Payavard Salamat
Year:2010 | Volume:4 | Issue:1-2|Papers Count:12

Background and Aim: The benefits of a unique computerized medical records and communication equipment’s is utilized to collect, storage, process, extract and relate to patient care information and management information. If this utilization is in accordance with the needs of managers and staff of medical records, many of the nation's health system problems will be dissolved. Information systems in health supply system by compiling, analyzing and publishing data provide utilization of information improve the health of the society. The purpose of this study is to investigate the process of clinical information systems in general hospitals of Tehran University of Medical Sciences based on available clinical information system in these hospitals.Materials and Methods: This descriptive study is an application study that conducted in order to determine the process of clinical information system in general hospitals of Tehran University of Medical Sciences based on available clinical information in these hospitals. The required data have been collected by a valid and reliable questionnaire. Descriptive statistics were used to analyze data.Results: With regard to the current condition and the importance of survey of the process of clinical information system in the studied hospitals, the authors provided the desired checklist in general hospitals with studying the related system in America, Australia and England countries, on the basis of country requirements in the form of clinical information system processes. We studied clinical information system processes in departments of admission, filling and retrieving, statistical and coding and also soft wares in this department.Discussion and Conclusion: It is necessary to create a coordinated and integrated clinical information system with suitable process and empower experts in the field of proper use of data with regard to the position of information system in each organization and its fundamental role in the adoption of accurate policies. We found that relative frequency of clinical information system processes is more than 60% in this department and clinical information system elements was observed 75% in all the departments except admission.

Background and Aim: APL is a Prevalent leukemia that Approximately included 5-10% of patients with acute myeloblastic leukemia. ATRA and recently arsenic is used for treatment. ATRA leadsto resistance to treatment and arsenic is toxic in high doses. AZT induce cell death in different ways. The purpose of this study was Assessment of effect of AZT, a telomerase inhibitor, on NB4 cell line (APL cell line) to reduce toxic effect of high dose arsenic.Materials and Methods: In this study, viability and metabolic activityof NB4 cells, treated by different concentrations of AZT (50, 100, 200 mM), was assessed by trypan blue dye method and MTT assay respectively.Results: Treated cells with AZT=50, 100, 200mM showed decreased viability, both in dose-dependent and time-dependent through trypan blue dye method and decreased cell metabolic activity by MTT assay.Discussion and Conclusion: Considering that AZT is able to induce apoptosis and decrease cell activity, it seems AZT is a suitable drug for inhibiting the growth of tumor cells.

Background and Aim: Analysis of efficiency in hospitals, as the most expensive operating unit of the health system, is very important. This costly unit has several departments that one of them is medical records. This study is trying to analyze the efficiency of medical records department for the enhancement of using medical records facilities.Materials and Methods: In this study, technical, scale and managerial efficiency of medical records department has been studied by data envelopment analysis method, and assuming the scale efficiency variable and the input axis.Information used in this study was the input variables (number of technician personnel and lower and Master of Science personnel and higher), output variables (number of emergency and outpatient and inpatient medical records and the number of filing unit visitors to respond) during 2007-2009.Results: The average technical efficiency of medical records departments is 84 percent, that indicates there is at least 16 percent capacity for an increase in performance. Average of management and scale Performance in units during the 3 years of study are 95 and 89 percent respectively. Most input surplus is relevant to technician and lower personnel.The average performance of these units in general hospitals is 80 percent and in specialized activities is 92 percent.Discussion and Conclusion: Relationship between studied indicators in this study with performance medical records departments showed that using such as employee personnel with undergraduate degrees and higher and educated in medical records filed, the use of managers with enough experience in this department and more use of computer systems for unit activities can fill 16 percent capacity of performance improvement in these units.

Background and Aim: The production of science is the key element of program to achieve sustainable development. Currently, the most important characteristic to produce knowledge is the number of document indexed from scientific journals in databases that do bibliometry and Scientometrics study.The aim of this study is evaluation of scientific production of Iranian medical domain based on the document indexed form scientific journal in chosen database, between 2005-2009.Materials and Methods: Analytical- descriptive method and bibliometry analytic was adapted. The study population includes all scientific journals that was published in English and indexed in WOS and Scopus until of the time of this study. Data collection tool was check list that was made by researchers& complete by referring and direct observation in WOS and Scopus databases.Data was analyzed by SPSS and other statistical methods.Results: Showed that from 44 journals title that studied, 18 titles was indexed in WOS and 20 titles was indexed in Scopus. The number of records and citation, according to the review with passing year, has been rising. Maximum number of documents and citations are related to the final years. Number of records in the Scopus database is more than WOS, but the differences in not significant (P- value=0/186).Discussion and Concoction: Journals visibility in the medical science filed in review databases in not desirable. Less than 50 percent of scientific journals were indexed in databases. Between the years studied, the scientific production of medical area of the country has been growing but to reach the proper situation, more effort is required.

Background and Aim: Patients' needs should be acknowledged properly in order to enable hospitals to take responsibility for their expenses. In this study, patients' satisfaction is assessed in various fields which are key elements of hospitals assessment program.Materials and Methods: In this cross-sectional study, 120 consecutive patients which are randomly selected from Hospitals affiliated to Tehran University of Medical Sciences (TUMS) were enrolled. A questionnaire was completed for their demographic, occupational, insurance status and their satisfaction of clinical services, nutrition, hospital environment and hospital facilities.Results: The age range of participants were11 to 80 years old; 61.9% were females and 38.1% were males. Overall, 78.1% were satisfied in respect to hospitals general status while there were significant differences considering satisfaction in hospital environment and facilities, clinical services and nutrition among recruited hospitals.Discussion and Conclusion: A strong correlation between the index of hospital environment and patients' satisfaction signifies further enhancements of hospital environment which could potentially increase patients' satisfaction. Also, the relationship between patients well being and satisfaction indicates health care staff role should be emphasized for patients' appreciation. Consequently, hospital administration should focus on current unsatisfied sections to improve health care quality.

Background and Aim: Homogeneity and Oneness is the feature of abstracting. These can't be achieved, without adherence to guidelines and international standards. The purpose of this study is evaluation of compliance abstracts of Persian-language journals of Tehran University of Medical Sciences, with ISO 214 & Vancouver's group guideline, in year 2009.Materials and Methods: Survey-descriptive method was adapted. The study sample included all full-text journal Reviews in English Persian language belonging to Tehran University of Medical Sciences. These journals were significant in TUMS website to date (30/2/2009). Total 100 abstracts from the latest issue of the journal articles for instance, were randomly selected. The data collected through two control lists separately, reflecting the standards of ISO 214 and instructions group in Vancouver for abstract writing. The data were analyzed by software and statistical techniques.Results: The average overall rate of compliance with ISO standards Review is 85/37 percent (SD 24/93 percent), and group instructions Vancouver is 84/44 percent (SD 24/36). Review of the "express findings" had the most and the "sub results presented" had minimum compliance with ISO standards. The "keyword existence" and "noted the findings" had the most and the "being derived from the headings keywords subject had "minimum compliance with the instructions in Vancouver group.Discussion and Conclusion: The abstract compliance with ISO 214 and Vancouver instruction was desirable. More comply from ISO 214 in "results presented" and Vancouver group instruction in, keywords subject in medicine seems to be required.

Background and Aim: Females were reported to have significantly lower hematocrit (Hct), which might be the cause of increased need for blood transfusion. The goal of this study is to determine risk factors affecting blood transfusion in patients undergoing coronary artery bypass graft procedure related to gender Materials and Methods: A cross sectional review of 500 (306 males and 194 females) ASA physical status I or Il patients undergoing bypass procedures with saphenous vein graft performed over a one year period were included in this study. The conducting of anesthesia was standardized. For each patient, we recorded the gender, age, body weight, height, body surface area (BSA), and duration of surgery. Hematocrit levels prior to surgery and the end of surgery were recorded. Packed red blood cell (PRBC) administration and use of fresh frozen plasma (FFP) and platelets were noted. Differences between the data for female and male patients were evaluated using Student' s t-test, Chi-square test and using regression analysis.Results: Approximately 57.2% (111) female and only 39.9% (121) male patients received PRBCs. On average, females received 1.6 units of PRBCs intraoperatively and 2.6 units of PRBCs during the entire hospital stay, while the males received 1.1 units and 1.8 units for similar periods (P=0.0001).When females and males were compared within the same subgroups for age, body surface area (BSA), duration of surgery, and preoperative Hct, etc....had a significant correlation with age, postoperative Hct and BSA in females but had a significant correlation with preoperative Hct, preoperative PRBC and duration of surgery in males (P<0.05). Multiple logistic regression analysis showed that the probability of a patient receiving or not receiving PRBC transfusion is significantly influenced by preoperative Hct, postoperative Hct, duration of surgery, preoperative PRBC mass, and gender.Discussion and Conclusion: Gender is an independent essential determinant of blood transfusion in CABG patients, and may interact with BSA, preoperative Hct, duration of surgery and other factors in determining the probability of transfusion.

Background and Aim: The study of organizational culture as a managerial tools, is necessary in health care organizations. Hospital administrators should compare present with desired hospitals' organizational culture continuously. This research is aimed to compare the present with desired organizational culture as administrators' view in Tehran University of Medical Sciences' Hospitals.Materials and Methods: A Cross - Sectional' descriptive and analytical study was conducted among 15 Tehran University of Medical Sciences' Hospitals administrators by a questionnaire including demographic information and 30 questions which determined the approach of TUMS hospitals administrators about current and appropriate organizational culture components. Before the main study, validity and reliability of the questionnaire was performed. The data was collected by SPSS version 15 software and analyzed by Chi-square, Pearson and T tests.Results: The result of this study showed that leadership was the most and control was the least organizational culture components which observed in present condition.Discussion and Conclussion: As TUMS hospital administrators' view, all of the hospitals organizational culture components, exception control and communication patterns, are not observed in current status.There is a significant difference between current and appropriate hospital organizational culture components as the administrator's view which impressed on the hospital management system. Therefore, the hospitals administrators are required to do strategic planning to optimize the hospitals organizational cultures.

Background and Aim: Tobacco use is a major contributor to deaths from chronic diseases, one which begins during adolescence. The aim of this study was estimate the smoking prevalence and examines the determinants of smoking behavior among high school students in Jahrom, Iran.Materials and Methods: This study is a cross-sectional survey that was done in Spring, 2007 in Jahrom.Students were selected by multistage sampling. An anonymous, valid, reliable, self administered questionnaire was filled in by all selected students presented at the day of the survey. Chi-square, student - t and logistic regression test was used to examine the determinants of smoking behavior.Results: The prevalence of smoking among high school and pre-college students was 9.4% and 12.7% respectively. 53% of high school and 88% of pre-college students received cigarette their first time from their friends.The most powerful determinant of smoking among students of both school levels was sex.Discussion and Conclusion: Effective smoking prevention programmers should take into account the dominant influence of peers and family members and also its focuss on the age of onset and maintenance of smoking behavior.

Background and Aim: Given The importance of patient satisfaction levels of health care is an effective role in planning health services management system. This study aimed to assess patient satisfaction of hospital services and related factors was designed in Baharloo study Hospital Materials and Methods: This is a cross sectional. The data is collected by questionnaire and interview and after completing the questionnaire based on the number of samples required in this study, the information was collected into the computer and analyzed.The study statistical society was 320 patients hospitalized in all different parts of the hospital in the second six months of 1387 were selected in the form of the random sampling. To measure the patient satisfaction used satisfaction questionnaire with six demographic questions and 20 satisfaction terms. Questionnaires was given to the patients by trained persons (non-medical staff) in the last session of therapy. In young patients the questionnaire was completed by the patients family or friend and about cases with illiteracy or low literacy the questionaire was completed by Trained questioners. Listen Results: Satisfaction including satisfaction levels was as follows: heat and cooling systems (44.8%) - facilities (48.3%) - Food Quality (44.8%) - daily clothes and sheets change (41.6%) - Sanitation and hygience (48.3%) - room lighting (56%) - the speed of filing reception files (58.6%) - Nurse attitude (55.2) - time presence of clinical nurses on the patient's bedside (58.6%) -appropriate communication with sick relatives (55.2%). Highest level of patient satisfaction was as follows: satisfaction of nurse time presence on the patient's bedside (58.6) - the speed of filing reception files and the patient good guidance by receptionist (58.6%) and room lighting (58%).Discussion and Conclusion: The largest percentage of patient dissatisfaction was regarding facilities of rooms, food quality and daily clothes and sheet change (24.1%).