JOURNAL OF ZABOL UNIVERSITY OF MEDICAL SCIENCES AND HEALTH SERVICES (JOURNAL OF ROSTAMINEH)
Year:2012 | Volume:4 | Issue:1|Papers Count:12

Introduction: Total quality management through continuous improvement of quality, also personnel involvement and consumer satisfaction creates a great opportunity for health care systems to control their costs and improve quality of their services. The main goal of this study is to evaluate the preparation of Zahedan University of medical sciences affiliated hospitals for total quality management establishment.Method: This descriptive cross-sectional study assesses the view of 67 managers of different parts of Zahedan University of medical sciences about research goals. As a result of limitation in number of society population, total of population was selected as a sample. We use a questionnaire that its validity was determined by Delphi technique include 41 likret type questions in 8 parts. Analysis of data has done in base of descriptive statistics and ANOVA test in SPSS 16.0 software.Results: According to our hypothesis, sections with average above 3 were in good situation. 6 of 8 factor include consumer focus (3.45), education (3.29), innovation culture (3.06), quality management structure (3.16), leadership commitment (3.17), work grouping (3.07) were optimal but personnel involvement (2.92) and attention to staff (2.49) were non optimal because their average were under 3.Conclusion: According to our research results, for better establishment of TQM system in Zahedan University affiliated hospitals, we need more consideration on personnel involvement and increased attention to staff and their needs. By making an ideal space for express the staff’s ideas and using these ideas in hospital management, we would have a better context to implement TQM system. So we can propose TQM as a quality system and a priority for future management of Zahedan University affiliated hospitals.

Introduction: Cautaneous Leishmaniasis is one of the zoonosis diseases that transmits by sand fly also, is one of the most important health problems in Iran. Determining the epidemiological aspects of disease is useful for planning the control programs. This study was designed to describe the situation of cutaneous Leishmaniasis in Maraveh tapeh district.Methods: this descriptive-analytical survey was performed on all confirmed and recorded cutaneous Leishmaniasis cases (297 persons) that were diagnosed during 2006-2011 in Maraveh Tapeh district. Patient’s characteristics such as age, sex, habitat, number and sites of ulcer (s), month and year of incidence were registered. Data were analyzed by chi-square test using SPSS 13 software.Results: from total of 297 under care patients, 148 cases (49.8%) were men and 149 cases (50.2%) were women. 270 patients (90.9%) were resided in rural areas, while 27 cases of them (9.1%) were lived in urban areas. The most frequent age group was 0-4 years old (51.5%). Face was the most common site of ulcer (34.7%) and 37.7% of cases had one ulcer. Highest prevalence of disease (73.7 %) was observed in October, November and December.Conclusion: Cautaneous Leishmaniasis was increased remarkably and it has been epidemic in west of Maraveh Tapeh district during 2010–2011. Therefore, comprehensive planning for control and prevention of this disease is necessary.

Introduction: Ionizing radiations are one of the harmful factors in workplaces that can cause serious and irreversible damages on workers that are exposing to them. The purpose of this study was to determine the health and protection status of radiology centers Covered by Zahedan University of Medical Sciences during 2010-2011.Methods: This cross sectional study was performed on 29 active radiology centers covered by Zahedan University of Medical Sciences. In this study, in addition to inspection of radiology centers by executives, dosimetry was performed with Graetz-x5c dosimeter and standard checklist was completed. Checklist was included general and construction conditions also quality of protection equipments. In addition, the status of ray room, darkroom and control room were monitored. Finally, data analysis was done using descriptive statistics indexes including mean and frequency also by SPSS software.Results: The results of this study showed that protective status of radiation room was favorable. Also, 100% of surveyed radiology centers had desirable protected ray room and dark room but only 55.17% of them had favorable store. From viewpoint of environmental health parameters, in most of centers the status of wastewater and solid waste collection and water plumbing was desirable and in accordance with healthy condition of public sites. Only 13.71% of centers performed quality control of their equipments and %95.55 of them had number of protective equipments for patients and their relatives; nonetheless, protective system for personnel was ideal.Conclusion: It can be concluded that there is a good coordination between academic centers about principles of radiation protection in all centers as well as radiographers. But due to lack of adequate and accurate monitoring of persons who are responsible for inspections, quality control of equipments, also protection for patients and their relatives was not appropriate. So, this issue must be considers seriously by authorities.

Introduction: Medical students need to successfully go through four stages of basic sciences, physiopathology, stagery, and internship in their seven- year's period of medical studies. Basic sciences stage consists of five semesters and in order to take part in the final nation-wide exam of this period, students require passing all the subjects also achieving to a minimum average of 12 out of 20 and compete with their fellow students from all around the country. The requirement to continue their studies in the next stages is to pass this exam.Methods: The present census study was conducted on published results of 40 periods of Basic Sciences in Zahedan University of Medical Sciences. Totally, there were 1691 participants. Published data were investigated and analyzed by Ministry of Health and Medical Education and findings were extracted.Results: Of all the participants, 65.8% passed the exam in first time. Furthermore, in the first four periods, the percentage of success was higher in Shahrivar compared to Esfand exam; however, in other periods it was otherwise. It was also turned out that 16 participants even after 4 times, could not pass the course., 9 students finally continued their studies, 4 person changed their field of study and 3 were dismissed from school. Totally, 99.6% of the students continued to study after taking the exam.Conclusion: According to findings of this comprehensive study and to the time of this study, almost all studied medical students have passed the exam, actually based on the required criteria and without considering the required minimum score for special courses. Therefore, some considerations seem to be taken into account to elevate the efficacy of this exam. The recent program of Ministry to increase the minimum level for passing the exam is a part of this attitude.

Introduction: Bacterial meningitis is a public health problem, that threats developing countries. Neonatal meningitis characterized as a result of infection and inflammation of the meninges and typically happens in the first 28 days of life., Illness has special characteristics during neonatal period. Etiology, clinical symptoms and mortality is different from older children. Mortality varies based on the treatment with survival rate of 17% to 29% and complications rate of 15% to 68%.This research evaluates the prevalence of newborn bacterial meningitis in Kosar Hospital.Methods: This is a cross sectional design study. Participants were 567 suspicious neonatal that referred to Kosar hospital between Jul 2007 and Jan 2011. Data were obtained by doing a retrospective design of the medical records following a structured survey. Diagnosis of bacterial meningitis is established by following laboratory criteria: presence of cell>30 leukocytes/mm3 with predominance of neutrophills; proteins in cerebrospinal fluid>200 mg/dL; glycorrhachia<40% of concomitant glycemia; identification of bacteria in bacterioscopic examination and/or culture of eliminate cerebrospinal fluid (CSF). Both descriptive and statistical analysis methods were applied.Results: In surveying reports of 567 newborns, prevalence of bacterial meningitis was 1% (6). All patients had positive CSF culture. Culture results were as follow: E.Coli in 2 case, each of Klebsiella pneumonia, Enterobacter spp., Pseudomonas aeruginosa and Staphylococcus aureus in 1 case.Conclusion: Infection of nervous system is one of the major problems in clinical practice, especially during the first month after birth. During this first month, nervous system's infection develops special characteristics, which are different from regular symptoms and it requires treatment due to increased risk of develop complications. It is strongly recommended to monitor ototoxic drugs that use to prevent effects on hearing system.

Introduction: Obesity is a condition that is associated with metabolic changes such as insulin resistance and loss of blood pressure control. These situations are causes of diabetes mellitus and hypertension. The aim of this study was to evaluate the association of body mass index (BMI) with pre-hypertension, pre-diabetes and other cardiovascular risk factors.Methods: 286 persons that were between 30-69 years old participated in Ischemic Heart Disease design in Jahrom. They were studied after exclusion of any history of cardiac diseases and smoking use. Body mass index, blood pressure, fasting blood glucose and serum lipids were measured in all persons (2009-2010).Results: By raise of body mass index from 38.7% in normal body mass index to 61.5% in obese persons (p=0.009), the percent of pre-hypertension was increased. But percent of pre-diabetes had not significant association with body mass index (p³0.05). Also, the mean systolic and diastolic blood pressure and LDL cholesterol were higher in overweight compared to normal body mass index persons. Also in obese persons, the mean systolic and diastolic blood pressures and triglycerides were higher than in normal body mass index persons.Conclusion: Increase of body mass index in healthy persons is associated with pre-hypertension. Thus, public education is necessary for prevention of obesity and overweight.

Introduction: Tuberculosis (TB) is one of the most common infectious diseases in the world that leads to more than 2 million deaths annually. Because of insufficient control, tuberculosis was declared as urgency by World Health Organization. The main reservoirs of infection are patients with smear-positive pulmonary TB, so to control of disease, educate the patients about self-care behaviors is necessary. The average index of tuberculosis in Sistan is more than 11 times of global index. The aim of this study was to determine the efficacy of health belief model on promotion of self-care behaviors of patients with smear-positive pulmonary tuberculosis in Sistan region in 2011.Methods: The framework of this quasi-experimental study is health belief model. The study group consisted of 160 patients that were divided equally into test and control groups. Data were collected by researcher made questionnaire. After that, the validity and reliability of the questionnaire were assessed. Pretest was conducted on two groups, to identify training requirements based on study objectives. Training materials were included manual and two pamphlets. The training plan was performed in the test group, during 3 sessions. After one month, post-test was taken among two groups. Data were analyzed by SPSS16 software and descriptive and analytical test in before and after of intervention.Results: The mean age of people that were under observation was 55.20 years and mean treatment duration was 32 days. Majority of them were female (53.8%), 76.9% were illiterate, 76.9% were lived in rural areas, 21.2% had a family history of disease, most of them (41.8%) had monthly incomes between 100000-200000 tomans and 83.7% of them had received training about TB. In general, results indicated promotion of model construct, knowledge and self-care behaviors in the test group after intervention, based on paired sample t-test significancy (P<0.001). Independent t-test showed that two groups had a significant difference (P<0.05) in all constructs, knowledge and self-care behaviors except perceived severity and self-efficacy after intervention. Kruskal-Wallis and mannwhitney tests showed significant correlation between demographic variables and original research variables, that the most important of them were age, education, habitat and train resources. The correlation test showed that after intervention, a positive correlation was between model construct and knowledge of self-care behavior (p<0.001) in test group. Based on regression analysis, perceived barriers (P=0.01) and knowledge (P<0.001) can be useful predictive in promotion of self-care behaviors.Conclusion: Health education promotes knowledge and self-care behaviors of patients through health belief model and prevents the outbreak of disease that can cause disability, mortality and socioeconomic problems in the community.

Introduction: Labor pain is a health and therapeutic problem in the world that causes increase of cesarean section rate. Recently, non-pharmacological methods such as massage were used for labor pain treatment. The aim of this study was examination the effect of massage on intensity and duration of labor pain in primigravida women.Materials & methods: This randomized controlled study was conducted on 2007. Sixty primigravida women expected to have a normal childbirth at Amiralmoemenin hospital in Zabol were randomly assigned to either the massage (n=30) or the control (n=30) group. The Visual analogue scale (VAS) was used as a measure of labor pain. The intensity and duration of pain also length of labor's first stage between two groups was compared in the active phase (5 cm) and transitional phase (8-10 cm). Data were analyzed using SPSS13 software.RESULTS: This study showed that manual massage decreased intensity and duration of labor pain in both stages of active phase. (1.963 Vs 2.718, p=0.0001 and 2.311 Vs 3.720, p=0.000), significantly.CONCLUSION: Findings suggest that massage is a cost-effective method that can decrease labor pain.

Introduction: Tuberculosis has been declared as a global emergency by World Health Organization. Unfortunately, average incidence rate of Tuberculosis in Sistan and Balouchestan province, approximately, is 11 times greater than global rate. The aim of this study was to survey the usefulness of Health Belief model required for a positive behavioral change in tuberculosis control in Sistan area in 2009.Methods: This quasi-experimental study is as before and after, and carried out on 110 adolescent patients with tuberculosis that were chosen from a Tuberculosis Center. Sampling method was non-probability. Data were collected through a standardized questionnaire which was designed based on Health Belief Model and included some additional information such as demographic variables. At first, with a descriptive study of individual perceptions, behaviors and indicators of TB were investigated, then, confirmation of scientific validity and reliability were used. The questionnaires were evaluated in terms of validity and then used. Participants’ educational needs were provided base on Health Belief Model in primary assessment, curriculums developed based on initial assessment and training was available through face-to-face, workshops, using Medias such as educational films and pamphlets. To determine the effect of educational intervention, post-test was done after two months. Data were analyzed with appropriate statistical tests and SPSS software.Results: Results of this study showed that prior to intervention, no significant difference (p>0.05) were found between average scores in case group in terms of acknowledge level, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy and behaviors. Also, after intervention, the average score for all mentioned variables has significantly increased in control group except for perceived barriers (p<0.05).Results showed that, the percentage of described behavioral changes was %8.8 that is the correlation between the constructs of health belief model and behavior of TB patients.Conclusion: Health education based on Health Belief Model in control of tuberculosis, can lead to improvement of knowledge and positive behavior in people. So that the greatest effects were pertain to perceived susceptibility and severity.

Introduction: Staphylococcus aureus and Salmonella typhimurium are an important cause of community and hospital acquired. infections caused by methicillin resistant S. aureus are mainly nosocomial and are increasing in all around the world. Many attempts have been made by the researchers to find new compounds as an appropriate substitute for these antibiotics. The aim of this study is evaluation and comparison of antibacterial activity of Malva neglecta extracts and nanosilver particles against resistant Staphylococus aureus and Salmonella typhimurium.Method: In this study aquatic and ethanolic extracts of Malva neglecta leaves prepared, and MIC and MBC of extracts and nanosilver particles for Staphylococus aureus and Salmonella typhimurium calculated with broth macrodilution and agar well diffusion methods. In animal model study, 5´105 CFU/ml of eacth bacteia was inoculated intraperitoneally and after 24 h, 0.5 cc (as MBC concentration of each extracts and nanosilver particles) of each Malva neglecta extracts and nanosilver particles inoculate i.p to female BALB/c mice. Then, the count of baceria in spleen were determined on Muller-Hinton agar after 7 days as the standard protocol.Results: Results indicated that MIC and MBC of Malva neglecta aquatic extract for Staphylococus aureus were 3.2 and 6.5 mg/ml and for ethanolic extract were 6.5 and 13 mg/ml and for nanosilver particles were 6.2 and 12.5 ppm, respectively and MIC and MBC of Malva neglecta aquatic and ethanolic extracts for Salmonella typhimurium were equal to 52.2 and 104.5 mg/ml and for nanosilver particles were 12.5 and 25 ppm, respectively. The in vivo average grown Staphylococus aureus 24 hours after of culture of spleen supernatant for aquatic and ethanolic extracts were 3´103 CFU/ml and 2´104 CFU/ml and for nanosilver particles were 300 CFU/ml, respectively in comparison with control group (3´107 CFU/ml). Also this in vivo results for Salmonella typhimurium were 6´103 CFU/ml and 7´104 CFU/ml for aquatic and ethanolic extracts for nanosilver particles were 500 CFU/ml, respectively in comparison with control group (4´108 CFU/ml).Conclotion: Overally in vitro and animal model the results indicated that aquatic extract of Malva neglecta and nanosilver particles were shown the most effective antimicrobial activity on Staphylococus aureus and Salmonella typhimurim in comparison with ethanolic extract and they can be useful in production of new drugs.