جستجوی مقالات مرتبط با کلیدواژه "اهواز" در نشریات گروه "پزشکی"

Blastocystis hominis is one of the most common protozoa found in the intestines of humans and animals. However, its pathogenicity, diagnosis, and treatment remain a challenge. The purpose of the present study was to determine and evaluate the knowledge and practice of Ahvaz laboratory workers regarding Blastocystis hominis during the years 2018 to 2019.

The present a cross-sectional descriptive study was conducted on 464 laboratory employees working in private and public laboratories in Ahvaz, Iran, during the years 2018-2019. The present study used a questionnaire and face-to-face and electronic interviews to evaluate the level of knowledge and practice of the laboratory staff regarding the protozoan Blastocystis hominis. The collected data were analyzed using Kolmogorov-Smirnov statistical tests, t-test, independent t-test, one-way analysis of variance, Pearson's correlation coefficient, and Tukey's post hoc test.

Out of the 464 participants in the study, 22.8% answered the questions through face-to-face interviews, and 77.2% answered the questions electronically. The minimum and maximum number of participants were associates (10.3%) and experts (56.7%), respectively. 67% of the participants had more than 10 years of work experience. More than 85% were aware of the protozoan nature of Blastocystis hominis. Over 50% of the participants considered Blastocystis hominis as one of the causes of diarrhea and abdominal pain, but their awareness of other clinical symptoms such as hives was low (12.3%). The practice of about 93% of the participants in using the direct expansion method was acceptable as a suitable diagnostic method for Blastocystis hominis. The relationship between work experience and their practice regarding this protozoan was also significant (p=0.007).

The present study indicated that laboratory staffs had an acceptable level of knowledge about Blastocystis hominis, but their performance in dealing with this protozoan was not at an acceptable level. Despite having proper knowledge about this protozoan, it seems that it has not received the attention it deserves within the laboratory community, and it is not of special importance among the intestinal parasites that are routinely reported. Therefore, it is important to bring more focus on this parasite in the field of medicine, especially in the teaching of parasitology to students of various medical fields, as well as through scientific conferences and refresher courses. This would help ensure the adoption of correct diagnostic and treatment methods for Blastocystis hominis.

Hospital staff performance in management positions significantly affects cost-effectiveness, service productivity, and the hospital’s success. Evaluating management performance at different levels could identify their strengths and weaknesses and discover their training needs. The current study aims to evaluate the performance of hospital managers in Ahvaz, Iran.

In this cross-sectional study, which was conducted in 13 public (teaching and non-teaching) and private hospitals, 11 top managers and 162 middle and operational managers were selected using census and stratified sampling methods, respectively. The data was collected by a questionnaire. The questionnaire consisted of two sections: demographics and the study main variables (planning, decision making, organizing, coordinating, communicating, controlling, leadership and budgeting). The data were analyzed using the 23rd version of the SPSS software.

The mean and standard deviation of the planning, decision-making, organizing, coordinating, communicating, leadership, controlling, and budgeting were (3.91±0.75), (3.98± 0.64), (4.06±0.71), (4.05±0.67), (4.03±0.62), (4.00±0.74), (3.99±0.67), and (2.99±1.21) respectively. In general, the mean overall performance of Ahvaz hospital managers was 3.88 out of 5. The best reported were in organizing and coordinating, and the weakest were in planning and budgeting performance.

  In general, the self-reported performance of Ahvaz hospital managers was relatively good. However, more training, especially in planning and budgeting, is suggested.

Electronic prescribing has been implemented in many countries, with its first application in outpatient care. In Iran, electronic prescribing has been seriously implemented for two years now, and while it has been successful in some regions, it has also faced challenges. Identifying these challenges and determining their causes can not only help address the problems faced by physicians but also significantly contribute to the improvement of the electronic prescribing program. The present study aimed to investigate the challenges faced by physicians in electronic prescribing in Ahvaz County in 2024.

This qualitative study was conducted in Ahvaz County, Khuzestan Province, Iran, in 2024, with a population of physicians. Participants were 33 individuals selected using a purposive sampling method. Data collection methods included semi-structured interviews with physicians, field notes, and recording reminders based on the principle of data saturation.

The data analysis process yielded four main themes (inconsistencies in drug coding, lack of security in electronic prescription systems, lack of legal regulations and non-acceptance of electronic prescribing by physicians) and 11 categories (inconsistency of some codes, duplicate codes, differences in the type of registration of a drug, absence of some codes for some drugs, lack of coordination between insurers, factors related to insurance organizations, inconsistency of patient information) and 21 subcategories.

Physicians face numerous challenges due to various reasons, such as inconsistencies in insurance systems in drug coding, the use of different prescriptions by insurance organizations, the lack of integration between insurance and pharmacy systems, frequent internet outages, lack of coordination between pharmacies and physicians, excessive or incorrect drug dispensing by some pharmacies. Addressing these challenges can pave the way for the success of the electronic prescribing program in Ahvaz.

An increase in the use of oral and dental health services and routine examinations can lead to better health and improve health equity indicators. This study aimed to analyze the factors affecting the utilization of oral and dental health services in the households of Ahvaz in 2022.

The present study is a cross-sectional descriptive-analytical study in which 715 households including 2680 people living in the city of Ahvaz were studied by using the stratified-cluster sampling method. The collection of the required data was performed through a questionnaire, and the logistic model and Stata software were used to analyze the data and estimate the elasticity of the influencing factors.

According to the results of this study, the utilization rate of oral and dental health services is 80.55%, and the odd ratio of the utilization of these services is 0.26% less for women compared to men, which is a statistically significant result. People with tertiary education also have a 1.83 times higher chance compared to other people to receive the services, which is statistically significant. People with income but without work have a 0.29 lower chance of receiving these services compared with unemployed people, although this result is not significant. Furthermore, people who have private insurance have 5.84 times more chances to receive these services, and this result is completely significant. Also, the individuals who exercise less than 3 times a week have the chance of receiving these services by 1.25 times compared to people who do not exercise at all, which is a significant result.

Based on the results of this study, it can be mentioned that employment and household income status, increased insurance coverage, higher education level, and a healthy lifestyle, including engaging in physical exercise, increase the chance of benefiting from dental services.

Ticks, as external parasites, biological carriers and reservoirs of various diseases, play a role in the transmission of various disease agents to humans and animals. The aim of the present study was to identify hard ticks (Acari: Ixodidae) in the southern villages of Ahvaz-Khorramshahr road in southwest Iran.

In this descriptive cross-sectional study which was conducted in 5 selected southern villages of the Ahvaz-Khorramshahr road in the summer and autumn of 2019, 156 heads of livestock were investigated, ticks in the two seasons of summer and autumn from different parts of the body of cattle, sheep and goats. were collected and identified according to Chegini's diagnostic key. The sample collection method was manual, the collected data were analyzed using descriptive statistical tests and Vines analysis.

In the present study, 156 animals were examined and 234 ticks were caught. A total of 3 species of ticks from 2 genera (Ripcephalus, Hyaloma) were identified. In total, Hyaluma marginatum was the most common species and Rhipicephalus sanguinus was the least abundant. The abundance of Rhipicephalus sanguinus was 16.4%, Hyaluma anatolicum was 36.2% and Hyaluma marginatum was 47.4% in this area. The highest abundance of Hyaloma marginatum and Ripicephalus sanguinus ticks was observed in Umm al-Tir village with 56% and 29%, respectively. The highest abundance of Hyaluma anatolicum species was observed in Krishan village with 50%. Tick infestation was observed in 6% of cattle, 13% of sheep and 10% of goats. The frequency of tick infection based on the body regions in cattle was in the head and neck (59%), under the tail and around the anus (27%), groin (14%), which statistically indicated a significant difference (02.02). p = 0).

The distribution of the collected ticks revealed that the studied areas were suitable for the activity of ticks due to the weather conditions, so health planners need to consider the possibility of the spread of tick-borne diseases in these areas.

Background and Objectives The aim of this study is to determine the prevalence of respiratory infections in children admitted to Aboozar Children's Hospital in Ahvaz and the associated risk factors. Subjects and Methods A total of147 children aged 12 years and below admitted to the emergency department were selected for this case-control study, including 96 children with respiratory infections and 51 children without respiratory and/or digestive infections as a control group. Their demographic, clinical, and laboratory data were recorded and statistically compared between the two groups. Results Pneumonia (80.2%), especially pneumonia caused by coronavirus 2019, was the most common type of respiratory infection in children. The prevalence and risk of respiratory complications were significantly higher in boys than in girls (p=0.003). The mean age of children with respiratory infections was also higher than that of the control group (p<0.05). In addition, high body mass index, underlying diseases, low birth weight, reduced or no breastfeeding, a family with many children, parental smoking and air pollution were significantly associated with the high risk of infection (p<0.05). Compared to the control group, the children with respiratory infections had lower levels of red blood cells and lymphocytes, but higher levels of neutrophils (p<0.05). Conclusion Knowledge of diagnostic markers and possible risk factors for respiratory infections in children at the beginning of admission to the ward can play a key role in timely diagnosis and treatment of patients.

Background and Objectives Considering the importance of pain control in patients, examining pain management awareness among medical students is necessary. Therefore, the present study aimed to investigate the relationship between moral intelligence and pain management awareness among medical interns at Jundishapur Ahvaz University of Medical Sciences. Subjects and Methods This cross-sectional descriptive study included 150 medical interns, who completed demographic information, the Lennik and Keil moral intelligence and Macmillan Pain Management questionnaires. Eventually, data were recorded and analyzed using SPSS software (version 26). Results The moral intelligence score of interns was 144.98 ± 17.18219. a total of 21 (14%) had average moral intelligence, and 129 (86%) cases showed good moral intelligence. The highest mean was related to accepting responsibility to serve others, and the lowest mean was related to the ability to forgive others' mistakes. The mean score for pain management was 73.72 ± 4.96446. Moreover, 30 (20%) cases had moderate pain management, and 120 (80%) cases showed good pain management. A statistically significant relationship was found between the moral intelligence and pain management score (P=0.003). The pain management score in women was significantly higher than that of men (p=0.001). Conclusion The indicators of moral intelligence and pain management in medical interns were at a good level, which indicates the success of general and specific educational programs in the field of developing moral skills in medical students.

The present study was conducted aiming to assess the effect of fear caused by COVID-19 on health-promoting lifestyle through the mediation role of anxiety.

This was a cross-sectional study on a sample of employees of government organizations in Ahvaz, Iran in 2021. The required data were collected using a multi-part questionnaire including demographic information, health-promoting lifestyle assessment questionnaire, fear of the corona virus questionnaire, and the anxiety scale for the corona virus. Data were analyzed using path analysis and bootstrap test was used to check the mediating role of variables.

In total 384 employees were entered into the study. The mean age of participants was 40.74 ± 6.07 years ranging from 24 to 60. The results showed that there was a positive and significant correlation between the fear of COVID-19 and Covid-19 anxiety (P<0.01). There was a negative and significant correlation between health-promoting lifestyle and both fear and anxiety caused by Corona (P<0.01). Based on the findings the fear caused by Corona and the health-promoting lifestyle had a statistically significant relationship directly and through the anxiety of the Corona disease (P<0.001).

The findings suggest that Corona anxiety mediates the relationship between fear of corona and health-promoting lifestyle. In general, with the increase in the fear of corona, the anxiety of corona disease increases and as a result, the health-promoting lifestyle decreases.

Enterococci are opportunistic bacteria that can become pathogenic if colonized. Resistance to commonly used antibiotics by Enterococci causing nosocomial infections is of concern, which necessitates judicious, responsible and evidence-based use of antibiotics. The aim of this study was to evaluate the pattern of antibiotic resistance of Enterococci isolated from patients admitted to Imam Khomeini Hospital in Ahvaz City, Iran.

The data of this cross-sectional description study were collected from October to March 2019 in the Microbiology Department of Imam Khomeini Hospital, Ahvaz City, Iran. Ninety samples of patients aged 1 to 99 years with infection caused by Enterococcus faecalis and Enterococcus faecium were included. The samples included urine culture, wound swab, vaginal swab, blood culture, catheter, sputum, broncho-aspirate, cerebrospinal fluid and other cases (abscess, drainage, ascites fluid, pleural fluid, culture fluid and purulent material). The antibiotic sensitivity of the isolates was measured using the agar disk diffusion method.

Enterococci were collected from 53 urine samples, 10 blood samples, 1 cerebrospinal fluid sample, 1 abscess sample, 2 cornea samples, 9 wound samples and 14 other secretion samples. The resistance of enterococcus strains against ciprofloxacin, ampicillin, imipenem and nalidixic acid was 66.7%, 42.6%, 55.6% and 93.3%, respectively. The highest sensitivity of Enterococcus isolates against ampicillin (42.6%) was observed. 43.3% of the samples obtained were from men and 56.7% from women.

Based on the results of this study, a significant percentage of Enterococci strains are resistant to ciprofloxacin, imipenem, and nalidixic acid. Over-the-counter and unnecessary use of available antibiotics should be avoided to prevent increased resistance to common antibiotics.

Primary immunodeficiency (PI) diseases are those occur because of a primarydisorder in the immune system.

This retrospective study was conducted on 70 children with PI diseases referred tothe allergy and immunology department of Abuzar Children Hospital in Ahvaz, Iran from 2015 to 2018.

The most common PI diseases in the majority of male children (56.92%) were severe combinedimmunodeficiency disease (21.42%) and chronic granulomatous disease (8.57%). Parents in most ofpatients (83%) were blood relatives. About 66.67% of all death cases (9.23%) was due to severe combinedimmunodeficiency disease; hypogammaglobulinemia and Griscelli syndrome accounted for about16.67% of deaths. The most common manifestations were pneumonia, fever, diarrhea, and sepsis.Based on the family history, 33 children had allergies, 9 had malignancy, one had autoimmune disease,and 39 had mothers with a history of abortion. Most of children were under treatment with intravenousimmunoglobulin and prophylactic antibiotics, (99.88% and 88.99%, respectively), while 2.81% were underinterferon-gamma therapy and transplantation, and 1.40% were receiving corticosteroids and granulocytecolony-stimulating factor therapy.

The severe combined immunodeficiency disease, chronic granulomatous disease, and Brutondisease are the most common PI diseases in children living in Ahvaz.

The widespread use of the Internet and social networks and the anonymity of people's identities in this space increases the scope for cyber aggression, so aggression in this field should be further investigated. This research aimed to determine the relationship between cyber aggression and emotion regulation, self-control, and depression.

In this descriptive study, the statistical population included all male students in the third grade of the first secondary school in Ahvaz in the academic year 2021-2022. Out of which, 180 were selected by random cluster sampling and individually answered cyber aggression, emotion regulation, self-control, and Beck Depression questionnaires. Data were analyzed using Pearson’s correlation coefficient and multiple linear regression statistical tests.

The results showed that cyber aggression has a negative relationship with emotion regulation (r=-0.402 and p<0.01) and self-control (r=-0.434 and p<0.01), and a positive relationship with depression (r=0.343 and p<0.05). According to the results of multiple linear regression analysis, emotion regulation (β=-0.321, B=-0.333 and p<0.001) and self-control (β=-0.142, B=-0.471 and p=0.044) negatively predict aggression, but depression (β=0.090, B=0.103 and p=0.173) does not predict cyber aggression.

The results of this study can help therapists and psychologists in the field of health from a theoretical aspect (enrichment of theoretical concepts in the adolescent field) and an operational aspect (holding educational workshops for adolescents in the field of emotion regulation training, self-control, and depression prevention).

The theory of planned behavior is known to be themost useful theory for better understanding of the predictors of drug abuse. Therefore, this study aimed to investigate the factors predicting the intention to drugs abuse based on the theory of planned behavior in couples referring to the premarital counseling center in East Ahvaz Health Center in 2019.

This cross-sectional analytical study based on correlational assessment was conducted on among all couples who referred to the counseling center. Totally, 360 couples were randomly selected from the couples' file number. The data collection tool was a questionnaire including drug use and the theory of planned behavior. In order to analyze the data, descriptive statistics and inferential tests such as multiple regression and logistic were used in SPSS version 16. A significance level of 0.05 was also considered. At all stages, ethical considerations were considered.

There observed a significant difference between the average constructs of the theory of planned behavior and demographic variables (p<0.05). There was no statistically significant relationship between behavioral intention and demographic variables of the participants (p>0.05). The results of regression analysis showed that perceived behavioral control and subjective norms together predict approximately 37% of changes in behavioral intention.

The theory of planned behavior is a suitable predictor for drugs abuse. It is suggested to use this theory in educational programs of different levels of drug abuse prevention

Hydatid cyst is a worldwide zoonotic disease caused by the larval stages ofEchinococcus granulosus. The aim of this study was to investigate the demographic, clinical and radiologicalcharacteristics of hydatidosis patients undergoing surgery in hospitals in Ahvaz during.

This study is a retrospective descriptive cross-sectional study based on the informationrecorded in the patients' files. Data were analyzed using SPSS software, descriptive statistics andChi-square test.

Of the 107 patients with a mean age of 36.78 years, 42.1% were male and 57.9% were female.The highest frequency was related to the age group of 31-40 and the lowest was related to the patientsunder 10 years old. 52.3% lived in the rural areas and 47.7% lived in the urban areas. In 70.1% of thepatients, liver was involved and recurrence was reported in 14%. In 59.8% of the patients, only one cystwas reported and in 40.2% more than one cyst was reported. The cysts size was 10 to 180 mm and about50% of the patients had CE2 cysts. The diagnostic method of all patients was imaging techniques anddrainage method was the most common method used.

This study showed that hydatid cyst in Khuzestan Province is still one of the important healthproblems that raise the need for educational programs based on the prevention and control of parasiticinfections, especially parasites transmitted by dogs. Observation of 14% recurrence also raises the importanceof choosing the appropriate surgical method by surgeons.

The invasion of microorganisms into the bloodstream and spread to different parts of body can cause disruption the functions of vital organs and even death. This study aimed to evaluation of positive blood cultures in patients suspected to septicemia admitted to the Imam Khomeini Hospital in 2013-2016.

  In this study, blood samples of patients were cultured and isolated bacteria were identified using standard methods. Antibacterial susceptibility testing of isolated bacteria to selected antibiotics was performed using disk diffusion method based on Clinical and Laboratory Standards Institute (CLSI) recommendations. Data were analyzed using SPSS 22 software and frequency distribution table.

The results showed 6.6% of the blood cultures were positive for bacteria. Isolated bacteria were 63.5% gram-positive and 36.5% were gram-negative bacteria. In our study, the most common micro-organisms in general were as follows: Staphylococcus coagulase negative (49.85%), Klebsiella Pneumonia (9.46%), Acinetobacter baumannii (8.33%) and Staphylococcus aureus (7.77%).  Gram-positive organisms have the highest resistance to Ampicillin, Ceftriaxone, Erythromycin and Cefazolin. In general, there was the highest resistance of gram-negative organisms to Cefazolin, Ceftriaxone and cefepime.

With appropriate antibiotics prescription, according to exact results of antibiogram and with sanitation in various parts of hospital, especially the neonatal’s part, can be proceed accurate treatment and reduce health costs.

The growing health care needs of students actuated world Health Organization to develop School-based health projects in the last decades. The most important plan that has received worldwide attention and in Iran for nearly one decade is Health Promoting School (HPS) program which being implemented with collaboration of Ministries of Health and Education. Present qualitative study was conducted to evaluate this program implementation in Ahvaz education organization (District 1).

In this qualitative study data was collected by semi-structured interview. The study population consisted of school health experts affiliated with Ahvaz West Health Center and health deputy, health experts affiliated with education organization (District 1 and school headmasters and expert staffs in HPS (22 persons). The sampling was purposeful and the interviews continued until saturation of data. Content analysis was used for analysis of the data.

Data analysis showed that most components of the HPS program in schools belong to education organization were not implemented properly. The major barriers were categorized into 5 and 47 main and subsidiary themes respectively. Poor stewardship and authority, policymaking and legislation, weaknesses in motivation, attitude and awareness of managers and experts, inadequacy in resources and infrastructure, ineptitude in program implementation and finally inappropriate evaluation system was specified as the main themes. According to results, some of the most important reasons for failure in HPS program consisted of, lack of functions definiteness between health deputy in ministry of health and education organization, job dissatisfaction in school health experts, not being a priority behalf education organization, insufficient delegation of authorized budget, lack of interpectoral cooperation between trustee organizations and indifference about program evaluation.

The most important challenge in the HPS program is the implementation barriers that make the establishment and implementation of this program almost ineffective. The serious and committed interaction between the ministry of Health and Education and between their respective provincial and county districts can provide the foundation for the implementation of this valuable program. A review of the organizational structure and executive framework of the program is also necessary.

Diabetes is the most common glandular disease in the world. The peak prevalence of type one is diagnosed during adolescence. Therefore, the issue of diabetes control in adolescence is very important. This study was designed to determine the relationship between family function and adolescent self-care behaviours in adolescents with type 1 diabetes.

In this cross-sectional study, the study population included all adolescents with type 1 diabetes referred to specialized diabetes clinics of Ahvaz Jundishapur University of Medical Sciences and their families. 62 families and their sick children were selected as the research sample by available sampling method and after obtaining informed consent, were studied. Data collection tools included demographic information form, Family Assessment Device and self-care of adolescents with diabetes questionnaire. Data were analyzed using independent t-test and Pearson correlation coefficient and SPSS software version 22.

Among the adolescents studied, 46.7% (29 people) were boys and 53.2% (33 people) were girls. All studied families reported the overall functioning of their families as unhealthy. Most of the adolescents in the study reported poor self-care (51.6%). 96.8% (n = 60) of the adolescents had HbAӏC blood levels higher than 9%. The results showed that there was a significant relationship between family functioning and self-care behaviours in adolescents (p = 0.014).

Based on the results obtained, it can be concluded that the performance of families with adolescents with type 1 diabetes is an important and influential variable on the child's self-care behaviours and blood sugar control. Therefore, helping families to increase their efficiency can play an important role in controlling diabetes.

The main topic of this study was to impact assessment of the outcome of Acute Lower Respiratory Infection (ALRI) attributed to PM2.5 exposure using the AirQ+ model in Ahvaz, southwestern Iran, as one of the most polluted cities in the world during the period (2008-2017).

Mortality data (including population and incidence of health outcome) and PM2.5 were obtained from the Deputy Minister of Health, Environmental Protection, and Meteorological Organizations of Ahvaz. After validating the data according to WHO guidelines, they entered the AirQ+ software. Also, BI values ​​in 100 thousand people and RR with 95% confidence intervals were used.

The highest concentration of PM2.5 was in 2010 (70.72 µg/m3) and the lowest in 2014 (41.97 µg/m3) and in all years of measurement the amount of PM2.5 was higher than the WHO standard (10 µg/m3) was. The results showed that in the health outcome of ALRI, there was a significant relationship between PM2.5 concentration, ratio, and attributed cases. Thus, with the increase of air pollution in Ahvaz due to PM2.5 pollutants, mortality and risk of this disease increased. During the ten years under study, the highest proportions and attributed cases of AP, BE, and NE in all health outcomes were observed in 2010. In ALRI, 41.43% were 8 and 10 people.

It can be concluded that appropriate measures and policies should be adopted to reduce air pollution in the control of PM2.5 pollutant sources. Until it reduced the health effects of this pollutant in urban children under 5 years of age.

Despite the importance of basic sciences as the basis for medical education, most students have a negative attitude toward the applicability of this phase of medical curriculum in clinical phases. This study was designed to investigate the viewpoints of medical students of Ahvaz Jundishapur University of Medical Sciences about clinical applicability of their Physiology course as one of the major courses in basic sciences. The data collection tool was a questionnaire consisting of 16 questions. In this study, 273 medical students were included. There were 117, 53, and 103 students in preclinical, clinical and residency levels, respectively. Data were collected between 2015-2018. According to the viewpoint of 71.1% of the participants in our study, the courses taught in basic sciences are applicable in clinical years. Also, 58.2% of the respondents were unaware of the clinical significance of the Physiology course. According to 78.8% of the students, indicating clinical points in basic science courses can have a profound impact on Physiology learning and its retrieval in clinical courses. The application of Physiology at the current level was moderate according to the viewpoints of 40.7% of the students while it was much and very much based on the viewpoints of 48% of the participants. The Physiology course has many clinical applications from the medical student’s perspective. Residents who have spent more time in clinical practice, as opposed to students at clinical and preclinical levels, put more emphasis on the clinical applicability of Physiology. Therefore, the greater the involvement of medical students in the clinical field, the higher their awareness about clinical applicability of Physiology.

Satisfaction with orthotic devices and services results in greater orthotic usage. Evaluation of users’ satisfaction could enhance the quality of orthotic devices and services. This study aimed to evaluate the users’ satisfaction with lower limb orthotic devices and technical orthopedic services in Ahvaz.

97 users of lower limb orthotic devices participated in this cross sectional study. User’s satisfaction was evaluated with the Orthotic & Prosthetic Users’ Survey (OPUS). The mean rank of OPUS, was analyzed with demographic data by SPSS version 22.

For device satisfaction, the highest satisfaction score was for “my orthosis fits well “(4/37) and the lowest score was for “cost of purchase and maintenance of orthosis” (2/75). For service satisfaction, the highest score was for “orthotist was responsive to my concerns and questions” (4/56), and the lowest score was for “coordination between orthotic staff and the users’ therapists and doctors” (2/75). The mean rank of service satisfaction was significantly higher than device satisfaction) p < 0/05(. The mean rank of device satisfaction was significantly different among four types of lower limb orthotic users  p < 0/05 .

Technical orthopedic managers should perform actions to facilitate insurance coverage. They should emphasize on enhancement of orthotic quality and durability, teamwork, and client centered approach to ensure the users’ satisfaction especially the long leg brace users.

There is no doubt that determining the efficiency of hospitals is one of the key steps that must be taken. Therefore, performance appraisal can help health plan executives to better understand its strengths and weaknesses. The purpose of this study is to evaluate the effect of health system transformation plan on the efficiency of selected hospitals in Ahvaz in the period 2012 to 2017.

Data related to seven hospitals implementing the project and one control hospital in 2012, 2013, 2016 and 2017 were collected. The efficiency of hospitals was calculated using data envelopment analysis technique using CCR method and WinDeap2 v 2.1 software. Independent t-test and Poisson using Stata v 15.1 software were used for inferential analysis.

The highest efficiency of hospitals were related to 2017 with average 0.987 and the efficiency of two hospitals in 2016 and 2017 was 1 and the other two hospitals have experienced an upward trend during these two years. Efficiency, number of hospital admissions, number of outpatient admissions and number of surgeries before the transformation plan were significantly different from after, but this difference was not true for the number of active beds, number of physicians and number of nurses.

Totally the efficiency of hospitals implementing transformation plan has been experienced an upward trend. considering the health system transformation plan in 2014, the improvement of the efficiency, the number of outpatient admissions, the number of hospital admissions and the number of surgeries was probably due to the transformation plan.