Research in Medicine

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Abstract Background: The Baldrige Criteria for Performance Excellence provide a systems perspective for understanding performance management. They reflect management practices against which an organization can measure itself. The Criteria have been accepted internationally as the model for performance excellence. Methods: This descriptive cross-sectional study was performed at Hasheminejad hospital, a training hospital of Iran University of Medical Science And Health Services, in Tehran. Members of the study team interviewed the Hospital administrator and senior managers according to the standard global Malcolm Baldrige questionnaire and documented the data. 7 criteria were used for performance assessment. Results: This hospital got 426 points from a maximum of 1000 (42.6%). Of 426 point, 46 (37% of maximum point) was for leadership criteria, 38 (44%) for strategic planning, 41 (50%) for focus on patients and other costumers, 40 (44%) for criteria of data assessment, analysis and management, 43 (51%) for focus on personnel, 33 (39%) for process management and 185 (41%) for function of organization. Conclusion: Baldrige model can be used as comprehensive model for assessing the performance of training hospitals. By using this model, managers can find strengths and weaknesses of organizations and then use this model for performance improvement. Keywords: performance assessment, Malcolm Baldrige, training hospital. Hasheminejad, Excellence model.

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Abstract Background: PGC-1α is involved in the regulation of several metabolic processes and its reduced expression has been observed in early stages of type 2 diabetes, (T2D). Changes in activity of PGC-1α, probably due to its polymorphisms, have extensive effects on metabolic processes in people with T2D. The association of rs2970847 polymorphism of PGC-1α gene with T2D has been investigated in several studies, but the results of these studies are diverse and sometimes contradictory. The aim of this meta-analysis was to investigate the relationship between Thr394Thr polymorphism of PGC-1α gene and T2D. Materials and Methods: This study was a systematic review of the available literature and resources. To find related documents, the following literature databases were searched: Scopus, PubMed, Google scholar, SID, Irandoc and Magiran. Articles were searched by combining critical and sensitive keywords, including: rs2970847, Thr394Thr polymorphism, PPARGC1A, PGC-1, PGC1alpha, Type 2 diabetes, type 2 diabetes, and T2D. Results: In 7 reviewed papers, the total number of T2D and control subjects was 2146 and 2814, respectively. For the GG, GA, and AA genotypes of the Thr394Thr polymorphism, OR (95% CI) were equal to 0.59 (95% CI=0.52-0.67), 1.25 (1.10-1.43), and 1.75 (1.45-2.08), respectively. The results showed that the association between the GG and GA genotypes of Thr394Thr polymorphism and susceptibility to T2D was statistically significant (P <0.05). Conclusion: This study generally demonstrated that rs2970847 polymorphism of PGC-1α gene is significantly associated with the risk of T2D. Keywords: PGC-1α, T2D, Thr394Thr polymorphism, rs2970847, Meta-analysis.

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Background: Obesity is associated with increased risk of many diseases. Methylation is an important factor in obesity, indicating epigenetic changes. However, there is lack of data about PGC-1α methylation and regular exercise. Purpose of this study was to determine effects of 6-week high-intensity interval training (HIIT) on PGC-1α methylation in gastrocnemius muscle of obese male rats.
Methods: In a experimental study, twenty four male Wistar rats were randomly divided into 4 groups (6 rats each): control healthy, trained healthy, control obese and trained obese. Healthy group consumed normal diet and obese group consumed high-fat diet (for 6 weeks). Trained healthy and trained obese performed swimming HIIT for 6 weeks. 24 hours after the last session of the training, gastrocnemius muscle of control and trained rats was extracted and then afterwards PGC-1α methylation was assayed. For analyzing data, paired sample t-test and one-way analysis of variance were used.
Results: After 6 weeks, body weight of trained obese group compared with control obese was decreased significantly (P=0.021). In addition, after 6-week HIIT, PGC-1α methylation of healthy (P=0.010) and obese group (P=0.037) compared with their control group was decreased significantly.
Conclusion: It appears that 6-week swimming HIIT can be effective on obesity state and significantly reduce PGC-1α methylation in gastrocnemius muscle of obese male rats.

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Background: Staphylococcus aureus is an opportunistic pathogenic bacterium that can provide invasive
conditions by secreting various toxins. It is involved in the development of skin infections, such as swollen
and ulcers. Today, one of the main problems is the treatment of Staphylococcus aureus resistant strains. The
aim of the current study was to detect virulence factors and antibiotic resistance among strains isolated from
wound infections of children who referred to Tehran Children’s Medical Hospital in 1396-97.
Materials and Methods: A total of 59 strains of Staphylococcus aureus isolated from wound infection were
collected during one year. Staphylococcus aureus was detected using biochemical tests. For antibiotic
susceptibility test, antibiotic disks (Mast، UK) were used according to the CLSI 2017. For detection of
virulance genes, including nuc، mecA، tsst-1، hla، hlb، hld، eta، etb، etc, PCR method was used.
Results: Vancomycin and linezolid were sensitives for all isolates and the highest resistance antibiotic was
penicillin with 98.3%. The frequency distribution of genes s mecA، tsst-1، hla، hlb، hld، eta، etb، and etd were
59.3%, 37.7%, 71.2%, 57.6%, 96.6%, 100%, 11.9%, 27.1%, respectively.
Conclusion: All isolates were sensitive to vancomycin and linezolid, and these antibiotics were the best
choices for the first line of treatment for staphylococcus aureus strains. Since all isolates of Staphylococcus
aureus were obtained from children wound infections and all of them contained oxfolitic A gene, control
and disinfection measures seem to be important among children, because these strains have the potential to
spread this gene among hospitalized patients.
 

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Amniotic band syndrome (ABS) is a rare congenital anomaly may affecting any region of the fetus. Here, we reported a case of ABS involving the upper limbs resulted in amputation, syndactyly and lymphedema of several fingers. One of the the amputated finger reimplanted on to the upper back of the fetus between two scapular bone. The finger-like mass had no osseous tissue.