مجله سازمان نظام پزشکی جمهوری اسلامی ایران
سال سی و پنجم شماره 1 (پیاپی 137، بهار 1396)

The quality of hospital services results in patients’ satisfaction. This study aimed to measure service quality in Tehran hospitals.
This descriptive and cross sectional study was carried out in 18 hospitals in Tehran in 2014. The perception and expectation of 707 inpatients were measured in 4 dimensions including environment, empathy, effectiveness and efficiency using HEALTHQUAL questionnaire. Data were analyzed using SPSS-V20.
The mean score of patients’ perception and expectation were 3.56 and 4.14 out of 5. Thus, a negative quality gap was calculated )- 0.57(. This negative gaps were - 0.58, - 0.59 and - 0.54 respectively at university, social security and private hospitals respectively. The highest perception and expectation scores were seen in effectiveness dimension of quality. There were significant relationships between hospital service quality and type of the hospital, patient insurance status, place of residence and waiting time (p Service quality in Tehran hospitals was lower than patient`s expectations. Hospital managers should investigate the causes of patients’ dissatisfaction and accordingly take corrective actions using quality management techniques.

Considering the importance of knowing the implications of health care workers and specially physicians’ dual practice in health policy, the aim of this study is to identify and analyze the current evidence in this field for the first time, using systematic literature review methodology.
a thorough search were performed in credible databases, search engines, specialized databases, and reference list of identified studies. The selected inclusion criteria were studies which were done using one of the rigorous and reliable known scientific methods.
the overall search found 3242 records, and none of them were considered eligible for including in the study according to the selected criteria. After showing the lack of high quality evidence in this area, the current knowledge in this field was categorized and analyzed from two perspective.
Results showed that there is not any rigorous and scientifically reliable evidence about the real implications of health care workers’ dual practice, and most of the related studies have been relied on theoretic methods, which their core assumptions were undermined in the broader literature. Furthermore, findings suggested that dual practice implications are context specific and may vary or differ from system to another system.

sleeping is a natural basic human requirement and is considered as an important health variable. This research aims at determining the status of sleep quality among pregnant women with gestational diabetesreferring to clinics and high risk pregnancy ward at Alzahra and Taleghani hospitals in Tabriz, Iran in 2015.
this sectional study was done on 182 qualified women in 28-36 week of pregnancy suffering from gestational diabetes referring to clinics and high risk pregnancy ward at Alzahra and Taleghani hospitals. Participants were selected through available sampling method. Personal-social-midwifery questionnaire and Pittsburg sleep quality were used for gathering data. Multivariate linear regression model was used for determining the relationship between sleep quality and its subsets with Personal-social-midwifery variables and controlling confounders.
Findings: The prevalence of sleep disturbance was 96.3% among pregnant women with gestational diabetes. Mean (standard deviation) of total score of sleep was 10.1 (3.96) in 0-21 achievable score among these women. According to multivariate linear regression model, the health status and home air conditioning and abortion record were related with sleep quality.( p The findings of current research show that sleep quality disturbance is very common among pregnant women with gestational diabetes . So it is necessary to train in a way to improve sleep quality in pregnant mothers.

Within recent years, the numbers of sports injuries in football have increased. In average, the amount of injuries for each professional football player is about 5.1 to 6.7 injuries in each 1000 hours of exercise and about 12 to 35 injuries in each 1000 hours of exercise. Considering very few studies done to determine the frequency of musculoskeletal injuries in professional football players in Iran, the present study aimed to determine the frequency of musculoskeletal injuries in football players of Iran Football Premier League.
Material and This descriptive cross-sectional studywas carried on all football players of Iran Football Premier League who referred to Iran Football Medical and Rehabilitation Center (IFMARC) located in Iran Football National Teams campus in their 2015 to 2016 Pre-Competition Assessments. Based on the standard protocol of PCMA (Pre-Competition Medical Assessment) approved by FIFA, the data of all athletes including their age, type of injury, location of injury, period of absence from the matches, the athlete’s position on the field and the BMI ( Body Mass Index) was registered.
In this study, 400 athletes with the average age of 19 -29 participated, of which 4.8% had complaints of pain. The highest record of injuries related to knee ligaments (42%) and worst injuries were inflicted on athletes in half-back positions (42%). The rate of injury on athletes with normal BMI and high BMI were 4.8% and 0.3%, respectively.
Considering further prevalence of knee injuries in football players of Iran Football Premier League, specially the athletes in mid-fielder positions, further planning in this regard such as presenting professional exercises to prevent knee injury specifically to mid-fielder players ,makes it possible to reduce rate of injuries.

The effectiveness of group play therapy in cognitive – behavioral style on coping styles of children was the objective of this study.
In a quasi-experimental design, first, for sampling, Ministry of Education for Region 5 was selected randomly. Then, using the cluster approach, four schools were selected in this area and the students in the level of fifth in primary schools, which their scores were higher than average in coping behaviors in children questionnaire (CCBQ), 28 students were selected randomly in both experimental and control groups. At the end of the study, children were evaluated again in each group using coping behaviors of children questionnaire. The data were analyzed by Analysis of Covariance.
Findings: Results showed that play therapy in cognitive – behavioral style has significant impact on coping style consistency of children toward improvement (P it seems that play therapy in cognitive – behavioral style has impact on coping style of children and it can improve children coping styles.

Many studies have examined the influence of psychological and genetic disorders on criminal behaviour. In criminal law, these factors may result in insanity defence; however, in many cases, genetic disorders and subsequently psychological disorders are not severe enough to result in insanity defence and instead, the defence of diminished responsibility might be raised. While many countries have recognised such defence, the Islamic Criminal Code of Iran has not recognised it yet. In the latest revision of this Code in 2013, the term ‘insanity’ was replaced by ‘psychological disorder’ and widened the circle of factors that may result in a criminal defence. Nonetheless, still, the only legal impact of genetic and psychological disorders is the insanity defence. This study by exploring the relation between psychological and genetic factors and different degrees of criminal responsibility examines the role of the insanity defence and diminished responsibility in Iran and some other countries.

Femoral head osteonecrosis is a condition that caused decreased femoral head blood supply. The risk factors which involving in this disease including long time corticosteroid consumption, smoking, alcoholism. In this report, we aim to introduce a case of avascular necrosis of femoral head in a woman with a history of OCP consumption.
Case report:A 24 Y/O woman presented with pain in pelvis and both thighs within past 7 months, which radiated to legs and toe tips. 13 months ago, she had a history of OCP consumption for 2 months. After that she had to stop continuing the OCP taking as a result of headache, vertigo and blurred vision; and then her symptoms proved after 7 days treating with prednisone (total dose of 350mg). She developed pain in her legs and disability of doing routines 6 months later.