فهرست مطالب

سازمان نظام پزشکی جمهوری اسلامی ایران - سال بیست و نهم شماره 2 (پیاپی 114، تابستان 1390)
  • سال بیست و نهم شماره 2 (پیاپی 114، تابستان 1390)
  • تاریخ انتشار: 1390/08/15
  • تعداد عناوین: 12
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  • Ali Mohmmadpour, Afsaneh Karimi, Yousef Mehdipour, Marziyeh Sararani, Masoumeh Forghani Page 121
    Background
    care of patient is a complex function; then the care givers must establish standards and criteria for delivery and evaluation of care of patient. Along this fact, Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has considered the international standards for care of patient (COP) in the hospital accreditation program; on the otherwise we must use international experiences for promotion of national hospital standards. So this research conducted to depict eaknesses of national care of patient standards in comparison with international one.
    Methods
    In this descriptive-comparative study the Joint Commission's COP standards (70 statements) were compared with MOH's hospital standards (43 questions). Data collection methods were use of available information on the internet (Joint Commission's COP standards) and the relevant references (MOH's standards). Data were collected using seven checklists based on the joint commission COP standards and were analyzed with comparative tables and descriptive statistical methods.
    Results
    Final collation of MOH's standards for hospitals and the Joint Commission's COP standards (43 questions versus 70 statements) showed that the former covered 13 statements (18.6 %) of the joint commission completely, covered 20 statements (28.6 %) partially, and did not cover the remaining 37 statements (52.8 %) at all. In other words, correspondence of MOH's hospital standardswith those of Joint Commission was 18.6 % completely, 28.6 % partially and 52.8 % with out any correspondence.
    Conclusion
    In general Ministry Of Health's COP standards have been very weak from the point of compilation, quantity and content.According to philosophy of healthcare organizations and importance of qualified healthcares services; it is necessary to reform national care of patient standards.
    Keywords: Standards, patient care, Health, Joint Commission on Accreditation of Healthcare Organizations
  • Farshad Okhovatian, Mohammad Niakan, Narjes Soltani Page 129
    Background
    The objective of this study was to investigate the amount of medical society's knowledge about the role of physiotherapy in treating and improving the confined patients.
    Methods
    A questionnaire has prepared with five clinical questions by multiple choice items. The volunteers have one or more items to choice. These questionnaires have randomly completed by the medical students of the Medical Universities around Iran.
    Results
    Our results have shown that only 47.5% of physicians are familiar with the role of physiotherapy for treating and improving restricted patients, on the other hand 18.6% prescribed unsuitable,expensive, and even harmful techniques for curing these patients.
    Conclusion
    The results of our study emphasis on the limited knowledge and information of the medical society about physiotherapy. Even in some cases that the role of physiotherapy has proven, they are not familiar with it. It may reflect the lack of medical training program and their educational syllabus.
    Keywords: physiotherapy, confined patients, burn, pulmonary disease, surgery
  • Amjad Kiani, Mohsen Mohammad Sadeghi, Lakh Hoveyda, Niloofar Farahmand Page 136
    Background
    Nowadays atherosclerosis phenomenon is considered as an inflammatory phenomenon.Not only CRP is a response to the acute phase but also it is sign of atherosclerosis.
    Methods
    In this analytic study 454 volunteer patients for coronary artery bypass graft(CABG)operation have been observed. Before being admitted to the hospital they have gone through CRP test based on mg/dl. Then All of the patients have been under CABG operation by on pump method. The surgeon, method of operation; anesthesia and treatment in ICU were the same for all of the patients. After the operation, the patients files were used to get some information regarding death, the use of balloon pump, the use of inotrop at the end of operation, ICU stay, pump time, aortic clump time and other parameters. The statistics considering any relationship between these factors and pre operation CRP level and death were analyzed.The patients have no sign of pre operation infection, inflammation and documented malignancy.
    Results
    For analysis correlation between pre operation CRP level and study parameters pierson and zero test was done. From the statistical point of view the correlation between addition of death,New York Heart Association (NYHA) class, pre operation MI and diabet,addition of post operation neurologic complication,pre operation EF, the use of balloon pump,addition of pump time, aortic clump time to addition of CRP level have been considered. No significant relationship was seen. But in old patients, women and somebody that had length ICU stay or uses inotrop at the end of operation CRP was high.
    Conclusion
    The level of pre operation CRP can be a good statical predictor for ICU stay, urgency, using Inotrop at the end of operation. But no significant correlation was observed betweendeath, pre operation EF, MI and diabet to pre operation CRP.
    Keywords: C, Reactive Protein, CABG, Aortic Clump, Atherosclerosis
  • Ebrahim Sadeghi, Fatemeh Azadinia Page 142
    Background
    Flat foot is a common musculoskeletal deformity but there is no consensus about the incidence of this deformity in literature. Development of the longitudinal arch of the foot depends on the individual’s age, gender, and race and also can be influenced by footwear properties or the age show-wearing has been started.This survey is to determine the prevalence of this deformity in students who were aged 7-14 in Isfahan.
    Methods
    671 participants who were met the inclusion criteria were recruited. Subject was selected by multi stage sampling from five educational areas in Isfahan.age, gender, height, and weight of subjects were recorded and a footprint were taken to extract an index(foot print Arch Index) indicating the height of the foot arch.
    Results
    the results of this study showed 23.5% loss of longitudinal arch including 14.1% the unilateral loss of the longitudinal foot arch and 9.5% the bilateral loss of the longitudinal foot arch. Frequency of longitudinal arch loss in both genders was almost the same (24.5%& 23% in boys and girls, respectively).The incidence of the flat foot showed an increase from the age of 7 years toward 10 but decreases after the age of 10.
    Conclusion
    the data demonstrate that the prevalence of flat foot is influenced by 3 factors: age, gender, and weight. Especially in overweight children a highly significant prevalence of flat foot was observed.
    Keywords: Foot, longitudinal arch, flat foot, footprint
  • Aliasghar Farazi, Mansoureh Jabbariasl, Masoomeh Sofian Page 150
    Background
    The incidence rate of smear positive tuberculosis in the country in 2010 was about 7 in the hundred thousand populations. Cure rate and failure rate have great importance in preventing the resistant tuberculosis. This study surveyed Relationship between initial smear grading with cure rate.
    Methods
    All new smear positive cases registered from March 2005 to May 2010 were analysed for cure and conversion to negative smear related to initial smear grading.
    Results
    From 354 Sm+ patients 276(78%) at the end of second month of treatment were Sm- and 52(14/7%) were Sm+. at the endof treatment cure rate was 79/7% and Relationship between initial smear grading with cure rate and conversion to negative smear in new Sm+ patients was statistically significant. In multivariate analysis, lower cure rate was significantly associated with age >45y and Initial smear 2+ and 3+ and remain smear positive at the end of the second month of treatment.
    Conclusion
    The more treatment failure and death from TB or emergence of resistant TB related to less negative smear rate at the end of two months of starting treatment and more patients that have initial smear 2+ & 3+, are from this group. This reiterates the need to pay more attention in motivating these patients to return to regular treatment and sustained commitment in the control of tuberculosis.
    Keywords: Initial Smear Grading, Cure Rate, Tuberculosis
  • Nouradin Sharifi, Naser Samadi Aidenloo Page 157
    Background
    Colorblindness is a kind of disorder in perception of color which is x- linked and congenital and it is seen mostly in men.The aim of this study is determining incidence of color blindness in Urmia high schools students.
    Methods
    This is a cross-sectional and perspective study. Two thousands boy and girl high school students underwent study. All of students were screened by color vision test in natural light. For every color vision defects cases were completed a questionnaire containing sex, familial marriage of parents and relationship of familial marriage of parents. Data collected analyzed by using Excel software.
    Results
    From 2000 students (1000 for boys and 1000 for girls) which were examined, 40 students of them (2%) were color blind,which 36 of them (3.6%) were boys and 4 of them (0.4%) were girls.Out of all kinds of colorblindness, 25 students (1.25%) were total,13 students (0.65%) were Deutan and 2 students (0.1%) were protan. Also, the parents of 5 students out of 40 color blind (12.5%) had familial marriage that colorblindness of 4 students (10%) were Total, and was 1 student was Deutan (2.5%). 87.5% of them had no familial marriage.
    Conclusion
    Although, there are difference between color blindness prevalence reported from various areas of world and results of this study but there is a similar between all of reports and results of this study.
    Keywords: Colorblindness, protan, Deutan
  • Masoumeh Hematyar, Marjan Mahgoubi, Fatemeh Katayoun Fadaki, Roya Emdadi, Mitra Sadighpour, Reza Mozafary Page 162
    Background
    The insulin level of fetus indicate the effects of maternal diabetes on fetus and it's health in future. There is not exact glucose threshold in maternal glucose tolerance test (GTT) for fetal hyperinsulinism and it's correlation with fetal morbidity and mortality. The aim of this study is to determine the correlation between insulin levels in cord blood with maternal blood glucose levels in 75 gram oral GTT.
    Methods
    This is a cohort study on 200 pregnant women in Tehran Javaheri hospital in 2009. The 75 gram OGTT was performed at 24- 28 weeks of gestation and then 2 cc of cord blood for measuring insulin was gotten at delivery time. The data analysed by SPSS ver 13 and correlation, regression and independent t test.
    Results
    5.5% of neonates have hyperinsulinism. The correlation between maternal fasting blood sugar and cord blood insulin was significant. The correlation between infant birth weight and cord blood insulin and also maternal first hour glucose level in 75 gram OGTT was significant. Although the level of cord blood insulin was higher in mothers with impaired GTT but the correlation was not significant.
    Conclusion
    The concentration of insulin in fetus indicate the levels of glucose that transfer from mother to fetus intrauterine. In this study the most correlation between hyperinsulinemia with maternal fasting blood sugar was observed. It seems maternal FBS has the most sensitivity for detection of hyperinsulinemia in fetus.
    Keywords: insulin, gestational diabetes, 75 gr oral glucose tolerance test, macrosomia
  • Mohsen Rezaeian Page 169
    One of the most important questions that arise whenever a paper is writing is who is/are the author(s) of the paper? In this article, we have been tried to answer the above question citing the most valid documents. Within the text of the article, first, authorship is defined. Then, the authorship dispute and the ways to overcome it are referred to. At the end, some other important issues such as the number and the order of the authors are discussed.One of the fundamental ways to overcome the authorship dispute is to encourage the authorship ethics. Furthermore, there are comprehensive guidelines which might facilitate to resolve any kinds of authorship disputes whenever they occur.
    Keywords: Article, Medical journals, Authorship, Authorship dispute