Journal of

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: Foodstuffs additives are a general term for materials that are added to the foodstuffs in order to increase durability and to improve the appearance, composition, taste and food nutritional value. Colors are classified in this group and are added to foodstuffs in order to increase their attraction. The aim of this survey was to analyze status of added colors to the juice of black cherry and juice of barberry which are produced in Tehran City, capital of Iran.

Materials and Methods: Three haundred thirty six samples of dried sweets were randomly collected and analyzed from different areas of Tehran. First, the samples were de-colored by Clorhidric Acid, and then were analyzed after refining by Thin Layer Chromatography (T.L.C) method.

Results: Eighty nine percent from the total samples contained colors. Among chromatic samples, 62 samples (18.5%) out the total samples, contained artificial, non-edible colors and 237 samples (70.5%) from the total samples contained artificial and edible colors (for Industrial Producers) and 37 samples (11%), contained natural colors. Carmoisine color was detected more than added colors in juice of black cherry and juice of barberry.

Conclusion: Low costs, stability, Ph and similarity of artificial dyes with natural dyes motivate the producers for high utilization of these dyes without considering their possible hazards and/or their edible quality aspects.

Background And Aim : Nowadays, many inflammatory diseases such as rheumatoid arthritis (RA) and Multiple sclerosis (MS) and many other autoimmune inflammatory diseases has involved the people of different communities and cure for them so far has not been provided. Many waste irreparable these diseases caused by overexertion and chronic inflammatory cells and effects of destructive enzymes. Proteolysis like matrix Mtaloproteinazes (MMPs). Hence in this study was discussed effect of drug 4 - amino pyridine (4-AP) to Progress of inflammation in a experimental model of inflammatory response.

Materials and Methods: In this study were used, 48 Out bred rat race, all female Sprague Dawely about 200-150 gr Weight and ages 6 to 8 weeks to induce inflammatory response experiment By bovine Serum albumin (BSA) + adjuvant complete Freund (CFA). Rats were in six groups of 8 each, including: Normal group, patient group, groups of Treatment-1,Treatment-2 , Prevention-1 and Prevention-2. drug 4-AP at different concentrations (400 and 800 micrograms) to groups of Treatment-1, 2 and Prevention-1, 2 rate (0 / 1 microliter) were injected and 48 to 72 hours after injection dosage reminder (only BSA) studied and were compared severity of inflammation.

Results: 48 Rats that were studied, eight rats (66/16%), no inflammatory signs, histopathology and production of antibody anti-BSA did not show and this same group were normal. 8 rats (66/16%) clear signs of severe inflammation showed that were our patient group.32 rats (66/66%), showed less severe signs of inflammation than patients that were the same groups of Treatment-1, 2 and Prevention-1, 2 that they had been received different concentrations of 4-AP.

Discussion and Conclusion: The difference in the severity of inflammation and diffuse infiltration of inflammatory cells in Evaluation clinical, radiology, histopathology and rate of antibody anti- BSA shows that the drug 4-AP reduces the severity of inflammation in the Groups receiving medication than normal and the patient group (p <0.05). Although statistical analysis showed 4-AP Has no effect on production rate of MMPs. The groups of rats had received high concentration the drug (Prevention2 and Treatment2) than groups that low concentration of the drug (Prevention-1 and Treatment-1) showed lower signs of inflammatory.

Background and Aim: Today, psychological diseases like so many diseases, have an old history. Clinical Information System of psychological diseases resulting from war is a part of the information management system of mental illnesses, due to the management of mental patients from the war. This study is aimed to compare information management of psychological diseases in American, Australia and England with Iran.

Methods and Materials: This research is a study. At first, the existing situation was studied in three Psychiatric Centers in Ahvaz and Tehran with the use of a cheek list. Then information system of psychological disease has been studied in elected countries and based on the need of our own country, proposing practical solutions for Iran.

Results: The results of this study showed that there was no a information system of psychological disease in Iran. Also, four factors of this system including (goals, content structure, informational elements, information registration criteria) are reviewed in four selective countries.

Discussion and Conclusion: The design and implementation of this system in psychiatric centers is recommended to set two main goals including quality control and cost control in Iran.

Background and Aim: Evaluation for STIs requires speculum examination. It is sometimes uncomfortable and rejected by many patients. Speculum examination often is impractical or not available in remote areas. Recently, it is possible to omit the speculum examination and noninvasively diagnose for Chlamydia and gonorrheal infections from urine sample. This comparison study was conducted by collected vaginal specimens directly without performing a speculum examination for the diagnosis of trichomonas infections.The aim of this study was comparison of two methods of vaginal discharge collection with and without speculum examination for diagnosis of the trichomonas infection.

Materials and Methods: We examined 100 patients with vaginal discharge to the gynecology clinic of the Taleghani hospital. Two vaginal swab were collected from vaginal discharge of patients before and during speculum examination for diagnosis of trichomoniasis. Both of vaginal specimens were tested with blinded microscopic. Compared collection methods sensitivities, specificity, positive predictive value, negative predictive value and accuracy of both methods was compared.

Results: Sensitivities, specificity, positive predictive value, negative predictive value and accuracy of speculum collection methods were 69%, 99%, 92% ,94% and 93% for trichomoniasis respectively. Sensitivities, specificity, positive predictive value, negative predictive value and accuracy of nonspeculum collection methods were 62.5%, 99%, 91%, 93% and 92% for trichomoniasis respectively. The differences between methods was not statistically significant (P= NS). There was a very good agreement between both methods for diagnosis of trichomoniasis (KAPPA= o.85).

Conclusions: We have demonstrated the benefit of  nonspeculum vaginal specimens for the diagnosis of trichomoniasis. This technique has applicability for studies involving the epidemiology of vaginal infection as well as for home diagnostic testing ,elder and pregnant women respectively.

Background and Aim: Adverse events in hospitals are found to be a major problem of all health systems in the world. In fact, drug interaction side effects are now the fourth leading cause of death in the U.S. The aim of the current study was to identify the opinions of clinicians working in Shariati and Emam hospitals towards the use of computer applications for detecting drug-food interactions.

Materials and Methods: Ninety clinicians including physicians, pharmacists and nurses were selected randomly in the current descriptive- analytical study. The opinions of clinicians toward using computer application systems for detecting drug-food interactions were assessed by a questionnaire. The questionnaire's validity and repeatability was examined in a pilot study. Cronbach's alpha was 0.85 which indicated an acceptable level of repeatability of the questionnaire. The questionnaire was distributed among the academic staffs in order to determine its validity.

Results: 95.4% of clinicians had positive attitudes towards the requirement of computer application to detect drug-food interactions. Around 94% of them showed their willingness towards using the computer application systems. Therefore, use of computer application seems to be necessary in health system.

Conclusions: The collection and analysis of data encourages further investments in computerized system to prevent drug-food interaction. Such built-in warning systems in hospitals alert doctors to drug-food interaction and improvement in patient care. Screening each patient's medication plan for drug-food interactions can reduce medical error and improve the quality of health care

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: Today, one of the challenges of doctors is how they can access medical information as quick as possible. Personal Digital Assistants (PDAs) and Smartphones are such information technologies that can be used to access health information. This study aimed to review the most important uses of Personal Digital Assistants and Smartphones in medicine and in accessing health information.

Materials and Methods: The researchers searched Pubmed, Google Scholar and Scopus to collect relevant articles about the use of PDAs and Smartphones among healthcare professionals. In this search, such terms as Handheld Computer, Smartphone, Personal Digital Assistant, Mobile phone and their synonyms were considered.

Conclusion: With regard to the vast amount of information produced daily, PDAs and Smartphones are useful devices for physicians and medical students because they can easily get the most recent bits of information at the point of care, and improve their medical knowledge through these devices. Utilization of PDAs and Smartphones in Medical Centers will improve the efficiency and quality of health services.

Background and Aim: Identification of entrepreneurial opportunities in the field of nutrition counseling is a central issue in employing nutrition consultants and meeting the needs of patients with chronic diseases better. To this end, the present survey has been conducted in order to analyze the supply and demand trends of diabetes nutrition counseling as a basic step toward identifying the entrepreneurial opportunities for nutrition consultants in Tehran.

Materials and Methods: To implement this descriptive-survey study, a questionnaire based on Likert scale was sent by email to 80 active professionals in the field of nutrition counseling services in Tehran, of whom 48 responded to its questions. Then, using SPSS11.5, the mean values of participants' responses were calculated and compared with one another.

Results: The findings obtained based on participants' responses revealed that the need for "nutritional counseling in the form of a treatment team" was mostly not met in different age, education and income groups of diabetic patients

Conclusion: "Nutrition counseling in the form of a treatment team" can be considered as a suitable field for entrepreneurial activities.

Background and Aim: Organizations have to establish modern management systems to progress and to obtain maturity. One of the techniques which started in Europe in the last two decades and is considered in management area of country during recent years is the model of organizational promotion (EFQM). The purpose of this study was Performance Evaluation of Rajaei Hospital Based on «EFQM» Organizational Excellence Model.

Materials and Methods: This cross-sectional study was conducted in year 2010 in Qazvin Rajai Hospital. Data collection tool, was EFQM organization Excellence Model questionnaire which was completed by all the managers. Validity and reliability of questionnaire was calculated. Results were analyzed using descriptive statistics.

Results: Results indicated that this hospital has acquired 99.183 scores out of 500 in enablers factor(88.36 percent of optimum score). Also has gained 183.71 scores out of 500 (36/75 percent of optimum score). Overall, this hospital has obtained 366.7 scores out of 1000 as the total score in the model for performance evaluation in year 2010.

Conclusion: Findings indicated that based on Excellence model criteria, this hospital is in a moderate level. Applying this model for Iranian hospitals which often meet serious problems in this area is informative and practical. Strong systematic view, paying attention to organizational process-based management and being result-oriented are advantageous of using this model.

Background and Aim: Cardiovascular diseases are the main cause of death and disabilities in the world. The purpose of the present study is to determine the perceived barriers and benefits of adopting health-promoting behaviors among individuals at risk of cardiovascular diseases referring to TUMS Teaching Hospitals in 2011.

Materials and Methods: This is a cross-sectional study in which 325 patients at risk of cardiovascular diseases were randomly selected. The data were collected using a self-made questionnaire having three parts: 14 items for demographic and health-related variables, 12 items for perceived barriers, and another 12 items for benefits. For data analysis, SPSS 18 was used.

Results: The mean age of patients was 53.56±11.27 about 47.7% of patients(n=155) were female and 52.3% (n=170) were male. There was a meaningful relationship between the mean of perceived benefits on the one hand and occupation, physical activity, type and frequency of physical activity, smoking and awareness of cardiovascular diseases on the other(p0.001). Moreover, the mean of perceived barriers showed a meaningful relationship with occupation, smoking and awareness of cardiovascular diseases(p0.05).

Conclusion: The findings of the present study revealed that demographic and health-related variables could affect the perception of barriers and benefits of adopting certain behaviors for the prevention of cardiovascular diseases. Therefore, using interventional and educational approaches appropriate for target group features can help us take effective steps towards health promotion.

Background and Aim: Nowadays, because of the intense competition between nutrition consultants and rapid changes in patients' demands for nutrition counseling, application of the concepts such as "Entrepreneurial Opportunities Recognition" in this field seems unavoidable. One of the most commonly used methods for recognition of entrepreneurial opportunities is "Strategic Analysis of External Environment". Present survey has been conducted in order to study the impact of nutrition consultants' educational level on their strategic analysis about entrepreneurial opportunities.

Materials and Methods: This analytical survey was implemented based on the data (nutrition consultants' educational levels and their responses regarding the supply and demand for nutrition counseling services) which was collected during a previous study entitled ((Analysis of supply and demand trends in the field of diabetes nutrition counseling: A basic step towards identifying the entrepreneurial opportunities for nutrition consultants)). Also, ((Spearman's correlation test)) and ((GLM multivariate test)) were performed for the analysis of aforementioned data.

Results: Both statistical tests showed that nutrition consultants' educational levels (including 1- Bachelor of Science and 2- Master of Science and PhD) had significant relationship with two-thirds of their comments.

Conclusion: Nutrition consultants' educational level has a relative impact on their strategic analysis about the entrepreneurial opportunities.

Background and Aim: Regarding the importance of communicators' presence in health programs and the fact that in recent years, we have witnessed a decrease in their cooperation or a cut in their relationship with the headquarters. This qualitative study was performed to clarify communicators and instructors' administrative-recreational experiences in breaking off with the headquarters.

Materials and Methods: This qualitative study was carried out on 60 healthcare communicators, 20 ex- communicators and 35 instructors selected through purposive sampling. The data were collected using focus discussion groups and semi-structured interviews with the participants. For data analysis, qualitative content analysis was employed.

Results: The findings of data analysis revealed two main levels: recreational and administrative. The key themes of the former included medical facilities, gifts, employment, futurism and camp and of the latter consisted of credit resources, instructors' conditions, organizational posts and orientation.

Conclusion: Expressing what is expected from communicators when selecting them can play a significant role in keeping them up with their jobs. Holding meetings between authorities and communicators' representatives to discuss their problems and present solutions, holding reward ceremonies, preparing the grounds for attracting financial resources to support communicators' programs, appreciating them and enhancing the communicators and instructors' academic level, and creating organizational posts for instructors can be effective in maintaining their presence and enhancing health communicators' program.

Background and Aim: Financial reforms in the healthcare system go back to 1384. This study aims to analyze and summarize the most important strengths of implementing the first phase of the reform in units affiliated with the Ministry of Health and Medical Education from the experts' point of view at middle and operational levels.

Materials and Methods: In this qualitative research study, 15 coaches of the new financial health management reform along with 8 financial managers of Medical Universities were selected purposefully to participate in expert panels to be interviewed. Data were saturated following the interviews. The data analysis process was conducted applying Kruger method with one of the researchers having no conflicts of interest with the topic.

Results: Human resources enabling, effective trainings, integrated information system, dynamic culture, structural appropriateness, efficiency and effectiveness, and perfect facilities were the seven themes extracted from the content analysis of the interviews each theme was further divided into some sub-themes.

Conclusion: Recognition of the strengths of the first phase of health system's financial management reform may help bring about the possibility of more correct and exact planning to direct these changes and maintain the achievements as well as designing a long-term horizon and determining an ideal vision for the next phases of the reform.

 Background and Aim: Today, many families either have pets or work in animal husbandry units. It is very important to investigate the mental outcomes of animal care and also to study their keepers’ personality traits. This study aims to perform a comparative examination of owners’ mental health and character specifications or those of animal husbandry units’ personnel.

 Materials and Methods: In this descriptive study, about 500 people were selected through available sampling technique. They had contact with animals or worked in a husbandry unit in the suburbs of Tehran. After referring to the veterinary clinic of Tehran University, they were studied using a general health questionnaire and an international personality question bank. The collected data were analyzed using SPSS software as well as multivariate and follow-up tests.

Results: The results of the present study show that all general mental health sub-scales except for anxiety are different in these groups. However, no difference was observed regarding responsibility and extroversion. Meanwhile, the adaptability of dog owners was lower than that of sheep owners moreover, cattlemen were more irritable than sheep owners.

Conclusion : In sum, the mental health of pet owners of the present study is at a lower level compared to that of those in other countries. It seems that the difference is due to religious and cultural differences existing between the two.

 Background and Aim: Considering the information needs of users improves the quality of care . We aimed to Survey the Compliance Rate of Surgical Information Systems with The Information Needs of surgeons.

Materials and Methods: This was a descriptive and original study. Statistical Society consisted of two groups. First was the hospital information systems in hospitals of Tehran University of Medical Sciences and Shahid Beheshti were the first group. The Second group were 982 surgeons. Hospitals that had the highest number of surgeries were the research sample. Researcher gathered data in two steps. First by questionnaire and then checklist was used to collect the data by interviewing the technicians’ of systems . All data has been analyzed by descriptive analysis.

Results: In Rasul and Emam hospitals surgical information systems in scheduling section(50%) had highest conformity with surgeons needs. In flexibility section in all hospitals except of Shariati, they had 50% conformity with information needs of surgeons.

Conclusion: From surgeons view flexibility capability, scheduling and accessing data had highest priority although systems from display capability had not the conformity with the user needs. In designing the surgical information systems in future it is better to consider these capabilities.

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: Despite all inherent advantages of information technology in health sector, its implementation still faces many problems. One of the most important barriers is people’s resistance. This study was carried out to survey the factors affecting the acceptance of information technology by Health Information Management (HIM) staff of Tehran University of Medical Sciences (TUMS) hospitals based on Technology Acceptance Model (TAM) in 2011.

Materials and Methods: It is a descriptive-analytical survey. The population of the study consisted of the HIM staff (363 members) of TUMS hospitals. As the sample, 123 employees were selected. The data gathering tool was a questionnaire the validity and reliability of which were confirmed. The data were collected and analyzed by SPSS software, descriptive statistical methods and Spearman Test.

Results: The results showed that there was a positive direct relationship between perceived ease of use (PEOU) on the one hand and the staff’s attitude and their application of IT on the other hand (R=0.14, P= 0.05 R=0.36, P=0.05). Also, perceived usefulness (PU) had a significant direct effect on the staff’s attitude and their application of IT (R=0.22, P= 0.05 R=0.37, P=0.05).

Conclusion : Perceived ease of use (PEOU) and perceived usefulness (PU) are the factors affecting the acceptance of information technology by the HIM staff of TUMS hospitals. Therefore, it is suggested that the above two principles be considered when designing and implementing the IT systems.

Background and Aim: The Effectiveness and success of an organization depends on two factors one is the employees’ Performances and the other is the level of understanding between managers and employees in prioritize of different job motivators. The aim of this study was to determine factors that affect staffs’ performances in Qazvin teaching hospitals based on the Herzberg’s theory.

Materials and Methods: This research was a descriptive study. To achieve the main aim of this study, one hundred and ten employees were selected through a multi- stage sampling method .In this study, for data collection a self-report questionnaire was used. The five-point Likert scale was used to determine the degree of importance of any hygiene and multinational's factors affecting the performance of the employees.

Results: Among hygiene factors, the prevailing place was for Job security with an average 4/39 and then followed by a suitable salary with an average 4/38 of 5 scores. Among multinational's factors, job responsibility with an average 4/38 and job interest with an average 4/38 were placed as the most important factors in employees’ performance. %70/8 employees mentioned that two factors of suitable salary and job security are the most important obstacle for improvement of employee’s performance.

Conclusion : The data of this study reveals that, Attention and Planning in providing

 proper salary and job security as hygiene factors and sense of responsibility and success as motivational factors, may play a more effective role in improving employees’ performance than any other factors.