Laboratories performance after outsourcing in the hospitals of shahid beheshti university of medical sciences

Nowadays, downsizing the government to have an effective and flexible organization is considered to be government's top priority in the world and outsourcing is one of the ways to achieve this goal. Accordingly, Shahid Beheshti University of Medical Sciences has delegated some of its hospitals' duties to the private sectors. The present study has been carried out to assess the performance of outsourced clinical laboratories. This Descriptive Evaluation study was carried out during 6 month [May 2011 till February 2012]. The data was collected by two questionnaires with close-ended questions and one with open-ended questions, and analyzed by Wilcoxon, using SPSS software. There is an improvement in outsourcing laboratory services. For example, increase in the number of tests [32%] and in the type of tests [37%]. Consequently, increase of hospital income [51%]. The number of personnel is decreased and their responsibility and behavior are improved. Overall, it seems that outsourcing laboratory program could achieve its major goals such as: Absorbing non-governmental resources in both administrative and financial aspects, omitting extra expenditure, acquiring benefits, and upgrading productivity of laboratories

effect of hydroalcoholic extract of olive leaves on blood pressure in rat model of two-kidney, one-clip goldblatt hypertension

In Iran's traditional medicine, the leaves of olive tree are of value for the treatment of hypertension. This study was designed to examine the effects of hydroalcoholic extract of olive leaves in rat model of two-kidney, one-clip hypertension and to further explore whether its hypotensive activity was mediated by enhancing the basal release of endothelium-derived nitric oxide. Animals were divided into two main groups including sham-operated and renal artery-clipped ones. The latter was further divided into 5 groups of untreated rats, vehicle-treated rats, which received daily oral administrations of one ml distilled water, and extract-treated rats receiving olive leaves extract at 50, 150 or 500 mg/kg in the same volume of vehicle starting the next day after the operation. Four weeks later, mean blood pressure and heart rate were measured under anesthesia before and after the administration of NG-nitro-L-arginine methyl ester [L-NAME]. Mean arterial pressures, and right kidney and heart weights of untreated and vehicle-treated renal artery-clipped rats were significantly higher but left kidney weights were significantly lower than those of shamoperated animals. However, there was no significant difference between the heart rates of these groups. Compared to vehicle-treated renal artery-clipped rats, treatment with hydroalcoholic extracts of olive leaves at 50, 150 or 500 mg/kg/day was associated with significantly lower mean arterial pressure, right kidney and heart weights but did not affect heart rate or left kidney weights. The intravenous administration of L-NAME resulted in a significant increase in mean arterial pressure in sham-operated and extract-treated rats whereas there was no change in renal artery clipped or vehicle-treated groups. The findings of the study show that hydroalcoholic extract of olive leaves prevents the clipinduced increase in mean arterial pressure, which might be partly mediated by enhancing the basal release of nitric oxide

[Lipoprotein [a] and its relationship with other lipids and lipoproteins in Iranian college students]

Lipoprotein [a] or Lp[a] is a cholesterol-rich particle with atherothrombogenic properties. Plasma level of Lp[a] varies in different populations, however, little data on normal range of Lp[a] lipoprotein among Iranian population is available The aim of this study was to estimate the normal range of Lp[a] and also its relationship with other lipoproteins in a group of Iranian students. This was a cross-sectional descriptive analytical study carried out on 150 college students [88 females and 62 males] aged 19-30 [21.8 +/- 2.3] who were clinically healthy and coming from various regions of Iran. The fasting serum levels of Lp[a], lipids, lipoproteins, apolipoproteins, total cholesterol [TC], triglycerides [TG], high-density lipoprotein-cholesterol [HDL-C], were determined by standard kits. Lp[a] and apo-B100 measurement was performed using electro-immunoassay, and apo-A1 by an immunoturbidimetric method. The data were further analyzed using SPSS, U- and t-tests to compare the variables and also the Pearson correlation test in determination of correlation between Lp[a] and other variables. A p-value of ? 0.05 was considered to be significant. Lp[a] with a mean of 19.46 +/- 19.44 mg/dl, did not showed any significant differences between males [16.33 +/- 18.79 mg/dl] and females [21.41 +/- 19.80 mg/dl]. In addition, no statistically significant correlation was demonstrated between the serum Lp[a] levels and oher variables such as age, lipids, and lipoproteins. A serum Lp[a] level higher than 30 mg/dl was shown in 14% of males, 36.5% of females and 21.5% of the total subjects. The mean serum concentration of Lp[a] in the present study was relatively higher than the values found by most researchers. This might be an acceptable explanation to high incidence of cardiovascular disease in some Iranian populations

[Outcome of multiple usages of disposable insulin syringes in insulin dependent patients referring to Shahid Motahari Clinic in Shiraz]

In spite of a high risk of infection, multiple usages of disposable insulin syringes among diabetic patients is quite common. The present study was designed to assess the outcome of multiple usages of disposable insulin syringes in insulin dependent patients referring to Shahid Motahari clinic in Shiraz. For this descriptive study, through a random sampling method, 117 patients were selected. Initial data were obtained by a questionnaire and the patients were asked to deliver their syringes following their last injection to be examined by microbiological tests. The injection site was also examined for the evidence of infection within a 24-hour period. In the next stage, 30 patients were randomly chosen among those who had used each syringe more than once and another reused syringe was received from them 1 week later. However, the second syringes were tested in microbiology lab 24 hours after the last injection. Totally, 82.1% of patients used their syringes more than once. No infection was detected at the site of injection, however, microbial contamination was found in four syringes and in 11 needles. 2 of these syringes were used just once. Syringe and needle contamination was found more commonly among those who did not use alcohol [for injection area disinfections] [p<0.02]. Syringe and needle contamination was not significantly associated with sex, frequency of reuse, insulin type, hygiene, place and method of keeping syringes between two injections. The cultured pathogens were as follow: staphylococcus aureus in 6, staphylococcus epidermidis in 2, non-entrococci in 3, and diphtheroid, bacillus subtilis, entrococci and anaerobic gram positive bacillus, each in one. The risk of syringe and needle contamination is more when disinfecting methods and disinfectants are not used. Furthermore, multiple usage of the insulin syringes in this study, did not lead to injection site infection

Effect adequate salt iodization on the prevalence of goiter: a cross- sectional comparative study among school children aged 6-18 years during 1989 and 1995

To evaluate the impact of salt iodization on the prevalence of goiter among school children in the city of Shiraz. Design: In 1989, prior to initiation of universal salt iodization in Iran, 2419 male and female students, 6-18 years were randomly selected and evaluated for the presence of goiter, which was graded according to WHO goiter classification. A similar study was carried out in the same schools in 1995 five years after the initiation of the salt iodization program and involved randomly selected students. A decrease in the prevalence of goiter from 85% in 1989 to 68% in 1995 was noted. The prevalence of visible goiter showed a dramatic rise from 5% in 1989 to 23% in 1995. In spite of salt iodization, there was only a partial decline in the prevalence of goiter and the area should still be considered hyperendemic. Further studies are needed to define the unresolved issues

Report of a family with two cases of MEN-IIa and one case of MEN-IIb

The multiple endocrine neoplasia MEN-IIb syndrome has been differentiated from MEN-IIa by the presence of various phenotypic features such as skeletal anomalies, Marfanoid habitus and mucosal neuromas, as well as the lack of parathyroid involvement. We report three members of a family [2 sisters and 1 brother] with characteristics of both syndromes. It tends to unify the MEN-11 syndromes as a single disorder with variable expressivity. All three cases had pheochromocytoma and thyroid carcinoma. Only one case had a Marfan-like appearance, mucosal neuromas and a parathyroid adenoma. Their mother expired with medullary carcinoma of the thyroid and another sister expired during parturition due to severe hypertension