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مقدمه: فلج مغزی، یکی از علل شایع شکایت قصور پزشکی در حوزه‌ی مامایی است. تصور می‌شود که پس از ابلاغ و اجرای بخش‌نامه‌ی ترویج زایمان طبیعی در سال ۱۳۹۳، شکایات مرتبط با آسیب مغزی نوزاد و فلج مغزی ناشی از آسیب‌های هیپوکسیک ایسکمیک حین Labor افزایش یافته است. از این رو، مطالعه‌ی حاضر با هدف مقایسه‌ی پرونده‌های شکایت قبل و بعد از این تاریخ انجام شد.روش‌ها: این مطالعه مقطعی بر روی 117 پرونده شکایت‌های با موضوع فلج مغزی مطرح‌شده در اداره کمیسیون پزشکی استان تهران از ابتدای سال ۱۳۹۰ تا انتهای سال ۱۳۹۶ که به صورت سرشماری انتخاب شدند، انجام شده است. داده‌ها با استفاده از فرم ثبت اطلاعات از پرونده‌ها استخراج گردید و با استفاده از نرم افزار SPSS واکاوی شد.یافته‌ها: زمان تولد تعداد ۶۴ مورد (7/54 درصد) از موارد شکایت در رابطه با فلج مغزی قبل از ابلاغ بخشنامه و ۵۳ مورد (3/45 درصد) بعد از آن بوده است. از ۶۴ مورد متولدین قبل از ابلاغ، تعداد ۳۳ مورد شکایت خود را قبل از این تاریخ ثبت کرده‌اند و سایر موارد (31 مورد) بعد از تاریخ ابلاغ بخشنامه طرح شکایت کرده‌اند و شکایات پس از ابلاغ به ۸۴ مورد رسیده است. با وجود این، تعداد متولدین در این بازه‌ی زمانی ۵۳ مورد بوده است و زمان تولد با زمان شکایت تفاوت آماری معنی‌داری داشت (001/0 > P).نتیجه‌گیری: با وجود افزایش تعداد شکایت با موضوع فلج مغزی در طی سال‌های اخیر، غالب موارد فلج مغزی مربوط به متولدین سال‌های قبل از ابلاغ بخش‌نامه است و ابلاغ بخش‌نامه‌ی ترویج زایمان طبیعی، منجر به افزایش شکایت با موضوع فلج مغزی در طی سال‌های مورد مطالعه نشده است.

Background: Today, despite the efforts of the medical community and health staff, the rate of dissatisfaction and complaints among patients is increasing and this highlights the importance of evaluating its related factors. The aim of this study was to analytically investigate complaints against ophthalmologists which were referred to the Legal Medicine Organization of Iran in Tehran during 2017-2019. Methods: In this cross-sectional (analytical-descriptive) study, the demographic data of patients and physicians including age, gender, marital status and academic degree, type of treatment measures leading to complaints, last decision of the medical commission, characteristics of protesting of patients and vote of revision commissions for all the complaints of ophthalmology were recorded and analyzed. Results: During 3 years, 176 complaints were recorded in the field of ophthalmology. Of these, 90(51.1%) complaints were from medical interventions which took place in university or government hospitals and clinics. Also, 27(15.3%) cases of malpractice were reported, among which negligent was the most common type, with 22 cases (81.5%). The highest number of complaints was for cataract surgery and the most frequent treatments with malpractice of the physicians were cornea transplantation. Although the most protests to the first decision were from the patients, the effectiveness of physicians’ protest was significantly higher (P<0.001). Conclusion: Nowadays, with advances in treatment methods and technologies in ophthalmology and enhancement in the knowledge of patients about their rights, their expectations from medical staff have changed. The findings of the present study suggest that due to the rise in the number of complaints in ophthalmological treatment while a decrease in malpractice rate, applying intervention actions such as good communication between physicians and patients and patient’s right perception of treatment and possible side effects can lead to less number of complaints. In addition, due to different opinions in consecutive commissions, utilizing a single approach based on new information and evidence seems necessary. [ABSTRACT FROM AUTHOR]

Background and purpose: Medicinal plants are among highly consumed natural drugs. Many herb shops produce and sell this products without any license. Traditional herbal distillates are widely used in Iran, so, the aim of this study was to determine ethanol and methanol concentrations in handmade herbal distillates in Tehran herb shops. Materials and methods: A total of 140 samples from 14 traditional handmade herbal distillates were obtained from Tehran herb shops and analyzed using headspace gas chromatography. Results: In this study, no sample contained ethanol. Peppermint distillate had significantly higher methanol content (334.62±153 ppm) compared with other distillates (P<0.05). Also, high amounts of methanol were found in Fenugreek (321.43 ppm) and Tarragon (311.39 ppm) distillates. Pennyroyal distillate did not contain methanol and rose water had the lowest methanol content (14.61 ppm). Conclusion: Handmade herbal distillates containing high concentrations of methanol can cause health problems in regular consumers. Therefore, highly consumed herbal distillates should be monitored to determine their methanol concentration. [ABSTRACT FROM AUTHOR]