Payavard Salamat
Year:2018 | Volume:11 | Issue:6 |Papers Count:14

Background and Aim: Staphylococcus aureus produces many virulence factors, including toxins, immune-modulatory factors, and exoenzymes. The study was performed to determine virulence and resistance-related factorset A, et B, tst, mec A and fem A in the S. aureus isolated from clinical samples using Multiplex PCR.Materials and Methods: In this cross - sectional study, a total 60 S. aureus were collected from the Shariati hospital in Tehran, Iran. Susceptibility test to several antimicrobial agents was performed by disk diffusion agar based on clinical and laboratory standard institute guidelines. After DNA extraction, the multiplex-PCR amplification of theet A, et B, tst, mec A and fem A was performed in all the clinical isolates.Results: In this study, all isolates (100%) were positive for the presence of femA gene. The highest and lowest resistance rate were related to erythromycin and cefoxitin, respectively.33.3% (n; 20) and 43.3% (n; 26) of isolates carried in order etb and tst genes. All strains were negative for the eta gene.Conclusion: Our results showed that, among many virulence factors produced by S. aureus, etb, tst play an important role in the pathogenesis of staphylococcal infections. Results suggested that identification of MRSA strains to be done using cefoxitin disk (in comparison of oxacillin) or PCR formec A gene.

Background and Aim: Personal Health Record (PHR) systems play a key role in employing patient-centered care. Besides, the inclination to use Internet services has increased in recent years. The goal of this study is to describe the needed requirements for developing the proposed hybrid PHR model in a social network.Materials and Methods: Using a descriptive study, a hybrid PHR model was designed in this paper to be implemented in the social health network. Then, by using observation, introspection and questionnaire methods, the requirements of the proposed social network were listed. The elicited requirements were then analyzed by SPSS 16 using descriptive statistics (absolute frequency). Finally, the proposed system was described in the Software Requirement Specification (SRS) standard format.Results: The proposed hybrid PHR model has benefits of all existing PHR models and is most consistent with PHR definition (individuals control and manage their PHR). It is also applicable and reliable both for individuals and physicians. The results indicated that the proposed system had PHR capabilities as well as social network functionalities. So, the possibility of creating relations between individuals provided more benefits in comparison to other PHR models.Conclusion: By providing reliable information, the social health network can improve patient-physician relationships. As a result, the proposed social health network can make possible the utilization of web 2.0 and social network capabilities in the healthcare field as well as the benefits of PHR records and patient-centered care.

Background and Aim: In each organization, there is a debate about the use of IT. Human development is one of the factors influencing the efficiency and success of any organization. The present study aimed to investigate the effects of information technology on empowerment of staff working in Tehran University of Medical Sciences.Materials and Methods: This study was descriptive-survey research and applied in terms of purpose. A total of 274 staff members from the Tehran University of Medical Sciences were surveyed by sampling according to the Krejcie-Morgan table from among 950 employees. The tools used in the Ardalan questionnaire were divided into two parts of IT, including 10 questions and a staff empowerment questionnaire containing 23 questions. Data were analyzed by SPSS 13 software, Kolmogorov-Smirnov test and one-sample T-test.Results: The research findings showed that the use of information technology on five dimensions of job empowerment including competency, improvement of quality of work, increased decision-making power, increasing self-control, and reducing job stress have a significant effect.Conclusion: The most important task of managers of universities is to improve the ability and job satisfaction of employees, holding in-service training courses in the field of computers and the Internet and encouraging employees to use more computers in their related activities.

Background and Aim: World Health Organization (WHO) has prioritized cultural competence to provide high-quality healthcare and patient-centered services.Therefore, it is necessary to develop them for all organizational levels. The present study aimed to determine the validity and reliability of the Persian version of OHCC (Ontario Healthy Communities Coalition) organizational cultural competence (2005) instrument in Tehran University of Medical Sciences (TUMS).Material and Methods: In order to confirm reliability, 143 staff members (nurses and physicians) in different administrative positions working in Imam Khomeini educational Hospital, completed the questionnaire. Modified HSR toolkit for translating and adapting instrument, was used for contextualizing the questionnaire: first, two medical education experts who were proficient in English translated it.Then, the content validity of Persian version was confirmed using Lawshe method (CVR and CVI=0.79); its internal consistency was calculated by Cronbach's alpha coefficient (0.912). It was backward translated to compare with the original copy and was sent to experts for their approval. Construct validity was calculated by LISREL software and the result showed that the questions were fit to the domains.The KMO, calculated for this instrument, was 0.751 and α was less than 0.05.Results: Content validity was confirmed by deleting two items from the original 22-item questionnaire. Cronbach's alpha was calculated as 0.912 following the removal of two items.Conclusion: The organizational cultural competence instrument was confirmed to be valid and reliable with 20 items in Iranian context.

Background and Aim: Milk is a suitable environment for most microorganisms.Pollution in the suckling production chain and its implementation result in unsatisfactory sanitation, long-term transportation, and the lack of facilities for storing milk. The purpose of the study was to identify and control the effects of common microorganisms of mast infections and their role in the transmission of diseases with milk as a major contribution to storage and, finally, the transmission of these pathogenic infections to humans.Materials and Methods: A total of 450 raw milk samples from traditional and industrial plants were collected around the city of Tehran. In order to determine the identity of the bacteria, their transmission to a differential culture, was used standard microbiological methods and antimicrobial susceptibility testing (Disc diffusion).Results: The results of biochemical experiments were conducted on 225 isolates from isolation and diagnosis of bacteria in raw milk, antibiotic susceptibility test in accordance with CLSI 2010 standard guidelines. Antibiotics of tylosin and streptomycin with the highest antibiotic resistance were 221 (98.2%) and 217 (96.5%), respectively, which were most susceptible to the tetra delta and ciprofloxacin respectively (0%, 100%) and 15 (6.7%) bacterial resistance cases were observed.Conclusion: According to the present situation and the results obtained, the level of contamination obtained from traditional and industrial livestock is still high.Although regular mastitis and infections are commonly found by specialists, but the contamination caused by milking and collecting is higher than normal values.The frequent use of antibiotics and the resulting resistance has provided a very important and controversial problem.

Background and Aim: Nowadays, e-procurement systems have provided many opportunities to improve supply and procurement activities in healthcare industry through Internet-based electronic communications for supplier-buyer interactions.Considering the fact that the implementation of these systems is not successful in many cases, extensive preparation in relevant areas is necessary before implementation. This paper aims to present a framework of key readiness factors of hospitals for the adoption of e-procurement system.Materials and Methods: This study was an applied descriptive survey. The framework of readiness factors was developed based on an extensive review of literature and e-readiness models as well as opinions of experts in the field of information technology, procurement, and healthcare systems. The proposed framework was applied in a case study of a specialty hospital located in Tehran in 2016. The data were collected using a questionnaire, and Fuzzy Cognitive Map (FCM) method was used for modeling and analysis of the identified factors.Results: In this research, a comprehensive framework of critical readiness factors of hospitals for e-procurement adoption was developed comprising five main components: management, technology, process, human resource, and environment.Environmental and managerial factors were identified as the most important readiness determinants of the case hospital, and among various factors, managers' expertise in IT, IT infrastructures of hospital, and continuous monitoring of system' s performance are of higher priority.Conclusion: This paper provides guidance for more accurate planning to improve readiness and successful adoption of e-procurement systems in hospitals by identifying the most important influential readiness factors.

Background and Aim: Glaucoma, with an increasing pressure inside the eye, is one of the causes of blindness worldwide. The only treatment for glaucoma is regular eye examination and control of intraocular pressure (IOP). The centralized information obtained from these examinations is an essential prerequisite for providing optimal healthcare which is possible by creating electronic records.Minimum Data Set (MDS) is a standard tool for getting access to accurate data, which is among the basic needs for the design of electronic records.Materials and Methods: This is descriptive-analytical study. The population of this study consisted of glaucoma patients’ medical records at Farabi Eye Hospital, reference books, and glaucoma specialists. The data collection tool was a questionnaire -- containing patients' records, and demographic and clinical data-- which was distributed between 22 available glaucoma specialists. The validity of the questionnaire was assessed by an expert team and its reliability was determined by test-retest method. Data analysis was performed by calculating the frequency percentage and Delphi test.Results: After reviewing the rate of experts’ agreement with the components of the survey, all of the cases with over 75% approval rate were considered as minimum data set for glaucoma. Minimum data set was divided into three general categories; including patient's records, demographic data, and clinical data.Conclusion: Determination of minimum data set for glaucoma will be an effective step to integrate and improve the management of patients’ records. Moreover, it will be feasible to store and retrieve such records.

Background and Aim: Pseudomonas aeruginosa is one of the most important factors in hospital infections, especially in patients with immune deficiency and Childhood diseases. The Virulence of bacteria are due to the presence of the Pyoverdine gene, which has many effects on the wild type of bacteria during the pathogenic pathway. Identification of different classes of PVD gene is necessary for the development of prevention and control Diseases program. In this research, the presence of PVD genes in the samples and their effect on pathogenicity was isolated and investigated.Materials and Methods: In the present study 60 Species of P. aeruginosa was isolated from clinical samples of human and animal, after approval by diagnostic tests and differential, were studied. Finally, for every 60 Species, isolated, Multiplex PCR was performed to detect target genes. Multiplex PCR method is to be considered as the gold standard. Its results are more reliable.Results: The results showed that the frequency of PVD gene in human isolates and livestock gene encoding the 3rd Pyoverdine was the highest frequency with 76.6% the lowest frequency is for Pyoverdine class 2 with 46%.Conclusion: As a result, the identification of three type’s genes of PVD classes in all strains tested by Pseudomonas could help to identify human patients and livestock with Pseudomonas infection and, given the presence of the genes encoding PVD, has a direct relation to important bacterial pathogenicity.

Background and Aim: Nowadays, one of the most important areas of application of information technology in the health sector is monitoring patients' condition.Recently utilization of body area sensor networks in healthcare had significant advances. The purpose of this article is to examine the applications of wireless health sensor networks in the field of health.Materials and Methods: This study was a review study which was done by searching in reliable scientific sources such as Pubmed, IEEE, Science Direct, Springer and other Persian information sources like Magiran and Sid between years 2000 - 2016. In order to search English sources, keywords such as “Wearable and implantable body sensors” “Body area sensor network”, and in order to search in Persian sources, keywords such as “implantable and wearable network nodes”, were used.Results: The tasks of the body sensor networks are to monitor the important parameters of the body, which are vital signs of health and illness. Additionally, various types of sensor networks can control various illnesses, for example, heart disease, neoplasms, diabetes, kidney disease, Parkinson's disease, infectious diseases, and so on. Also a variety of wireless body sensor networks in the medical field are divided into two main categories: the wearable wireless body area networks and the implantable wireless body area network.Conclusion: The use of body sensor networks has tremendous impact on health and leads to improvements in the life quality and comfort of patients. These technologies are improving, and their development aims to help patients, doctors and the treatment team.

Background and Aim: Medication errors are preventable event, which may result inappropriate medication intake or damage to patients and, Medication management is a complicated process including multiple activities in order to improve patient safety. There are many documentations that indicate the considerable potential of information technology, especially mhealth in this area. The aim of this study was to review the mobile based medication management systems in order to extract the requirements for these systems development.Materials and Methods: Four electronic databases (PubMed, Embase, Web of Science and Science Direct) were searched for papers regarding mHealth based medication management systems. After screening the abstracts and publications information a descriptive study was performed on 15 papers.Results: In this study, 13 functional requirements were extracted and the user requirements was divided into six main groups. Also the technologies which was used in order to implement the functional requirements were extracted.Conclusion: According to the current study, medication management systems using mhealth technologies are feasible for people with chronic diseases, elderly people and etc. but there is not any medication management system for visually impaired people. Although due to their disabilities they are at higher risk of medication errors and it is a research gap that should be considered in future works.

Background and Aim: Enteropathogenic Escherichia coli (EPEC) pathotypes belong to Enterobacteriaceae family that is known as the cause of gastroenteritis and diarrhea in under-5-year-old children. These bacteria have high prevalence in developed and developing countries that may cause severe illness or even death.The aim of this study was to examine EPEC prevalence in diarrheal samples of children under 5 years -- caused by the country’s food -- by PCR method.Materials and Methods: In a cross-sectional study, 45diarrheal samples of children suffering from country food outbreaks were transferred to the Department of Microbiology, School of Public Health, Tehran University of Medical Sciences (TUMS). E. coli strain was identified using standard methods and biochemical tests. For the detection of Enteropathogenic E. coli, the presence of eae gene was checked by PCR method, and serologic test using specific antiserum (Mast company, England) was checked by agglutination method on slide.Results: Of the 45 outbreaks, 28 Escherichia coli were identified, among which 1 isolate (3.6%) was identified as E. coli EPEC. This isolate contained eae gene.Based on the serological response of somatic antigen (O) and flagella (H), the isolated Escherichia coli serotype was EPEC O119B14.Conclusion: Although the prevalence of EPEC E. coli in children’s diarrheal samples from food outbreaks is low, the presence of these isolates is important and should be considered.

Background and Aim: Ergonomics is the science of refining and optimizing the working environment, occupation and equipment, and matching it with human capabilities and limitations. The purpose of this study was to compare the working environment conditions of the library staff with Ergonomic Principles in selected Universities of Medical Sciences in Tehran in 2016.Materials and Methods: This is a descriptive and cross-sectional study. The population of this study included all faculty librarians of selected Medical Sciences Universities in Tehran. This study was conducted by census method and all population members (n=85) were studied. The data collection tools were ergonomic checklist in the library environment and a researcher-made questionnaire on the educational status of ergonomic principles. The data were analyzed by SPSS software version 22 after they were collected and entered into the computer.Results: Based on the obtained findings, it became clear that the status of variables such as body conditions, work space, equipment and environmental conditions was average in terms of ergonomic principles and health variables, and safety factors and welfare facilities were at an undesirable level. In each of the variables of body condition, work space, equipment and safety factors among the libraries of selected Universities, ergonomic conditions did not have significant differences.Conclusion: According to the results of this study, it can be concluded that the conditions of the librarians’ working environment in the studied community were not favorable in terms of ergonomic conditions.