مجله سازمان نظام پزشکی جمهوری اسلامی ایران
سال چهلم شماره 4 (پیاپی 160، زمستان 1401)

Today, according to the statistics of medication errors in Iran, they are considered one of the most common medical errors, and due to the complications caused by it, measures should be taken for it. Medication errors can be caused by several reasons, the most important of which in this article are the definitions and prevention solutions, and the aforementioned suggestions are compatible with the laws of Iran’s medical legal system and conventional procedures in the field of health because they are enforceable. It is the country.

In this article, the medication error prevention strategy has been proposed based on four practical steps, including all drug treatment processes, even from the pre-prescription and prescription (training of doctors) to after the occurrence of the medication error and the complaint stage in the court. In this regard, we believe that in order to minimize drug error statistics, it requires the coordination and cooperation of all the country’s organs to achieve this as soon as possible, apart from all the analytical and interpretative discussions of this issue, which have been done many times by different researchers, there is a need for practical ideas. And there are more applicable also, these suggestions have been predicted by taking into account the electronicization of prescriptions and the causes of medication errors so that they have the possibility of implementing it in the Iranian society, rather than having only an analytical aspect.

In many hospitals, the rapid response team (RRT) is specialized in monitoring critical symptoms and timely intervention. The purpose of this study is to investigate the impact of RRT implantation (including reducing cardiorespiratory resuscitation and intubation rate) in adult patients admitted to Namazi Hospital in Shiraz.

This cross-sectional study was conducted in Shiraz Namazi Hospital on 15,448 patients over 18 years of age hospitalized in the emergency room and selected internal wards from April 2019 to January 2022. This study was divided into three periods. The trend of clinical outcomes (cardio-respiratory resuscitation and intubation) in the first and third periods (before and after the RRT implementation) was analyzed using Joinpoint Regression analysis.

The mean monthly cardiorespiratory resuscitation showed a significant decrease (p-value < 0.001) in the third period in the emergency department. Also, the mean intubation rate decreased by 10 units (p-value: 0.1). According to the results of Joinpoint Regression Analysis, the monthly percentage changes (MPC) of cardiorespiratory resuscitation in the emergency department before the establishment of RRT had a positive upward slope of 7.4%, while after the implementation of RRT, MPC was 2.9% with a negative slope.

Implementing the rapid response team can reduce cardiorespiratory resuscitation and intubation rate by screening at-risk patients with warning signs, using trained staff and early intervention, and indirectly reducing the complications caused by cardiac arrest.

The main goal of this research is to use a balanced score card (BSC) in order to establish the strategic management of physical education and sports for the students of the Ministry of Health and Medical Education.

The present research is a strategic study, which is an applied research in terms of the research objectives and it is a mixed type (quantitative and qualitative) in terms of the data collection method. In the qualitative section, in order to prepare and formulate the strategic plan, a statistical sample of 12 experts was used as members of the research strategic council. Besides, library approaches, such as articles, books, magazines, and the Internet were used to collect the theoretical foundations and background of the research. In the quantitative section, the matrices of strategic studies, including the Internal Factor Evaluation (IFE) Matrix and External Factor Evaluation (EFE) Matrix and Analytic Hierarchy Process (AHP) were used for ranking opinions and strategies in Expert Choice and SPSS software for data analysis.

In the present research, a balanced scorecard was used to evaluate the performance and implementation of strategies, and AHP hierarchical analysis was used for evaluating the importance and weight of the strategies of each aspect. Based on the balanced scorecard, four aspects of internal management, infrastructure development and income generation, culture promotion, and development of public sports and championship sports were identified as the main aspects of physical education and sports for students of the Ministry of Health and Medical Education. In addition, based on the results of this study, 10 strategies, 30 goals, 39 measures, and 45 actions were obtained.

Based on the SWOT analysis, a total of ten strategies, including two SO strategies, three WO strategies, two WT strategies, and three ST strategies were developed for physical education and sports for the students of the Ministry of Health and Medical Education, which include: strengthening the relationship between education and sports with the approach of making it attractive in universities of medical sciences, development and promotion of sport spaces, places, equipment, and activities through purposeful allocation and distribution of funds, development of income generation plans through sports competitions and events, extracurricular sports courses, promotional measures and financial support, strengthening relationship between the Ministry of Health and Medical Education with other institutions in order to participate and link with them for the active living/empowerment and development of human resources, physical training and sports, purposefulness in sending and hosting national sports competitions and events, student and international sports, developing and applying sports research with a research-oriented approach, setting up and creating a database for recording and storing health and physical activity information of individuals, developing and strengthening sports talent search projects in universities of medical sciences with the help of the Ministry of Youth and Sports, promoting interaction with prominent coaches, leagues, and club

The position of the principle of confidentiality in the health sector in the current era, which is known as the information age, requires the existence of legal mechanisms as guarantees to respect it and to uphold the ethical principles and determine its boundaries in the health sector. The fact that the access to patients' information can lead to intentional and unintentional disclosure of their data reveals the necessity of the current research.

This study was conducted using a doctrinal approach. Library-based research and books and articles have been used to collect information. To organize this research, honesty and fidelity have been observed alongside authenticity.

Investigations show that there are deficiencies in Iran's subject laws; because the law must respect the rights of citizens and have the ability to guide its subordinates, while in Article 19 of the Law on Preventing Sexually Transmitted Diseases and Infectious Diseases approved in 1941, despite the counting of diseases in an exclusive manner and remaining silent the consequences of breach of confidentiality in emerging diseases such as AIDS, hepatitis and covid-19 are not seen in such guidelines. Also, considering the principle of openness and taking it into consideration when enacting the law, it should be said that such a thing has not been done in Article 648 of the Islamic Penal Code (Penalties) regarding the distinction between intentional and unintentional disclosure of a secret in the relevant matter, and in both cases, the behavior of the perpetrator is the same as the answer.

By making amendments to the above laws and taking into account the principles of medical professional ethics as well as comparative law, including the set of laws related to the responsibility of health insurance in the United States of America in this case, an important step can be taken in the direction of protecting the rights of patients.

The aim of this research was to predict psychological capital based on socio-economic status and personality traits with the mediation of self-impairment in diabetic patients.

The research method was descriptive-correlational and statistical population included all patients with type 2 diabetes who had medical records from 2015- 16 in Qaemshahr Diabetes Association. During this period, 2400 people with files in the Diabetes Association, constituted the statistical population of this research. The sample size was estimated to be 350 people using Morgan’s table. The people of the sample group responded to four Luthans Psychological Capital Questionnaires (PCQ), Costa and McCree Personality Traits Questionnaire (NEO), Socio-Economic Status Questionnaire (SES) and Jones and Rodolt Self-handicapping Questionnaire (SHS). The data was analyzed using the structural equation modeling method with the help of AMOS software.

The analysis of the conceptual model of the research showed that there is a significant relationship between socio-economic status along with personality traits and with the mediation of self-handicapping, and these variables predict psychological capital in people with diabetes, which fits with the collected data.

Therefore, it can be concluded that dealing with different dimensions of psychological capital can improve health and treatment status, different dimensions of personality, socio-economic status and quality of life of diabetic patients and improve access to services in this area

Guillain Barre Syndrome (GBS) is an immune mediated neuropathy following infection with a highly variable course and outcome. The aim of this study was to investigate the factors affecting the length of hospital stay of children with GBS.

In this retrospective descriptive-analytical study, the records of 324 children with GBS admitted in Tabriz Pediatric Hospital from June 2003 to December 2013 were studied. By carefully reviewing the existing information, the missing cases were carefully examined and any possible errors in record-keeping were eliminated as far as possible

175 patients (54%) were female and 149 patients (46%) were male. The age range was at least 6 months and maximum 16 years old and the mean was 5.13 ± 3.66 years. In this study, cases referring in summer were reported more (104 cases, 32.1%) than other seasons. In the treatment of patients with Guillain Barre, 272 (86.4%) patients were treated with IVIG, of which 206 (65.4%) received IVIG alone and 66 (21%) with IVIG also received methylprednisolone. 17 cases (5.4%) were treated with plasmapheresis and 26 cases (8.3%) received no treatment. Sensory and autonomic nerve involvements were observed in 46.6% and 16.4% of children, respectively. Cranial nerve involvement was reported in 127 children (39.4%) of which most of patients had involvement of 9th cranial nerve (89 patients, 34.4%).Of the children under study, only 31 (9.6%) needed mechanical ventilation, with a mean of 20.75 ± 21.25 days for these children. The mean duration of hospital stay was 10.07 ± 12.24 days, with more than half of the children (181 patients, 59.9%) being discharged from hospital within one week. 107 (35.4%) children were hospitalized for one to four weeks and 14 (4.7%) were hospitalized for more than four weeks.

The duration of hospitalization in children with GBS has a direct relationship with the type of treatment, autonomic and cranial nerve involvement, severity of illness and mechanical ventilation.

Melanoma is the most severe subset of skin cancer, with high invasiveness and rapid metastasis to other organs. Recently, the role of exercise training in the prevention and treatment of cancer has received much attention. Pineapple belongs to the bromolyase family and the bromoloid subfamily, with suggested anti-cancer properties. Matrix metalloproteinases are a family of proteolytic enzymes that destroy the extracellular matrix and basement membrane, and in this sense, they are important in physiological and pathological processes. Previous reports showed that MMP-2 and MMP-9 are essentially expressed in malignant melanomas, and their expression is strongly related to melanoma atypia and dedifferentiation in melanocytic lesions, so the aim of this study is to study the changes in gene expression of metalloproteins MMP-2 and MMP-9 on liver tissue and tumor volume after resistance exercise and consumption of pineapple extract in mice with melanoma cancer.

This study was conducted on 32 heads of C57 mice in four groups including control, resistance training, pineapple extract and resistance training-pineapple. After tumor induction in mice, the program of resistance training and pineapple extract at the dose of 300 mg/kg by gavage was implemented for six weeks. The weight and tumor volume of mice were measured.

After obtaining blood and tissue samples, gene expression of MMP-2 and MMP-9 metalloproteins in liver tissue was performed by RT-PCR method. Then the data were analyzed using one-way analysis of variance, two-factor analysis of variance and post hoc test, and the significance level of p≤0.05 was considered.

The findings showed that compared to the control group, resistance training and pineapple-training led to a significant decrease in tumor volume and a decrease in the gene expression of metalloproteins MMP-2 and MMP-9 in the liver tissue.