Identifying and prioritizing the factors effective in customer satisfaction using the TOPSIS method

Introduction: Customer satisfaction has been suggested as one of the interesting and challenging issues of management in the new millennium. In addition, oral and dental health and the quality of the services the health centers delivered to the patients directly affect the customer satisfaction. Therefore, the present study aimed to identify, investigate, and rank the factors affecting the customer satisfaction in the department of dentistry of Shiraz Farhangiyan health center

Method: The present descriptive study was conducted on the specialists and patients of the department of dentistry of Shiraz Farhangiyan health center. The validity of the questionnaire utilized in the study was confirmed by expert professors and its reliability was approved using the Cronbach's alpha formula. Finally, the study data were analyzed in SPSS statistical software [v. 16], using inferential statistics

Results: All the hypotheses were confirmed by the results of the statistical analyses and quality, services, and expenditures revealed to affect the customer satisfaction in the department of dentistry of Shiraz Farhangiyan health center. Moreover, these factors were ranked using the TOPSIS method and the results showed quality and expenditures as the most and the least effective factors in customer satisfaction, respectively

Conclusion: Since restoring and arranging the organization based on the customer needs is among the main priorities of designing an organization, managers are suggested to take measures for organizational reformation based on the customers' priorities. Of course, conducting such programs is of utmost importance in health and treatment environments, leading to provision of better services and facilitation of learning, education, and research. Thus, identifying the effective factors in customer satisfaction and ranking them are highly important

Hemoglobin D [Hb D Punjab/ Los Angeles and Hb D Iran] and Co-Inheritance with Alpha- and Beta- Thalassemia in southern Iran

Hemoglobin-D [Hb D] is an uncommon structural hemoglobin variant, which is reported to be prevalent in north western India. There are only a few small series, of this entity in the literature. We report the largest single center experience on this entity from Iran. Between November 2002 and December 2010 as a result of screening premaritally for betathalassemia in Shiraz, Fars Province, Southern Iran, column chromatography, Hb electrophoresis, solubility test, and/or high performance liquid chromatography [HPLC], direct sequencing and restriction analysis were used for hemoglobinopathies and structural Hb variants. The data of 220 subjects with Hb D variants are analyzed in this report. These comprised of 180 carries of Hb D; 92 cases of Hb D Punjab/Los Angeles [beta 121[Glutamic acid -> Glutamine]] and 88 subjects with Hb D Iran [beta 22 [Glu- > Gln]], 3 homozygous cases for Hb D, 17 subjects with betathalassemia- Hb D, 12 with Hb D- alpha- thalassemia- 1, 3 homozygous Hb D- alpha thalassemia- 1 trait, one with Hb D Punjab - sickle cell anemia, and two with Hb D Iran/sickle cell anemia. The carriers of Hb D and homozygous cases for Hb D were not anemic and had normal red blood cell morphology, as they are not usually detected. If Hb D was inherited in combination with thalassemia, the subjects had mild anemia and in some of them, the spleen was palpable [1-2 cm]. Co-inheritance of alpha thalassemia and Hb D resulted in the slightly higher Hb level and lower Hb D level as compared to Hb D/ betathalassemia cases [Hb D 24-37% vs 57-88%]. Co inheritance of Hb D and sickle cell results was moderate to severe hemolytic anemia

Interaction of syntactic comprehension and ability of cognitive sequence processing in persian speaking broca aphasic patients

Recent studies shown that related or common neuro-physiological processes are required for processing non-linguistic structures [e.g. cognitive sequencing] and some aspects of syntactic structure in language. As there has not been such research in Iran, this study surveys the relationship between the ability to process cognitive non-linguistic abilities and comprehension of non-canonical syntactic structures in Broca aphasic patients. A pre test and post test quasi-f experimental design was chosen in this study. The syntactic comprehension of 10 aphasic patients [6 men and 4 women] who according to the Farsi Aphasic Test [Nilipour,1993], have been recognized to be Broca aphasics, was assessed before and after a training period of 10 weeks [a session every week] on cognitive sequencing. The syntactic comprehension was assessed using a test which was designed for Persian language on the basis of standard test for comprehension in aphasia. The ability to process cognitive sequences was assessed using Lelekov test. The subjects were selected in a purposeful manner from among the Broca aphasics who were under therapy in the state speech therapy centers in Tehran. The percent of the correct answers to every syntactic structure and to the cognitive sequences for each person was measured before and after a training period of 10 weeks. Data were analyzed by Paired -T-test. The findings showed that there is a direct relation between the ability of the patients for comprehending the non-canonical syntactic structures and their ability for processing cognitive sequencing. [R=0.50]. After the training period, the ability of the patients for understanding syntactic structures with non-canonical word order improved significantly [P<0.05].There was no significant change in their ability for understanding syntactic structures with canonical word order [P>0.05]. Their ability for processing cognitive sequencing increased significantly during the training period [P<0.05]. Reinforcement of the ability to process complex cognitive sequences in Broca aphasic patients improves their comprehension of syntactic structures with non-canonical word order but it has no effect on their comprehension of structures with canonical word order

Bone marrow transplantation in thalassaemia patients in Shiraz, Islamic Republic of Iran

We report the results of allogeneic bone marrow transplantation in 26 female and 37 male patients with beta-thalassaemia major [age range: 2-17 years], performed at Namazi Hospital over the period 1992-99. In all cases, standard conditioning and immunosuppressive regimens were employed. Currently, 50 patients remain thalassaemia-free, 9 of whom have developed chronic graft-versus-host disease. There were 8 deaths among the 13 unsuccessful transplant cases: 4 due to acute uncontrollable graft-versus-host disease, and 4 to non-transplant-related causes such as hypoglycaemia, hypersensitivity reactions and advanced disease. We conclude that allogeneic bone marrow transplantation is an effective therapy for the treatment of beta-thalassaemia major, particularly for patients classified as classes I and II

Effectiveness of osmotic fragility screening with varying saline concentration in detecting B-Thalassemia trait

Thalassemia is a major health problem in Iran. The prevalence of thalassemia minor is high and screening program for detecting beta -thalassemia trait has been established in southern parts of Iran since 1992. To determine the efficacy of naked-eye single-tube red cell osmotic fragility test [OFT] as a screening test for beta -thalassemia trait. Three different concentrations [0.36%, 0.37% and 0.38%] of buffered saline solutions were used. OFT were applied to three groups of subjects: 50 normal individuals, 50 subjects with genetically proven beta -thalassemia trait, and 15 patients with proved iron-deficiency anemia. The results demonstrated that 0.37% saline was the best solution for OFT. It could detect 98% of heterozygous beta -thalassemia patients compared to 96% and 84% detection rate obtained with respective 0.36% and 0.38% saline. Specificity of OFT with 0.37% saline was 96% whereas that of 0.36% and 0.38% saline were 84% and 94%, respectively. The OFT with 0.37% saline was also positive in 5 [33.3%] patients with iron-deficiency anemia. OFT done with 0.37% buffered saline solution provides more accurate results. Since the test is inexpensive and practical it might be considered as the single screening test to be used in areas with limited laboratory facilities and economic resources

Acute graft-versus-host disease in thalassaemic marrow transplantation with low-dose antithymocyte globulin

Our unit performed transplantations on 21 classes II and III thalassaemic patients [class II patients had either hepatomegaly or portal fibrosis and class III patients had both]. We used busulfan [15 mg/kg] and cyclophosphamide [200 mg/kg]. Graft-versus-host disease [GVHD] prophylaxis was cyclosporin, prednisolone and low-dose antithymocyte globulin. Our patient data showed a low incidence of acute GVHD following transplantation. We offer this regimen as an acceptable therapy for thalassaemic patients undergoing allogeneic marrow transplantation as a safe clinical procedure, irrespective of the class of patient

Intestinal zinc absorption in iron-deficient women

To investigate the effect of iron deficiency on intestinal absorption of zinc, changes in serum zinc level 5 hours after ingestion of 100 mg zinc sulfate, considered as an index of intestinal zinc absorption, were measured in 50 iron-deficient women aged between 18 - 48 years. Thirteen normal individuals, with an age range of 20 to 24 years, were selected as controls. Zinc measurements were performed by atomic absorption spectrophotometry. Post-ingestion serum zinc levels were significantly lower in the iron - deficient women, although the per cent increase in zinc uptake was similar in patients and controls. The zinc level was significantly lower in patients before and after zinc ingestion, compared to the corresponding control levels. The results of high performance liquid chromatography [HPLC] measurements of serum vitamin A levels, similar to the zinc pattern, were significantly lower in the patients before and after zinc intake, compared to the corresponding controls, while serum vitamin E, measured by HPLC, remained unchanged in all subjects

ENT complications in B-thalassemia major

During three years [from 1989-1991], 100 cases of homozygous beta-thalassemia were investigated for ENT complications. All cases were receiving irregular, low dose. subcutaneous infusion of desferrioxamine. One hundred healthy subjects were studied as controls. Conductive hearing loss in 20 patients [20%; 18 bilateral] and sensorineural hearing loss at high frequencies in 5 patients [5%; 4 bilateral] were found. Ototoxic effects of desferrioxamine are dose-related and can occur at relatively high doses. The homozygous beta thalassemic patients showed more auditory impairment than controls. There was also a higher incidence of tonsillar hypertrophy, adenotonsillitis and submandibular lymph node enlargement compared with the controls. Twenty patients [20%] had significant problems requiring surgery

Treatment of cyclic thrombocytopenia with medroxy-progesterone acetate

A female with severe cyclic thrombocytopenia is reported. The periods of oscillation were between 21 to 31 days. The lowest platelet counts were at the time of ovulation when the estradiol secretion reaches a peak. The highest platelet counts were before menstrual flow when plasma progesterone is high. With the possibility that estrogen is the cause of thrombocytopenia and progesterone can counteract this effect, the patient was administered medroxy-progesterone acetate 10 mg per day, which resulted in correction of the periodic thrombocytopenia