Journal of

Background and Aim: Hospitals should be able to satisfy their clients’ needs in less time and with best quality possible. Length of Stay (LOS) in hospitals is considered as a key performance indicator, especially in emergency departments. In this study, the analysis of LOS in emergency departments was performed so that some of the factors affecting patients’ length of stay could be found. 
Materials and Methods: This descriptive-analytical and cross-sectional study was performed in the emergency departments of two teaching hospitals of Tehran University of Medical Sciences (TUMS). Seventy-two patient samples were included. The patients’ length of stay in emergency ward was measured from the entrance time until the time they left the emergency department. Data on both descriptive (mean and standard deviation) and analytical statistics (one-way ANOVA, independent sample t-test and linear regression) were analyzed with SPSS software.
Results: Patients’ average LOS in emergency departments was estimated at around 3 hours and 13 minutes (SD=1.52). Such variables as patients’ marital status, days of the week (holidays or regular days) and admission time (day or night) were determined as the factors affecting LOS. 
Conclusion: The time spent to give services in hospital emergency rooms is at an appropriate level and items such as marital status, holidays of a week, and time of the day can be referred to as factors affecting patients’ length of stay. With regard to these findings, health managers can rely on the results for the effective planning and management of hospital emergency departments.

Background and Aim: Iron deficiency anemia is one of the most common nutritional problems of women in reproductive age, which has a major impact on fetal growth, low birthweight and premature delivery. This study aimed to assess the prevalence of anemia and related factors in pregnant women having referred to health centers of Mazandaran province.

Materials and Methods: In this descriptive-analytical study, 866 pregnant women were selected through stratified cluster sampling method from 19 cities, affiliated to Mazandaran University of Medical Sciences. Data was collected by using the registration form and information obtained through maternal family documents and a questionnaire. SPSS software version 18 was used and the data were analysed by descriptive and analytical statistics such as mean comparison test, chi-square and logistic regression. 
Results: The prevalence of anemia in Mazandaran was 13.4% and it was higher among pregnant women in urban areas than those in rural areas. Logistic regression showed that mother’s age, number of pregnancies, prenatal care, unwanted pregnancy, consumption of red meat, using iron tablets, tea drinking, and mother’s education level had a significant effect on anemia.
Conclusion: Since iron deficiency anemia is a preventable problem and pregnant women are among the vulnerable groups, considering care programs before and during pregnancy, having appropriate dietary patterns, consumption of iron supplements, and having a program to prevent unwanted pregnancies may lead to reducing the risk of catching a disease.

Background and Aim: Indexing a country's scientific journals in international citation databases can lead to the promotion of its academic status and its participation in global knowledge production. This study aimed to assess the conformity of Iranian English-language medical journals’ citations with the objective criteria of journals in the selected databases.
Materials and Methods: This was a descriptive, evaluative research. The study population included 52 Iranian English-language medical journals that are not indexed in Web of Science, PubMed and Scopus databases and 465 articles in these issues, and about 11235 citations to the articles. The data have been collected by a checklist. For data analysis, Excel software was used.
Results: Some 88.5 percent of journals had a style for writing references; a style that has been observed by most of them. The rate of self-citation was low. Only 2.9 percent of citations were done in the year this study was performed. Journals with 87.2 percent had received the highest number of citations. The old citation time and the imbalance in the types of cited resources were the most important reasons of the weakness of the studied journals and of their not being indexed in the mentioned databases. 
Conclusion: Providing valid styles for writing references and controlling the citations accurately should be put on the agenda of journals. The time of references must be newer, and there should be a relative balance in the types of referenced sources.  

Background and Aim: Conditions, advantages and limitations of professional ethics have not been discussed. The present study aimed to determine the framework, dimensions and requirements of professional ethics in selected countries in order to review their experiences.
Materials and Methods: The present study was comparatively conducted in 2017. Considering inclusion criteria in designing study including purposeful and specified activity in terms of professional ethics, five countries of United Kingdom, Malaysia, Japan, Turkey and United States of America achieved the conditions to enter the study. For data analysis, comparative tables were used which included dimensional comparison obtained from professional ethics development study in the selected countries. 
Results: Medical and nursing associations and headquarters units in Ministries of Health, prepare appropriate utilization of professional ethics principles. Using temporary or permanent and regular committees in line units, also includes other characteristics of attention to the professional ethics concept in the selected countries. In Malaysia and Japan, professional ethics is taught in different courses and majors. 
Conclusion: Applying professional ethics concept requires information transparency and factors such as education, organizational structure set up and their establishments and institutionalizing must should be discussed more and to be localized on the basis of the countries situations.

Background and Aim: In today’s world, antibiotic resistance is inevitable. This has been the case since the discovery of antibiotics. The aim of this research is to study serotyping and multiple antibiotic resistance pattern of Shigella sonnei isolated from diarrheal stool of patients hospitalized in Children’s Medical Center in Tehran.
Materials and Methods: In this descriptive study, 600  diarrheal  stool specimens were obtained from patients hospitalized  in Children’s Medical Center in Tehran over a period of twelve months. The stool samples were collected in Cary-Blair transport medium and transferred to the laboratory. The identification was carried out according to the standard cultivation method, and the antibiotic susceptibility test was performed by Kerry Bauer disk method according to with CLSI procedure.
Results: Out of 600 samples, only 18 (3%) were found to be contaminated with Shigella sonnei. The results of  antibiotic resistance patterns of these isolates showed that they were resistant to tetracycline; streptomycin, clindamycin and cortimoxazol. Furthermore, 66.67% of isolates had multiple resistance to tetracycline, cortimoxazol, streptomycin, ticarcillin and clindamycin antibiotics.
Conclusion: The results of this study showed that multiple resistance of Shigella sonnei to tested antibiotics is increasing. This  is alarming; necessary steps should be taken to prevent such a phenomenon.

Background and Aim: Thalassemia is a chronic disease which is extremely expensive, complex and debilitating. The management skill of thalassemia patients should be enhanced to minimize the risk of disease complications. The main purpose of this study was to develop personal electronic health records for thalassemia major patients.                                             

Materials and Methods: This is a developmental applied study which was conducted to develop a personal electronic health record for thalassemia major. First, a questionnaire was prepared to determine the data elements and was filled by Hematology and Oncology professionals in the country (110 persons). Then, based on the results of needs analysis, the system was designed using PHP programming language and MySQL database and was evaluated by 50 thalassemia patients who referred to the Thalassemia Clinic of Bu Ali Sina Hospital of Mazandaran University of Medical of Sciences during the second half of the month of Aban. Finally, a standard questionnaire of usability and user satisfaction assessment was distributed among them.   
Results: Usability evaluation of the system showed that patients evaluated the system at a good level with a mean rating of 7.91 (out of 9 points). 

Conclusion: The web-based systems can be used to help thalassemia patients to control injection and reduce the complications of the disease and to promote health. 

Background and Aim: Scientometric studies are one of the most effective methods of scientific evaluation in databases. The aim of this study was to investigate Breast cancer in Iran from 2000-2016.
Materials and Methods: This study has an applied approach and was conducted using scientometric indices. The st tistical population was the indexed articles related to Breast cancer between the years 2000 and 2016 by Iranian researchers at the Science Web site.
Results: During the period 2000-2016, researchers have published 2198 articles on Breast cancer that indicate a steady and steady increase in the number of studies conducted in this area. The results of the study showed that Qaderi is the most prolific researcher in the field of Breast cancer in terms of the number of articles in Iran, Ebrahimi and Montazeri are in the second and third positions respectively. The highest H-index belongs to Montazeri, Qaderi and Abraham, respectively. Researchers in the field of Breast cancer have collaborated with researchers from 65 countries and more with the United States and Canada. The most co-operation has been between researchers in Tehran and Tabriz. The analysis of the keywords used in Breast cancer research in the form of supragloss showed that Iran, Apoptosis and Polymorphism were the most frequent keywords in the studied works.
Conclusion: The upward trend in Breast cancer research indicates the growing importance of this area in Iran. Given the global growth of Breast cancer research and the importance of international research participation, Iranianresearchers should more and more engage in scientific collaboration with their counterparts abroad.

Background and Aim: In recent years, tuberculosis is a major cause of illness and mortality due to infectious diseases. In fact, one of the reasons for increasing the incidence of tuberculosis is that it is often associated with HIV infection. The present study aimed to design and establish a mobile-based self-care system for controlling tuberculosis.
Materials and Methods: The data required in this research for evaluating the information and designing the application were collected in two main steps: first, the data required in this research for information needs assessment and application design were collected by searching in library resources. A questionnaire was applied by physicians to validate and determine the significance of these elements.  Afterwards, based on information elements and the self-care, application was designed in the Android Studio environment.
Results: Information elements and functional capabilities required by the program were determined. Web-based services as a system interface, not only provided the communication between the patient and the care provider, also allowed for patient monitoring and disease control. Then evaluation of the performance and performance of the program was done by doctors and software experts. The findings showed user satisfaction with the application.
Conclusion: Monitoring of treatment electronically allows for less costly monitoring of the patient. In this study, we present a prototype of the relationship between self-care application and portal and its potential benefits, which will allow future studies to improve and add new capabilities.

Backgrounds and Aim: One of the effective strategies for targeting chemotherapy in the treatment of cancer is the use of lipid nano-carriers. In this study, an optimal formulation of niosomal drug containing doxorubicin has been developed to better fight cancer cells.
Material and Methods: Niosomal vesicles were prepared using phosphatidylcholine (22%), span60 (52/5%), cholesterol (22/5%) and DSPE-PEG2000 (5%) by thin-film method. Doxorubicin were loaded into the niosomes using inactive loading method. Their physico-chemical features were assayed using Zeta-Sizer, FTIR and SEM, and drug release amount was calculated at 37° C and 44° C. At the end, the toxicity of the nano drug carrier system was measured on the KG-1 cell line of the bone marrow cancer by MTT method.
Results: Niosomal vesicles containing Doxorubicin showed the size of 160.37±65.2 nm, 94.18% drug encapsulation efficiency  -58.11± 1.24 mV of zeta potential and polydispersity index (PDI) of 0.234±0.02 The prepared niosomal system presented drug controlled release and FTIR investigation showed almost no interaction between nano-carrier containing drug and the drug itself. As well, morphological examination of nano-carriers using SEM microscopy revealed that they have spherical structures. Also, cellular studies showed that drug toxicity was higher in encapsulated conditions compared to non-encapsulated conditions.
Conclusion:The results of this study, meanwhile confirming the proper physicochemical characteristics of the system and being Slow-release system indicate that this nano-carrier anionic increases the toxicity of the drug for the KG-1 cell line of the bone marrow, thus, this niosomal nano-carrier can be a suitable carrier for drug delivery to cancer cells.

Background and Aim: To provide effective care, health care providers need timely and appropriate information. Electronic records provide quick access and easy management of data. The aim of this study was to develop electronic health records for patients with hydatidiform mole and evaluation of completeness of medical records
Materials and Methods: This applied study was conducted in 2017. After verifying the minimum data set required for the system, data were extracted from patient records using a checklist and entered into SQL server. SQL server 2012 and Visual Studio 2013 to design electronic records and SPSS 20 for data analysis was used. Extent of data completion in patient records was also assesed.
Results: Data on the completion of paper records indicated that in 100% of cases, “address” item was filled in. The less completed data was related to carotene deficiency (%1.1). Our findings also showed that the eight most important items like age of first menstruation, first gestational age, interval between pregnancies, number of sexual partners, menstruation between pregnancies, contraceptive methods, social habits and radiotherapy, were not completed in all records.
Conclusion: Many of the important minimum data set for hydatidiform mole disease were either not completed or completed in limited numbers in paper records. By developing such health records, we can ensure better prevention and treatment, and regular follow-up for the patients and help them to save their time and costs.