مجله دانشگاه علوم پزشکی قم
سال پانزدهم شماره 2 (پیاپی 109، اردیبهشت 1400)

Coronavirus syndrome has now become a global challenge. Meanwhile, nurses are under great psychological pressure due to their presence in the front line of treatment. Therefore, this study was conducted to investigate psychological disorders in nurses facing patients with Covid-19 in 2020.

In this cross-sectional descriptive study, 275 nurses working in hospitals receiving infected covid-19 patients were randomly assigned to complete the study and completed the demographic checklist and PTSD and Depression and Anxiety Questionnaires (DASS-21).

The mean and standard deviation of post-traumatic stress disorder in the present study was 17.46 ± 5.42 and 23.5% of the subjects had post-traumatic stress disorder. Also, the mean and standard deviation of depression was 14.83 ± 4.59 The mean and standard deviation of their anxiety was 13.72 ±   4.38.

This study has shown that with the onset and spread of coronavirus disease, the nurses has experienced a lot of stress and anxiety. Lack of sufficient knowledge about the disease, fear of contracting the disease and transmission of the disease to other family members, as well as opposition from family members were among the reasons for anxiety.

The importance of evaluating the performance indices of the emergency department as one of the most important hospital wards is obvious to everyone. Therefore, in the present study, we determined emergency performance indices in emergency centers of educational hospitals of Zanjan University of Medical Sciences.

This is a cross-sectional descriptive study. In this study, data related to performance indices of emergency center in educational hospitals of Gilan University of Medical Sciences were collected during one full week in Ayatollah Moosavi and Valiasr hospitals by simple random sampling of the Poisson model in a continuous and gradual manner and we recorded the data. In this study, in total, 1341 samples were evaluated in relation to the variable of indices. Finally, the data were analyzed using proper descriptive and inferential statistics and SPSS Ver. 22. The instrument was a questionnaire which included the underlying profile (age, gender, marital status, insurance status, place of residence and degree of education) of the referrals to the emergency department and data of performance indices. Given that the questionnaire used is a checklist related to the standard performance indices recommended by the Ministry of Health of the country, it is reliable and valid.

Emergency performance indices in Zanjanchr educational centers was at a favorable level in comparison with other studies; except in cases when there is a triage time interval up to the first physicianchr visit that is suggested that by doing provisions on the physical environment and ease in the process of patient admission, reduce this time interval and to reduce the long-term stay of  patients in emergency departments we can mention strategies such as preventing multiple services, making the number of counseling purposeful and restricting them to essential counseling and ultimately, following up on the treatment as soon as possible by the relevant services.

Emergency performance indices in Zanjan educational and treatment centers is at a favorable level in comparison with other studies; except in cases when there is a triage time interval up to the first physicianchr visit that is suggested that by doing provisions on the physical environment and ease in the process of patient admission, reduce this time interval and to reduce the long-term stay of  patients in emergency departments we can mention strategies such as preventing multiple services, making the number of counseling purposeful and restricting them to essential counseling and ultimately, following up on the treatment as soon as possible by the relevant services.

The health sector evolution plan was implemented in 2014 with three approaches financial protections of people, establishing justice in access to health services and improving quality of services in hospitals. This study aimed to compare some hospital indicators before and after the implementation of the transformation plan in training hospitals affiliated to Zabol University of Medical Sciences.

This descriptive-analytic study was carried out in 3 training hospitals of Zabol University of Medical Sciences in 2019. 8 hospital indicators were monthly extracted at 2 stages (3 years before and after the implementation of HTP 2014) by referring to the statistics unit of hospital. Paired sample t-test was run in the SPSS software 19 to compare the obtained data.

Results showed that implementation of health system transformation plan on the bed occupancy rate (P = 0.040) and active bed ratio (P = 0.003) in hospital A, number of surgeries (P = 0.032) in hospital B and the bed occupancy rate (P = 0.000), active bed to fixed ratio (P = 0.014) and number of surgeries (P = 0.014) and patient-to-population ratio (P = 0.042) were effective in hospital C. Changes in the ratio of burn, Psychiatric, ICU beds to population and patient-to-population ratio and ratio of beds to fixed, number of surgeries were statistically significant (P <0.05).

The implementation of the transformation plan has been accompanied by significant changes in some hospital indicators of the hospitals.

Today, knowledge is deemed a valuable and strategic resource while on the other hand, knowledge management is not possible without proper organizational structure. Therefore, this study was conducted to investigate the impact of organizational structure on knowledge management in public hospitals.

This applied - exploratory study was performed on 570 employees at Qom University of Medical Sciences hospitals. The research instrument was a standard researcher-made questionnaire with a five-part Likert scale. The validity of the questionnaire was assessed through content, convergent and divergent validity tests. In addition, instrument reliability was measured by Cronbach’s alpha and composite reliability test. Data were analyzed through exploratory and confirmatory factor analysis as well as structural equation modeling by SPSS v. 20 and Lisrel 8.8 software.

The mean and standard deviation of the knowledge management component were found to be 3.354±0.816. The results of exploratory factor analysis showed that KMO was equal to 0.936 and that Bartlett test was significant at the level of 0.001. Cronbach’s alpha and composite reliability were between 0.982-0.983 and 0.926, respectively. Furthermore, convergence validity was found to be 0.806 while divergent validity of variables was also confirmed. Confirming its fit indicators, exploratory factor analysis categorized the organizational structure into three sections of formality, decentralization, and strategies.

The results showed that the three components of organizational structure have a positive and significant relationship with the establishment of knowledge management. Therefore, supporting senior managers in knowledge-based strategies and increasing employee participation in decision-making and decentralization will be useful for implementing knowledge management.

Surgery via different mechanisms causes immunosuppression in the postoperative period. The aim of the present study was to investigate the effects of preoperative administration of cyclooxygenase inhibitors on blood levels of Interleukin-2 (IL-2), Interferon-γ (IFN-γ), Tumor Necrosis Factor-α (TNF-α), white blood cells (WBCs) and lymphocytes.

Seventy-five male Wistar rats were divided into five groups (n=15 for each group). Group 1 was gavaged with normal saline for 3 consecutive days without surgery. Group 2 was gavaged with normal saline for 3 consecutive days. Groups 3 to 5 were gavaged with indomethacin (4 mg/kg) and celecoxib (7.5 and 15 mg/kg), respectively, for 3 consecutive days. In Groups 2 to 5, one hour after drugs administration on the third day, laparotomy was used as a surgery pattern. Blood samples were collected 24 hours after surgery and levels IL-2, IFN-γ, TNF-α, WBCs and lymphocytes were determined. Data were analyzed using one-way ANOVA test.

Based on the results, a decrease in blood levels of IL-2, IFN-γ and lymphocytes along with an increase in TNF-α and WBCs were observed 24 hours after surgery compared to control rats (P<0.05). Indomethacin (4 mg/kg) and celecoxib (15 mg/kg) improved the decreased level of IL-2 (P<0.05). There was no significant difference in IFN-γ and lymphocytes between surgery group and the groups treated with indomethacin or celecoxib (P>0.05). Also, only celecoxib (15 mg/kg) could decrease the elevated levels TNF-α and WBCs (P<0.05).

Perioperative use of cyclooxygenase inhibitors can improve immune system function.

One of the most popular systems for creating structural changes in hospitals is total quality management; Which is known as one of the most important philosophies to increase the effectiveness of the organization and competitive advantage. This study aimed to investigate the barriers to the establishment of TQM in hospitals in Kerman

This descriptive-correlational study examined the barriers to the establishment of TQM in hospitals in Kerman in 2019-2020. 377 managers and experts, medical, administrative and financial staff of the hospitals (188 Educational and 189 non-educational), entered the study through simple random sampling. Niga Barriers to implementing TQM questionnaire, Hershey & Blanchard Leadership Styles Questionnaire and Staff Maturity Questionnaire was used for data collection. Descriptive statistics (frequency, mean and standard deviation) and analytical statistics (Chi-square, independent t-test, analysis of variance and Tukey) were used to analyze the data. The significance level was 0.05.

The average total barriers to the implementation of TQM in Educational hospitals was more than non-Educational (P=0.046). The highest mean was related to cultural barriers and staff and imperative leadership and the professional organizational maturity of staff. There was a significant difference between the barriers to the implementation of TQM and leadership style and organizational maturity of staff (P<0.05).

According to the results, the most obstacles to establishing TQM in Kerman hospitals were cultural barriers and staff, which were created due to the command leadership style. It is better for hospital managers to recognize the obstacles to the implementation of TQM, in order to remove these obstacles.

Investigating the changes in CT scans of patients is one of the most important methods to determine the prognosis of patients with head trauma, which has been considered by researchers. The aim of this study was to determine the findings of delayed CT scan in blunt head trauma patients referred to Shahid Bahonar Hospital of Kerman in 2020.

This was a descriptive-analytical study. All patients with blunt head trauma underwent the initial Brain CT based on indications according to the guideline after six Hour of monitoring in the emergency room if they hadnchrt any discharge conditions based on the indications in the guideline The brain controls CT was performed. Findings were analyzed by SPSS25 software. Chi-square, Independent T test, ANOVA and logistic regression were used.

  The results showed that 98.5% of the participants had no changes in their control CT scan. In the change group, 40% of cases had decreased hemorrhage, 35% of cases had increased hemorrhage and 25% of them had new intracranial hemorrhage. There was not also a statistically significant relationship between gender, drug history, outcome, initial CT-Scan findings, age, GCS score, systolic blood pressure, heart rate and duration with CT changes (in unchanged, exacerbated, recovered groups) (P> 0.05). But the results showed that the frequency of exacerbation of symptoms in people with underlying cranial disease was significantly higher than other groups (P=0.05).

According to the results, it is possible that performing a primary CT scan in patients with head trauma in EDs is a good method for assessing the general condition of patients with mild to moderate trauma. However, evaluation of the necessity of control CT scan requires research with a larger sample size and longer follow-up.

Infertility is one of the bitter experiences of life that causes many psychological problems for the individual and his family. The aim of this study was to investigate the role of infertility stress and defeat in predicting the quality of infertile women marital relationship.

The present study was a descriptive correlational study. A sample of 120 infertile women using the available sampling method was selected from women who referred to the Infertility Center in Birjand in 2020. Research tools included Newton et al. infertility stress scale, Gilbert and Allenchr sense of failure, and the quality of the right marriage relationship with colleagues. To analyze the data, Pearson correlation coefficient and multiple regressions were used simultaneously using SPSS software version 22 at a significance level of 0.05.

The results showed that there was a direct relationship between infertility stress (r = 0.722) and feelings of failure (r = 0.651) and the quality of marital relationship (p <0.01). Also, the value of standardized regression coefficient (Beta) for infertility stress components including social dimension (p = 0.014, β = 0.135), sexual dimension (p = 0.035, β = 0.88), communication (p = 0.166, β = 0.260), lifestyle non-acceptance (p <0.001, β = 0.235), need for parenting (p <0.001, β = 0.219) and failure feeling component Included feelings of stagnation (p <0.001, β = 0.240), feeling of loss (p <0.001, β = 0.225) and feelings of satisfaction (p <0.001, β = 0.261).

Based on the results of the study, it can be said that with increasing infertility stress and feelings of failure, the quality of the marital relationship of infertile women decreases. Thus, infertility stress and feelings of failure play a crucial role in the quality of infertile womenchrmarital relationship.

residual cyst is an odontogenic cyst that develops after a tooth with a radicular cyst is extracted so that all or part of the cyst remain in place.  These cysts are known as asymptomatic inflammatory odontogenic cysts and form approximately 10% of odontogenic cysts.

Case Report: 

a 30 years old man patient, referred to the department of oral medicine of Yazd dental university for evaluation of radiolucent lesion seen in panoramic radiography.  Large oval shape unilacular radiolucency with well-circumscribed and corticated borders was seen that extended from the distal of left central tooth to the apex of second premolar on the same side.the canine tooth also appeared to be in sinus space.

According to the present study, basically, residual cystic should be considered in differential diagnosis of unilacular radiolucency in edentulous area.