[ level of propensity to outsource study: based on hospital services features by managers and staff perspective in hospitals of Shiraz university of medical science, 2010]

The inefficiency of financing health care in developing countries made led in many health policy-makers to consider alternate means of service provisions. Outsourcing public financed health services in private sector organization is one of the interventions. Advocates claim that the contracting out of health care services will improve the service delivery performances through stimulating competition among providers and also by creating economic incentives to improve performance through linking payment to provider performance. The purpose of this cross sectional study was to provide decision matrix to guide decision-makers whether outsource hospital services or not. Tow kind of questionnaire were developed and used. Findings showed that the most propensities of outsource is in nutrition services [87%], and the least is in nursing services [43.4%] based on administrators' attitude. Shaping of decision matrix showed propensity to outsourcing of nursing, radiology, laboratory services are high while nutrition services is been low. Some differences between of decision matrix and administrators' propensity to outsourcing in radiology and laboratory services. Lack of attention in characteristics of the hospital services might be one of the reasons. Cost saving is the main reason for outsourcing the services while administrators should consider as an effect and side effect of outsourcings

[Estimation of the costs of MRI 3 Tesla and MRI 1.5 Tesla in Iran, for the purpose of comparison]

The aim of this study was to estimate and compare the costs of MRI3Tesla and MRI1/5 Tesla in Iran in order to offer recommendations to the health system policymakers and hospital administrators in regard to the use of MRI 3 Tesla and its costs in Iran. This was an economic evaluation study which was performed by reviewing articles and economic modeling. Data were obtained from internet and the main suppliers of this technology and their representatives in Iran and also hospitals using these technologies. We divided the costs into three categories: capital costs including buildings and machinery depreciation, staff costs and other costs [costs of consumable materials, running costs and maintenance]. For 1500 tests per year, the unit cost was estimated at 4,500,000 Rials per test for MRI 3 Tesla and 3,500,000 Rials for 1.5 Tesla. If the number of tests per year was 3000, the unit cost would be 2,400,000 Rials for 3 Tesla and1,900,000 Rials for 1.5 Tesla. For 6000 tests per year, the unit cost would be was 1,350,000 Rials for 3 Tesla and 1,050,000 Rials for 1.5 Tesla. For 12,000 tests per year, the unit cost would be 710,000 Rials for 3 Tesla and 560,000 Rials for 1.5 Tesla. For 24000 tests per year, the unit cost would be 373000 Rials and 300,000 Rials for 3 Tesla and 1.5 Tesla respectively. For 1500 to 24000 tests per year the cost of each test with MRI 3 Tesla system in Iran, will vary between 373000 to 4527000 Rials. It is recommended that this technology be used in the centers with sufficient number of patients otherwise it may give rise to extra costs

Inappropriate admission and hospitalization in teaching hospitals of Tehran University of Medical Sciences, Iran

To determine the appropriateness of admission and hospitalization of patients in two major teaching hospitals of Tehran University of Medical Sciences [TUMS]. Appropriateness Evaluation Protocol was employed to evaluate 1732 days of hospital stay and 258 patient admissions. Findings indicated that 22.8% of admissions were inappropriate and length of stay for patients who had inappropriate admissions was significantly shorter than those who had appropriate admission. Statistical tests demonstrated a significant difference between hospital wards in terms of inappropriate admission [p < 0.0001]. On average 8.6% of patient days were inappropriate and it is significantly different between two hospitals. It was also found that the more patient length of stay, the more inappropriate patient day. Delay in discharge process was the most frequent reason indicated for inappropriate hospital stay. A substantial proportion of hospital admissions and stays were found to be inappropriate due to management procedures and more likely lack of health care services in lower level of health system

Characterization of specific IgE antibody related to antigen 5 of echinococcus granulosus

Anaphylactic reactions, such as urticaria, edema, respiratory symptoms, and anaphylactic shock often complicate the course of Cystic Echinococcosis [CE]. To investigate the role of the IgE immunoreactive antigen 5 [Ag 5] in the sero-positive patients with CE, we determined N-terminal of 57 kDa subunit of Ag5 responsible for IgE and C-terminal of this active antigen related to induction of IgG specifically. Immunoblotting analysis showed that specific IgE to 57-kDa subunit related to inter-chain disulphide band of two 22 kDa and 38-kDa component of Ag5 and conformational epitope on this subunits. In addition, since the 57 kDa component arise from the removal of the C-terminal portion of 22 kDa subunit of Ag5, thus IgE specifically recognized N-terminal of 22 kDa subunit which remain bounds to the other component, whereas IgG reacted with C-terminal of 38 kDa component of Ag5. Recognition of the specific binding site on the 57 kDa subunit of Ag5 could leads to understanding the mechanism regulating IgE/IgG production in some immune circumstances that IgE tends to some dominate, whereas in other IgG predominates

Evaluation of a native preparation of HCV core protein [2-122] for potential applications in immunization, diagnosis and mAb production

Infection with hepatitis C virus [HCV] is a worldwide problem. Among HCV proteins, core antigen [Ag], besides its importance for diagnostic application is a prime candidate for component of a vaccine. Herein, we report results of studies on production of the hydrophilic domain of core Ag [2-122] in native conformation by an arabinose induction system in E.coli and the primary characterization of this recombinant protein for applications in diagnosis, immunization and mAb production. Recombinant core [r-Core] was able to detect anti-core antibodies in HCV positive serum samples in a dilution rate of 1/3200. It was also capable to elicit a potent anti-HCV humoral immune response in BALB/c mice. Finally, we established two stable clones of hybridoma which shown to produce specific and sensitive mAbs against the core protein. HCV core was able to elicit a broad range of antibody specificities depending on the immunogen conformation. Therefore, it may be possible to get new mAbs with higher affinities towards native conformation of core Ag

Characterization of a monoclonal antiody specific for the parasite surface antigen-2 of leishmanie major

The Leishmania major Parasite surface Antigen-2 [PSA-2] is a family of glycoinositol phospholipids anchored glycoprotoins expressed in both promastigotes and amastigotes. Promastigote PSA-2 comprises three polypeptides with approximate molecular weight of 96, 80 and 50 kDa. Amastigote express a distinct but closely PSA-2 polypeptide with molecular weight of 50 kDa. In this study fusion of SP2/0 myeloma cells with immunized mice spleenocytes infected with promastigotes of L. major intraperitoneally resulted to a clone of hybridoma producing a specific antibody that only reacts with L. major parasite surface antigen [PSA-2]. This mAb showed no crossreactivity with either other Leishmania species including L. tropica, L. donovani and L. infantum or recombinant gp63. Western blot analysis of culture supernatant revealed multiple b and s with molecular weight of 50, 58, 80 and 96 kDa only in L. major

Preparation of monoclonal antibody against the common determinants of HBsAg

Subtype-specific monoclonal antibodies are valuable tools for structural analysis of hepatitis B virus surface antigens and epidemiological investigations. Nineteen hybridoma clones producing monoclonal antibodies [MAb] specific for different epitopes of hepatitis B surface antigens [HBsAg] were established from mice immunized with HBsAg of either ayw or adw subtype. The immunizing antigens were purified from serum of carrier individuals or extracts of transgenic plants by affinity chromatography using polyclonal anti-HBs antibody. The specificity of MAbs was determined by enzyme-linked immunosorbent assay and immunoblotting using a panel of purified HBsAg of given subtypes. Out of the 19 MAbs, 9 were found to be specific for the common "a" determinant, and the remainders were specific for either "d" [n=2], "y" [n=5] or "w" [n=3] subtypic determinants. None of the subtype-specific MAbs displayed cross-reactivity with the other major subtypic epitopes. These MAbs have potential as monospecific reagents for subtyping HBsAg in carrier individuals for epidemiological and experimental investigations