مژگان کریمی

In the electric discharge machining process, the material is separated from the surface of the work piece by an electric spark, and in the presence of the dielectric material and tool electrode, changes are made on the surface of the work piece. In this project, we investigated the effect of dielectric material and brass tool electrode diffusion on the surface of carbon steel workpiece by means of quantmetric analysis, X-ray diffraction and electrochemical impedance spectroscopy. The effect of the parameters such as electric current intensity (I), pulse on time (ton), pulse off time (toff) and machining time (τ) on the composition of work peace, microstructure and electrochemical corrosion of machined work peace, were investigated. The results of quantmetric analysis showed that with the increase of machining parameters, the amount of diffused copper (from brass tool electrode) and carbon (from pyrolysis of flashing dielectric material) on the surface of machined carbon steel was increased. X-ray diffraction results confirmed that the formation of different phases such as Fe1.92C0.08, Cu4, Cu2 and Fe2 on the surface of workpiece, which was accordance with the quantmetric results. Electrochemical studies showed that during the EDM process, the electrochemical corrosion resistance was increased.

The goal of Customer Relationship Management (CRM) is to create new relationships, increase customer value, retain customers and increase profitability. The Patient Relationship Management System (PRM) is a key strategy in managing interactions between healthcare organizations and customers. In PRM, the focus of organizations is on determining and meeting the needs of the patient.

This review article has been performed the role of customer relationship management system in the health care sector using method of library research and searching valid websites.

PRM has the ability to achieve better coherence between health care departments, which in turn improves clinical outcomes and patient satisfaction. Moreover, PRM improves the patient follow-up system, better understanding of their needs, and Provides better care services to patients. Increasing operational efficiency, centralizing data, better management of current customers, and strengthening the hospital image are some of the effects of implementing CRM in hospitals.

Nowadays, health care sector has become a competitive market. New technologies have changed the care environment. Therefore, health care organizations are trying to keep their customers. Customer relationship management is a strategy that enables more insights for customers as well as more effective and satisfying interactions for healthcare organizations.

The purpose of this study is to design a model of the place of public sports in the health-oriented lifestyle of the Navy personnel of the Army of the Islamic Republic of Iran. The research was conducted by mixed method. Data collection methods included library studies, content analysis method and review of 73 semi-structured researches and interviews. The statistical population in the qualitative section were naval sports and health experts. Since this study sought to describe the qualitative characteristics and themes of Klinger, thematic analysis was used. The results showed that after reviewing the interviews and deleting similar codes, first 169 basic themes codes were classified, then they were classified into organizing themes 1 and 2. Organizer 1 with 40 themes and Organizer 2 with 12 themes were classified and then a researcher-made questionnaire was designed and provided to the statistical population of Tehran Navy personnel which was 450 people and calculated by Cochran's formula 207 people as a statistical sample in the form of They were randomly selected and answered a researcher-made questionnaire. The results after ranking the factors showed that management ranked first, education ranked second, facilities ranked third, physiology ranked fourth, media ranked fifth and other topics ranked next, and finally the model was designed.

The variety of sweets along with significant difference level of hygiene in the production, supplies and high potential contamination of sweets ingredients with Escherichia coli, led to investigate the frequency of broad-spectrum beta lactamase strains of E. coli in sweets and determine the presence of SHV, TEM and CTX-M genes. In this descriptive cross-sectional study, 150 confectionery samples were collected from traditional confectionery workshops in Yazd. Detection of E. coli strains was carried out by standard biochemical tests and antibiotic susceptibility test was performed using CLSI guidelines. Via combined ESBL disk method on the muller hinton agar medium producing strains were identified. All the ESBL producing strains were evaluated using the PCR test for the existence of SHV, TEM and CTX-M genes. In 30 isolates, (20%) E.coli was obtained. The results of antibiotic susceptibility test showed that the highest and the lowest antibiotic resistance was related to chloramphenicol l (22 isolates, 73.3%) and Imipenem (8 isolates, 26.6%). The results of the combined disk test was showed that only 9 isolates produced ESBL. The molecular analysis on considered genes indicated that 2, 4 and 3 isolates were positive for presence of TEM, SHV, and CTX-M genes, respectively. The prevalence of antibiotic-resistant isolates in traditional Yazd sweets in this study highlights the importance of more observing and control measures in the preparation and distribution of sweets.

Hospitals employing telesurgery need to be evaluated to determine whether they satisfy the international standards. The main goal of this research was to assess the software, hardware, telecommunication equipments, privacy and security methods, and staffing requirements for supporting and executing telesurgery in hospitals affiliated to Tehran universities of medical sciences, Tehran, Iran. This descriptive study included 23 hospitals affiliated to Tehran universities of medical sciences. Hospitals were selected by stratified sampling followed by simple random sampling. Data was collected by observation and interviews using a checklist. Descriptive statistics was applied for data analyses. According to our findings, 10 studied hospitals employed telesurgery among which 90% used telementoring, 30% used teleproctoring accompanied by telementoring, and 10% used telerobotic surgery. None of the hospitals used telepresence surgery. Most common equipments were video camera (80%) and microphone (100%). TCP/IP was the most common telecommunication standard with which most hospitals were more familiar. Moreover, 80% of hospitals used informed consents in order to assure the security and privacy of telesurgical information. Overall, we consider the hospitals which employ telesurgery in weak conditions in terms of satisfying the related standards. Accessing and distributing appropriate infrastructures, equipments and transferring methods and standards are main prerequisites for successful implementation of telesurgical applications.

Postpartom hemorrhage is one of the most major problems that threaten the mother's health and is regarded as one of the most important reasons for mortality specially in the developing countries. So far, many studies have been conducted in regard to effectiveness of chemical and herbal medicine on decrease of Postpartom hemorrhage. This study aimed to investigate effectiveness of date (Rutab) on postpartum hemorrhage. This is a clinical trial study in which 94 subjects, having the adequate criteria for the research, were selected in Shahid Sadoughi Hospital. The participants were divided into two groups. In the first group, immediately after placenta delivery infusion, 20 unit oxytocin in 1000 ml 5% dextrose in water with normal salin solution(group 1) were given, whereas in the second group, infusion of 10 unit oxytocin in 1000 ml 5% dextrose in water with normal salin solution associated with 100 gram date (Rutab) were given and the patients were required to have them in 10 minutes. At the same time a plastic and a cotton sheet were widen under the patients. Blood loss was determined by regular weighting of the buttocks that were previously weighted. The difference was calculated before and after weight (1 gram increase in weight was considered to be equivalent to 1ml blood). Data were submitted to SPSS software and then analyzed by T-test, Chi-squre, Mann-whitney. The two groups were homogenous in regard to all the variables. The study results indicated that the bleeding mean was 127/11 ml at the two hour after delivery in the first group and 68/5 ml in the second group. There was a significant difference between postpartum hemorrhages of the two groups Since date(Rutab) was more effective than infusion oxytocin on post partum hemorrhage and no side effect was reported for that, it is recommended that its significance will be prposed to related specialist. Moreover, extra investigations are necessitated for future studies.