مجله پیاورد سلامت
سال دهم شماره 3 (امرداد و شهریور 1395)

Vegetables are one of the major components of food basket and consumption of them is on the rise. On the other hand, diseases and outbreaks caused by this group of foodstuffs have increasing trend. This study was performed to investigate the microbial contamination of vegetables used in south of Tehran.
Hundred fresh packaged and non packaged vegetable samples composed of 10 kinds, were examined based on the methods presented in Iran national standards. For each sample, enumeration of enterococcus and total microbial count was carried out by the pour plate technique in KF agar and plate count agar, respectively. Escherichia coli detection was also performed using lauryl sulfate broth, EC broth, peptone water and MacConkey agar mediums. Biochemical tests namely urea hydrolysis, motility, sulfide hydrogen (SH2) production, gas production and sugar fermentation were conducted as conformational tests of Escherichia coli.
All (100%) of mixed leafy vegetables, spinaches, peppers, kuku (Persian food) vegetables, wheat sprouts and mung been sprouts had contamination higher than acceptable limits. In the case of green onions, basils, kuku vegetables, mushrooms and broccolis, respectively 40, 60, 30, 90 and 30 % of the samples were in contravention with acceptable limits, in terms of at least one parameter.
Our results show that consumption of vegetables specially those used as raw, need more attention at washing point and need to use hygienic rules of health department and health care centers, at shopping and consumption steps.

Effective educational programs, is one of the most basic methods in prevention of Nosocomial infection. This study aimed to compare the effects of E-learning versus lecture-based education in prevention of Nosocomial infections among hospital staffs.
A randomized pre and posttest control group design was conducted on 98 hospital staffs in 2013 after allocating into two groups of "lecture-based education" and "E-learning”. Data were collected by a researcher-made questionnaire which its validity and reliability was confirmed by a pilot study. Wilcoxon, Paired and Independent sample T-test was conducted using SPSS, version18.
There was a significant difference for outcomes before and after education based on two approach of lecture-based (p=0.01) and E-learning (p=0.01).The mean and standard deviation of knowledge in lecture-based education and E-learning group were 12.73± 2.76, 11.50 ± 2.64 respectively. The level of knowledge in the lecture group was significantly higher than that of participants in the E-learning group (p=0.02).
Despite the effectiveness of E-learning in learning and raising awareness of the learners, using of this method among health-related organizations need to empower employees, remove the barriers and suitable infrastructure.

Computerized physician order entry system is the process of entering orders electronically. It is a replacement for manual system and is considered as a part of a clinical information system. The appropriate design of this system leads to the enhancement of its capabilities, ensures orders accurately and comprehensively, and transfers information to different parts rapidly. Therefore, transfer time and the error related to the wrong path or misinterpretations will be omitted; in the end, efficiency will increase. This study aims to present different perspectives on design principles of computerized physician order entry system for stakeholders.
In this review article, Google, Google Scholar, Pub Med, Web of Science and Scopus databases were searched with some keywords related to design principles of computerized physician order entry system.
Based on the performed studies, factors such as inappropriate design of links, display page, set of orders content, drug database, structure of order environment, rules, formats, mechanism of getting reports of errors, and finally clinical decision support system have led to the decrease of doctors’ performance, increase of new errors, and reduction of patients’ safety.
Inappropriate design leads to the increase of new errors after the implementation of system; therefore, proper and principled design of this system can lead to the improvement of practitioners’ function, decrease of prescription errors and drug side effects, reduction of costs, efficiency increase, workflow

Brain tumors have remained as a significant cause of morbidity and mortality and are often refractory to treatment. The grading of brain tumor has an important implication in clinical management. Currently, magnetic resonance spectroscopy (MRS) is an important dimension in evaluating metabolites and grading brain tumors. The aim of this study is to evaluate metabolites in brain tumors and grading brain gliomas using HMRS (proton magnetic resonance spectroscopy).
Studies were performed using single voxel MRS, at a field strength of 3Tesla and pulse sequence using point resolved single volume spectroscopy (PRESS) with repetition time (TR) 1000-6000ms and echo time (TE) 36-136ms, and distinguished metabolites including Choline (Cho), Creatin (Cr), and N-acetyl aspartate (NAA) were detected.
Thirty-seven cases (17 males and 20 females) had data which passed quality control. The patients’ age ranged from 7 to 81 years with a mean of 41.46±2.78. MRS data were processed using SYNGO software in terms of mean spectra and metabolite concentrations which were compared using minitab and SPSS. Significant differences were found in concentrations of key metabolites, and Cho/NAA and Cho/Cr ratios using t-test with a significance level (α≤0.05). In the assessment of age rate and tumor grading, the malignancies of brain tumors did not correlate with patients’ age and sex.
MRS can detect subtle differences between low-grade brain tumors in children and should form part of the clinical assessment of these tumors.

Cosmetic surgery rhinoplasty, has dramatically been increased during the last two decades. This study aims to explore its effects on the quality of life of individuals gone under the surgery.
This was a descriptive and analytical study which was performed as a cross-sectional study. From all plastic surgery clinics in Teheran, 25 clinics were selected randomly as the site of study. In the next step 110 patients undergone rhinoplasty were selected randomly from these clinics. Collected data was analyzed by Spss17.
Findings revealed that, the mean score of quality of life before and after surgery was statistically significant. While mean score of general benefits increased the score of social support and physical health was decreased after the surgery. The most motivating factors for surgery were external factors. In addition there was a positive correlation between quality of life and the time of interview. Also the mean cost of surgery was increased.
Overall quality of life among study population was decreased. It could be because of unnecessary surgeries, medical errors, and etc. The reduction for social support may be resulted from unacceptable consequences of rhinoplasty particularly in terms of appearance. Physical health of respondents was negatively affected by rhinoplastiy surgery. Malfunctions of upper respiratory system after rhinoplastiy surgery is known as the main reason for it. Correlations between the times of surgery and interview suggest a long term assessment of impacts of such surgeries.

Because of extension of health services and comprehensive receivers, the need for health services management is inevitable. Despite the availability of health care services, people do not embrace the full range of these services. This study was conducted to determine the reasons for unwillingness to use health care services presented to age group under 9 years from perspective of health workers in Qom province, during 2013.
This cross-sectional study was done to evaluate the perspective of health personals about services that presented to population with age group less than 9 years. This study was done with a questionnaire as a matrix evaluation of health services. Data were analyzed by Spss 15 Software. Chi square test were used for the evaluation of the hypothesis.
The main reasons for the lack of interest to receive the health care services from perspective of health workers were: lack of health knowledge in recipients of services, inadequate information, poor methods of health care delivery, quality of health care and unsuitable access to health care.
To encourage people to get the health care services provided at health centers in Qom province should hold training meetings, to enhance the knowledge of health care recipients. About presentation of services and methods of service delivery in health centers, we should give enough knowledge to people. Also we should try to promote the level of services, while people motivate to get the services.

Cancer is one of the stressful problems of humans life. The concept of cancer will included a complex problems such as cancer pain, physical and psychological, social, and cultural pains. The aim of this study was to determine the relationship between the physical environment of hospital and quality of life in cancer patients.
In this mixed study (qualitative – quantitative), 60 cancer patients referred to Imam Khomeini hospital of Ardabil and Shahid Beheshti hospital of Hamadan in 2013 were selected randomly. The data were collected by interview and observation and using the SL-36 quality of life questionnaire and also structured questionnaires was used.
The analysis confirmed that images of natural scenes and artificial plants in hospital rooms increase the quality of life. See watching the outside plant, even outside the room, increase the quality of life.
This study confirms the quality of life increasing properties of natural elements in healthcare environment.

One of the most important and useful models for assessing hospital performance is the Pabon Lasso Model, a graphical model that determines the relative performance of hospitals using three indicators: 1. Bed Occupancy Rate (BOR); 2. Bed turnover (BTO); 3 Average Length of Stay (ALS). The aim of this research is to investigate the performance of the hospitals affiliated with Tehran University of Medical Sciences in Iran during the year 2011 based on the Pabon Lasso Model.
This descriptive and cross-sectional study conducted in 2011. All the 16 hospitals affiliated to Tehran University of Medical Sciences formed the study population. Data was analyzed by Excel software and Pabon lasso model.
The following average results for each performance indicator were obtained: Average Length of Stay (ALS) = 6.55 days. Bed Occupancy Rate (BOR) = 74.151% and Bed Turnover (BTO) = 70.24 times per year18.75% hospitals were located in the Pabon Lasso Model zone 1.25% hospitals in zone 2.25% of hospitals in zone 3, and 31.25% hospitals in zone 4 of the model.
The study showed that 75% of the studied hospitals were inefficient. Applying Pabon Lasso model compared hospital's performance. Thus, using one of the active ways of problem recognition in hospitals and perceiving the relation of performance indicators will be helpful in establishing new policy and reviewing current policy in order to maximize performance capacity.