مجله سازمان نظام پزشکی جمهوری اسلامی ایران
سال سی و سوم شماره 4 (پیاپی 132، زمستان 1394)

Women and children form two-thirds of the country’s population and the health of mothers and children is effective in improving the health of the entire community. Using the experience of successful countries in the world in this field, can improve maternal and child health indicators in Iran.
The present study aimed to improve maternal and child health services management system with design a model from a comparative study conducted in selected developed countries
This is a comparative quantitative - qualitative study. Countries are selected by comparing maternal and child health indicators in the world with cluster sampling and then study of management system has done in them, so relevant aspects of the conceptual model and important variables identified. The initial questionnaire was developed and the experts confirmed it. Then final questionnaire was given to 185 experts and the obtained data using statistical method (factor analysis) were analyzed and the final pattern extracted.
A total of seven factors were found to be effective in the management of maternal and child health services, including support systems, human resource management, provision of equipment, support policies (state and local), systematic system of maternal care, referral and unified registration system and physical and financial resource management. Supporting government policies, support system and human resource management factors with a load factor of 0/9 and 0/29 have maximum and minimum impact on it.
In proposed model, the greatest impact is from supports system and the government’s support policies.

The main goal of the current research is to evaluate the drawing quality of 4 to 12 years old on the basis of Bender-Gestalt Test. Bender-Gestalt Test is aimed to evaluate visual-motor abilities in children and educational assessments.
The research is conducted in a descriptive framework. The sample included a total number of 707 normal children, aged 4-12 years old, who were selected among kindergartens and schools in Tehran using cluster sampling method. The data were analyzed through descriptive statistics, including frequency and percentile.
Results indicated that 76% of children who were 8 years old could draw the same as Figure A, 65% of children in age 6 were able to draw the same as Figure 1, 72% of children in age 9 were able to draw the same as Figure2, 85% of children in age 9 were able to draw the same as Figure 3, 62% of 8-year old children could to draw the same as Figure 4, 75% of children in age 9 were able to draw the same as Figure 5, 60% of children in age 8 were able to draw the same as Figure 6,7 and 8. 78.22% of all children in age 9 could draw all the cards entirely.
The finding of the research led to the observation of normal error pattern in children in order to obtain a visual standard for their lag or evolutionary progress. The findings are highly recommended for clinical and educational matters.

Grip strength is one of the important criteria in determining the physical fitness of all people, especially athletes. The purpose of this study was to compare the Hand-grip strength of young highly trained male athletes of different fields and the effect of some anthropometric indices on it.
This cross-sectional study was done on 78 athletes of four fields -wrestling, badminton, tennis, judo and 20 matched nonathletes (as control group). A questionnaire was used to record demographic data, also MIE Digital Pinch / Grip Analyser System was applied to evaluate hand grip strength, anthropometric indices( the forearm length and the upper third of the forearm circumference) was measured by cm tape. ANOVA and Tukey tests were used for statistical analysis and comparing the data of the groups. Pearson correlation coefficient was also calculated to determine the correlation between hand grip strength and anthropometric indices.
There was a significant difference between athletes and non-athletes in hand grip strength (P=( 0001/0 as well as wrestlers, tennis, badminton and judo players; The highest difference was between wrestlers and badminton players (P=0/0001 with the average difference= 13.65) and the lowest difference was observed between the control group and badminton players (P = 0/04 with the average difference= 5.10). Also, there were some correlations between the upper third of the forearm circumference and grip strength in the wrestlers, in the badminton players and the judo players (P = 0/03, P = 0/04, P = 0/0001, respectively).
The results of this study indicated significant differences between athletes and non-athletes as well as significant differences among wrestlers, tennis, badminton and judo players. In addition, there were some correlations between the forearm circumference and hand grip strength of wrestlers, badminton and judo players.

Helicobacter pylori infects 50–60% of the world population and is major cause of gastritis, duodenal (peptic) and gastric ulcers, gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue (MALT) lymphomas. H. pylori infection has a worldwide distribution and almost a third of the world’s population is infected. This study was conducted to determine the level of anti- H. pylori IgG, IgM in suspected patients of Salmas.
A total of 461 (ages 0-70 years) referred to the reference medical laboratories of Salmas city in 2013-2014 were studied. The blood samples were taken and anti-H.pylori antibody titers of IgM and IgG were determined by ELISA.
Out of 461 samples, 267 cases (58%) were women and 194(42%) were male, 320 cases had both of anti-Helicobacter (IgM and IgG), and 141cases were negative.
Strategies to improve sanitary facilities, educational status, and socioeconomic status should be implemented to minimize H. pylori infection.

Nausea and vomiting are among the wide-spread post-operative consequences. This condition may occurred up to 6 hours after the surgery causing discomfort in patients seriously accompanied by some consequences such as pain, water and electrolyte balance disorder as well as the pulmonary aspirations. In order to treat the Post-Operative nausea and vomiting (PONV), the antihistaminergic, anticholinergic and triple-spiral antidepressant drugs. In addition to the medication, some complementary treatments are also useful, e.g. ginger herbal which is one of the natural healings used for motion sickness, nausea, vomiting and dizziness.
The present research is of quasi-experimental-analytical blind one-tailed type in which the root of ginger plant was powdered by industrial grinder and filled in 500mg capsules (500mg iron capsules were discharged and filled with 500mg of ginger powder) and 2gr (1gr before and 1gr after operation) were given to the eligible patients. Then the nausea intensity and the number of vomiting of the patients were measured for a period of 6 hours after surgery; since then the results were compared in two control and model groups. In order to analyze the data, the descriptive statistical methods and t test were used.
The results revealed that use of ginger powder can meaningfully relief the post-operative nausea intensity and number of vomiting of the patients.

Upper gastrointestinal bleeding (UGIB) is usually a medical emergency which needs appropriate medical and endoscopic treatment. The incidence of this disorder is between 48 to 180 patients in each 100,000 adult per year in USA. Although medical and endoscopic treatment has been improved recently but the mortality rate of this disorder has not significantly changed, and the mortality rate is about 5%-10%.The prevalence of UGIB is growing regarding to increase in patients age and comorbid illnesses such as cardiovascular and renal disease. The other etiology is increase in use of drugs like NSAID and aspirin. Proper evaluation and treatment of patients with UGIB is necessary to improve the outcome of patients. In this study we review the initial approach and treatment of patients with overt UGIB.

One instance of errors in diagnosis which cannot be considered medical malpractice pertain to rare cases of VasculitisHenoch-Schonlein. The aim of this study was to shed light on the legal aspects of VasculitisHenoch-Schonlein by illuminating this disease, providing a comprehensive definition of what constitutes medical malpractice, and pointing out cases of errors in diagnosis resulting from the insufficient development of medical sciences. The disease: Henoch-Schonleinpurpura is a immunoglobulin Amediated non-autoimmunegranulomatosi self-limited multisystemic Vasculitis which affects small vessels. Symptoms used for the diagnosis of this clinical tetrad include non- thrombocytopenic palpable purpura, abdominal pain, arthritis, and kidney problems. In some cases, the symptoms of this disease manifest themselves a mere one or two days before the appearance of the rash, thus making diagnosis complicated.
Discussion and Failure to diagnosis the disease in patients suffering from severe abdominal pain prior to the appearance of rashes is a normal occurrence and in cases in which the area of the abdomen where it is most severe is not opened, even the doctor can be held accountable. Furthermore, plastering a patient’s limb, considering joint pain and movement limitations prior to the appearance of rashes, cannot be considered medical malpractice. In this study, it is argued that cases in which damage to the patient caused by the medical staff resulting from insufficient development of medical sciences and technology cannot be considered medical malpractice unless the doctor has failed to benefit from accessible and widely accepted scientific methods of diagnosis.