Journal of

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: 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. 

Background and Aim: Acute promyelocytic leukemia (APL) is associated with the t(1517) ,fusing promyelocytic leukemia (PML) and retinoic acid receptor-a (RARa) genes. This disease is uniquely sensitive to treatment with all-trans retinoic acid (ATRA) and highly responsive to conventional chemotherapy. The t(1117)(q23q21) abnormality associated with a PLZF-RARa rearrangement is the commonest of the alternative translocations accounting for less than 1% APL. Blasts from PLZF-RARa cases have been found to be resistant to the differentiating effects of retinoids. In this study we aimed to determine the PLZF-RARa and fusion genes in patients with APL morphology who referred to Hematology-Oncology and BMT research center, Tehran Shariaty Hospital in 2006.

Materials & Methods: Peripheral blood and/or bone marrow samples were taken from 200 patients with APL morphology and 200 patients with other subtypes of AML. The mono-nuclear cells were enriched by centrifugation over a ficoll-isopaque gradient. RNA extracted by Trizol or TriReagent and then reverse transcribed to cDNA using random primers. PCR performed using specific primers for each fusion. PCR products electerophoresed on a 2% agarose gel containing 0.05% ethidiume bromide.

Results: In 2 (1%) patients with APL-morphology the RT-PCR analysis showed PLZF-RARa fusion transcripts.

Conclusion: It can be concluded that RT-PCR is a rapid and sensitive method for detection of abnormal fusion genes in leukemia and allows the definition of a correct strategy for treatment and subsequent minimal residual disease monitoring

Background and Aim: The risk of infectious diseases in laboratory's personnel is high and several factors can increase these risk. Some of these factors are general, such as burning (with stray acid and base) and electric shock hazards. Which are not exclusive for laboratories. In other hand some several risk factors such as burning liquids are exclusive for laboratories. And there is limited information available about them.

Materials and Methods: This cross-sectional study was designed to evaluate accidental exposures of all laboratories personnel of Teaching Hospitals of Tehran University of Medical Sciences during 2004- 2005. We selected 416 laboratories personnel's in 15 different teaching hospitably TUMS for our study. The data were collected using a questionnaire and SPSS software was applied for data analysis.

Results:There was no significant association between accidental exposures with gender (p=0.51), educational level (p=0.11) and age (0.09) of laboratories personnel. But, accidental exposures were lower among those who had job experience between 5 to 10 years (p<0.05) compare to less than 5 years or more than 10 years job experience.

Conclusions:Although age, gender and educational level of laboratories personnel did not influence their exposure to laboratory's accidents, little or extensive job experience may increase accidental exposures among them. 

Background and Aim: Prevalence of anabolic steroids (ASs) consumption among bodybuilders has increased progressively. Therefore, the purpose of this study was to evaluate the effect of ASs consumption on C-reactive protein (CRP) in bodybuilders.

Materials and Methods: Sixty healthy men (age: 24/1± 9/1yr weight: 77±10 kg and height: 172±12 cm) participated in the study voluntarily. These subjects were selected from three groups. First group (FG) was bodybuilders who consumed ASs (n=20), second group (SG) was bodybuilders who did not consume ASs (n=20) and third group (TG) were untrained subjects as control (n=20). Blood samples were collected in fasting state (12 hours) at 09:00 for CRP assessment. Strength and volume of the forearm, pectoral major and femur muscles were measured via 1RM test and muscle circumstances, respectively. Speed was assessed by 30m speed test. Analysis of variance test and LSD post-hoc test was used.

Results: FG had significantly greater blood CRP (P<0/05) compared to other groups. However, differences between SG and TG were not significant. Muscle strength, and forearm and femur circumstances were greater in FG than other groups. Furthermore, this was greater in SG than TG. But chest circumstance was greater in FG and SG than TG only. There were no significant differences in speed between groups.

Conclusion: ASs consumption for muscle strength and volume improvement in bodybuilders is accompanied by higher level of CRP (as a cardiovascular risk factor).

Background and Aim: Procalcitonin is prohormone of calcitonin and is made 116 amino acids. The normal value of procalcitonin is less than 0.5 ng/ml, that if this amount exceeds, infection is indicated. This poly-peptide is a marker for the diagnosis of primary infection. Increased amounts of procalcitonin is associated with infection especially bacterial infections.

Materials and Methods: 32 patients with liver cirrhosis and 16 healthy controls enrolled in this study were. Serum PCT levels in these subjects was measured. PCT level was measured by semi-quantitative method.

Results: Patient group included 23 males and nine females with mean age of 45 years and SD= 17.44 years, the control group included 11 males and 5 females with mean age of 46 years and SD=15.5 years.
The statistical analysis showed that there was significant difference between PCT levels in patients and controls (P<0.05).Furthermore PCT levels was significantly hgher in cirrhotic patients with hepatitisec background.

Conclusion: Since these patients had no symptoms of infection and were hospitalized for endoscopy test and the PCT test was positive in 78.1% of cirrhotic patients ,whereas this ratio was 25% in the control group, the patients probably were infected and should be under proper treatment.

Background and Aim: Salmonellosis is a gastroenteritis caused by different serotypes of Salmonella and is the most common type of food poisoning in the world. The purpose of this research study is to optimize the conventional method for the isolation of Salmonella SPP from the diarrheic specimens of children.

Materials and Methods: Stool specimens were obtained from one hundred patients admitted to Children's Medical Center for diarrhea. The enrichment media were prepared by 3 methods: Rappaport Vassiliadis broth (RV), Tetrathionate broth (TT), and Selenite Cystine broth (SC). Then, for the isolation of Salmonella SPP, the enrichment methods RV and TT were used and incubated at 42° C, and SC at 37° C. After 24 hours of incubation, the enrichment samples were inoculated into the following 6 different media: Hektone Enteric agar (HE), Rambach agar (RA), CHROMagar Salmnella (CHROMagar Salmonella), Brilliant Green agar (BG), Salmonella-Shigella agar (SS), and Xylose-Lysine-Deoxycholate agar (XLD).

Results: In total, 13 out of one hundred samples were identified as Salmonella SPP. All of these 13 Salmonella SPP samples (i. e., 100%) were positive on RV broth the figures were 8 (61.5%) and 3 (23%) on SC and TT broths, respectively. The highest amount of isolation was found by the combination of RV broth and RA agar (100%). The lowest rate, however, was obtained by the combination of TT agar and BG broth (15.4%).

Conclusion: The comparison results of 3 enrichment media and 6 selective media showed that the mixture of RV broth and RA agar would be very fine for the isolation of Salmonella SPP.

Background and Aim: Over the past decade, the number of private centers providing health care services in Iran has had a continuous growth and the highly competitive market in private hospitals industry has caused increasing pressure on them to provide services with a higher quality. The purpose of this study was to assess the quality of services being provided in private hospitals of Tehran as judged by patients.

Materials and Methods: This cross-sectional study was conducted in 2010 in Tehran. The study sample comprised 983 patients, randomly selected from 8 private hospitals. The survey instrument was the standard SERVQUAL questionnaire. Wilcoxon, t-test, and Kruskal-Wallis tests were used for statistical analyses.

Results: The total mean scores of patients' expectation and perception were 4.92 and 4.02, respectively. The highest figures were related to the tangible factors dimension and the lowest ones to the empathy dimension. The differences between the perception and expectation for all the 22 items and the 5 dimensions were found to be statistically significant(p< 0.001).

Conclusion: SERVQUAL is valid and reliable in hospital settings as a standard tool for the assessment of quality. The results of the present study have revealed the areas that need to be improved as far as the patients are concerned. Measuring the opinion of patients can help facilitate the provision of hospital services, and improve the quality of such services and patients' satisfaction.

Background and Aim: Health information System (HIS) is a comprehensive software used to unify and transfer hospital data effectively. It is vastly employed to improve input quality, decrease data-transfer time, increase satisfaction level, promote health services quality, and minimize hospital costs.

Materials and Methods: This is an applied-descriptive study. The research population consisted of 120 HIS users who worked before and after the HIS application at Masih-Daneshvari Hospital. For data collection purposes, a questionnaire was used. The data were then analyzed with SPSS software, and descriptive and inferential statistical methods.

Results: According to data analysis, the application of the existing communication system among the different sections and wards was very good (81%), the accessibility to patient medical information and facilitating treatment processes were good (44% and 61%, respectively), and the analysis of budgeting data (11%), the possibility of clinical researches (19%), the presentation of guides for operators (18%), and the accessibility to statistical and financial data (17% and 22%, respectively) were assessed as poor.

Conclusion: The results of this survey show that the application of Hospital Information System has a positive effect on accuracy, facility, and treatment processes, and emphasize the importance of programming to enhance the quality of hospital services.

Background and Aim: In strategic planning, there are several procedures to perform internal assessment or strength and weakness of organizations. Among other methods created for this purpose, Wiseboard model is the one in which the following six internal dimensions are considered: Organizational Structure, Leadership, Coordination, Reward System and Communication. This study measures three of these variables in hospitals of Tehran University of Medical Sciences (TUMS).

Materials and Methods: This survey is a descriptive, analytical and cross-sectional study conducted during 2010 and 2011. The research population comprised all those working at TUMS hospitals from which a random sample of about 580 people was selected. The questionnaire's reliability was estimated to be 91% and the data were analyzed by the SPSS software.

Results: Of the subjects, 75.4% were below diploma level, 13% above diploma, 7.8% higher diploma, 66.4 bachelor holders, 2.6% master holders, and 5.4% had a doctoral degree or higher. Some 72.6% of the subjects were in Clinical and 19.8% in Nonclinical fields. The mean values of Goal Setting, Organizational Structure, and Leadership came out to be 24.47, 20.37, and 22.06, respectively.

Conclusion: Based on the findings of this research study, TUMS hospitals have weaknesses in some aspects and they need improvement in some areas in the following order: Organizational Structure, Leadership, and Goal Setting.

Background and Aim: Dental caries in children caused by repeatable consumption of sweet product especially at night, that itself mostly depend on economic and cultural background of the society and family.
One of the most common diseases of human being is dental caries, which are caused by many factors, such as microorganisms, dieting, passing time, and the host itself. Among the microorganisms Streptococci mutants play the major role in causing dental caries. The aim of this research was to investigate the role of Streptococci mutants in dental caries between two groups of children sensitive and resistance to caries.

Materials and Methods: This was a cross-sectional research, in which 120 children(60 susceptible and 60 resistance) aged between 3 to 5 referred to Tehran University dental school were selected randomly. The selection criteria for the sensitive and resistance dental caries were dmfs > 5 and dmfs < 10 respectively. None of the groups had used any drug or fluoride products before sampling. Saliva of both groups were collected, and transferred to the specific culture media(Mitis Salivarious Agar). After incubation at 37 oC colonies of S.mutans were counted.

Results: There was a significant difference between the number of colony counting(cfu/ml) with age and consumption of repeated sugar product, while. there was no significant difference between(cfu/ml) sex, oral hygiene, and nutrition period during infancy.

Conclusion: The results of this study showed that the consumption of sugar product in childhood results in dental carries.

Background and Aim: Focus on organizational health could ensure the future success of any organization. Considering the fast changing conditions of hospitals and the necessity of effectiveness, employees are required who can show voluntary behavior towards the organization and customers. Therefore, this study mainly aims to survey the relationship between organizational health and organizational citizenship behavior in selected hospitals of Tehran University of Medical Sciences(TUMS).

Materials and Methods: This cross-sectional, descriptive-analytic study was conducted in 2010. The population of the study comprised the entire staff of TUMS selected hospitals. In total, 312 employees were selected. The researchers gathered their data using questionnaires of organizational health and organizational citizenship behavior. For data analysis, both descriptive statistics(percentage, mean, standard deviation and variance) and inferential statistics(Pearson correlation and regression) were applied. The data were analyzed using SPSS18 software.

Results: The correlation between the organizational health and five dimensions of organizational citizenship behavior(Conscientiousness, Altruism, Helping Behavior, Civil Virtue, Sportsmanship, and Courtesy) was significant(p = 0/0001).

Conclusion: Given this significant correlation between organizational health and organizational citizenship behavior, organizations can make improvements in employees' behavior. This can be achieved by creating harmony among members and through continuous improvement and growth.

Background and Aim: Decision support systems(DSSs) refer to one of the types of information technology applications that can help clinicians to make right and timely decisions about patients. The aim of this study is to learn more about DSSs and their applications and effects on health care.

Materials and Methods: In this systematic review, articles which were published between 2000 and 2012, which were available as full texts through databases and search engines -- such as PubMED, EBSCO host research, Google scholar and Yahoo -- and which were also of clinical-trial type were examined besides, certain books in this area were used as primary sources.

Conclusion : The findings show that DSSs were applied in five areas in health care, which had a significant effect on improving the process of care and the performance of providers. These areas are as follows: disease progress management(15.15%), care and treatment(27.27%), medication(27.27%), evaluation(27.27%), and preventation(12.12%). In general, improvement can be seen in three areas: quality of care and patient safety, cost effectiveness, and provider’s level of knowledge.

Background and Aim: Firms are always looking for a way to increase the profitability of products or services. Therefore, the determination of cost of services to achieve this goal seems necessary. Aiming to clarify such costs in governmental units, the present study was designed to explain the allocation of costs based on each unit’s activities.

Materials and Methods: This was a descriptive study. Using field methods, the data were obtained from the activities carried out in Medical Imaging Center of Imam Khomeini Hospital in 2010-2011. To calculate the expenses of each unit, both direct and indirect costs of that unit were included. Data were analyzed using activity-based calculations. And ultimately, the cost-benefit of services rendered in each unit was calculated based on the difference between revenues and expenses.

Results: With the average revenue of 573,486 rials and a cost of 527,962 rials per service, the benefit per service was computed to be equal to 45,524 rials.

Conclusion: With the full implementation of the accrual accounting system, the cost of all services can be obtained, and services will be priced optimally in each unit. Besides, the management of all costs and elimination of unnecessary ones will lead to the reduction of the total cost of services while maintaining the necessary efficiency. Moreover, it will enable the organization to survive and develop based on its strategic activities.

Background and Aim: Knowledge management is effective in promoting organizational structure, level of services, and universities competency power. The present study was aimed to assess knowledge management effective factors including information technology, organization culture, human resources, and librarians' skills among university librarians in Urmia.

Materials and Methods: This analytical survey was conducted on 102 university librarians in Urmia. The data were collected using a questionnaire where its validity and reliability was confirmed by specialists’ overviews and Cronbach's Alpha (0.94). In order to analyze the data, first the middle of the effective factors of knowledge management was estimated. Next, synchronic effect of the variables was estimated via multinomial logistic regression. Also Chi-square was used to assess the relationship between majors and sex factor of the librarians considering their perspective on knowledge management.

Results: Organizational culture, information technology and human resources are the most effective factors to knowledge management circulation. Also the median degree of the knowledge management process includes knowledge creation and reservation and knowledge sharing and employing which was 2/7 and 2/2 respectively.

Conclusion: Knowledge management is an important factor in human resources and competency environment of organizations. Libraries can with launching of knowledge management circulation, earn some promotions, for example: saving research and development costs, capacity increasing, employers’ job satisfaction, maintenance of competency environment and etc.

Background and Aim: Peripheral and intermediate laboratories have an important role in diagnosis, treatment and prevention of tuberculosis. Today, without these laboratories, maintaining health and preventing the spread of tuberculosis is not possible. The aim of this study was Evaluation of manpower, equipment and quality control standards in peripheral and intermediate laboratories assessment checklist within seven selected provinces in year 2011.

Materials and Methods: This study was a cross-sectional survey. In this study eighty tow peripheral and intermediate laboratories from seven selected provinces were studied in year 2011. A standardized checklist was used to assess peripheral and intermediate laboratories.

Results: The result showed that Esfahan with 20 labs and 8870000 population had the highest number of labs and coverage people between other provinces. Khorasan Razavi with an average of 263 per month has the highest number of admission number and Golestan, with an average of 139 positive cases per month, had the highest number of positive cases between other provinces. In 82 labs 117 laboratory technicians were engaged providing services to patients.

Conclusion : The results of this study showed that conditions of most peripheral and intermediate laboratories are optimum and nearly standard. Control and evaluation of peripheral and intermediate laboratories, expert personnel, facilities and equipment are necessary to improve the TB control program in the country.

 Background and Aim: Along with the constant increase in world population and consequently, the growing need to provide cellulose, as the most abundant organic substance in nature to produce cellulose products, concerns regarding the possible contamination of these products might cause skin, and genital and urinary infections. The aim of this study is to determine the possible microbial contamination of these products supplied in the city of Tehran.

 Materials and Methods: This is a descriptive study on 200 samples of unexpired cellulose products including napkins, nappies, sanitary napkin, and cardboard boxes to carry sweets. Fifty samples were obtained in the city of Tehran during six months from September 2011 to February 2012. Microbial contamination was investigated according to the procedure proposed by the Institute of Standards and Industrial Research of Iran.

 Results: The results obtained indicate that 18 samples (9%) exceeded the level allowed for aerobic bacteria and molds in one gram of specimens. Besides, 16 samples (8%) were contaminated with at least one of the following bacteria: Streptococcus Group D, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. A total of 34 samples (17%) could not be consumed. The least and the most contaminated products were sanitary napkins (0.5%) and cardboard boxes to carry sweets (5%), respectively.

 Conclusion: The presence of pathogenic bacteria in cellulose products that could cause skin, and genital and urinary tract infections asks for more control over such sanitary products.

 Background and Aim: : Technical knowledge of managers of health care industry regarding budgeting have an essential function on increased efficiency of organizations working in this sector, since every single right decision, rely on appropriate knowledge and analysis. Therefore, the purpose of this study was assessment of technical knowledge of managers of health care system regarding budgeting.

 Materials and Methods: This was a descriptive  -analytic, cross- sectional study. From 80 managers of Tabriz Medical Sciences University 63 participated in the study and a questionnaire was employed to collect data. Data was analyzed by Spss 16 software, Pearson correlation test, T test and ANOVA.

 Results: Mean of total scores was 16.9±4.6 of 30. There was no significant difference between total scores in different courses (P=0.276) and positions (P=0.431). Mean of total scores between women and men (P=0.782) were the same.

 There weren't significant relation between technical knowledge of managers with age (p=0.392, r=0.1), job background (p=0.299, r=0.1) and management background (p=0.121, r=0.2).

 Conclusion: With respect to low level of manager's awareness about budgeting,improving of technical knowledge is essential. Lack of significant relation between technical knowledge of managers and their length of management practices, with unstable situation, may harm seriously organizational achievements. Reviewing and promotion of educational programs and continuous training of managers with respect to budgeting seems to be an essential need for improving manager's performance.

 Background and Aim: Smoking can influence liver or heart enzymes. The main aim of this study is to determine the effects of cigarette or waterpipe smoke on serum level of alanine aminotransferase (SGOT) or aspartate aminotransferase (SGPT) in male rats.

 Materials and Methods: In this experimental laboratory study, 15 male Wistar rats were randomly divided into control groups of 5, and animals were exposed to cigarette and waterpipe smoke. After 6 weeks, blood samples were collected using cardiac puncture method. Following serum collection, levels of SGOT or SGPT were measured by spectroscopy method. Data were statistically analyzed and compared between groups using one-way ANOVA.

 Results: Serum levels of SGPT significantly increased in rats exposed to waterpipe and cigarette smoke compared with control animals (P<0.05), but serum levels of SGOT significantly increased only in animals exposed to waterpipe smoke. There was not a significant difference between serum levels of SGOT or SGPT in rats exposed to waterpipe or cigarette smoke.

 Conclusion: Waterpipe smoke -- like cigarette smoke -- has pathophysiological effects on liver and heart, which appears in elevated serum levels of SGOT and SGPT.

Background and Aim: Learning basic issues in nursing requires new strategies that can enhance knowledge retention among nurses. This study aimed to determine the effect of lecturing by peer-nurses on critical units nurses’ retaining knowledge of electrocardiogram (ECG) interpretation.

Materials and Methods: In this experimental study, two units (as test and control groups) were selected randomly from among critical care units of Semnan University of Medical Sciences hospitals. First, a pretest was performed on nurses in both groups. Then, the nurses of test group were trained by a peer-nurse how to interpret ECGs. A posttest was performed on the two groups both a week and a year later. Finally, the data were analyzed using Pearson’s correlation coefficient, t-paired and t-tests.

Results: The mean of nurses’ scores of ECG interpretation in pretest was 9.55±2.73 in the test group and 10.82±3.43 in the control group. In the first posttest, mean scores of nurses’ knowledge in test and control groups were 15.27±2.57 and 11.36±3.29, respectively. In the second posttest, nurses’ mean scores in test and control groups were 10.82±4.07 and 11.33±2.95, respectively. There was a significant difference (p<0.05) between the pretest and the first posttest in the test group, but there was no such difference for the second posttest (p>0.05).

Conclusion: Lecturing by peer-nurses can enhance nurses’ knowledge about ECG interpretation in the short run, but it cannot enhance knowledge retention. So it is suggested that other educational methods be used in nurses' in-service training programs designed for ECG interpretation.