Journal of

Background: In recent years lots have been done for hospital automation but this non harmonized ac­tions leads to different software usage and entrance of different data into the system when partly is not useful . In this way, usage of soft wares in medical records specialty in the high loaded reception and recording will decrease defect in registration and storage of medical data. Using computerized system which cover applied soft wares could decrease many problems in medical data records. Any research in medical record area needs to be fed with data there fore it should be to use and evaluation of comput­erized systems. 

Method: This cross sectional study was conducted in reception and recording department teaching hospitals of Tehran University of Medical Sciences (TUMS), Iran, using check list and direct collection of the data in the hospital. We used descriptive statistics tools to analysis the data.

Results: Specialized hospital and general hospital use computerized system for medical record with percents of 49.06% and 40.73% respectively .search of the input data and output data were considered as 66.7%.

Conclusion: The usage of automation in reception and recording departments of TUMS hospitals was low and even the operating system was not capable to register the patients data. Even though a few humble of systems in medical records awards were set which would be the source of some problems is saving and processing the data.

Background: Study of the attitudes of health information management experts in health systems could be regarded in order to maximize utilization of information. The research reported here aimed to study of attitudes of medical records departments in Iran about mechanisms of development of health care system information technology.

Material and method: A cross- sectional research was developed by a questionnaire to study the atti­tudes of medical records departments of 17 universities by mail in Iran. 49 of them completed the questionnaire and returned it to us. Therefore the response rate was 70 percent. The data were saved by SPSS software and analyzed by statistical method.

Results: Faculty members of universities of medical sciences believe that the must hindrances of de­velopment of electronic health records in Iran are low budget and lack of standards.

Conclusion: Utilization of health information management experts attitudes could be assured the im­provement of health care information technology.

Background and Aim: Ever-increasing development of access to appropriate software and hardware for e-learning especially development of worldwide web has suggested new horizons for educational institutes. It is much important in medical sciences, because Medical Sciences deal with the health of human beings. Since beside issues related to education, research and information production, appropriate treatment of the patients is possible through having up to date and new information as well. For this reason Medical Sciences utilize information technology as soon as possible in order to prepare essential information for physicians quickly. This article discusses the role of e-learning in Medical Sciences universities.

Materials and Methods: in this literature review article, gathering information has been done by using paper and paperless documents related to the topic.

Results: For implementing of e-learning in Medical Sciences organization there should be some infra-structures, standards and skills which are to be noted prior to commencing e-learning. These     infra-structures, standards and skills play a special role in successful implementation of e-learning.

Conclusion: Regarding the advantages of e-learning naturally possesses, there is no doubt in necessity of developing Medical Sciences e-learning. But the ways of efficient access to this sort of education is much more important. So, it is recommended that by comparing the existing process in the world and using the experiences of prominent countries in this field, the most appropriate method be chosen and applied.

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:To assess of human force and population's programming at high level, is very important that we know rates and characteristics of population. Growth of population has direct relationship with fertility rate of women in community. To control of population and arrive to index of N.R.R.(Net reproduction rate) equal to one ,each family must be has one or tow children .Thus ,in families that they have more over tow children, we must be search about factors affected and attempt to reduce of population's growth , until arrive to a stationary population.

Materials and Methods: The cross-sectional study upon 500 women that are married and have 45 years old and more in Bushehr. Tow-stage random sampling was used in this study. First, Bushehr divided into 23 hypothesis blocks of 1000 households and thus, 20 points from each of blocks were selected by chance. Also, from each of 20 pointes, 25 families were selected by chance. In this study, a questionnaire was used for collecting of data, that questioners were asked of chief of households. The data was analyzed with SPSS package version 13. To find relationship between variables together and with response variable , was used kendall's tau test and chi-square for trend test. The multiple-logistic regression was used to find factors affected on parity progression ratios.

Results: In this study 181 persons(36.2%) of women had illiterate, 229 persons(45.8%) had primary education and 90 persons(18%) of them had high and more education .The age of the first marriage of 456 persons(91.2 %)  of women were under 25 years old and the age of the first pregnancy of 196(39.2 %) of them were under 20 years old. Probability of arrive to the first child in Bushehr was equal 0.98,and probability of arrive to second, thirst and fourth children was equal 0.92,0.81 and 0.72 respectively. This study shows that the factor like the age of the first marriage of women has a negative effect on PPR (parity progression ratio) from zero to one child, and the factors like the women's education and having a dead child have a positive effect on it. The results indicate that the factor like having a dead child has increasing effect on PPR from one to tow children, and the factors like the women's education, the age of the first pregnancy and marriage have a decreasing effect on it. In this research it is observed that having a dead child has a positive effect on PPR from tow to three children, and the factors like the age of the first pregnancy and marriage, education of women and their husbands have a negative effect on PPR from tow to three children. Also it is observed that sexually and having a dead child has increasing effect on PPR from three to four children, and the factors like, the women's education, job and education of husband , and the age of the first pregnancy of  women have decreasing effect on PPR from three to four children.

Conclusion: The results indicate that probability of arrive to third and fourth children are high. Thus it is show the controlling of family planning in Bushehr dose not good carry out within families belong lately decades.

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: Currently in most hospitals medical mission and medical  documents secession don't be notified  about any disciplines in the framework of documenting medical data and in parallel the document makers will be overshadowed by non-executing these principles qualitatively and quantitatively(1).

Materials and Methods: The above study is a sectional one that describes the situation of recording informational items in the surgical special sheets. In order to collect information collect information from considered sheets, it has been used of 1040 files of hospitalized because of surgery operation in the under study hospitals.

Results: The results of the study showed that 67.5% and 53.4% of informational items have not been recorded in nte sheets General and special hospitals. In the operation report sheet more informational items has been recorded in proportion to others which amounts to 59.9%. Informational items related to the tests in the pre operation care sheet, complementary information in the operation report sheets, and after surgery care and observed side-effects in the anesthesia sheet have the most non recording information.

Conclusion: The situation of recording informational items in the surgical special sheets in contrast to previous studied samples is not desirable. Regarding to the importance of these sheets and their position in relation to the information recorded in them, it is necessary to take needed measures to remove the factors that result in non recording the informational items.

Background and Aim: Sudden death in athletes commonly is due to unknown cardiovascular diseases. Therefore many protocols have designed for screening in the world. In the last years has been spent more attention to sport in elderly athletes and the number of their competitions have been increased. The aim of this study was evaluation of risk factor of cardiovascular diseases in Iranian elderly wrestlers.

Materials and Methods: All the members (60 athletes) of Iran team in Elderly Wrestling World Championship 2006 have taken census in the present study. At two sections the cardiovascular health state of them has evaluated: history taking and physical examination, electro­cardiography and exercise test. All date was analyzed by SPSS version 14 and mean and standard deviation for presenting findings.

Results: Sixty athletes aged 37 to 78 years (54.65±8.75) with history of exercise from 12 to 55 years (37.8±9.4) have been studied. In the history of 66.7% and in physical examination and history 75.1% athletes had at least one risk factor. Exercise test results of wrestlers were highly positive and positive in 8.6% and 5.2% respectively.

Conclusion: We suggest a perfect history taking and a complete physical examination for each athlete at the first step. If you found abnormalities then noninvasive diagnostic testes such as electrocardiography, exercise test and echocardiography will be useful and informative.

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.

Conflict management is a kind of management which could be administered the organization with the best ways and create balance between organization and staffs and  eliminates the conflict. Generally , conflict management is the process of conflict roles recognition between intergroups and intragroups and use of conflict techniques for eliminate or simulate conflict for organizational effectiveness.
This research is aimed to introduce conflict management and how to use its strategies to modify this phenomenon.
This research shows that organizational conflict have both instructive and destructive results. Managers should use conflict management in every organization. Most conflict management strategy used to control conflict is collaboration between managers and staffs. Conflict management has important role to make managers successful . Although, a minimum of conflict is appropriate in every organization but no managers agree with anarchism in his organization

Background and Aim: Fatal disease of cancer, ranks second after cardiovascular disease, as the most important causes of mortality in many developing countries, including Iran. Breast cancer is the most common disease among women. TPS is one of the tumor markers which has specially been considered due to its exclusive physiological characteristics like its easy measurement in serum of cancer patients.

Materials and Methods: This study has been set up to evaluate the efficiency of this tumor marker in the prognosis, treatment control and follow up of patients with Breast cancer. TPS has been measured with ELISA in 34 persons including 28 healthy people and 6 patients with breast cancer. Sampling has been done in three times depending on treatment methods.

Results: TPS has been measured  in samples which contend of 2 to 3 ml of serum from patients and the health.

Conclusion: The results has revealed that the serum TPS is not only as a measure of prognosis but also would be helpful in follow up and treatment control of the disease.

Conclusion: Serological analysis can be settled in the diagnosis and trend of cancer with production of polyclonal antibody against TPS gene family and planning appropriate pattern.

Background and Aim: Stroke is an important cause of morbidity and mortality in patients undergoing coronary artery bypass (CABG) surgery. There are various mechanisms that can cause prioperative strokes in patients undergoing CABG other than Carotid Artery disease. The goal of this study is to evaluate whether the presence of stenosis internal carotid artery (ICA) influences prioperative stroke and mortality rates in patients subjected to Coronary Artery Bypass Grafting. 

Materials and Methods: After institutional ethical committee review and approval, a retrospective review was undertaken of 1978 bypass procedures with saphenous vein graft performed over a period of four years is conducted. All those who had valve replacement or non-CABG procedure were excluded from this study. Carotid duplex ultrasonography scans were performed as part of preoperative evaluation of these patients. Ultrasound imaging measurement and velocity criteria were taken in to consideration in the estimation of degree of the carotid arteries. The stenosis of ICA was classified as non significant stenosis when there was<60% narrowing of the arterial lumen, and significant stenosis when there was 60%-99% narrowing of the arterial lumen.

Results: prioperative stroke rates were 0.8 %, 46.8% and 90%for groups A, B, and C, respectively. Group A results varied significantly from group's B (P=0.0001) and C (P=0.0001). Statistically significant difference was noted between groups B and C (p=0.0001    ). Prioperative mortality rates for groups A, B, and C, were 1.0 %, 16.7 % and 70 % respectively. The mortality rate for group A was lower than for groups B (P=0.0001) and C (P=0.0001).

Conclusion: The presence of an ICA occlusion increases the morbidity and mortality in patients undergoing CABG.

Background and Aim: Discontinuing aspirin use in patients before coronary artery bypass grafting (CABG) has focused on bleeding risks. The aim of this study was to determind the effect of aspirin use on overall mortality with this procedure.

Materials and Methods: In a retrospective review was under taken of 2,252 consecutive isolated coronary artery bypass grafting (CABG) procedures performed between July 1995 and May 3003 in Tehran, Shriati hospital. Patients who had isolated CABG operations and received aspirin were analyzed and compared to nonusers undergoing similar bypass procedures during the same period. Aspirin use was defined by identification of ingestion within 7 days before the operation.

Results: CABG patients using preoperative aspirin were less likely to experience in hospital hemorrhage compared to nonusers (P=0.0001). Significant difference was seen for transfusion of blood products, and need for reexploration for hemorrhage between patients who did and did not receive aspirin (P=0.0001).
Mortality in multivariate (odds ratio [OR] =0.12, 95%confidence interval [0.05, 0.28] analysis was less to patients using aspirin compared to nonusers (p=0.0001).

Conclusions : Preoperative aspirin use appears to be associated with a decreased risk of mortality in CABG patients with significant increase in hemorrhage, blood product requirements, or related morbidities.

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

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

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

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

Background and Aim: One of the main criteria in scientometric evaluation of the medical sciences universities is the number of published articles in the journals that have high Impact Factor (IF). The IF is an indicator to evaluate the journals. Many shortcomings of IF were revealed. This review aims to bring out the challenges of IF and the related solutions of them.

Materials and Methods: Required literatures for this review were collected by searching in related databases such as Web of Science (WOS), Scopus, Google Scholar, and also Google search engine as well as SIGMetrics Discussion Group. Determined search strategy limits search to exact phrase and synonyms. Results selected considering relevancy. The review covers the literatures published between 1972- 2007.

Results: We found at least 18 shortcomings of IF which reduce the efficacy of this indicator. In addition, they stated some solutions versus the shortcomings however, there is no suggested resolution for some of the shortcomings.

Conclusions: Considering the shortcoming of IF, however it could not be ignored because of its accessibility and ease of use. Solely, IF cannot solve the researchers' problem of qualified journal selection. Such solution needs awareness about IF challenges. Readers' judgments and journal clubs are valuable qualitative ways, which can help IF in the evaluation of journals.

Background and Aim: General Store department is responsible for on time preparing commodities for hospitals departments. It's a place for saving materials and resources. Safety in store department and its materials has importance due to preserving high quality and continuous services.
General Store department safety should be audited by assessment System to reduce waste materials and human resources such as building, commodities and patient and personnelُ s lives and in case of facing with a problem, try to solve it. The aim of this study was determination of safety standards in hospital general stores in TUMS.

Materials and Methods: This research was conducted as a cross-sectional study safety and usage of management principles was advised and measured in hospitals of TUMS sampling was nُ t performed.

Results: Safety rate in research population was more than 85/42 percent. Score in safety aspects like as physical spaces, preventing robbery, blazing materials appropriate storing, commodities arrangement, utilizing suitable tools was more than 80%. Protection against fire and storing rote able materials estimated 79% and 77%.
Safety rate in several aspects was assessed in the study hospitals.

Discussion and Conclusion: Although, hospital store rooms assessed as safe but they should try to develop fire protection systems and store rote able materials preservation appropriately.

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.

Backgrounds and Aim: Self-care behaviors are an important aspect of Heart Failure (HF), management, Educating self-care behaviors to HF patients have to be a part of routine management of HF in hospitals and health care Centers. The aim of this study was to determine the impact of an educational intervention on self-care behaviors and its perceived benefits and barriers in patients with HF in Tehran.

Materials and Methods: This is was an interventional study. A Simple sampling was conducted on 180 outpatients (90 intervention group and 90 control group) with HF referring to Shaheed Rajaee Heart Hospital in Tehran to participate in this study. Before and 2 months after implementing the educational program through group discussion, face to face interview, educational movies and pamphlets, a self-prepared questionnaire was completed by the participants. Validity and reliability of the scales were approved. SPSS software was used for the purpose of data entry, manipulation, and analysis.

Results: After implementing the educational program, patients' self-care (74.5%) and perceived benefits (19.35%) were significantly increased (P<0.0001) and their perceived barriers (27.76%) were significantly decreased (P<0.0001). After intervention there was no significant difference in these variables in control group.

Discussion and Conclusion: In order to design effective educational programs, healthcare professionals and nurses should better understand self-care behaviors in HF patients and their determinants and develop educational interventions. Promoting perceived benefits and barriers of these behaviors are priorities of the program. Healthcare professionals and nurses applying such educational programs can have a more effective role in promoting self-care behaviors and consequently quality of life of HF patients.

Background and Aim: Occupational diseases are certain types of diseases that have been caused by special jobs and subject to special circumstances. There are several factors that can intensify these diseases. Various countries have indicated that they have played an effective role in decreasing exposures and its economic costs and attracting optimal resources through establishment of a comprehensive information system for occupational diseases with a appropriate structure. Health improvement is considered as the first aim of the health system which requires a comprehensive, complete and integrated information system on occupational disease.

Materials and Methods: This is a descriptive Comparative study which was conducted in 2008 during which information systems in countries such as US, Finland, France and Iran have been studied based on their objectives and structures. Main instrument of this research was articles, books, magazines, valid internet sites in English language. Then, the gathered data were classified and analyzed.

Results: All the three selected countries had an electronic information system and database in the field of occupational disease. In Finland, data of occupational diseases as well as their damages are kept in separate databases while US lacks a comprehensive system. There are countless systems in these countries in this field. In France, supervision on laboratories is a priority. In Iran, there is no certain comprehensive system for registering diseases.

Discussion and Conclusion: All of these countries have the same objectives. Structure of occupational diseases information system, in Finland, is more comprehensive. Iran lacks such a system, so it is recommended to make use of the experiences of other countries and establish electronic comprehensive disease system in this country.