Sadra Medical Sciences Journal
Year:2019 | Volume:7 | Issue:3 |Papers Count:9

Background Hospital beds are the most expensive part of the service delivery system in the health system of the countries, and the intensive care beds are more important. This study has been conducted with the aim of designing a model for distribution of intensive care beds in the country. Material & Methods The current study is a descriptive-analytical type that has been performed through 2018-19. The study population consisted of 340 health managers and experts in 10 health centers of medical universities in Iran. Data were collected through a researcher-made questionnaire and analyzed by SPSS 25 and Lisrel8. 8 software. The main components affecting the distribution of intensive care beds were identified by exploratory and confirmatory factor analysis to model confirmation and the method of analyzing the main elements by vertical rotation and also Varimax technique. Results In exploratory factor analysis, 34 variables were divided into 6 main components. Results of fitting indices for the model indicates acceptance of the studied index and acceptance of the model. Also six economic factors (with 5 components), organizational (with 7 components), political-social (with 5 components), structural (with 7 components), demographic (with 5 components), geographical (with 5 components), were identified as main dimensions which covered 59. 36 percent of the total variance of the variables. After confirmatory factor analysis, all factors were in good order, and the model was well fitted and validated. The demographic dimension had the highest weight (0. 80) and the economic dimension (0. 53) had the least effect on the distribution of intensive care beds. Discussion and conclusion In this study, a model of distribution of intensive care beds was explained and among the influential components, demographic factor component plays a very important role in the distribution of intensive care beds. Health system policymakers and managers must pay particular attention to the effective components in decision-making for proper allocation of hospital resources, especially hospital beds to achieve justice in health.

Background Pterion is a suture that is located in the lateral side of the skull in the depth of which there are middle meningeal vessels, the root of the lateral sulucus, the sinus cavernus, the bruca area and the insula cortex. In addition, it is a landmark for craniotomy and surgical approaches in tumors of the Willis ring or the frontal lobe for neurosurgeons. Due to the importance of pterion morphometry for neurologists, in the present study, morphometric indices of pterion and its types were studied in dry skulls. Methods This descriptive study was performed on 37 skulls with no deformity and pathologic problems in 2017-2018. The vertical distance of the pterion to the center of the zygomatic arch and its horizontal distance to the frontosigmatic suture were measured. Murphy division was used to investigate the types of pterions. Finally, the data were entered into SPSS software and analyzed with descriptive statistics and T-test. Result A total of 37 skulls were examined. The mean vertical distance of the pterion to the center of the zygomatic arc was 1. 99 ± 1. 41 cm and the mean horizontal distance of the pterion to the frontosigmatic suture was 2. 80 ± 0. 76 cm. The frequency of the sphenoparital, frontotemporal, stellate, and epipetric types were 89. 1%, 5. 4%, 2. 7%, and 2. 7%, respectively. The statistical test did not show any significant difference between the distance between the pterion and the zygomatic arch (p = 0. 16) on the left and right. There was a significant difference between the pterion and the fento-zygomatic suture on the left and right (p = 0. 005). Discussion and Conclusion The study of morphological features of the skull bone is useful for neurologists, forensic specialists, and anatomists. However, other studies with a higher sample size on the skull bone, as well as radiographs and CT scans in different parts of the country appear necessary.

Background Little is known about the epidemiology of temporal lobe epilepsy (TLE) in the developing world. This study aimed to investigate the demographic and clinical characteristics of patients with TLE in southern Iran. Methods In this retrospective study, all patients with TLE who had referred to the Outpatient Epilepsy Clinic at Shiraz University of Medical Sciences from 2008 to 2013 were studied. Demographic variables and the clinical signs/symptoms of this disease were summarized descriptively. Results 225 patients (113 males& 112 females) were studied. Age at seizure onset was 17. 7 years. Complex partial seizures, tonic-clonic seizures, and auras were reported by 179 (79. 5%), 160 (71. 1%), and 139 (61. 7%), respectively. Focal seizure waves were observed in 201 patients (90. 6%). Magnetic resonance imaging (MRI) was normal in 39 patients (17. 3%) and mesial temporal sclerosis was detected in 117 patients (52%). Conclusion Temporal lobe epilepsy is a common epileptic syndrome. Age at onset spans a wide range, from infancy to adulthood. Complex partial seizures are the most common seizure type; however this is not a defining seizure type. Electroencephalography and MRI are ancillary diagnostic tests. However, atypical findings in a patient with a typical history of TLE should not deter from correct diagnosis.

Introduction Student life is an exciting and challenging era. During this period, all students must have more mental health and self-reliance so that they can achieve success in their education and career. Since the major part of academic success depends on the students' psychological state, this study was conducted to investigate the psychological status and academic performance of nursing students at the School of Nursing and Midwifery in Shiraz. Method In this cross-sectional study, the psychological state of 144 nursing students was evaluated based on a mental syndrome questionnaire (SCL-90-R). After collecting the questionnaires, the students were divided into two main groups, without psychological problems and with psychological problems, based on the scores obtained. At the end of the course, their educational status as well as the rate of academic failure were determined in both groups. Result Data analysis showed that 42. 2% had signs of psychological disorders, but there was no statistically significant correlation between their demographic characteristics and semesterly GPA (15. 98± 2. 10) and their mental status (p>0. 05). However, there was a significant correlation between the psychological state of an individual and the level of interest in the field (p<0. 05) Discussion and Conclusion Students are exposed to psychological disorders due to their special circumstances and this can affect their educational status. It is necessary to take special measures in order to pave the ground to prevent such disorders in universities.

Background Holdingcontinuing medical education programs (CME) is one of the recommended global strategies for attaining rational drug prescribing by physicians. The aim of this study was to assess the barriers and fill the gap between the current situation and the favorable status of CME by evaluating experts’ viewpoints on the role of these programs in improving the status of drug prescribing. Methods This qualitative study was conducted using a semi-structured interview. Participants included those who were well-informed and experienced in the field of rational use and prescribing drugs. Sampling was done in a targeted way and 16 people were interviewed. The interviews were evaluated after the implementation of the theme analysis method. Results In this study, two major concepts including the needs for CME and barriers to effective CME were presented by the participants. The needs for CME included 4 main themes, and the barriers to effective CME included 6 themes (physical, financial, motivational, supervisional, executive, and policy making barriers) and 12 sub themes. Conclusion Regarding the multiple barriers to achieving the effective CME and improving the rational drug prescribing, and in order to overcome these barriers and achieve a favorable status, a review of the content and quality of CME, outcome-based planning, and continuous quality promotion are required.

Background The increasing tendency of women towards the traditional and complementary medicine shows the changes taking place nowadays. The present study has been carried out with the aim of studying the factors related to the women’ s use of traditional and complementary medicine. Methods This was an analytical and a cross-sectional study in which 464 women who visited six non-conventional medical centers and gave their consent were studied using complete enumeration method. The data were collected using a researcher-made questionnaire whose validity and reliability were confirmed and analyzed through SPSS software. The Andersen Socio-behavioral healthcare utilization model was selected as the theoretical model. Results Based on the theoretical model, the factors related to the use of traditional and complementary medicine were studied in three categories namely predisposing factors, enabling factors, and needs. The results showed that the variables such as job status, attitude toward the traditional and complementary medicine, social networks, and access to traditional and complementary medicine have a positive and significant correlation with the use of traditional and complementary medicine. Discussion and Conclusion The key factors related to the use of traditional and complementary medicine were predisposing factors like social networks and positive attitude toward the traditional and complementary medicine, and enabling factors like job status and access to traditional and complementary medicine. Since the findings of the present study show no correlation between many demographic factors and the use of traditional and complementary medicine, for future studies it is better to focus on other social and cultural factors related to the use of traditional and complementary medicine.

Background Managers have a main role in the leadership and supervision of clinical and administrative human resource to improve efficiency and effectiveness in different departments of hospitals. Thus, managers are required to communicate effectively. The current study aimed to identify the main factors affecting the development of interdepartmental relations of the managers of medical centers at Shiraz University of Medical Sciences (SUMS). Methods This is a qualitative study conducted through content analysis in 2018. Eight managers with at least 5 years’ experience of management at SUMS were selected through purposive sampling to participate in the study. Data were collected by a semi-structured questionnaire. Finally, eight deep and semi-structured interviews were conducted, findings were saturated, and themes were extracted. Results The findings showed that the main factors affecting the development of interdepartmental relations are categorized in three themes: individual factors including leadership, moral features, personality features, communication skills; technical factors including modern technology; and organizational and structural factors including organizational culture. Discussion and Conclusion Establishing effective communication between different departments of hospitals are among managers’ duties. According to the study findings, it is important to consider individual characteristics of managers as well as technical and organizational factors as important elements affecting interdepartmental relations to achieve organizational goals.

Introduction Health Reform Plan is being implemented in line with its high goals including health equity. One of the important points that contributes to this goal and is included in the healthcare reform system map is the attention to the capabilities of websites and their services. Therefore, this study has aimed at the evaluation of the performance of Iran’ s medical university websites with respect to Reform Plan. Methods This descriptive survey research is to measure the performance of websites in accordance with the goals set out in the Health Reform Plan map and to use the IT checklist as a template. Data were analyzed for all 44 universities in 2018 and the descriptive statistical analysis was done by using SPSS. The score of each university was evaluated according to the average total score of observing the indicators related to each question so that the highest score per question for each university is one and the lowest score is zero and the average score is 0. 5. Results Only 11 universities received above the average score of 44 universities. Shiraz University with 0. 86, Tabriz University with 0. 76, Sabzevar University with 0. 74, and Urumieh University with 0. 70 scores ranked first to fourth, respectively. In addition, no goals have been achieved for the goals mentioned in universities of medical sciences. Conclusion The university websites have been struggling to meet the goals of the Reform Plan, especially in deprived areas and type 2 and type 3 universities. Electronic welfare services including appointment scheduling website and other websites have been created on these websites, and this has led to a change in the use of websites that used to give information and now they render services.

Over the last two decades, due to the advances in the techniques used in the design and synthesis of peptides as well as the understanding of the underlying molecular mechanisms involved in their therapeutic action on skin disorders, novel applications have been emerged for peptides as cosmeceuticals. There are several advantages in the use of bioactive and biomimetic peptides such as availability, diverse and selective mode of action in skin physiology, and lack of immunogenic reactions that have attracted skin specialists’ attention for their potential use as anti-wrinkle agents. These peptides are known to have various biological roles against skin ageing, most prominently as extracellular matrix signal modulators and collagen synthesis stimulants. In addition, they may act as carrier peptides, antioxidants, neurotransmitter or enzyme inhibitors. However, they are facing a few obstacles for widespread applications in topical anti-ageing skin products: a) clinical evidence for the therapeutic efficacy is still limited; b) skin penetration may be weak due to their hydrophilicity, high molar mass, and binding to other ingredients; and c) high cost. Peptide transport through skin can be effectively boosted by penetration enhancers, lipophilic modifications, peptide microencapsulation, and skin microporation. There are currently more than 30 therapeutic peptides that have been occasionally introduced into the market of skin care products. This review summarizes different classes of topical peptides with proven effectiveness against skin ageing in-vivo. Moreover, the challenges of and approaches to peptide transport through skin OR (the delivery challenges and approaches) are discussed