool in developing countries. With this tool, organizations located in remote places can have access to potential customers and gain valuble benefits. Efficient application of E-business models in Iran requires the identification of opportunities and barriers as well as the preparation of suitable and basic plans with regard to socio-economic factors together with the provision of executive, legal, technological, and communications infrastructures.

Background and Aim: Although vancomycine is used for the treatment of methicillin resistant Staphylococci, but vancomycine alone might not be effective for the treatment of methicillin resistant Staphylococci in compromised host. In the same time antimicrobial activity of cefepim on gram positive bacteria especially Staphylococci is well known. In this study the synergism effect of cefepim and vavcomycin on positive and negative coagulase Staphylococci in vitro condition was investigated.

Materials and Methods: In total, 100 clinical samples of coagulase positive and negative Staphylococci were isolated from urine and blood samples from patients in Imam Khomeini Hospital during one year and identified .The modified Bauer-Kirby were used for the antibiotic susceptibility and macrodilution method for the MIC according to NCCLS procedure.

Results: The results showed that after adding vancomycin to cefepime in concentration from 0.05+ 0.5 , to 0.8+8 , growth reduction reached from 3.5% to 100%.The synergism effect of the two mentioned antibiotics on coagulase negative Staphylococci resistant to methicillin were shown that from concentration of 0.05+ 0.5 to 0.8+8 , a reduction in growth from 4.5% to 100% was observed.

Conclusion: The results of this study showed that vancomycin and cefepime has synergic effect on Staphylococci

Background and Aim: Acute leukemia is one of the main causes of cancer in the world. Now a days using natural materials as source of anticancer drugs is more recommended. HESA-A is a drug of herbal-marine origin (patented by Iranian researcher). HESA-A is composed of 50% inorganic substance، 45% organic substance (aminoenthraquinone) and 5% water. In this study effects of HESA-A، on NB4 cell line (Acute promyelocytic leukemia cells) was evaluated.

Materials and Methods: HESA-A was prepared in normal saline as a stock solution (80 mg/ml, PH=7.4), and then was sterilized. After culturing and proliferation of NB4 cell line, the cells were treated by doses of 1, 2, 4 and 8 mg/ml of HESA-A. Respectively after 72h, the percentage of viable and dead cells were counted by using Trypan blue staining in Neubanr hemocytometer. Then by MTTassay, the percentage of cell survival were determined by ELISA reader in 570nm. Finally the effects of HESA-A on apoptosis were evaluated by flocytometery.

Results: This invitro study shows that HESA-A has a cytotoxcic and antiprolifrative effects against NB4 cell line (Dose dependent).IC50 dose was 5mg/ml .HESA-A can result in apoptosis in 50% of the cells.

Conclusion: Although the mechanism of HESA-A cytotoxicity action is not known, yet this study shows that this drug may cause apoptosis of cells by dose dependent method.