Journal of Medical Council of Iran
Year:2012 | Volume:30 | Issue:3|Papers Count:11

Background: Over three decades of research on social determinants of health suggest unequivocal impact of factors like childhood development, education, employment, housing, entertainment, public transportation, agriculture and social support, on people’s health. In the aftermath of the Islamic Revolution, there has been eye-catching progress in the areas of maternal and child health. The key role of the Islamic Consultative Assembly in examining and approving five years development plans of the Islamic Republic is irrefutable. The implementation of national development plans has often contained core determinants of health, in particular in the areas of employment, housing, social support, health services, environment and food security. The support rendered by the Islamic Consultative Assembly to promoting health in the past three decades, spurs further hope for greater strides in terms of health indicators of the country, in accordance with the following strategies:-To draw full support of the Health and Medical Commission of the Islamic Consultative Assembly, to ensure approval and monitoring of health oriented laws and regulations and policies in all 14 commissions of the Assembly;-To negotiate and win the support of all members of the Assembly’s fractions, and heads of forums for provincial groups of parliamentarians, to encourage approval of health oriented policies at the Assembly and their implementation within provinces;-To cooperate with the Ministry of interior in promoting the performance of the Provincial Councils on Health and Food Security and Islamic Councils at city and village levels, to stimulate participation of all in improving the situation of their immediate environment;-To supervise and provide support to the Ministry of Health and Medical Education in further activating the National Council on Health and Food Security;-To lunch a monitoring system at the Research Center of the Islamic Consultative Assembly to oversee indicators related to health equity.

Background: Ankle sprains are the most common musculoskeletal injuries that occur in athletes all over the world. Ankle sprains can also cause longterm disability such as ankle pain, Functional ankle instability, postural disorders, recurrent ankle sprain and etc.Methods: The purpose of this study was to examine prospectively intrinsic and extrinsic risk factors for ankle sprains in 125 Irainin athletes that were divided into two groups: Healthy and Injured groups. Ankle range of motions, Achilles Tendon’s flexibility and Calf’s size were measured and related questionnaire was completed.Results: Ankle sprains were more common in soccer, basketball and volleyball than other sports. Severe ankle inversion was the most common (94.4%) mechanism of ankle sprain. Fatigue, not warming up, improper landing, ankle rotations were expressed by the athletes as the main reasons causing their ankle sprains. There were no significant differences between ages, weight, height, training sessions, playing surfaces, foot wears and ankle sprains. Most interestingly was the significant relation between balance training and ankle sprain prevention (P value=0.00574).Conclusion: The intrinsic factors such as fatigue, not warming up, improper landing were most common risk factors for ankle sprain in Iranian athletes. One of the main findings of the present study was the positive role of balance training as a key factor in prevention of ankle sprains.

Background: Job satisfaction is defined as the viewpoint of a person and the collection of positive thoughts about his job. In the other word, job satisfaction is affected by salary, interconnections and etc. Job satisfaction of physiotherapists has never been investigated precisely in Iran so the aim of this study was to evaluate the job satisfaction of Iranian physiotherapists.Methods: 102 physiotherapists attended in the annual congress of physical therapy participated in this study and filled the “Sternberg” job satisfaction form. This test comprised of 30 questions. Except the twelfth and thirteen’s questions other questions have three items and items are graded to one, three or five according to the question. Higher grade indicates more job satisfaction. SPSS software was used to analyze the data.Results: results showed that 81.4% of physiotherapists had an average satisfaction, 15.7% had low satisfaction and 2% had very low job satisfaction scores. Our test range was between 39 and 122 and showed that none of the 102 participants had a high job satisfaction.Conclusion: complete independence in managing the patients is one of the satisfaction reasons for the physiotherapists all round the world and physical and mental stress is a reason for unsatisfaction. It is suggested that job satisfaction need to be evaluated every six months to study the changes occur.

Background: Sometimes first trimester Vaginal bleeding occurs due to multiple unknown factors but don’t terminate the pregnancy. Outcomes of these Pregnancies are the subject of debate. This study estimates the outcomes in these Pregnancies, which might be complicated with first trimester vaginal bleeding.Methods: this was a prospective cohort study. 236 cases included women gravid 1, 2 with a history of first trimester vaginal bleeding and delivery after 28 weeks of gestational age admitted to Imam Hossein hospital during 1388, 1390. Control group included 944 women gravid 1, 2 without any history of first trimester vaginal bleeding within the same period of time. Data were analyzed was used to estimate relative risk (R.R) and 95% confidence intervals (95%CI).Results: compared with the control group (n=944) women with a history of first trimester vaginal bleeding (n=236) were more likely to have, premature rupture of membranes (R.R=7.5, CI 95%), gestational hypertension (R.R=4.8, CI 95%), abruption (R.R=4.5, CI 95%), low birth weight (R.R=1/9, CI 95%), intra uterine growth restriction (R.R=2.7, CI95%), Apgar at 5 minute<7 (R.R=3.4, CI95%), admission to NICU (R.R=4.3, CI95%).Conclusion: It seems that first trimester vaginal bleeding has affected complications of late pregnancy of mother and infant. The effect of interventions in pregnant women with first trimester bleeding are recommended in the prevention and reduction of late complications.

Background: Reforming and providing primary health care services in the past two decades had a wonderful impact on health indicators, particularly in rural communities. Infant Mortality Rate (IMR) always regarded as an important indicator of health system. This study conducted to show the twenty-year IMR trend and its relationship with some of socio-economic indicators in Fars province, south of Iran, during 1990-2009.Methods: In this time-series study, using ecological data from vital horoscope and also regression model, we showed trend of IMR and also affecting some health and non-health indicators on twenty-year IMR trend. P value under 0.05 was considered as significant level.Results: During this 20-years period, IMR had a downward trend from 31.5 to 16.2 in 1000 live births (p<0.001). There is a significant relation (p<0.05) exist between IMR and predictive variables such as Gross Domestic Product (GDP), literacy of women above 15 and rate of deliveries in hospital, and IMR.Conclusion: Decreasing and improving IMR during the past two-decades period showed that the government health policy and investment had achieved a successful result. However, with promotion and renewing primary health cares, we can improve IMR and other health indicators than before.

Background: Nowadays, economical management of hospitals is a very complex procedures. In modern countries, reshaping of whole health care system management, and redesigning all financial and budgeting protocols is a priority. The objective of this study was determination of rates and causes of income deficits at hospitals in order to intervene to reduce it, concerning both financial and budgeting protocols and human resource.Methods: During a period of nine months (2011-2012) by using a Cross sectional descriptive/analytical method, 22 twenty two hospitals were assessed. All the procedures in hospital from admitting a patient and entering his data in the hospital software, to discharging patient and communication with insurance companies, was checked.Results: Our results showed that there is a huge amount of money loss in all our hospitals. This loss is either due to technical failure of registry system in hospitals, or mismanagement and inappropriate application of human resources. Entering data of given services to patients was inadequate. In many cases, they did not send necessary documents to insurance companies that lead to wasting of resources.Conclusion: Based on our findings it is possible to say, by upgrading used software in hospitals for entering all given services to the patients as well as increasing the ability and desire of hospital staff, the income of the hospital will increase dramatically.

Background: Liver enzyme alteration may be an incidental finding in asymptomatic individuals who have undergone routine laboratory tests. Isolated alteration of liver enzymes in a healthy individual often represent a challenge even for experienced clinicians. In this article we decide to provide a guide to interpreting alterations to liver enzyme levels.Liver enzyme alterations are classified to predominantly hepatocellular or predominantly cholestatic patterns. We review abnormal enzymatic activity within the 2 subgroups, and suggested initial investigations.

Dual practice is a common phenomen that is considered a challenge for health care system. In this paper, we provide underlying issues about dual practice it’s, strengths and weaknesses, and methods to manage it. Finally, we propose a solution for Iran.In this review, we have searched electronic databases, models, and government documents about dual practice of health care workers with “dual practice” and “health care workers” as key words.Types of interventions categorized in 3 groups: Complete prohibition dual practice, acceptance dual practice with some restrictions, Complete acceptance. In Iran acceptance of dual practice with some restrictions is logic. But Mechanisms of it needs further studies. So revision the 36 article of Fifth Development Plan is recommended.