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Abstract Background & aim: Autism is one of the diseases with clearly associated disorders. Children with autism are not able to express the pain and in case of signs of mental disability in children a delay in reporting of diagnosis or misdiagnosis will occurs. The aim of this study was to report a case of risperidone in children with autism and suspected dysphagia. Case Presentation: This case report dealt with a rare complication of Risperidone side effect diagnosed as dysphagia in an autistic child. Risperdal is approved for autism treatment and the common side effects of this drug is increased appetite, but has led to difficulty in eating in children. To investigate the cause of dysphagia, no para-clinic examination was conducted. Conclusion: It is necessary to take a complete drug history in patients with problems of communication and swallowing disorders. Key words: Risperidone, Autism, Dysphagia, Child

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Abstract

 

Background and Aim: Polycystic ovary syndrome (PCOS) is one of the most important reproductive and endocrine disorders in women. Evening primrose oil is a phytosterogenic plants, and there are many reports about the effects of phytoestrogens on the hypothalamus-pituitary axis. Regarding the side effects of existing drugs, the aim of this study was to evaluate the effect of evening primrose oil (EPO) on changes in sex hormones, serum glucose and insulin levels and insulin sensitivity in PCOS.

 

Methods: In this experimental study 30 female Sprague Dawley rats with regular sexual cycle were divided into five groups (n=6). Group 1: control. Group 2: (control treatment) received evening primrose oil gavage at dose of 1000mg/kg for 21 days. Group 3: PCOS induced by estradiol valerate. Group 4: After induction of PCOS received evening primrose oil gavage at dose of 1000mg/kg for 21 days. Group 5: After induction of PCOS received evening primrose oil gavage at dose of 2000mg/kg for 21 days. Finally, blood samples were collected from heart and then sex hormones, glucose and insulin concentrations were determined. The results were analyzed by SPSS software using one-way ANOVA and Duncan 's test.

 

Results: The FSH level increased significantly in the fourth and fifth groups compared to the third (p <0.05). Levels of LH and testosterone levels were significantly lower in the fourth and fifth groups than the third group (p <0.05). There was no significant difference in the level of FSH and LH among the other groups. The serum levels of insulin and glucose in the fourth and fifth groups were significantly lower than the third group (p <0.05). Also, insulin sensitivity was higher in the treatment groups than in the third group (p <0.05). There was no significant difference in insulin, glucose and insulin sensitivity among other groups.

 

Conclusions: By changing the concentration of FSH, LH and testosterone hormones in polycystic ovary syndrome, evening primrose oil, can reduce the complications of these hormonal changes. EPO also reduces insulin and serum glucose and increases insulin sensitivity in PCOS. With more complete studies, Evening primrose oil can be recommended as a good alternative to chemical drugs for the treatment of PCOS.

 

 

 

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Background & aim: As health and financial resources become more complex and limited in health care organizations, outsourcing and proper management become more important. Therefore, the purpose of the present study was to determine the dimensions of management and design a model for outsourcing management of non-clinical services in public hospitals.
 
Methods: The present a descriptive-analytical study was conducted in 2021. The study population included health system policy makers, outsourcing experts and managers of public hospitals. A 28-item questionnaire was used to collect data, the variables of which were extracted from comparative studies of selected countries. The validity of the structure was evaluated by experts and the Cronbach's alpha coefficient was determined to be 0.85. In order to obtain reliable results, the final questionnaire was distributed among 308 people in the research community. For sampling using the stratified method and data analysis, factor analysis was performed using statistical tests and the final model was extracted.
 
Results: According to the final model, 6 main and effective factors on outsourcing management were identified, which included: planning, decision making, performance management, contracting, communication and knowledge management. Planning factors with coefficients of 0.94 had the most impact and knowledge management had the least effect with a coefficient of 0.34 in the outsourcing management of non-clinical services in Iranian hospitals.
 
Conclusion: According to the model, there were various factors in effective management that dimensions related to planning and decision making are of special importance and it is necessary to pay more attention when outsourcing non-clinical services in public hospitals.
 
 
 

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Background & aim: Stigma refers to negative and destructive attitudes and beliefs that society has towards some social groups, such as mental patients, disabled people, or a certain race. In Iran, there is no comprehensive and accurate questionnaire about the stigma of physical disability from a sociological point of view. Therefore, the purpose of this research was to determine the validity and reliability of the physical disability stigma questionnaire.

Methods: The present survey-cross-sectional study that was conducted among 620 people with physical disabilities living in Tehran and Yasuj cities using convenience sampling method. In order to evaluate the validity of the questionnaire, content, face, construct, convergent, discriminant, Cross-validated Communality and redundancy were used, and Cronbach's alpha, loop method, and composite reliability were used to evaluate reliability. Data were analyzed using SPSS ans PLS analytical softwares.

Results: The results indicated that convergent validity was established at the level of variables (AVE > 0.50) and at the level of items (factor loadings > 0.40) which indicated the validity and accuracy of the investigated items to measure the related variables. According to factor loading values, in measuring social stigma, family stigma dimension (0.770); In the measurement of perceived stigma, the dimension of "feeling being seen differently (0.870)" and in the measurement of self-stigma, the dimension of "avoidance stigma (0.871)" had a greater impact than other dimensions. It was correspondingly displayed that divergent validity was established at the level of variables and items, and according to the Fornell-Larcker index, the square root of the extracted average variance of each factor was greater than the maximum correlation of that factor with other factors. The results of combined reliability indicated that the questionnaire had acceptable internal consistency reliability and the reliability of the measurement model was confirmed (CR > 0.70). Finally, the results of common cross-validity and redundancy revealed that the measurement model had good quality, appropriateness and predictive power (Q2 > 0.11).

Conclusion: According to the validity and reliability indicators of the measurement tool, it can be said that this questionnaire was appropriate in terms of content. The items were able to measure the desired variables. Moreover, the questionnaire had a worthy and satisfactory quality and can be a proper tool for measuring the physical disability stigma.