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Background: Considering the high prevalence of COVID-19 in Iran, it is necessary to allocate health resources in response to this pandemic. Due to limitations in the number of hospital beds, analysis of the length of hospital stay in COVID-19 patients may be helpful for decision-making.Methods: This retrospective cohort study (survival study) was conducted through a follow-up of 1465 COVID-19 patients in Yazd Province, Iran. Demographic, diagnostic, and clinical data were collected using the COVID-19 data dashboard of Shahid Sadoughi University of Medical Sciences. The Kaplan-Meier method and Cox regression were used to calculate the survival probability and hazard ratio; the log-rank test was applied to compare survival function according to qualitative variables.Results: The median and mean survival time was 25 days (95% CI: 19.10-30.89 days) and 28.38 days (95% CI: 25.6-31.16 days), respectively. The Survival probability for one week, two weeks, three weeks, four weeks, five weeks, six weeks, and seven weeks and more was 92%, 76%, 57%, 48%, 45%, 33%, and 20%, respectively. There was a significant relationship between survival time and age categories, CT scan results, history of chronic pulmonary disease, history of diabetes, history of cardiovascular disease, and disease severity (P

Statement of the Problem: Determining the prevalence of respiratory viruses' coinfection with coronavirus disease 2019 (COVID-19) is essential to defining its true clinical influence.Purpose: This study aimed to evaluate co-infection rates between severe acute respiratory syndrome–related coronavirus 2 (SARS-CoV-2) and respiratory syncytial virus (RSV) in infected patients in Shiraz, south of Iran.Materials and Method: In a cross-sectional descriptive study, oropharyngeal, nasopharyngeal aspirate (NPA), and saliva samples of 50 COVID-19 patients who were referred to Ali-Asghar hospital (Shiraz, Iran) from March to August 2020, were collected. A control group consisted of age and sex-matched healthy participants. The nasopharyngeal and oropharyngeal aspirates were collected by sterile swabs. All cases were hospitalized, and all SARS-CoV-2 patients had a fever and respiratory symptoms. The samples were packed in a vial with 1 mL of transport medium and transported to the Valfagre specialty laboratory, where they were tested for RSV using a real-time polymerase chain reaction (PCR).Results: 100 nasopharyngeal/oropharyngeal aspirates and saliva samples including 50 healthy controls (24 females, 26 males) and 50 COVID-19 patients' samples (27 males and 23 females) were studied. There was no significant difference regarding age as well as gender between both groups (P>0.05). None of the healthy subjects was infected with RSV; however, 5(10%) patients from COVID-19 group were infected with the RSV virus. Chi-square test did not show a significant difference between RSV infection in COVID-19 patients and healthy subjects.Conclusion: The outcome of present research showed that concurrent RSV with COVID 19 infection might be seen in hospitalized patients in Shiraz Southwest of Iran. For more reliable findings, further research on bigger populations, including more pathogens in several places around the country, and considering the severity of symptoms is required.

Odontomas are benign tumors of jaws with mixed tissue, which are the result of proliferation of odontogenic epithelium and mesenchymal cells. They occur almost centrally and seldom peripherally. There is no report of such a lesion externally while attaching a tooth crown. In this case, we present a lesion on the buccal surface of the right maxillary central incisor crown, which is misconstrued with a dental overgrowth. Such cases may confuse diagnosis during clinical examination. Radiographically, such odontomas may be mistaken for various other lesions. Ultimate diagnosis should be relied upon microscopic evaluation and histopathological results.

Objective: To investigate the prevalence of chemical burns among the patients admitted to Shiraz burn treatment centers. Methods: It is a descriptive study that was conducted on 62 patients with chemical burns who were admitted between 2008 and 2018. The patients’ records were used in the research using the census sampling process. A questionnaire with questions about age, sex, the extent of the burn, the cause of the burn, duration of hospital stay, level of education, incident location, and clinical outcome was used to collect data (survival-death). The data was analyzed by using descriptive statistical methods. Results: The prevalence of chemical burns was 1% during 2008-2018. Acid and alkali burns were accounted for 93.5% and 6.5% of burns, respectively. 77.4% of patients were male, and 22.6% were female. The mean age of patients was 27 years. The average burn percentage was 16%. 70.6% of patients were illiterate or had primary education. Burns occurred at the workplace and home in 12.9% and 66.1% of cases, respectively. Moreover, Burns occurred due to accident (61%), acid attack (29%), and self-immolation (10%). The average length of hospital stay was 20 days. One patient (1.6%) died from burns. Conclusion: The study’s findings revealed that chemical burns were more common in men than women, and the majority of chemical burns occurred at home. To minimize the occurrence of chemical burns and acid attacks, teaching methods of preventing burns is important at home and work, as well as restricting nonspecialists’ access to chemicals.

Background: Patients with multiple sclerosis (MS) require health literacy to manage the symptomsand problems of the disease, which improves their quality of life. Health literacy is recognized asa critical indicator of health care outcomes. This study aimed to compare the effect of peer-led andlecture-based education on health literacy in MS patients.Methods: This quasi-experimental study was conducted on MS patients in Jahrom from December2018 to November 2019. 90 patients were selected using convenience sampling and then assigned intocontrol (n=45) and intervention groups (n=45). While routine education was presented to patients inthe control group, peer education intervention was held for the intervention group. The number ofsessions held for both groups was six sessions (one session per week). For data collection, MS healthliteracy questionnaire (MSHLQ) was used before and one month after the intervention in both groups.Data were analyzed through SPSS version 21 using Chi-square, Fisher’s exact test and t-test. Thesignificance level was considered p

Statement of the Problem: Mel-CAM (CD146, MUC18) is a 113-kD heterophilic cell-cell adhesion glycoprotein found in normal and tumoral tissues. The biologic functions and role of the Mel-CAM can be employed as a diagnostic marker in pathology. Purpose: The aim of this study was assessing the expression of Mel-CAM in common oral carcinomas like salivary gland mucoepidermoid carcinoma (MEC) and oral squamous cell carcinoma (OSCC) to differentiate the OSCC from high-grade MEC. Materials and Method: This study was performed on 19 specimens of MEC and 17 specimens of OSCC, which were retrieved from the archive of Department of Pathology of Taleghani Hospital, Tehran, Iran. Immunohistochemical staining was performed by using antibody against CD146. The data were analyzed using SPSS software through Mann-Whitney, Spearman's correlation coefficient, and Kruskal-Wallis tests. Results: Mel-CAM was expressed in all MEC samples and 10 OSCC cases. The two groups were significantly different regarding the CD146 expression (p= 0.035). Furthermore, the CD146 expression was found to be significantly correlated with the invasion mode (p= 0.002), tumor size (p= 0.012), and histological grade (p= 0.024) in OSCC group. No significant correlation existed between the expression, intensity, and location with the histological grade of MEC (p> 0.05) nor was any significant correlation detected between the CD146 expression and lymph node metastasis in neither group. Conclusion: Regarding the significant correlation between the CD146 expression and the prognostic factors in OSCC, this marker may predict the prognosis in OSCC patients, but not the MEC lesions. It cannot be used for differentiating high-grade MEC and OSCC.

Statement of the Problem: Human tooth is clinically the most appropriate material that can be used for in-vitro dental research. However, there are limitations and drawbacks for using human teeth. Therefore, alternatives to samples of human teeth for dental studies are necessary. Purpose: This study purposed to evaluate and compare the microstructure and chemical composition of enamel and dentin of teeth in some lab animals. Materials and Method: In this experimental study, teeth of mouse, rabbit, guinea pig, dog, cat, and sheep were used. Scanning electron microscope observations and X-ray diffraction analysis were performed on samples. Results: This study revealed resemblance in general structure of dentin and enamel between mentioned animals and human. The minimum mean of dentinal tubules diameter is found in guinea pig (0.5µ), while the highest is in cat (1.5µ). Also the lowest and the highest mean intertubular distance was measured respectively in guinea pig (3µ) and sheep (4.8µ) and the maximum and minimum mean diameter of rods was measured in rabbit (6.6µ) and guinea pig (1.5µ), respectively. Conclusion: The recorded details and the measured values indicate great resemblance between dog and human dentin and enamel. Cat is in the second place for dentinal studies; sheep and guinea pig have the least resemblance to human within the scope of the reviewed criteria.

Background: Multiple sclerosis (MS) is a chronic nervous system disease with a wide range ofsymptoms that affect the self-care ability of patients in daily activities of life; the patients afflictedwith this disease face with many challenges. This study was conducted to explore the activities of dailyliving (ADL) challenges of these patients.Methods: In this conventional content analysis study, fourteen MS patients who were selectedpurposively from Iran MS Society in Jahrom (Iran) participated in 2018. Data were gathered usingsemi-structured and in-depth interviews. A total of 14 interviews were conducted. These data wereanalyzed using MAXQDA 10 Software and the Graneheim and Lundman method.Results: Analysis of data led to extraction of the main theme “fear of ambiguous future of diseases”as the most important daily living challenge in MS patients. This challenges were categorized in fourmain categories: 1) confrontation to physical, emotional, psychological and behavioral changes, 2) fearof becoming crippled, 3) tolerance of financial burden of the disease, and 4) confrontation to culturalsocial wrong beliefs.Conclusion: The results of this study showed that people with MS face a number of ADL challenges.Fear of an ambiguous future leads to problems in ADL of patients. Therefore, considering the ADLchallenges, health care personnel especially nurses, family members and social organizations canimprove ADL and compromise patients with the disease as much as possible by providing conditionsfor application of the self-care activities and their implementation by patients.

Introduction: Virtual social networks are increasingly beingused by academics and students in health sciences. It is necessaryto examine opportunities and challenges of these networks basedon the views of faculty and students to describe the existingsituation and planning for proper use. The purpose of this studywas to explore the experiences of students and faculty membersabout opportunities and challenges of using virtual socialnetworks in education.Methods: In this qualitative content analysis study, twentytwosemi-structured interviews were conducted with 8 facultymembers and 14 students at Jahrom Universities of MedicalSciences. Participants were selected by purposive sampling.To analyze the data, an inductive content analysis method wasused. The rigor of qualitative data was checked, using Guba andLincoln’s criteria.Results: Five main categories were extracted from the dataas opportunities for using virtual networks in educationincluding improving communication skills; promoting learning;strengthening and facilitating learning of clinical procedures;creating research questions; and educating patients. Four maincategories were also derived as challenges of using virtualnetworks in education including accuracy and validity ofinformation; security and privacy; proper contextualization andculture-building; and control and monitor on virtual networks.Conclusion: According to the results, unique opportunities andchallenges were explored regarding using virtual networks ineducation. These opportunities and challenges and finding waysto obviate challenges and converting it to the opportunities canlead to effective virtual learning, particularly in students whomainly use this method of education, and consequently increasethe quality of learning.Keywords: Social network, Education, Students, Faculty, Qualitative research

Statement of the Problem: After introducing digital radiography, practitioners started reading radiographs from computer monitors; however, many still prefer hard-copy radiographs. Purpose: This study aimed to assess the possible superiority of either type of radiograph recording media (computer monitor, film, or paper) in diagnosis and perception of the depth of the cariogenic lesions. Materials and Method: Twenty digital bitewing radiographs, obtained from 200 posterior extracted teeth, were displayed on an LG monitor and printed on paper and film using Kodak printers. Two observers independently measured lesions depth on the images. Serial sections of teeth were obtained and the sections were evaluated by a stereomicroscope to determine the actual depth of cariogenic lesions. The efficacy of the each medium was assessed by determining its specificity and sensitivity in comparison with those of histological images. Weighted kappa coefficients and the ROC analysis were used for the statistical analysis. Results: Strong intra- and inter-observer agreements (0.818 to 0.958, 0.77 to 0.85) were found for all detection methods. The highest Az value was obtained with the monitor-displayed images (Az: 0.879); however, differences between detection methods were not statistically significant (p> 0.05). Conclusion: Monitor-displayed bitewing radiographs, paper, and film prints used in our study performed similarly in the detection of proximal caries.

Background: Due to many physical and mental disorders that occur in multiple sclerosis patients, identifying the factors affecting coping based on the experiences of patients using qualitative study is essential to improve their quality of life. This study was conducted to explore the antecedents of coping with the disease in patients with multiple sclerosis. Methods: This is a qualitative study conducted on 11 patients with multiple sclerosis in 2015 in Tehran, Iran. These patients were selected based on purposive sampling. Data were collected using semi-structured and in-depth interviews and coded. These data were analyzed using the conventional content analysis. The rigor of qualitative data using the criteria proposed by Guba and Lincoln were assessed. Results: Five main categories were revealed: (1) social support, (2) lenience, (3) reliance on faith, (4) knowledge of multiple sclerosis and modeling, and (5) economic and environmental situation. Each category had several distinct sub-categories. Conclusions: The results of this study showed that coping with multiple sclerosis is a complex, multidimensional and contextual concept that is affected by various factors in relation to the context of Iran. The findings of the study can provide the healthcare professionals with deeper recognition and understanding of these antecedents to improve successful coping in Iranian patients suffering from multiple sclerosis.

Introduction: Clearly, there are some challenges and difficulties in fulfilling social accountability which should be identified and dealt with in order to reach the ultimate goal. The main objective of this study was to identify the challenges associated with social accountability. Methods: In this qualitative study, focus groups and in-depth semi-structured interview were used to obtain the opinions and experiences of 35 people with 4 focus groups of students, faculty members, patients and their companions in Jahrom University of Medical Sciences. Purpose-based sampling was performed. The participants asked “What is social accountability?” And then it continued with the more specific question, i.e. “What factors increase or decrease social accountability?” After identifying the categories and sub-categories, conventional content analysis was used to analyze the data. Results: Overall, 97 codes were extracted from the text and five main categories were revealed: notification, sense of responsibility, practical education, and professional status and ethics. Conclusion: Since there are numerous challenges in the field of social accountability, it is essential that we understand the challenges and barriers and take effective steps to implement reforms.

Statement of the Problem: Determining the prevalence of respiratory viruses' coinfection with coronavirus disease 2019 (COVID-19) is essential to defining its true clinical influence. Purpose: This study aimed to evaluate co-infection rates between severe acute respiratory syndrome–related coronavirus 2 (SARS-CoV-2) and respiratory syncytial virus (RSV) in infected patients in Shiraz, south of Iran. Materials and Method: In a cross-sectional descriptive study, oropharyngeal, nasopharyngeal aspirate (NPA), and saliva samples of 50 COVID-19 patients who were referred to AliAsghar hospital (Shiraz, Iran) from March to August 2020, were collected. A control group consisted of age and sex-matched healthy participants. The nasopharyngeal and oropharyngeal aspirates were collected by sterile swabs. All cases were hospitalized, and all SARS-CoV-2 patients had a fever and respiratory symptoms. The samples were packed in a vial with 1 mL of transport medium and transported to the Valfagre specialty laboratory, where they were tested for RSV using a real-time polymerase chain reaction (PCR). Results: 100 nasopharyngeal/oropharyngeal aspirates and saliva samples including 50 healthy controls (24 females, 26 males) and 50 COVID-19 patients' samples (27 males and 23 females) were studied. There was no significant difference regarding age as well as gender between both groups (p>0.05). None of the healthy subjects was infected with RSV; however, 5(10%) patients from COVID-19 group were infected with the RSV virus. Chisquare test did not show a significant difference between RSV infection in COVID-19 patients and healthy subjects. Conclusion: The outcome of present research showed that concurrent RSV with COVID 19 infection might be seen in hospitalized patients in Shiraz Southwest of Iran. For more reliable findings, further research on bigger populations, including more pathogens in several places around the country, and considering the severity of symptoms is required. [ABSTRACT FROM AUTHOR]

Odontomas are benign tumors of jaws with mixed tissue, which are the result of proliferation of odontogenic epithelium and mesenchymal cells. They occur almost centrally and seldom peripherally. There is no report of such a lesion externally while attaching a tooth crown. In this case, we present a lesion on the buccal surface of the right maxillary central incisor crown, which is misconstrued with a dental overgrowth. Such cases may confuse diagnosis during clinical examination. Radiographically, such odontomas may be mistaken for various other lesions. Ultimate diagnosis should be relied upon microscopic evaluation and histopathological results. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Mel-CAM (CD146, MUC18) is a 113-kD heterophilic cell-cell adhesion glycoprotein found in normal and tumoral tissues. The biologic functions and role of the Mel-CAM can be employed as a diagnostic marker in pathology. Purpose: The aim of this study was assessing the expression of Mel-CAM in common oral carcinomas like salivary gland mucoepidermoid carcinoma (MEC) and oral squamous cell carcinoma (OSCC) to differentiate the OSCC from high-grade MEC. Materials and Method: This study was performed on 19 specimens of MEC and 17 specimens of OSCC, which were retrieved from the archive of Department of Pathology of Taleghani Hospital, Tehran, Iran. Immunohistochemical staining was performed by using antibody against CD146. The data were analyzed using SPSS software through Mann- Whitney, Spearman's correlation coefficient, and Kruskal-Wallis tests. Results: Mel-CAM was expressed in all MEC samples and 10 OSCC cases. The two groups were significantly different regarding the CD146 expression (p= 0.035). Furthermore, the CD146 expression was found to be significantly correlated with the invasion mode (p= 0.002), tumor size (p= 0.012), and histological grade (p= 0.024) in OSCC group. No significant correlation existed between the expression, intensity, and location with the histological grade of MEC (p> 0.05) nor was any significant correlation detected between the CD146 expression and lymph node metastasis in neither group. Conclusion: Regarding the significant correlation between the CD146 expression and the prognostic factors in OSCC, this marker may predict the prognosis in OSCC patients, but not the MEC lesions. It cannot be used for differentiating high-grade MEC and OSCC. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Human tooth is clinically the most appropriate material that can be used for in-vitro dental research. However, there are limitations and drawbacks for using human teeth. Therefore, alternatives to samples of human teeth for dental studies are necessary. Purpose: This study purposed to evaluate and compare the microstructure and chemical composition of enamel and dentin of teeth in some lab animals. Materials and Method: In this experimental study, teeth of mouse, rabbit, guinea pig, dog, cat, and sheep were used. Scanning electron microscope observations and X-ray diffraction analysis were performed on samples. Results: This study revealed resemblance in general structure of dentin and enamel between mentioned animals and human. The minimum mean of dentinal tubules diameter is found in guinea pig (0.5μ), while the highest is in cat (1.5μ). Also the lowest and the highest mean intertubular distance was measured respectively in guinea pig (3μ) and sheep (4.8μ) and the maximum and minimum mean diameter of rods was measured in rabbit (6.6μ) and guinea pig (1.5μ), respectively. Conclusion: The recorded details and the measured values indicate great resemblance between dog and human dentin and enamel. Cat is in the second place for dentinal studies; sheep and guinea pig have the least resemblance to human within the scope of the reviewed criteria. [ABSTRACT FROM AUTHOR]

Statement of the Problem: After introducing digital radiography, practitioners started reading radiographs from computer monitors; however, many still prefer hard-copy radiographs. Purpose: This study aimed to assess the possible superiority of either type of radiograph recording media (computer monitor, film, or paper) in diagnosis and perception of the depth of the cariogenic lesions. Materials and Method: Twenty digital bitewing radiographs, obtained from 200 posterior extracted teeth, were displayed on an LG monitor and printed on paper and film using Kodak printers. Two observers independently measured lesions depth on the images. Serial sections of teeth were obtained and the sections were evaluated by a stereomicroscope to determine the actual depth of cariogenic lesions. The efficacy of the each medium was assessed by determining its specificity and sensitivity in comparison with those of histological images. Weighted kappa coefficients and the ROC analysis were used for the statistical analysis. Results: Strong intra- and inter-observer agreements (0.818 to 0.958, 0.77 to 0.85) were found for all detection methods. The highest Az value was obtained with the monitor-displayed images (Az: 0.879); however, differences between detection methods were not statistically significant (p> 0.05). Conclusion: Monitor-displayed bitewing radiographs, paper, and film prints used in our study performed similarly in the detection of proximal caries. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Odontogenic keratocyst (OKC) is a developmental odontogenic cyst with specific histopathological features, high recurrence rate, and aggressive clinical behavior. Angiogenesis might be considered as an important factor for the growth, expansion, and distribution of this lesion. Purpose: The aim of the present study was to determine the mean vascular densities (MVD) of OKCs and dentigerous cysts to evaluate their relationship with the biologic behavior of these lesions. Materials and Method: In this cross-sectional analytical study, angiogenesis was assessed in OKC and dentigerous cyst by measuring the MVD. Immunohistochemistry was carried out using CD34 and CD105. The results were analyzed with independent samples t-test. The data were analyzed, setting p value at 0.05. Results: The MVDs with the use of CD34 and CD105 markers were significantly higher in OKC compared to dentigerous cyst (p< 0.05). In addition, MVDs obtained by CD105 in dentigerous cysts and OKC were significantly less than those based on CD34 (p< 0.05). Conclusion: Based on the results of the present study, it can be suggested that angiogenesis might be one of the possible mechanisms involved in higher aggressive biologic behavior and greater recurrence rate of OKC compared to dentigerous cysts. [ABSTRACT FROM AUTHOR]

Statement of the Problem Stem cells are considered as new implement for tissue regeneration. Several niches in adult human body are colonized by multipotent stem cells but access to these potential reservoirs is often limited. Although human dental pulp stem cells isolated from healthy teeth have been extensively characterized, it is still unknown whether stem cells also exist in reactive lesions of oral cavity such as pyogenic granuloma and peripheral ossifying fibroma which are deliberated as inflammatory proliferation of different cell families. Purpose The aim of this study was to explore for clues to see whether pyogenic granuloma or peripheral ossifying fibroma contain dental mesenchymal stem cell (DMSC). Materials and Method Four pyogenic granuloma and four peripheral ossifying fibroma specimens were collected by excisional biopsy and preserved in PBS-EDTA at -86 °C. Then we cut them in 5µm diameter using Cryostat. Having been rinsed with PBS, the samples were stained with a primary mouse anti-human STRO-1 monoclonal IgM antibody. Afterward, a secondary goat anti-mouse IgM-FITC antibody was applied to detect STRO-1+ cells as probable stem cells by immunofluorescence technique. Results Immunofluorescence microscopy revealed presence of STRO-1+ cells in these lesions, particularly localized on perivascular zone. The negative control group was not glowing. Conclusion Based on these results, it was found that reactive lesions of pyogenic granuloma and peripheral ossifying fibroma have STRO-1 positive cells, which raises the possibility that these cells may be DMSCs. [ABSTRACT FROM AUTHOR]

Introduction: Many studies have investigated the relationship between motivation and educational outcomes. The present study was conducted to determine whether the students’ motivation in Shiraz University of Medical Sciences (SUMS) decreases during educational years. Methods: 770 students in SUMS were selected by multi-stage stratified random sampling from each field and entrance year. The first questionnaire contained 57 questions on the effect of economic, social, educational, geographical and personality factors on the students’ motivation. The second one was based on 50 incomplete sentences. The validity and reliability of these questionnaires were approved by the experts and Cronbach’s Alpha coefficients (85% and 90%, respectively). In this cross-sectional study, ANOVA, t-test and Chisquare tests were applied for data analysis at the 0.05 significance level. Results: Six factors with the most effect on academic motivation were “family attitudes”, “getting good jobs in future”, “respect for themselves”, “ the ability to learn”, “believing their role in victory and defeat” and “the tendency toward optimism about themselves”. In addition, comparing professional doctorate and basic sciences’ results revealed no significant relationship between academic motivation and educational years (F=0.819, p=0.397). But comparing field by field showed that Dentistry and Hospital Management and Medical Information (HMMI) had a significant decrease in motivation score by increase in educational years (F=3.991, p=0.015). Conclusion: Achievement motivation level in SUMS students was higher than average and did not decrease during educational years. Also, the results showed that personal, social and educational related factors affected motivation level more than economic and environmental factors.

Introduction: The present study aimed to find an appropriate method to inform senior high school students to correctly select their academic field of study and their intentions. Methods: This is a descriptive-analytic and cross-sectional study. A verified questionnaire was given to a total of 2600 students selected by stratified random sampling method (ten different colleges and entrance year from the 1st to 4th are considered as the strata). The position of the present field of study (major) among the list of the fields in the entrance exam was asked. The students’ methods of familiarity with different fields of study in Shiraz University of Medical Sciences (SUMS), the reasons for their selection, the students’ motivation and insistence on studying in the same field and university were asked in the questionnaire. Data were analyzed using independent two samples t-test, Analysis of Variance (ANOVA) and Chi-Square test. Results: The most significant references for university field selection were high school teachers, the students' parents and the adjacency of university to one's living place. Also, the results revealed the good reputation of SUMS in the first year and its downward trend during the following years. 59.4% of the 1st year students were satisfied with their field of study and SUMS. 31.8% were satisfied with the university but not with their fields of study. 6.4% were dissatisfied with the university but not with their fields of study. 2% of the students were dissatisfied with both their fields of study and university. Dissatisfaction with SUMS and field of study increased little by little so that the results obtained among the students who had entered the university earlier (in the 4th year of their study) showed nearly 16.3% dissatisfaction with both the university and the study fields . Conclusion: The methods for introducing the university are recommended to be revised.

Objective: To investigate and understand the current status of inter-organizational management in relief organizations as well as the relief organizations personnel behavior when facing mass traffic incidents (MCTI). The inter-organizational barriers and facilitators are also discussed in response to MCTI management and in order to help direct future actions to improve pre-hospital emergency services. Methods: The current qualitative study was performed through face-to-face, semi-structured interviews with 31 individuals from pre-hospital emergency services authorities and personnel, Red Crescent and Yazd, Kohgiluyeh and Boyer-Ahmad, Fars, and Qom provinces police. These provinces were selected by purposive sampling in 2018-2019. The conventional content analysis method was applied to analyze the data in this research. Results: Three main categories and 14 subcategories were determined. The categories are including relief organizations coordination (having four subcategories: independent relief organizations, interdepartmental services integration, insufficient knowledge of organizations about one other, and performance based on job descriptions), resource and infrastructure management (having four subcategories: adverse information management, proper information management, lack of medical resources and capacities considered, and upgrading of medical resources and capacities considered), and response management of relief organizations (having six subcategories: incomplete assessment, improving the quality of assessment, weakness in establishing scene security, scene security management, poor response, and cooperation in response). Conclusion: Relief organizations need to perform under a unified command. It has inter-organizational cooperation and provide integration of interdepartmental services in order to manage responsiveness at the scene. It also prevents an independent, chaos, and inability of the injured to properly understand and needs in MCTI.

Objective: To identify and prioritize the key Components of prehospital emergency system to prevent mortality in road traffic injuries. Methods: A total of 25 emergency medicine practitioners, emergency ward nurses, and managers of prehospital emergency centers participated in this adjusted Delphi study in three rounds. After extracting the primary components through reviewing systematic studies and interviewing experts, the Delphi rounds were performed with the presence of experts. The data were analyzed with both qualitative content analysis and quantitative analysis using SPSS20 software. For the analysis and selection of the final priorities, the coefficient of agreement of over 70% was used. Results: After doing three Delphi rounds, in the final Delphi round, 10 superior components were selected respectively as follows: correct history taking of the victim, examining possible cervical injury, the time spent from the first call to arrival of technicians to the scene, the time spent from arriving at the scene to the time of hospital transport, passing of re-education courses by EMS technicians, coordination among the rescue organizations, police, the Red Crescent, fire station, and healthcare organizations, integrated commandership at scene, police attendance in the scene before EMS arrival at the scene, proper ambulance equipment with respect to the required equipment (A, B, C) on the basis of victim’s condition, and coordination with the target hospital for patient transport. Conclusion: This study determined the most applicable managerial methods of prehospital emergency components pertaining to preventable fatal road traffic injuries through empowerment of EMS systems in the fields of victim assessment, time management indices, personnel training, coordination between the involved organs, and the presence of the main commander in the scene.