فصلنامه طب و تزکیه
سال بیست و دوم شماره 3 (پیاپی 88، پاییز 1392)

Goal: The rate of plastic surgery in Iran relative to it’s population is one of the highest in the world،knowing the psychcosocial factors that effect this kind of surgery on the people and also why people decide to under go such a procedure is of great importance، this research was conducted to study the causes of people’s tendency to undergo rhinoplasty in Tehran between years2011-2012. this study was a cross sectional study which all of 16-50 years old Tehran resident who wants rhinoplasty between years 2011 and 2012 had constitute its study population. After listing all hospitals and surgical centers in which surgery was performed،research location was randomly selected. Overall 800 patients during 8 months had been entered into the study. Data collection instrument in this study was questionnaire which it’s validity and reliability have been confirmed. 132 (16. 5%) of the study subjects were male and 668 (84. 5%) were female. The mean and standard deviation of age was 23. 65_+2. 87،and people between 18 -25 years old had the highest frequency. Among all parameters،self esteem and peer advices had shown a significant difference between male and female groups [p<0. 05]. Low self esteem was the most important factor in motivation for rhinoplasty among the participants in this study. Low self esteem، peer advices and social attitude toward themselves، were the most significant factors in tendency for this kind of surgery. assessment of the the motivation of the people for rhinoplasty should be done by the surgeon before rhinoplasty، in order to increases the patient’s satisfaction and at the same time reduces the direct and indirect costs of this surgery.

In most countries، socioeconomic status and demographic characteristics are somehow associated with all health consequences. Generally، the health problems and mortality among people who live in lower socioeconomic levels is higher، and the extent of those varies according to age، gender and race. It seems that the main factor for the differences is in the socioeconomic level. This is a review study، and related articles were collected by searching the keywords like socio - economic status، health outcomes، health behaviors، life expectancy in the published literature and databases such as: Web of Science، Science Direct، Google Scholar، Springer and Google. This study has compared the effects and interactions between health variables and demographic variables. In recent decades، several studies have shown positive relationship between individual’s socioeconomic statuses (SES) with their health. This Studies have shown that the individual’s socioeconomic status (age، sex، race، location and migration، education، income، occupation، etc.) are closely associated with mortality، life expectancy، disease، health behaviors، and access to health services in the western countries، but this relationship has not been yet established in the other countries and this relationship should be separately examine in every country based on economic، social، and demographic characteristics of the country. The results of studies show that socioeconomic status indicators have a strong relationship with the social and community health and economic growth.

Proper planning and training in any courses، especially in medical education prevent loss of a large part of the human efficient power and in this field increase physician satisfaction، trained Physicians with higher education knowledge and skills and a higher level of health for society. This study aimed to assess urology training course for general practitioners، among students of Tehran University of Medical Sciences has been done. In this cross sectional study of 501 medical students، urology course was assessed with questionnaire. Questions were in three sections: background information، program content evaluation and fitness evaluation time. The data were analyzed by spss software. The majority of students، 71. 1 % of the total ages evaluate practical training insufficient. Training time evaluated more insufficient by older students (11 %) than youngers (4 %). Also، those who were satisfied with the physical space of educational evaluated the training time less insufficient (4 %). In whom were satisfied with the final exam urology 83 % evaluate the training time more sufficient and 17 % had a high evaluation. evaluation of content showed statistically significant differences between the two sexes، and men were considered more (38 %) than women (23 %) that programs are necessary. Medical students’ satisfaction of quantity and quality of education and also increase in efficiency of medical student training in order to achieve a better level of public health goals require a complete re-evaluation in medical education.

Iran’s presumed rank in the top 12 countries of the world in terms of medicinal and industrial plants based on “The 20-year Perspective Plan” requires achieving objective information and insight about Iranian society’s current status especially regarding consumption of medicinal plants. Such information can be acquired through social researches. The present research was conducted using questionnaires. In order to acquire information and knowing about mechanism of medicinal plant consumption، the questionnaires enquired all family members of the students in Isfahan University of Technology. Sample size was chosen 682 families، and finally، 1047 questionnaires were collected. ANOVA test was applied to analysis and compare the opinions of participating groups. The results indicated that 71. 5% of Iranian people (statistically inferred from results of the research examinees) take medicinal plants (herbal products). 70% of male population and 73. 5% of female population use herbs as medication. Also، majority of Iranian people intake the herbs after boiling (41. 8% of the administered herbs)، and، 66. 8% of medicinal plants are purchased from apothecary. Relatives، friends، and the traditional culture inherited from the ancestors are the main sources of knowledge on how to use medicinal plants for Iranian people as 69. 1% of the herbs administered by Iranians have been introduced and adopted in this manner. Undoubtedly، achieving a superior position in the global ranking of medicinal plants (herbal products) requires culture-building، meticulous programming، and also provision of suitable contexts for creating salubrious and sustainable jobs out of the natural resources in the national development processes.

Morning report has been considered as an important educational tool and activity. In internal medicine، surgery، pediatrics، and obstetrics and gynecology departments of Urmia university of medical sciences morning report is conducted 5 to 6 times a week with the participation of students، interns and residents. However، nothing is known about its effectiveness. The aim of this study was to assess the degree of the learners’ satisfaction from the process of morning report. This study was a cross-sectional study which was conducted above-mentioned clinical departments. A 10-item questionnaire connected with different aspects of morning report process and one open question related with the views of the learners about the pitfalls and methods of improving morning report process was used. The students، interns and residents of each department after giving a written consent entered the study. The data of the questionnaire was divided into two groups of satisfaction and dissatisfaction. The answers to the open question were coded and grouped under the themes of the climate، implementation، format and content of morning report. In departments of internal medicine، surgery and pediatrics respectively، 18%، 16% and 48% of students were satisfied with the process of morning report. In These departments and obstetrics and gynecology departments respectively، 63%، 2%، 38% and 15% of the interns، and 51، 78%، 77% and 39% of the residents were satisfied with the process of morning report. The summary of the coded data from the open question is provided in table3. The results of the study showed that the learners were highly dissatisfied with the process of the morning report in the clinical departments involved in this study. In addition، the findings showed that there is a wide gap between the needs and expectations of the participants and what actually happens during the morning report sessions.

Telemedicine Technology is the main factor for capacity building as well as quality improvement of health services. Due to economic and social impact، systematic plan to acquire and use this technology was the dominant view and so it is important to move toward it. The aim of this study is to determine key factors influencing the use of telemedicine technology with studying expert›s viewpoints. The method of this research was a descriptive survey. In this research we used Delphi technique and purposive sampling method. A questionnaire with 3 main parts was used for data gathering. SPSS software was used to analyze these data. The findings of this research shows that all the key factors obtained from other countries experiences and the majority of National Innovation System factors are necessary in the opinion of experts. From the total score of 790، current situation of Iran obtained 297 scores that were 38 percent of total score. The most weakness for implementation of telemedicine technology was reported for coordination، intellectual property right and access to knowledge. The most capability of this technology is increasing access to health services. In the current situation of Iran، the best way to use telemedicine technology is to develop a national master plan as well as strengthening infrastructures and internal empowering.

Continous use of Clinical and Diagnosis Tariffs Reference book (known as ‘California’ book)، published in the early of 1970s، and caused many challenges in the health sector. In order to correct some of these challenges، experts from the Ministry of Health and Medical Education in Iran have developed new tariff book entitled’ relative values of clinical and diagnosis services “in 2008. Due to the importance and great impact of this book on health system costs and income of delivery units، this study intended to study experts’ points of views about these tariff references. This is a qualitative study، involving face to face interviews with policy makers atthe Ministry of Health and related organizations، and experts who had experiences about medical tariffs. All interviews were recorded and written. We used the thematic framework method for analyzing qualitative data. Presenting relative values for most of clinical services، establishing good balance between relative values of interdisciplinary and intradisiplinary services، and provision of up-to-date tariffs based on health technologies are the advantages of the new tariff book. On the Other hand the new book has some disadvantages such as: doubtful adjustment to information and financial system of country and adaptation with the payment system of the health service sectors. The usage of ‘California’ book is suggested by some experts but its improper impacts on medical education and delivery of health care services in the country are the most disadvantages of the former book. It seems substitution of ‘California’ book with new tariff book and use of new tariff book in 2008، have a total positive effect on health system of country. Future efforts should consider correcting of the new book’s potential weaknesses and reforming the payment system in the country.

One of the questions، Related to Fetus and barrenness curement، is about the criteria of being a human and Fetus as a single sole. Clarification of this subject، besides the determination of a verdict for abortion and its blood money، will be helpful in the discussion of fetus selection. The Fetus undergoes stages such as Zigoot، morulla، pre-fetus، and Fetus. So it is vital to determine in which of these stages، it can be considered a mean of single sole and a proper verdict will be drivenfrom it. Again، beforethat stage، is it imperative to respect the fetus and to protect it. This research is analytic and library-oriented. At first we have discussed the criteria of a single sole from western’s points of view. Then we did the same regarding Islamic Jurisprudent and theology. Discussion and Western thinkers-to consider Fetus a single sole-have suggested various criteria such Fecundation، placenta، the brain waves reflection، Fetus durability، and its birth. So، great diversities in their criteria tell us they don’t have any acceptable criteria to determine what human really is. Rather، Divine theology، besides clarifying necessary principles to identify human being، has determined the stages that a being passes to become a man. He undergoes various stages such as: minerals، plant life، animal life، till envolves into an actual man. Based on these foundations، in theology، Shiite; jurisprudents have determined the verdicts of abortion in any above named stages. To respect Fetus and to protect unnecessary abortion on a hand، and its lack of human characteristics، on the hand، has led to diversal opinions، among western thinkers، of what a single sole is. Islam has not faced this problem since its perfect Jurisprudence has primarily introduced a very exact criterion. The comparison between what the Jurisprudents say and what Divine theology claims، indicates the harmony between Shiite Jurisprudents and this school of thought. Jurisprudent doesn’t need to rely on philosophy to solve this problem. It is responsive by itself. However، its answer is in the agreement with that of Mulla Sadra; of course، each follows its own method. Rather، western thinkers، to find a solution to the question of “fetus as a single sole”، have clung to philosophy but philosophy is not capable of providing an accurate answer.