[Designing the evaluation framework for clinical governance in IR Iran AJA hospitals]

Clinical Governance now selected as a model to improve the quality of health care services in hospitals of Iran, in recent years Army hospitals have made good progress in implementing this model, but over several years there is no appropriate tool for assessing clinical governance in the country. First, researcher studid books and paper related to the subject and do a search on the Internet and with content analysis provide the necessary framework then provided draft validate by the panel of experts with Lavashh method. After the questionnaire used to assess the four Army's hospitals. provided questionaire has eight areas; commitment to quality, clinical effectiveness, risk management, patient centerdness, staff management, information management, learning and clinical audit and has three dimention; infrasructure, deploy and results. Evaluation results show that hospitals in most areas are on average or closer to average. The results show that a more coherent plan is needed to improve clinical governance conditions in armys hospitals

[Evaluation of lead acetate side effects on rat hippocampus and the effects of vitamin C on these]

To investigate the effect of ascorbic acid against lead-induced neurotoxicity in the rat hippocampus. The heads of 40 male Sprague-Dawley rats were divided into 4 groups: normal, control, lead-treated and lead plus ascorbic acid-treated. Lead acetate [20mg/kg] was administered intraperitonealy to rats for 7days in third and fourth groups. During this period, rats in the fourth group received 500 mg ascorbic acid, in drinking water daily. At the end of the treatment, all rats were sacrified and their hippocamps were excluded. Using TEM the samples were examined in terms of natural and apoptotic cells. Histopathological evaluation showed that apoptosis was attenuated significantly in the ascorbic acid group but not in the lead group. Simultaneous administration of ascorbic acid and lead increased the level of Bcl-2 and decreased Bax protein compared with lead-treated only. It seems that ascorbic acid may reduce the lead-induced toxicity in central nervous system

In-patient satisfaction and its related factors in Taleghani University Hospital, Tehran, Iran

Patient satisfaction survey is an instrumental component in hospital's quality of care monitoring in relation to cost and services. This study was conducted to evaluate patient satisfaction and its related factors. A cross sectional study was performed between April 2006 and August 2006. Sample size was determined as 476 from 5021 by randomized sampling in several phases according to the proportion of hospitalized patient. Participants were interviewed privately face to face in the hospital at discharge time. Interviews were conducted by trained interviewers using pre tested questionnaires. Correlation between variables was estimated by using Pearson's Correlation. The majority, 83% of patient was quite satisfied with their care and 1% was dissatisfied. About 91% of patients were most satisfied with physician communication and treatment. Only 27% of patients were satisfied with nutrition status. There was no relationship between age, education and total satisfaction. Percentage of patient faithfulness and recommendation for this hospital to their friends was 66% and 65% respectively. Both male and female patients whose hospital stay was between 11-15 days were more satisfied with the service provided. In general, patients were quite satisfied with their hospital care. More studies such as this survey are required to improve the quality of care and overall health cares outcome

[Patient satisfaction and its related factors in Ayatollah Taleghani Hospital in 2006]

Patient satisfaction survey is an instrumental component in monitoring the hospital's quality of care, in relation to cost and services. Many studies have been conducted throughout the world to determine the patient satisfaction and its related factors. This study was carried out to evaluate patient satisfaction and its related factors. A cross sectional study was based on in-hospital patient who attended the Taleghni hospital between April 2006 and August 2006. Sample size was determined as 476 from 5021 by randomized sampling. Sample sizes in each ward were according to the proportion of hospitalized patient. Participants were interviewed privately face to face in the hospital at discharge time. Interviews were conducted by trained interviewers using pre tested questionnaires [Verona Service Satisfaction Scale- VSSS 32]. Correlation between total satisfaction and Patient's age, education] was estimated by using Pearson's Correlation. Prevalence and confidence interval [CI] of unsatisfied patient was calculated. In majority, 83% of patients were quite satisfied with their care and 1.5% was dissatisfied [CI=0.7-2.2]. 93% of patient was most satisfied with physician communication and treatment. Only 49% of patients were satisfied with nutrition status. There was no relationship between age, educational status and total satisfaction. Percentage of patient-faithfulness was 66%. 65% of admitted subjects were recommending this hospital to their friends. Patients whose in-hospital course was between 11-15 days were more satisfied with hospitalization among both sexes. In general, patients were quite satisfied with their hospital care. Further studies similar to this survey is offer to improve the quality of care and overall health-care outcomes

[Comparison between Cyclosporine and cyclosporine plus Vitamin A on sertoli cell]

Background: in man the immunosuppressive drug Cyclosporine A [Cs A] has been used successfully in organ transplantation and in the treatment of autoimmune disorders and exerts toxic effect on various parenchymal organs. This study was performed with the aim of testing whether Cyclosporine plus vitamin A would be reversed the effect of cyclosporine on rat's testis

Methods and Materials: 40 male Wistar rats, 2 months old were divided into four groups [10 in each group]. Experimental groups [A] were injected daily 40 mg/kg body weight of Cyclosporine and olive oil subcutaneously and in group [B] rats were injected daily 40 mg/kg body weight of Cyclosporine and olive oil plus vitamin A. In group [C] rats were injected only olive oil and in group [D] rats were normal and without any injection. Rats were kept under optimal hygienic condition, temperature 25 degreeC, relative humidity 40 to 45% and light provided for a 12-h day/12-h night cycle for 2 weeks. They were given water and rodent pellets. After 2 weeks rats were killed and testis were fixed in formalin 10% and were stained and studied with light microscopy

Results: distances between seminiferous tubules were increased. Accumulation of necrotic materials of the cells in the lumen of seminiferous, oligospermia, displacement of seminiferous tubules and changing the situation of sertoli nuclei were seen. All of changes were not seen in group [B]

Conclusions: we can use vitamin A as a protective in young patient against Cs side effects

prevalence of migraine in patients with major depression disorder in Tehran [2005]

There is a known association between migraine and affective disorders, but the information is sparse concerning the prevalence of the migraine in subgroups of the affective disorders. The purpose of this study was undertaken to investigate the prevalence of migraine headaches in major depressive disorder [MDD] patients in number of psychiatric hospitals. One hundred five patients with major depressive disorder in psychiatric wards of five hospitals were examined by an epidemiological study. All subjects had DSM-IV criteria for MDD. Migraine was diagnosed according to IHS-Criteria. Interviews with patients were accomplished by the physicians. SPSS-12 was used for statistical analysis. From one hundred five MDD patients 62 [59%] had migraine headaches. The mean age was 41 +/- 1.3 years [range between 19 -79]. From 29 women 16 [55.2%] and from 76 men 46 [60.5%] had migraine headache. Only 15 [14.3%] subjects had graduated degree. Migraine headache was seen with increased frequency in the MDD population. Because the clinical statement for missing migraine are enormous, recognition of the common co-morbidity of migraine headaches with MDD is essential from point of the possibility of using the association of MDD with migraine to study both the pathophysiology and genetics of these affective disorders

[ prevalence of migraine in patients with major depression disorder in Tehran [2005]]

Background: There is known association between migraine and affective disorders, but the information is sparse concerning the prevalence of the migraine in subgroups of the affective disorders. The purpose of this study was undertaken to investigate the prevalence of migraine headaches in major depression disorder [MOD] patients in number of psychiatric hospitals

Materials and methods: One hundred five patients with major depression disorder in psychiatric wards of five hospitals were examined by an epidemiological study. All subjects had DSM-IV criteria for MOD. Migraine was diagnosed according to IHS-Criteria. Interviews with patients were accomplished by the physicians. SPSS-12 was used for statistical analysis

Results: From one hundred five MOD patients 62[59%] had migraine headaches. The mean age was 41+/-1.3 years [range between19-79]. From 29 women 16[55.2%] and from 76 men 46[60.5%] had migraine headache. Only 15 [14.3%] subjects had graduated degree

Conclusions: Migraine headache was seen with increased frequency in the MOD population. Because the clinical statement for missing migraine are enormous, recognition of the common co-morbidity of migraine headaches with MOD is essential from point of the possibility of using the association of MOD with migraine to study both the pathophysiology and genetics of these affective disorders

[Alginate extration of Pseudomonas aeroginosa and study of penetratuion of antibiotic agents through alginate using a sandwich cup method]

Background: P seudomonas aeroginosa is one of the most important oppourtunistic bacteria which produces biofilm. It has been reported that biofilm forming bacteria are more resistant to antibiotic treatment and immunologic response. Biofilms, communities of cells adhering to a surface enclosed in a self-producing polymeric matrix. Biofilms might be responsible for 65% of bacterial infections

Materials and methods: In this study we investigated the role of the barrier formed by alginate against antibiotic penetration. Mucoid isolates of P. aeruginosa were collected from 2 hospitals and identified by biochemical tests. Strain M2 14 P. aeruginosa produces more biofilm compared with other strains. Alginate was extracted from mucoid -type P. aeruginosa [M2 14] with method described by Gaven. We evaluated the penetration of antibiotics macrolides [azithromycin, erythromycin], aminoglycosides [amikacin, gentamicin] lactames [imipenem, ceftazidem], fluoruqinolones [ciprofloxacin, ofloxacin] through P. aeruginosa [M214] alginate with a sandwich cup method described by Hiromi Kuman

Results: The results indicated that macrolides demonstrated penetration rate 100%, fluroquinolones and lactames demonstrated relatively high penetration rate>85%, whereas aminoglycosides showed low penetration [amikacin=59%, gentamicin=73%]

Conclusions: In this study, the role of alginate as a barrier against antibiotics penetration was proven