Shiraz Emedical Journal
Volume:14 Issue: 4, Oct 2013

Beside the structural and managerial reforms in health system, high considerations are devoted to the financial arrangements. Reforming financial arrangements of health systems, method of payment to health services providers has always been one of the most important issues.. In this article we have studied the experience of using a novel payment method in “Family Physician Program” in Iran.. We have reviewed the official documents of Ministry of health and medical education and the “Medical Services Insurance Organization” of Iran as data sources.. Payment method that used for family physician program in Iran is a mixed payment method in which capitation fee, fixed monthly salary, deductibles, franchises, performance based payments, and even bounces (as an incentive payment) are used simultaneously.. Mixed Payment Method has the potential of using the benefits of each payment methods, and minimizing their defects. It also has the risk of encountering the defects of all payment mechanisms..

The public health impact of parasitic infection has been consistently underestimated in the past, but there is now a general consensus that diseases caused by intestinal parasites represent an important public health problem, especially children. Recent studies suggest that even moderate intensity of infection may have adverse effects on growth, iron deficiency anemia and cognitive function, practically for children of school age.. Aim of the present study was to determine the intestinal parasitic infection in school going children.. The stool samples were collected from different municipal school in and around Amalapuram according to the standard procedures between June 2006 to August 2006. All the stool samples were examined by the direct microscopic examination and by the formalin-ether concentration methods. Analysis of the data was carried out by using Epi info software.. A total 208 stool specimen were collected. The mean age group was 8.8 ± 2.11. 133 (63.9%) were infected with one or more intestinal parasites. 95 (71.4%) of the students were infected with single parasite, 38 (28.6%) with two or more parasites. The most common was Entamoeba histolytica (E.histolytica) with 41 (30.8%) single and 26 (19.54%) with multiple infections. The second most common was Giardia intestinalis (G.intestinalis) with 25 (18.8%) single and 25 (18.8%) with multiple infections. The third one was Entamoeba coli (E.coli) with 15 (11.3%) single and 17 (12.78%) with multiple infections. E.histolytica and G.intestinalis were the most commonly found parasite in multiple infections. 1.5% of Ascaris lumbricoides, 5.3% Hookworm, 0.8% Enterobius vermicularis and 0.8% of Trichuris trichuria were found in the stool sample.. Intestinal parasitic infection is an important public health problem in Andhra Pradesh, India. Rural residence, mother education less than primary school and no hand wash with soap after toilets were the significant risk factors. Interventions including health education on personal hygiene, appropriate water management like boiling and use of latrines to the school children and to the parents..

Epithelioid hemangioendothelioma (EHE) of the liver is a rare vascular tumor. We introduce a case with EHE of the liver who is presented with lungs symptoms.. A 45-year-old man who was a known case of lung chemical injury due to exposure to mustard gas presented with a 2-year history of non-productive cough. He denied any gasterointestinal (GI) symptoms such as pain, diarrhea, constipation, bleeding, vomiting and nausea.. Imaging study revealed a large lobular mass in liver along with lung metastasis. Pathology test result confirmed an epithelioid hemangioendothelioma of the liver..

The doubt in re-allocating some of current resources from holding communication skills workshops to others, we conducted this study to answer: What and how were the communication skills of residents in medical faculty? Were any changes needed to be done in educational system?. The aim of this study was to find out that, what and how were the communication skills of residents in medical faculty? Were any changes needed to be done in educational system?. We designed one OSCE station with a standard patient to evaluate 53 Internal medicine residents'' communication skills in 2010. We had videotaping with an undercover cam inside a monken to record the residents'' interview with SP, by written permission of exam directors. We carefully and repeatedly reviewed the videotapes, analyzed the researcher made validated questionnaires'' data using SPSS.16.We also gave detailed feed back to the residents.. The mean of Residents’ total score with a normal distribution was 23.62 ± 2.46. Independent- samples T-test [sig. (2-tailed: 0.441)] and Test statistics of Kruskal Wallis test (sig: 0.314) indicated none- significant difference in residents’ total score in different gender and ages. Post Hoc comparisons by using the method of Tukey HSD in One- Way ANOVA indicated that educational impacts of communication skills workshops are not lasting for up to one year.. This study makes suggestions to address and overcome the still existing problem of residents’ poor communication skills..

Accurate blood pressure measurement has more importance in diagnosis, assessment of cardiovascular risk and efficacy of antihypertensive agents in hypertensive patients.. Present study was designed for sphygmomanometers accuracy assessment in two study hospitals.. During the present cross sectional study, accuracy of 63 sphygmomanometers from two study hospitals was evaluated. Sphygmomanometer evaluation was performed according researcher prepared check list contains most of possible physical and functional defects. Accuracy detection in randomly selected sphygmomanometers was performed by comparison with one standard mercury sphygmomanometer. More than three mmhg pressure differences in two points or more than ten mmhg pressure difference in one point were considered as inaccurate sphygmomanometer.. Among sphygmomanometers, 25 (39.6%) devices had excluded due to physical defects. Air leak (15.9%) was most cause of sphygmomanometers exclusion from the study. According study accuracy determination method, among 38 sphygmomanometers, 21 (55.27%) devices were inaccurate and 17 (44.82%) devices were accurate. All of three mercury sphygmomanometers were accurate. Mean of errors in included sphygmomanometers was 4.98 mmhg and 34.2% of included sphygmomanometers in one point accuracy determination had more than 10 mmhg differences with standard sphygmomanometer.. Current devices in our health care centers were inaccurate in most cases and might report wrong number as patients’ blood pressure..

Toxoplasmosis can cause serious complications among persons with weakened immune systems and therefore in solid organ transplant patients.. The aim of the study was to evaluate the value of screening for toxoplasma antibody titers in the donors and recipients candidate for renal transplantation in Ahvaz city, Iran.. In a cross sectional study from March 2010 to April 2012, we evaluated donors and recipients who referred to our kidney transplant center in Naft Hospital, Ahwaz, Iran.Routine pre transplante laboratory testes including liver function and toxoplasma IgG and IgM antibody were performed.. A total of 52 people, 30 donors (20 male and 10 Female) and 22 recipients (12 male and 10 female) were included in the study. Mean age of donors and recipients were 30.32 ± 6.75 years and 45.09 ± 10.57 years respectively. The marker of HBV and HCV infection were negative in 100% of recipients and donors. Toxoplasma IgG antibody was positive in 45.45 percent of recipients (N = 10) and 63.33 percent of donors (N = 19) but there was no statistically significant difference between them (P = 0. 057) and between males and females (P = 0.74). Toxoplasma IgM antibody was negative in 100 percent of recipients (N = 22) and 93.33 percent of donors (N = 28).. According to seropositivity for toxoplasma infection in about half of donors and recipients candidate for kidney transplantation, we should perform screening for this infection to avoid kidney donation from seropositive donor to seronegative recipient..

Since the isolation and characterization of the adenomatous polyposis coli (APC) gene in 1991, none of the currently available techniques were able to detect 100% of the germline mutations. In the present study we have used Heteroduplex Analysis (HA) and followed by DNA sequencing to test in an exhaustive analysis of entire APC coding region in a group of 26 unrelated Khorasanies patients with familial adenomatous polyposis (FAP). Sixtheen causative mutations (61.5%) were detected. This study shows that HA is less sensitive for single base pair substitutions, whereas mutations related to insertions or deletions are easier to detect by the HA method. Since more than 70% of APC mutations are small deletion (66%) or small insertions (6%), therefore HA is particularly suitable for the APC mutation detection..