فهرست مطالب منصور بابایی

Considering the wide range of services of the health system, proper training and distribution of human capital is highly important. It is worth mentioning that any imbalance in the distribution of human resources will result in a shortage or over-recruitment of medical staff. The purpose of this review article is to analyze the workload Indicator Staffing Need and determine the number of human capital required based on the standard of the World Health Organization.

This study is a Narrative review research. The statistical population includes available documents regarding the determination of the workload Indicator Staffing Need from January 2003 to April 2023. The sampling method was determined according to the documents related to the workload Indicator Staffing Need. The validity of the present study was implemented by searching in authoritative Persian and English-language scientific databases, including Google Scholar, IranMedex and Magiran, Scopus, and PubMed. Also, for reliability, a comparative study of documents was used. The search strategy included Human resource planning, Wisn, "Workload" and "Workload Indicator staff need" keywords and their Persian equivalent.

The classification and review of documents related to the subject of the study were examined in the three continents of Asia, Europe, and Africa. The findings indicated that the key success factor in the accurate estimation of the demand and supply of human resources in the health system is correct policy-making at headquarters levels and choosing a timely scientific-executive approach based on the precise definition of job processes. According to the documents and articles and comparison of common factors, and also concerning the World Health Organization Workload Indicator Staffing Need findings of the study were divided into 48 managerial components and 13 technical components, and then the data were.

Many medical sciences universities in Iran do not use a specific model and indicator to estimate the number and calculate the workload of their employees. It can be said that most universities of medical sciences, instead of using a systematic model, still use old and mental models to deal with high workload and estimate the required number of employees. So, it is highly important to pay attention to the implementation of the two-dimensional managerial-policy-making model at the level of senior managers and perform scientific-executive measures according to the conditions and organizational culture.

Diabetic macular edema (DME) is one of the common complications of diabetes which significantly accounts for preventable visual impairment and blindness. Central macular thickness (CMT) is a feature found in DME patients. This study aims to determine the relationship between optical coherence tomography (OCT)-measured CMT and visual acuity (VA) in patients with DME before and after intravitreal injection of bevacizumab.

This cross-sectional study was conducted on 100 patients with diabetic macular edema with involvement of both eyes referred to the Ophthalmology Department of Rouhani Hospital in Babol who underwent intravitreal injection of Bevacizumab. VA (measured by Snellen chart), CMT (measured by OCT), clinical and paraclinical factors (including the duration of diabetes, glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), hypertension, and smoking history data) were evaluated and compared among all patients just before and 45 days after Bevacizumab injection.

Before the injection of Bevacizumab in 200 eyes, the mean value of VA (letter score) and mean value of CMT (µm) were 36.83±12.73 and 425.48±85.18 µm, respectively (p<0.001, 95% CI=12.5 – 17.5 and 95% CI=-71.5 – -55.5, respectively). 45 days after Bevacizumab injection, the mean value of absolute VA changes was 15.24±10.16, and the mean value of absolute CMT changes was -67.83±43.08 µm (coefficient=-0.18, 95% CI=-0.39 – 0.05).

Although VA was correlated moderately with CMT and the polynomial regression model enhanced the predictive ability, it remains fully obvious that CMT and clinical factors could play an essential role as VA surrogates.

Due to their active and stressful life, military personnel needs special nutrition. Nutritional supplements are meant to complement a healthy diet that includes vitamins, minerals, medicinal plants, amino acids, enzymes, and macronutrients. The depletion of muscle and liver glycogen reserves leads to a decrease in concentration, fatigue, and a decrease in physical and mental performance. Moderate to vigorous physical activity, one to three hours per day, requires 6 to 10 grams of carbohydrates per kilogram of body weight. It has been shown that the consumption of fat, including a high dose of conjugated linoleic acid (CLA) and omega-3, is effective in testosterone production, an issue that can be important for active people such as military forces due to the anabolic effects of testosterone. In people with vigorous physical activity, it is recommended to receive 1.4 to 2 grams of protein per kilogram of body weight, which is higher than in general people. Also, branched-chain amino acids (BCAA) compete with tryptophan in crossing the blood-brain barrier, delaying the feeling of fatigue. Excessive amounts of antioxidants in the form of supplements in people with vigorous physical activity disrupt the adaptation to physical activity and are not recommended. Vitamin D, iron, and zinc are involved in many natural functions of the body, and due to the special conditions of the military forces, there is a possibility of a lack of these nutrients in these people. This deficiency can endanger a person's physical performance and even health. Therefore, special attention should be paid to their adequate intake in the diet. Caffeine, nitrate, and creatine are among the substances that are effective in delaying the feeling of fatigue and have attracted the attention of people with vigorous physical activity. These nutrients can help military personnel during operations and increase their efficiency. In general, getting enough nutrients is very important for military personnel. Due to the special conditions during military operations, it is not possible to receive meals that can provide all the necessary nutrients. On the other hand, due to vigorous physical activities, the rate of metabolism, as well as the loss of nutrients in these people, is more than in general people, which increases the amount of need. Therefore, in order for the military forces to be able to have their maximum efficiency and also to prevent injuries and diseases that can have great costs and consequences for a country, the use of nutritional supplements to improve the nutritional status of these people can be considered.

During the COVID-19 pandemic, the presence of ocular symptoms was common in COVID-19 patients, which can cause secondary complications in the treatment of ocular diseases. On the other hand, obesity can cause secondary symptoms in infectious diseases by impairing the function of the immune system, which indicates the relationship between involvement of different tissues and dysfunction of the cellular immune system. The aim of this study was to investigate the relationship between body indexes (i.e., age, height, weight, and BMI) and the presence of ocular symptoms in patients with COVID-19.

In this cross-sectional study (from March 2021 to May 2021), ocular symptoms (including blurred vision, epiphora, photophobia, discharge and exudate, redness, pain, and itching of the eyes) and body indexes (age, height, weight and BMI) were evaluated in 108 patients with COVID-19, who were referred to Ayatollah Rouhani hospital, Babol, Iran. The independent t-test and Kruskal-Wallis statistical tests were used to examine the data relationship in SPSS software.

The results showed that the mean body weight in COVID-19 patients with blurred vision was significantly higher than COVID-19 patients without blurred vision (P=0.003, t=-3.056). The mean height of COVID-19 patients with epiphora was significantly lower than the mean height of COVID-19 patients without epiphora (P=0.018, t=2.398). Also, the BMI of COVID-19 patients with epiphora was 30.00 ±4.07 kg/m2, while the BMI of COVID-19 patients without epiphora was 27.68±4.42 kg/m2 (P=0.047, t=0.026). In COVID-19 patients with at least one ocular symptom, height was significantly lower than heigh of COVID-19 patients without any ocular symptoms (P=0.001, t=3.397).

Our results indicate the essential role of obesity in the occurrence of eye symptoms in COVID-19 patients. In this study, it was found that blurred vision, epiphora and the presence of at least one eye symptom in COVID-19 patients were significantly associated with the upward trend of BMI (as an index of obesity).

Central serous retinopathy (CSR) is an idiopathic retinal disease that causes visual impairment and metamorphopsia. Due to the unknown etiology of CSR, the present study was conducted to investigate the role of metabolic disorders such as hyperlipidemia, diabetes, hypothyroidism, and hypertension (as a cardiovascular disease) in the treatment outcome of CSR patients.

This cross-sectional study was performed on 55 CSR patients whose problem was approved by ophthalmologic examinations in the Ophthalmology center of Ayatollah Rouhani Hospital, Babol, Iran. The patients were then treated with intravitreal injection of 1.25 mg/0.05 ml bevacizumab (Avastin®) 3 to 4 millimeters away from limbus under sterile conditions. Based on having and not having hypertension, diabetes, hypothyroidism and obesity, all patients underwent ophthalmological examination, including visual acuity (VA) and central macular thickness (CMT) by optical coherence tomography (OCT) before injection and one month after that.

The mean age of CSR patients (32 men and 23 women) was 42±11.50 years. After treatment, the CMT value in hypertensive patients (328.66±34.00 µm) was significantly higher than non-hypertensive patients (302.56±41.79) (p=0.025). The CMT value after treatment was considerably lower in non-diabetic patients (306.08±42.49 µm) compared to diabetic patients (336.77±17.42 µm) (p=0.039). Neither VA nor CMT was significantly different between hyperlipidemic patients and non-hyperlipidemic patients. In addition, there were no significant differences in VA and CMT between patients with hypothyroidism and without hypothyroidism.

The results of this study showed that hypertension and diabetes are important factors in CSR patients’ response to bevacizumab injection.

With the spread of coronavirus disease 2019, secondary ocular manifestations were observed as common complications in COVID-19 patients, which can challenge the diagnosis and treatment of ocular diseases. The aim of this study is to investigate the association between laboratory parameters and ocular diseases and to determine their specificity and sensitivity in the diagnosis of ocular diseases in COVID-19 patients admitted to the intensive care unit.

In this cross-sectional study, 89 patients with COVID-19 admitted to the intensive care unit of Ayatollah Rouhani Hospital in Babol were examined from December 2020 to February 2021. Clinical examinations were performed according to the global standards for ophthalmology examinations for patients, and patients were examined in terms of intraocular pressure, cup-to-disc ratio, ocular manifestations, and ocular diseases. Routine hematology and biochemical laboratory tests were performed for all patients. Patients were compared in the group with an ocular disease (manifestation) and the group without that ocular disease (manifestation).

Out of 89 patients with COVID-19 hospitalized in the intensive care unit, 44 women and 45 men participated in the study and the mean age of the patients was 58.5±14.64 years. The number of white blood cells was significantly lower in COVID-19 patients with pinguecula compared to non-pinguecula patients (p=0.026). Furthermore, the relative percentage of lymphocytes was significantly lower (p=0.003) in COVID-19 patients with cataract (9.64±13.20%) compared to non-cataract patients (14.25±17.95%). The relative percentage of neutrophils was higher in COVID-19 patients with cataract compared to non-cataract patients (p=0.01). RBC is significantly reduced in COVID-19 patients with chemosis (p=0.024). For the relative percentage of neutrophils greater than or equal to 82.55%, cataract for COVID-19 patients admitted to the intensive care unit with 0.83% sensitivity and 66.7% specificity is positive.

The results of the study showed that blood cells and some biochemical parameters are associated with ocular diseases in COVID-19 patients admitted to the intensive care unit.

Human resources are the most important resource in any organization. Therefore, it is very important to pay attention to the quality of their working life, since it covers a large part of the employees' lives. The aim of this study was to study the role of quality of work-life on staff performance in a military university.

This research is a quantitative research and is applied in terms of purpose. In terms of strategy, it is a descriptive survey and causal research. The statistical population included the staff of a military university in Tehran, 262 people were selected as a sample using the available sampling method. In the proposed model, the quality of work-life was considered as an effective variable that has 8 dimensions of fair and adequate payment, safe and healthy work environment, providing opportunities for growth and continuous security, legalism in the labor organization, social dependence of working life, general space Life, integration and cohesion in the organization was the development of human capabilities and also job performance was considered as an influential variable that had three dimensions of skill and knowledge, quality, responsibility. Variables were assessed using a questionnaire with three sections: demographic questions, quality of work-life questions and employee performance questions.

The research findings showed that fair payment with a coefficient of 0.81, provision of growth opportunity with a coefficient of 0.76, legalism with a coefficient of 0.74, development of human capability with a coefficient of 0.69, safe work environment with a coefficient of 64. 0, integration and cohesion with a coefficient of 0.6, social dependence with a coefficient of 0.59 and the overall living space with a coefficient of 0.57 affect the performance of employees.

Universities are the scientific driving force of the country in the national and international arenas and the dynamism and promotion of its staff can have positive results in the national arena. However, improving the performance of staff depends on the quality of their working life. The results of this study showed that fair payment, growth opportunity and legalism as dimensions of quality of working life have the greatest impact on employee performance, respectively, and more attention should be paid to them. The results also show a positive and significant relationship between other dimensions of quality of work-life and employee performance.

The medical equipment supply chain management is one of the main challenges for hospitals and medical centers. Meanwhile, military hospitals need more serious attention because of their critical position. The purpose of this study is to identify and prioritize the factors affecting the management of medical equipment supply chain in a military hospital in Tehran and finally evaluating the performance of the hospital in this regard.

At first, by examining previous researches and interviewing with some of staff and hospital managers, the influential factors in the management of the medical equipment supply chain were identified. in this regard, The MAXQDA 2020 software was used for this purpose. Then, effective methods were weighed using Fuzzy Analytic Hierarchy Process (AHP). Finally, the current performance of the hospital was assessed using a questionnaire.

Based on the findings, the factors affecting the supply chain of medical equipment supply were divided into 5 general categories. These 5 categories which found their weights obtained from fuzzy AHP, respectively: Resources and stakeholders, internal operations management, sustainability, integrity and information management. Also, the results of the performance evaluation showed that the current condition of the hospital is 43%, which is actually less than the acceptable level.

The importance of medical equipment supply chain management is not only due to its important role in the quality of treatment but also because of its major contribution to the hospitalchr('39')s operating budget. It should be noted that the factors affecting this issue are directly and indirectly related to each other. Finally, identifying weaknesses and proper planning to improve them can amend the condition of the hospital and ultimately enhance patient satisfaction.

Today, in universities and research institutes, the lack of attention to commercialization makes it impossible or difficult to enter the markets for technology and research products. therefore, this study aims to design a commercialization model for research achievements of a military research institute.

This descriptive-analytic study was done in a cross-sectional study in 2019. The research population consists of senior, middle and operational managers, faculty, experts and researchers in a military research institute. The sampling was done by census method and number of 130 people. The data gathering tool is a researcher-made questionnaire whose validity and reliability have been confirmed. The composite reliability for each of the four domains (individual, intra-organizational, external organizational and communication) was higher than 0.7, indicating appropriate homogeneity or internal consistency. To collect and analyze quantitative data, a structural equation model based on partial least squares approach was performed with Smart-PLS3 software.

The pattern of factors influencing the commercialization of academic research achievements was divided into four groups of 60 factors: individual intra-organizational, external organizational and communication. According to the research findings in the final model of the research, the correlation was significant for all dimensions and the communication factors had the lowest correlation (0.880) and intra-organizational (0.971) the highest correlation. To ensure the quality of the measurement model, positive values of the cv-com index represent the appropriate quality of the measurement model.

Governments and other effective institutions with formulas and facilitating and accelerating policies should move universities towards a model of knowledge-based commercialization by adopting smart measures. On the other hand, universities are pursuing strategies such as holding joint conferences and meetings with industry to increase the relevance and awareness of the partieschr('39') needs and capabilities in the path of commercialization.

Healthy diet has an important role in the success of military operations, so the commanders and all forces must understand the relationship between proper diet and the physical ability to perform physical activity. The aim of the current study is to evaluate the nutritional status of the military in order to provide strategies to improve the health status and increase the efficiency of individuals.

This study has been done on 89 navies in the cities of Bandar Abbas and Bandar Lengeh, south of Iran in 2019. Demographic information, IPAQ and FFQ168 questionnaires were used to collect data.

There were 89 navy men with an average age of 32.6 years. The average daily calorie intake was 2973 kcal. The average daily intake of milk and dairy products, vegetables, fruits, cereals and meats were 1.2, 3.15, 3.55, 1.2 and 1.6 units per day, respectively. The highest deficiency of the main groups of the pyramid was related to the dairy group (77.5%). In the evaluation of micronutrient status, deficiency of calcium (48.3%), vitamin A (83%), zinc (52.8%), omega 3 (46.1%) and vitamin C (33.7%) were reported.

This study showed that the navy in the field of food intake, especially in the consumption of dairy products and sources of calcium, vegetables, fruits, protein sources, omega 3 and energy intake needs to intervene to increase access and consumption of food items.

Clinical studies show the effect of vitamin D on muscle strength in athletes. In addition, vitamin D deficiency is more common in people with higher physical activity than in others. Therefore, it seems vitamin D supplementation in the military can improve their health and physical performance.

This study is a double-blind clinical trial was done in Isfahan, Iran in 2019. According to the inclusion and exclusion criteria, 100 militaries were randomly assigned to two groups of supplement and placebo groups (n=50). Demographic data and physical activity of militaries were collected by questionnaires. For all of the participants, measurements of height, weight, waist circumference, fat and muscle mass of the body were conducted. Sport tests of speed and time of fatigue were done. Data analysis was performed by SPSS software, version 18.0.

The two groups of intervention and placebo were matched in terms of age, serum vitamin D level and level of physical activity. The mean of serum vitamin D level in the intervention group at the end of the study was higher than the placebo group (p <0.05). There were no differences in anthropometric indices (weight, waist circumference and BMI) as well as body composition between the two groups receiving vitamin D and placebo at the end of the study (p <0.05). Fatigue time more increased in the vitamin D supplement group than in the control group (p <0.05) but no difference was seen in the 10 m speed test (p <0.05). 

The findings of this study show that vitamin D supplementation can increase fatigue time in military force, but it does not influence body composition and speed.

Investigating the dimensions and components of research management satisfaction can identify appropriate executive solutions for the qualitative and quantitative enhancement of research projects. The purpose of the present study was to provide an appropriate theoretical and practical framework for evaluating satisfaction with research management and its application for evaluating researcherschr('39') satisfaction in a selected military medical university.

The present study was an applied study in terms of purpose and was a mixed qualitative-quantitative study in terms of methodology. In the first step, the main dimensions and components of researcherschr('39') satisfaction with research management extracted using literature review and expert opinion survey. In the second step, a structured questionnaire designed and standardized to measure the satisfaction of researchers in each of these dimensions. Qualitative and quantitative methods were used to assess the content validity of the questionnaire. Cronbachchr('39')s alpha used to assess questionnaire reliability. Finally, the questionnaire distributed randomly among 150 researchers and faculty members of a military medical university. The relationship between satisfaction with demographic and occupational characteristics of the respondents evaluated by ANOVA at SPSS-16 software.

Six dimensions and 15 components were identified to measure satisfaction with the research management system. The main dimensions of measuring satisfaction with research management included research leadership, capacity building, creating hope, organizational communication, research organization, and resource allocation. The highest satisfaction was related to creating hope (2.71±0.82) and the least satisfaction was related to resource allocation (1.79±0.31). There was no statistically significant relationship between demographic and occupational variables of respondents and satisfaction with research management (P>0.05).

Given that the least satisfaction of the researchers were in two dimensions of resource allocation and capacity building, it is recommended that research managers pay more attention to equitable distribution of resources in addition to creating new resources and developing financial and non-financial research capacities simultaneously.

Healthy diet as one of the most important aspects of health has the main impact on physical and mental functioning of people under stress conditions. The aim of this study was to compare the intake of macronutrients and antioxidant compounds based on military stress.

105 military personnel aged 18 to 45 years in operational zones with different degrees of stress were enrolled in this study. Military personnel were allocated into two groups with high (n = 27) and low (n = 48) stress and the food intake of each group was compared. Dass21, IPAQ, FFQ 168 item and demographic data questionnaires were used to assess the subjects. Data were analyzed using SPSS software 20 version.

Both groups were match in terms of demographic data. The low stress group had significantly higher vitamin E, selenium, protein, total dairy and low fat dairy intake than the high stress group (p<0.05). The low stress group also had higher intakes of fruits, vegetables, energy, fat and meat than the high stress group. Fast food intake and biscuits were lower in the low stress group than in the high stress group, although these differences were not significant (p>0.05).

The study found that military people with low stress levels had higher levels of selenium, vitamin E, and vitamin C intakes than those with high levels of stress. Military people with low stress levels had a better dietary pattern.

Cataract refers to the opacity of the lens that impairs vision. Sailors are at risk for radiation sickness and trauma. The present study investigates the prevalence of cataracts and the factors affecting it in Iranian sailors.

This cross-sectional study was performed during 2017. The medical records of all Iranian sailors who went to the ophthalmology department and had a cataract were included in the census method. The researcher extracted the necessary data from the medical records of patients by visiting the ophthalmology department and registering it in the checklist. A checklist containing demographic (age, sex, education) and clinical data of patients was recorded. Data were analyzed using SPSS software version 16.

The total number of medical records of Iranian sailors was 2,500, of which 337 (13.48%) had cataracts or had a history of cataract surgery. The mean age, diabetes, medicine use, and head trauma were significantly higher in people with cataracts than others and their education level was significantly lower than others.

Considering that the sailors is one of the groups at risk for cataracts and a prevalence of 13.48% was reported in the present study, so periodic medical examination is necessary in this case.

Calcium and vitamin D are essential nutrients for the physical and mental health of the military. Soldiers and military personnel are always at risk for bone fractures, making them more likely to consume calcium and vitamin D sources such as milk and dairy products. The purpose of this study was to evaluate the consumption of milk and dairy products and the status of calcium and vitamin D intake in the Iranian Navy personnel.

This study was performed on 89 Navy personnel in Bandar Abbas city in 2018. After collecting demographic data, physical activity was recorded using a physical activity questionnaire and calcium and vitamin D intake were recorded with FFQ168. Data were analyzed using SPSS 20 software.

89 military men with a mean age of 32.6±5.1 years were assessed. The average sleep time was 7.2 hours per day. The average daily energy intake was 2973 kcal. The average intake of the dairy group was 1.2 units/day and the prevalence of calcium deficiency was 77.5%. On average, 20.2% of subjects had vitamin D deficiency and 79.8% of subjects had normal or higher vitamin D intake. Also for calcium, on average 48.3% had lower than standard and 51.7% had normal or high calcium intake.

Many of the Navy subjects had lower dairy and calcium intakes, but for vitamin D, most people showed a standard intake. However, for a more accurate judgment, it is advisable to measure serum vitamin D levels.