Journal of

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: 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: The major tasks of libraries is collecting information resources in appropriate shapes for clients needs and organize resources for making them available. This study has been done to review this status in school and hospital libraries of Tehran University of Medical Sciences.

Materials and Methods: This is survey descriptive research. Method statistical population consisted of all college and hospital libraries of Tehran University of Medical Sciences. Intrument data collection was a questionnaire that its resiability and validity was measured Setting tables and getting percentages is performed as the Average measures in Excel spss version 12 programes.

Results: The highest rate of bachelores and masteres in libraries organized sector (more than 62 percent) belong to the libraries professionals. Staffes of 7 libraries (32 percent)are familiar with abstract and indexing services and staff is of more than 45 percent of libraries (more than 10 libraries) are familiar with a variety of subject headings and thesauri .

Conclusion: Low percentage of the average organization also show little attention in organizing some non-book materials. Low percentage of librarians orientation with abstracting and indexing services and also thesauri (45%) are the reason for this little attention.

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: Hospital's traditional charter that mostly emphasized productivity has been replaced by a charter that stresses social and environmental issues. On this basis, to achieve success, managers should regard both the inner and the outer environments of hospitals. This study aims at measuring hospitals' social responsibility.

Materials and Methods: The present descriptive-analytic study was carried out through a cross-sectional method in 2010. The study population consisted of hospital managers of the city of Isfahan (n=21). The data collection instrument was a researcher-made questionnaire. The instrument's content validity was determined by the experts' views and its reliability calculated through Cronbach's α was found to be 0.95. The collected data were analyzed using SPSS software (version 16) and the hypotheses were tested by t-test, ANOVA and Eta coefficients. The maximum mean score was 100.

Results: The mean score of hospitals' social responsibility was computed to be 68.6. The mean scores of leadership and inner processes, market place, community policies, environmental policies, and workplace policies were found to be 72.2, 70, 67.8, 67.4 and 66.2, respectively. There was no significant relationship between hospital's social responsibility and type of hospital's possession and activity (pvalue > 0.05).

Conclusion: The social responsibility of hospitals was assessed as moderate. To improve hospital's social responsibility, it is suggested that more attention be paid to workplace and environmental policie

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: Excessive Bleeding continues to play a key role and an important cause of morbidity and mortality after cardiopulmonary bypass (CPB). The goal of this study was to determine the differences in bleeding and transfusion between OPCAB and on -pump CABG patients.

Materials and Methods: In a randomized, double blinded prospective study 300 patient's undergoing coronary revascularization surgery were enrolled, 150 CABG patients were compared with 150 OPCAB patients. The patients were assessed during the first 72 hours to determine the postoperative side effects. The 2 groups were compared using the chi-square test or fisher's exact test and the rank sum test.

Results: CABG patients received more intraoperative red blood cells (P<0.0001), more albumin and more fresh- frozen plasma (P<0.0001). Postoperatively, CABG patients were more likely to receive more platelets (29.3% ν 70.7 %, P<0.007). During the operative and the initial 4-hour postoperative period OPCAB patients exhibited greater blood loss (P<0.0001) however, at 12,24and 72 hours postoperatively, CABG patients exhibited greater blood loss. There were4 death in CABG patients (P<0.05)

Conclusion: Despite not reversing the heparin at the end of the OPCAB surgery, OPCAB surgery was associated with an overall reduction in platelets, fresh- frozen plasma, Albumin and transfusion requirements.

Background and Aim: Malnutrition is one of the causative agents of death in children. So, this study was done for assessment of anthropometric indices of students and malnutrition status in Golpayegan, Iran.

Materials and Methods: This research was done as a descriptive - analytical (inferential) study. Sampling was done as clusters and multistage. In order to collect data, the standard questionnaire of anthropometric indicators standards (ANIS) pattern was used. Low and low height was used based on Z score. Collected data was analyzed by Epi-info and SPSS software.

Results: Of 1062 schoolboys, 550 were male and 512 were female. Anthropometric indicators including age (month), weight (kg) and height (Cm) showed significant differences (P < 0.05). The mean of malnutrition index was 5.4 % (WAZ<-2) and 3% (WAZ<-2) in our study.

Conclusion: The significant difference between prevalence of slimness, low weighting and low growth in rural and urban Schoolboys is an indicator of the undesirable situation in rural areas. Therefore, nutritional planning should be considered in rural children.

Background and Aim: Elderly is a physiological phenomenon with many inevitable complications, which their effects significantly can be reduced by individual's life style. Therefore in this study we have evaluated the impact of subjects' knowledge on their lifestyle.

Materials and Methods: This study was a semi experimental and interventional one that has been conducted in Urmia University of Medical Science. Thus 200 women between 54 to 80 years old were enrolled in this study and their knowledge, attitude and behavior toward a healthy lifestyle was surveyed before and 6 months after giving them a proper education. Subsequently the required information gathered from questionnaires and the data analyzed by mcmanaman paired and t paired tests. In this study all data analyzed by SPSS software and the P value lessu than 0.05 recognized to be statistically significant.

Results: The scores of before and 6 months after subjects get the required education were 29.165.86 vs. 34.266.32 respectively (P<0.001). This significant difference demonstrates the positive impact of life style education on attitude, behavior and knowledge of individuals in respect to their lifestyle. These results were even more magnificent comparing the literate and illiterate subjects.

Conclusion: Based on our study we conclude that education has an important positive role in all elder groups improving their lifestyle.

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: Bone sialoprotein (BSP) is a specific marker of osteoblastic differentiation. In this research, the effect of Zoledronic Acid on BSP expression and methylation status during osteoblastic differentiation of mesenchymal stem cells (MSCs) was evaluated.

Materials and Methods: In this experimental study, MSCs were isolated from human bone marrow. For osteogenic differentiation, hMSCs were pulse treated with zoledronic acid, and were incubated in osteogenic differentiation medium for 3 weeks. The DNA and RNA were extracted after the first, second and third weeks of culture and also from undifferentiated MSCs. After Sodium bisulfate (SBS) treatment, gene specific methylation analysis for BSP was carried out using Methylation Specific PCR technique.

Results: BSP expression was observed in osteoblastic differentiated cells whereas it was not seen in MSCs. MSP showed that BSP was unmethylated during osteoblastic differentiation.

Conclusion: BSP was expressed from the first week of differentiation. This confirms that zoledronic acid accelerates osteoblastic differentiation. Unmethylation status of BSP indicates that zoledronic acid does not have any effect on BSP methylation status. Other genetic or epigenetic mechanisms may control BSP expression during osteoblastic differentiation induction by zoledronic acid.

Background and Aim: Theses are considered as one of the sources for research in the field of education. The aim of this study was to determine the popular topics during 1349-1389 (1970-2010) and to examine the amount of educational interference and the type of such interference in different theses.

Materials and Methods: This research study was done using the descriptive-analytic method and employing the content analysis technique. The choice of topics was based on the categories derived from the Medical Headings of the American National Library. All related theses (336 in this field) were reviewed and the data were analyzed by SPSS software.

Results: In this review, most finished theses belonged to Tehran University of Medical Sciences (62.5%), Tarbiat Modares University (25.3%), and Iran University of Medical Sciences (12.2%). MSc theses were mainly about diseases (23.8%) however, doctoral dissertations were mostly about the prevention of diseases(26.2%).

Conclusion: Although in the recent decade, there has been an increase in new topics and educational interference in theses, some important issues like the training of patients are still neglected. It seems that some strategies like preparing a suitable information bank of thesis in the field of health education can be a good guide for selecting new topics and ignoring old ones.

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: Myocardial infarction (MI) is a major cause of morbidity and mortality worldwide. Epidemiological studies indicate that MI results from complex interactions between long-term environmental influences, concomitant disorders, and genetic susceptibility factors. Identification of genetic risk factors, particularly in premature MI, is very important. Since thrombosis plays a critical role in the pathophysiology of MI, recent studies focus on coagulation genetic polymorphisms. The critical role of platelets and their surface glycoproteins in the formation of occlusive thrombus leading to acute myocardial infarction is now well accepted. Platelets have two major receptors for collagen, glycoprotein I/IIa (integrin α2β1) and glycoprotein VI. In the present study, platelet GP VI T13254C polymorphism was chosen due to its potential association with altered platelet reactivity. The aim of the present study was to determine whether or not GP VI T13254C polymorphism was associated with premature acute myocardial infarction.

Materials and Methods: One hundred patients with premature acute myocardial infarction and 100 age-matched controls with normal coronary angiograms were studied. Genotyping was done using PCR followed by RFLP. Statistical analyses included chi-square, t-test and logistic regression model.

Results: The findings of the present study showed that the prevalence of T13254C polymorphism did not differ much between patient (38%) and control (33%) groups and that polymorphism was not associated with premature acute MI (P=0.46). Logistic regression analysis also indicated no association between this polymorphism and premature acute MI (P=0.20).

Conclusion: This study showed that there was no significant association between GP VI T13254C polymorphism and premature acute MI.

Background and Aim: Vaccination is one of the most important primary prevention and preventing the spread of infectious diseases. DTP3 is commonly used as a criteria for the availability of health services. The purpose of this study was determining vaccination coverage of DTP3 and factors influencing it.

Materials and Methods: One thounsed and four hundred fiftey eight children (12-24 month old) from 17th district of Tehran were enrolled in this cross sectional study. In this study, vaccination status of the DTP3 vaccination schedule according to the demographic variables was determined. Information was collected by a questionnaire referring to children's vaccination card. Sampling method was cluster sampling and included 146 clusters with 10 children in every cluster. Data collected were analyzed using spssv13 software and chi-square and t tests.

Results: In this study, 744 girls and 714 boys participated. 1241 patients, (85.1%) cases received their vaccines at the right time. 190 patients (13%) cases had not received the vaccine at the proper time, and 27 patients (1.9 %) were not vaccinated. Between vaccine status and mother's education (p=0.003), father's education (p=0.012), family income (p=0.003), number of children in the family (p=0.006), birth order (p=0.007), and status of family's medical record in the health center (active - inactive)(p=0.002), significant difference was observed.

Conclusion: Although vaccination coverage rate of DTP3 was 98%, more than 13% of cases, did not receive the vaccine at the right time and this constitutes to childhood illness. More research is needed to identify factors influencing no vaccination at the right time.

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: The hierarchical and bureaucratic form of governmental administration is changing into a new type of flexible and market-based public management called Enterpreneurial Management Revolution. According to Stevenson, entrepreneurial management comprises a number of opportunity-based management activities for the maintenance of organizations in order to have their contribution in social value creation. This research study aims to study the organizational performance of medical sciences universities of Tehran based on Stevenson Model.

Materials and Methods: This research is a field study in which a structured questionnaire containing 22 main questions on the Likert Scale was distributed among the staff members of medical sciences universities in Tehran. The validity of the questionnaire was confirmed by experts and its reliability was estimated using Test- Retest Method. The Cronbach alpha coefficient was found to be 0.95. The data collection device was given to 379 staff members, of whom 325 filled it out. The data were completely recorded and then analyzed by SPSS software version 18.

Results: The results of the study show that regarding entrepreneurial management approach, medical universities are at an average level.
According to the present research and all related studies, this is the case in all other governmental organizations.

Conclusion: The results of the study indicate that organizational restructuring, decentralization, and continuous improvement in processes are the milestones of entrepreneurial revolution strategies in medical universities and all other public organizations.

Background and Aim: Group B streptococcus(GBS)(Streptococcus agalactiae) is the leading cause of morbidity and mortality of the newborn infant and accounted as a factor leading septicemia after birth in mothers. Infections in infants are usually acquired by contact with the genital tract of the mother during labor and delivery. So a rapid screening test for group B streptococcus that could accurately identify pregnant women who are carrying the bacteria at the time of delivery would obviate the need for prenatal screening.The goal of this study was molecular epidemiology of group B beta Hemolytic Streptococcal(GBS) colonization in the vaginal flora of pregnant women.

Materials and Methods: Samples were taken from mucus of anal and vaginal of 250 pregnant women during 35-37 week's ingestion by swap. Samples were tested by standard culture using Todd Hewitt Broth and Blood Agar and also by PCR using cfb gene.

Results: Culture identified 21(8.4%) women as carriage of GBS from 250 women but PCR assay could identify 24(9/6%) women. In comparison to culture results, sensitivity, NPV Specificity PPV of PCR Were(100%, 100% and 97%, 82%) respectively. The times that used for PCR assay and culture were 2h and 36h respectively.

Conclusion: In conclusion, we found that group B streptococci can be detected rapidly and reliably by a PCR assay of combined vaginal and anal secretions from pregnant women at the time of delivery. Also this study shows that incidence of GBS is at high rate in Iranian pregnant woman, so we recommend screening of pregnant woman for detecting of GBS emphatically.

Background and Aim: Annually, large amounts of fees that paid by hospitals will not be reimbursed as deductions by health insurances and takes irreparable financial losses to hospitals. The purpose of this study was to determine the amount of deductions imposed on hospital bills of Tehran University of Medical Sciences and their causes related to documentation.

Materials and Methods: The present research was a cross-sectional and descriptive study performed in year 2009 on educational hospitals of Tehran University of Medical Sciences. All deductions reports related to Medical Services and Social Insurance related to year 2008 was collected from Income Unit of hospitals. The amount of deduction of each hospital was extracted and organized in the form of comparative tables. Data was analysed by descriptive statistics and Excel application. Then, the amount, type and causes of annually deduction of each hospital was determined.

Results: Most deductions imposed on inpatient bills have been related to the tests, appliances, medicine, residency, surgeon commission, and anesthesia and for outpatient bills have been related to visit, tests and medicine which most of them have been created due to documentation deficiencies.

Conclusion: Most of deductions are due to unfamiliarity of care staff with documentation requirements of insurance organizations. Therefore it is necessary to use a multi-aspect mechanism including education of documentation principles to staff, supervision on record control in the Medical Record Unit and establishment of a committee by university for related activities.

Background and Aim: The disabled people are a part of our society (1%) and a disabled will face incorrect behaviors from childhood that is caused by an incomplete understanding of the society, but family can play a constructive role to increase the disabled abilities.
This study was conducted to determine the views of deaf, blind and physical motor handicaps and their families regarding disability in the family in the Qazvin and Karaj.

Materials and Methods: One hundered and fifty handicaps and their families from handicaps center, welfare office, the disabled school students, the Mostazafan and Janbazan foundation were enrolled in this study. Information was collected by using 2 questionnaires. T test and Analyses Of Variance have been applied for data analysis, using SPSS software.

Results: The results show that among different disabilities, the deaf ones and their families had more positive view than other disabled ones about their disabilities.
Also, increasing the number of family members can cause more negative view about disability (p<0.05). This study shows that there isn't a significant relationship between the disabled view and his / her gender, cause of disability and parents high education

Conclusion: With regard to the similarity of the disables and their families views about disability and also their need to obtain more awareness about disability, the disable's needs and complications, it is necessary to stress on correct training of disabled person, his/ her family and the society.