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Background: Trichomonas vaginalis (T.vaginalis) and Neisseria gonorrhoeae (N.gonorrhoeae) are two most common non-viral sexually transmitted infections in the world. No data are available regarding the epidemiology of genital infections in women of Qom, central Iran. Objective: Epidemiological investigation of sexually transmitted infections in genital specimens of women referred to the referral gynecology hospital in Qom, central Iran. Materials and Methods: Genital swab specimens were collected from women volunteers and used for identification of bacterial and protozoal infections by conventional microbial diagnostics, porA pseudo gene LightCycler® real-time PCR (for N.gonorrhoeae) and ITS-PCR (for T.vaginalis). Results: Of 420 volunteers, 277 (65.9%) had genital signs/symptoms, including 38.3% malodorous discharge, 37.9% dyspareunia, and 54.8% abdominal pain. Totally, 2 isolates of Streptococcus agalactiae were identified. Five specimens (1.2%) in Thayer-Martin culture and 17 (4.1%) in real-time PCR were identified as N.gonorrhoeae. Fifty-four specimens (12.9%) in wet mount, 64 (15.2%) in Dorset’s culture, and 81 (19.3%) in ITS-PCR showed positive results for T.vaginalis. Five mixed infections of T.vaginalis+ N.gonorrhoeae were found. The risk of T.vaginalis infection was increased in women with low-birth-weight (p=0.00; OR=43.29), history of abortion (p=0.00; OR=91.84), and premature rupture of membranes (PROM) (p=0.00; OR=21.75). The probability of finding nuclear leukocytes (p=0.00; OR=43.34) in vaginal smear was higher in T.vaginalis infection. Conclusion: The significant prevalence of trichomoniasis and gonorrhea emphasizes the need for accurate diagnosis and effective surveillance to prevent serious reproductive complications in women.

Background and Aim: Extended-spectrum β-lactamases are groups of enzyme with the capability of hydrolyzing cephalosporins and aztreonam. Various types of extended-spectrum β-lactamases (ESBLs), such as blaTEM and blaSHV are present prominently in E. coli strains. This study aimed to determine the frequency of blaTEM and blaSHV genes in the extended-spectrum β-lactamases, producing E. coli strains from urinary tract infections in Karaj city. Materials and Methods: In this study which performed during the summer of 2015, antibiotic susceptibility pattern of 119 isolated E. coli strains from urinary tract infections were determined to 16 different antibiotics using Kirby-Bauer disk diffusion method. Extended-spectrum β-lactamases-producing bacteria were identified using double disc diffusion method by combination discs and were studied by using specific primers for genes blaTEM and blaSHV. Results and Conclusions: The highest and lowest percentage of resistance to the antibiotic were tetracycline (61%) and nitrofurantoin (8.5%), respectively. 42.8% of isolates were extended-spectrum β-lactamases positive. Based on the PCR results the frequency of blaTEM and blaSHV were 60.78% and 39.21% respectively and 9.32% of isolates had both genes. High levels of genes blaTEM and blaSHV resistance to third generation of cephalosporins strains considered a problem. Diagnose of extended-spectrum β-lactamases strains in clinical laboratory also should be considered and it is recommended that prescription of cephalosporins should be restricted to susceptible isolates.

Background: In addition to passive immunotherapy using anti-HER2 monoclonal antibodies, active immunotherapy via HER2 targeting is an interesting approach to inducing specific anti-tumor immune responses. We have recently reported the immunogenicity of HER2 subdomains following DNA immunization and HER2 protein boosting. In the present study, we evaluated the immunogenicity of different HER2 extracellular subdomains for the induction of anti-HER2 antibody response in BALB/c mice. Objective: To investigate and characterize antibody responses to human recombinant proteins of HER2 extracellular subdomains in immunized mice. Methods: Four subdomains of HER2 extracellular domain were expressed in E.coli; subsequently, purified recombinant proteins were intraperitoneally injected in BALB/c mice with Freund's adjuvant. The anti-HER2 antibody response was detected by ELISA, immunoblotting and flow cytometry. Results: All the four HER2 subdomains along with the full extracellular domain (fECD) were able to induce specific anti-HER2 antibodies. Although anti-HER2 subdomains antibodies could not react with eukaryotic recombinant fECD protein by ELISA, they were able to recognize this protein by immunoblotting under both reduced and non-reduced conditions. Furthermore, only the sera of mice immunized with fECD protein could recognize native HER2 on HER2 overexpressing tumor cells (>99%) by flow cytometry. Moreover, fECD immunized mice sera inhibited the proliferation of tumor cells by XTT assay. Conclusion: The prokaryotic recombinant proteins of HER2 extracellular subdomains are immunogenic, yet the induced specific antibodies do not react with the native HER2 protein due to the paucity of post-translation modifications and /or distortion of the native conformation of isolated HER2 extracellular subdomains which might be potentially effective for induction of cell mediated immune response against HER2.

Background and Aim: Acinetobacter baumannii is one of the most important multi drug-resistant species associated with nosocomial infections. Several factors involve in resistance to drug and its pathogenicity. Of these factors, OmpA protein plays a crucial role. Therefore, the aim of current research was to assess resistance to drug and also ompA gene existence in A. baumannii isolated from clinical sources. Materials and Methods: Firstly, clinical samples were collected from Imam Khomeini, Milad and Motahari Hospitals during 2015-2016 years and the final confirmation were done by using biochemical methods. Afterwards, susceptibilities to antibiotics of different classes were determined by disc diffusion method and presence of ompA gene was checked by using PCR method and verified by sequencing. Results: The results show that of 650 clinical samples, 156 (24%) of isolates were formed of A. baumannii and mostly showed resistance to different classes of antibiotics. 92.95% of isolates were multi drug resistance (MDR) and finally 86.53% were extremely drug resistance (XDR). All of them contained ompA gene. Conclusions: Existence of multi drug resistance in most isolates as well as presence of ompA in all samples can cause bacterial virulence and drug resistance. It seems essential to provide continuous monitoring and determination of antibiotic susceptibility of clinical A. baumannii, decrease the moral and material damage caused by the bacteria.

Background: AmpC β-lactamases are important cephalosporinases chromosomally encoded in many of Enterobacteriaceae and a few other organisms where they mediate resistance to cephalothin, cefazolin, cefoxitin and penicillins. The six different families of plasmid-mediated AmpC β-lactamases have been described, but no phenotypic test can discriminate among them. AmpC multiplex PCR has been successfully used to discriminate plasmid-mediated ampC specific families in organisms such as Klebsiella pneumonia and Escherichia coli. The aim of this study was to indicate the prevalence of AmpC β-lactamase genes by specifically designed primers through PCR test.Methods: 243 total clinical urine samples were collected, and 227 isolates were identified as Escherichia coli based on standard biochemical tests. Subsequently, the isolates were screened by disc diffusion and combined disc test for β-lactamase production. Resistant isolates were evaluated by PCR for ampC family determination. Results: Antibiotic resistance pattern were observed as follows: cefepime (%25), ceftazidime (%31), ceftriaxone (%37), cefotaxime (%38). The ratio of isolates was detected as ESBLs and AmpC producers were 34% and 5.2%, respectively. PCR performed on 12 selected isolates via phenotypic tests and the results revealed that among 12 isolates, 11 contained blaCMY-42. Conclusion: Unfortunately, antibiotic resistance has become an increasingly critical problem in many countries like Iran and occurrence of isolates co-expressing AmpC-β-lactamases and ESBLs can create serious problems in the future. As antibiotic options in the treatment of AmpC β-lactamases and ESBLs producing organisms are extremely limited, molecular screening by laboratories is suggested to reduce the risk of therapeutic defeat.

Abstract Background: The present research aimed to measure the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) on reducing the severity of symptoms of post-traumatic Stress Disorder (PTSD) and Stuttering in a four-year-old child post-traumatic stress disorder in children is one of the disorders relating to trauma and stressful factors, also, stutterring or word fluency disorder is a nerve growth disorder. Materials and Methods: This research design was conducted as a case study with a multiple baseline design. Participant in this research was a four-year- old child with Diagnostic Posttraumatic Stress Disorder and Psychogenic Stuttering. He had been placed under the intervention with EMDR at Shahid Birjand Counseling Center. The instruments used for this research included demographic researcher-made questionnaire, the third edition of stuttering severity test, the scale of parents’ report of post-traumatic Symptoms and child’s report of posttraumatic Symptoms. Data analysis was done through graphic and descriptive analysis. The data was collected as base line and during the treatment as well as after the treatment and follow-up (in terms of 3 and 24 months). Results: Means percentage improvement (MPI) to reducing the severity of post-traumatic symptoms was achieved as %74.66 and it was %56.06 for reduction of the severity of stuttering and they continued to maintain in the follow-up period. Conclusion: Results showed that EMDR method had affected on reduction of the severity of post-traumatic stress disorder symptoms and stuttering intensity.

Evaluation of protective effect of fennel on mouse ovary against the destructive effects of cyclophosphamide (CP) was the aim of this study. Adult female NMARI mice were randomly divided into six groups (n = 8): (A) negative control, (B) CP200 mg/kg, (C) fennel 400 mg/kg/day, (E, F, and D) that received fennel 200, 400 and 100 mg/kg/day respectively + CP200 mg/kg. Their ovary weight, volume, and diameter (WVD) were measured. Five micron sections were stained using the H&E method. The serum levels of oestrogen and progesterone were measured using ELISA kit. The results showed that WVD significantly reduced in the CP-treated groups in comparison with the A and C, but WVD increased after treatment of the mice with fennel extract, in comparison with B group. A significant decrease of serum in terms of oestrogen and progesterone levels among CP-treated groups in comparison with the A group was observed. In the CP-treated groups a reduction in the number of different ovarian follicles in comparison with the A and C groups was observed. However, in the treated animals with fennel extract, these parameters significantly increased in comparison with the B group. Finally, it is concluded that fennel can protect ovary from cyclophosphamide side effects. Keywords: Cyclophosphamide, Fennel, Mice, Ovary

Background: Diabetes mellitus type 1 is one of the most prevalent endocrine diseases in pediatrics. Diabetic ketoacidosis is considered as one of the most threatening clinical pictures of DM1, especially if occurred as the first presentation of DM1 in children. Objectives: The current study aimed to identify factors which may play a role in DKA onset in children. Methods: This case-control study included all patients under 18 years old who referred to department of pediatrics endocrinology at Mashhad University Hospital (Imam Reza) from January 2013 to December 2015 as newly diagnosed patients with DM1. Patients who fulfilled DKA criteria at diagnosis were considered as DKA group and those who referred with other presentations were considered as control group (non-DKA group). Data were analyzed by SPSS software ver. 16. Results: During the study period, 97 (39.2% male) newly diagnosed patients were included as DKA group. Accordingly 97 gender- and age-matched patients were added as non-DKA group. The most prevalent symptoms in both groups were polyuria (91.88%) and polydipsia (88.66%). Fever and cold symptoms were significantly higher in the DKA group (P < 0.001 and P =0.005, respectively). Hemoglobin A1c level was significantly higher in the DKA group (P = 0.001), while body mass index was significantly lower in the DKA group (P = 0.045). Fever and father’s education level were the most important risk and protective factors in the DKA onset in newly diagnosed patients with DM1 (adjusted OR = 10.1, 95% CI = 2.9-35.3; P < 0.001 and adjusted OR = 0.5, 95% CI = 0.3 - 0.9 and P = 0.019, respectively). Conclusions: In conclusion, a recent febrile illness was found as the strongest risk factor and father’s education level as the main protective factor in the DKA to diagnose children with DM1. The study findings suggested that DKA is a severe form of DM1 instead of a neglected or misdiagnosed disease.

Background & Aim: Episiotomy is one of the most common surgical procedures in obstetrics, which requires analgesia. Entonox gas is known to have analgesic and sedative properties. However, no studies have been found on the analgesic effects of Entonox on episiotomy incision. Therefore, this study aimed to compare the effects of Entonox and lidocaine on pain intensity during episiotomy incision in nulliparous women. Materials and Methods: This randomized controlled trial was conducted on 120 term nulliparous women, who met the inclusion criteria. Subjects were selected by randomized sampling and equally divided into two groups of intervention and control (n=60). In the intervention group, Entonox gas was applied two minutes before episiotomy incision until the end of the procedure. On the other hand, the control group received 5 ml of lidocaine 2% as routine care before episiotomy incision. Data were collected using visual analogue scale to compare the study groups in terms of pain intensity. In addition, patient satisfaction with pain management technique during episiotomy and side effects of Entonox were assessed. Data analysis was performed in SPSS version 22 using Mann-Whitney U and Chi-square tests, and P value of less than 0.05 was considered statistically significant. Results: In this study, no significant difference was observed between the intervention and control groups regarding pain intensity (P=0.52). Moreover, no significant difference was observed in the satisfaction level of the two groups (P=0.70). Conclusion: According to the results of this study, Entonox could be used as an effective and noninvasive alternative to lidocaine to reduce pain during episiotomy incision without significant side effects.

Correction to: An Ex vivo Analysis of Apical Transportation in Root Canals Prepared with BT Race Rotary and Hand K-Flexofile by Cone Beam Computed Tomography Abbas Mesgarani1, Azadeh Zakariaie2, Azam Haddadi Kohsar1, Sina Haghanifar3, Jamshid Yazdani Charati4, Arman Ebrahimi5 1 Assistant Professor, Department of Endodontics, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran 2 Resident of Oral and Maxillofacial Radiology, School of Dentistry, Isfahan (khorasgan) Branch, Islamic Azad University, Isfahan, Iran 3 Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran 4 Professor, Department of Biostatistics, Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran 5 Resident of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan (khorasgan) Branch, Islamic Azad University, Isfahan, Iran In the article published in volume 30, issue 185, 2020, the the academic rank and affiliation for the Jamshid Yazdani Charati was published incorrectly, which is now corrected. J Mazandaran Univ Med Sci 2020; 30(188): 203-204 (Persian).

Background: Multidrug resistance is a serious problem in the treatment of urinary tract infections. Integrons are ancient structures that contain determinants of a site-specific recombination system to capture genes encoding antimicrobial resistance. The aim of this study was to determine the prevalence of multidrug resistant Klebsiella isolates in clinical specimens. In addition, the existence of integrons in resistant isolates was assessed by amplification of integrase genes. Methods: Susceptibility of 100 Klebsiella isolates was determined to 19 antibiotics by the Kirby-Bauer disc diffusion method and integron classes were detected. Then the multi-drug resistance association with the existence of the integrase gene was calculated by chi-squre and fisher exact tests. Results: According to antibiogram results, 54 isolates were multidrug resistant. By amplification of intergrase gene it was revealed that 27% of the isolates harbor integrons. Also by PCR-RFLP it was revealed that all of them were class 1. The existence of integrons was confirmed in 25 of our multidrug resistant isolates, indicating the frequency rate is high and integrons may be partly responsible for multidrug resistant. Conclusion: Multidrug resistance suggests that strategy for treatment of patients with Klebsiella infections needs to be revised. The possibility of transmission of resistance genes by integrons would be decreased by treatment of patients with the appropriate antibiotics.

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BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is one of the most common reasons for visiting psychiatrists and psychologists. This study aimed to investigate the prevalence of ADHD and its related risk factors among children at elementary schools. MATERIALS AND METHODS: This cross-sectional study focused on teachers and parents of 779 elementary students who were selected through stratified cluster random sampling; Conners Parent and Teacher Questionnaires were used to collecting data. The data were analyzed by the use of descriptive statistics (frequency and percentage), independent samples t-test, Chi-square, one-way ANOVA, and linear regression. The significant level was set at 0.05. Results: According to teachers' responses, the prevalence of ADHD among students in elementary schools was 4.4%, whereas parents reported a prevalence of 0.5%. There was a significant relationship between childhood ADHD and marital status of parents, fathers' smoking habits, previous experience of living in rural areas, children's previous history of having diseases and using the medicine, previous history of ADHD, and psychological problems in the family. Conclusions: According to the study, teachers and parents suffer from a lack of knowledge about ADHD. Thus, the educational workshops and programs should be held for teachers, parents, and counselors to inform them about the procedures for timely diagnosis and treatment of ADHD.

Background: Domestic violence is a serious threat to the physical and mental health of women. The aim of the present study was to find and compare the frequency of domestic violence between methamphetamine users, patients with psychiatric disorders, and healthy people. Methods: In this analytical cross-sectional study, methamphetamine users (n=30) and patients with psychiatric disorders (n=30) were women whose husbands were hospitalized during 2014 in Shafa Psychiatric Hospital in Guilan. Diagnosis was done with DSMIV-TR. Healthy people (n=60) were women whose husbands had no primary or drug induced psychiatric disorder or addiction. CTS-2 test was used to evaluate violence. Results: The frequency of psychological, physical and sexual violence in the groups suffering from psychiatric disease and methamphetamine users was higher than the healthy group (P=0.001). We observed a direct correlation between the mean of psychological and physical violence in the three groups (r=0.9, P=0.001), (r=0.7, P=0.0001) and (r=0.53, P=0.005), respectively. Direct correlation between the psychological and physical violence was only observed in the healthy group (r=0.8, P=0.007). Conclusion: The results showed that methamphetamine users such as psychiatric patients are at increased risk of violence. Domestic violence screening of these patients is necessary. It seems that this substance is a new source of increasing domestic violence with more undesirable outcomes in Iran.

Introduction: Complaint is the expression of dissatisfaction with an organization in relation to its products or services. The aim of this study was to investigate the complaint management process in hospitals affiliated to Kashan University of Medical Sciences and to propose solutions for the improvement of this process. Materials and Methods: This cross-sectional, applied study was performed in 2013 at all hospitals affiliated to Kashan University of Medical Sciences, Kashan, Iran. The study was conducted in two major steps, i.e., evaluation of the process and solution delivery. The study population in the evaluation step comprised of 27 individuals who were involved in the complaint management process. On the other hand, 40 experts were recruited in the second stage. Sample selection was performed through targeted random sampling. Data were collected, using a checklist which was based on the national and international standards. The checklist, consisting of 101 yes/no questions was completed via interview and observation. Also, the expert comments were collected through Delphi technique. For statistical analysis, descriptive statistics were calculated, using SPSS Version 16. Results: Based on the findings, 8 (29.6%) out of 27 participants stated that patients had access to information related to the process of complaint registration. All 27 (100%) participants claimed that no committees at hospitals were responsible for investigating patient complaints, although the patients could completely track their complaints. Conclusion: Based on the findings, there was inadequate information regarding the process of patient complaint management in the evaluated hospitals.

Objective: To check biofilm formation by Acinetobacter baumannii (A. baumannii) clinical isolates and show their susceptibility to different antibiotics and investigate a possible link between establishment of biofilm and multidrug resistance. Methods: This study was performed on clinical samples collected from patients with nosocomial infections in three hospitals of Tehran. Samples were initially screened by culture and biochemical tests for the presence of different species of Acinetobacter. Identifications were further confirmed by PCR assays. Their susceptibilities to 11 antibiotics of different classes were determined by disc diffusion method according to Clinical and Laboratory Standards Institute guidelines. The ability to produce biofilm was investigated using methods: culture on Congo red agar, microtiter plate, and test tube method. Results: From the overall clinical samples, 156 specimens were confirmed to contain A. baumannii. The bacteria were highly resistant to most antibiotics except polymyxin B. Of these isolates, 10.26% were able to produce biofilms as shown on Congo red agar. However, the percentage of bacteria with positive biofilm in test tube, standard microtiter plate, and modified microtiter plate assays were 48.72%, 66.66%, and 73.72%, respectively. At least 92% of the biofilm forming isolates were multidrug resistant. Conclusions: Since most of the multidrug resistant strains produce biofilm, it seems necessary to provide continuous monitoring and determination of antibiotic susceptibility of clinical A. baumannii. This would help to select the most appropriate antibiotic for treatment.

To achieve the optimal model for capital asset pricing has always been a central issue in studies of the financial field. In this study we consider Fama and French three-factor model augmented by the Pastor and Stambaugh (2003) liquidity risk factor. Unlike most previous studies in this model, stock level beta is allowed to vary with firm-level size and book-to-market value. To verify the above mentioned model, risk-adjusted returns calculated using the model and its relationship with financial market anomalies are examined. The examined anomalies in this study are: firm size, ratio of book value to market value, stock turnover ratio and the past returns. Using individual daily and monthly returns of sample’s companies of Tehran Stock Exchange and Securities for the period 1380 to 1393, we find that all considered anomalies can be captured by this model.

Introduction: Body dysmorphic disorder is one of the common disorders in which adolescents by a preoccupation with physical defects in the body is identified. Purpose: The aim of this research was to evaluate The effectiveness of acceptance and commitment therapy (ACT) on obsessions-compulsions in najafabad girl adolescents with body dysmorphic disorder. Methods: In this clinical trial and randomly on girls in the city of Najafabad in 2014 on the basis of DSM-IV-TR diagnostic criteria for BDD and were randomly assigned to either experimental or control group. The Yale-Brown obsessive compulsive scale modified for body dysmorphic disorder (BDD-YBOCS). The experimental group received 8 weekly acceptance and commitment therapy intervention sessions. The control group was in the waiting list until end of the follow up. The same measures were used for post-test and follow up. It was utilized multivariate analysis of covariance method using SPSS.18 for analysis of data. Funding: the result of significant differenee of body dissatisfaction between control and experimental groups(P < 0/01). also, the result revealed a significant diffirences of obssessions and compulsions between control and experimental groups. Results:Acceptance and commitment therapy and has effect on obsessions-compulsions adolescents with body dysmorphic disorder

There is currently no treatment for effectively slowing the progression of Alzheimer's disease, so early prevention is very important. Numerous studies have shown that flavonoids can improve memory impairment. The present study investigated the effects of myricetin, a member of the flavonoids, on intracerebroventricular streptozotocin induced neuronal loss and memory impairment in rat models of Alzheimer's disease. Myricetin at 5 or 10 mg/kg was intraperitoneally injected into rats over 21 days. Control rats were treated with 10 mL/kg saline. Behavioral test (the shuttle box test) was performed on day 22 to examine learning and memory in rats. Immediately after that, hematoxylin-eosin staining was performed to observe the morphological change in hippocampal CA3 pyramidal neurons. Myricetin greatly increased the number of hippocampal CA3 pyramidal neurons and improved learning and memory impairments in rats with Alzheimer's disease. These findings suggest that myricetin is beneficial for treatment of Alzheimer's disease.

Disease is a matter with which each person may face in his life. If caregivers want to provide real and complete health care services, comprehensive attention to the spiritual needs of a patient is indispensibe. Since many people obtain spirituality through religion, appropriate religious care can promote spiritual health of patients. This research aimed at examining religious care program and determining the impact of religious care on spiritual health of hospitalized patients provided by the clergymen at the patients' bedsides. In this clinical trial, 142 patients hospitalized in Qom Nekuoei hospital were selected randomly and divided into experimental and control groups. After completing the questionnaire on demographic information and spiritual health questionnaire by the participants, religious care program was implemented in the experimental group and then the two groups were followed after intervention. The two groups had no statistically significant difference before intervention in spiritual health score and its domains (religious health and existential health) but after intervention there were statistically significant differences. Spiritual health score and its domains increased after the intervention (P

An amendment to this paper has been published and can be accessed via the original article.

The manual delineation of region of interest (RoI) in 3D magnetic resonance imaging (MRI) of the prostate is time-consuming and subjective. Correct identification of prostate tissue is helpful to define a precise RoI to be used in CAD systems in clinical practice during diagnostic imaging, radiotherapy and monitoring the progress of disease. Conditional GAN (cGAN), cycleGAN and U-Net models and their performances were studied for the detection and segmentation of prostate tissue in 3D multi-parametric MRI scans. These models were trained and evaluated on MRI data from 40 patients with biopsy-proven prostate cancer. Due to the limited amount of available training data, three augmentation schemes were proposed to artificially increase the training samples. These models were tested on a clinical dataset annotated for this study and on a public dataset (PROMISE12). The cGAN model outperformed the U-Net and cycleGAN predictions owing to the inclusion of paired image supervision. Based on our quantitative results, cGAN gained a Dice score of 0.78 and 0.75 on the private and the PROMISE12 public datasets, respectively.

Background: Infection with resistant bacteria are still reported in hospitals despite the routine cleaning of hospital surfaces. Presence of drug-resistant microbes in the on environment of hospitals and on medical equipment is indicative of the need for control measures which could impact the emergence of such microbes. In addition, biofilms are increasingly associated with human infections and it necessitates careful considerations on usage of a diverse range of medical devices, such as catheters, implants and pacemakers in hospitals. Methods: This study was designed to compare the effect of silver, ZnO nanoparticles and curcumin on drug-resistant Gram-positive and Gram-negative bacteria which were already isolated from different wards of the hospital. The MIC value were determined for silver, curcumin and ZnO nanoparticles. As the second step, the expression level of the genes involved in biofilm formation in S. aureus, including icaA, icaD, fnbA and fnbB, was studied to analyze the physiological reaction to controlled concentrations of such nanoparticles using RT-qPCR assessments. Results: In this study, a total of 172 bacterial isolates were recovered from clinical and environmental samples (96 and 76 isolates, respectively). API-20 test revealed that these isolates belonged to 8 species. All antimicrobial resistant isolates were susceptible to the metal oxide nanoparticles. The results of q-PCR in this study showed that the expression of icaA and icaD genes in the presence of silver, curcumin and zinc nanoparticles were not significantly reduced compared to the control samples. But, exposure to nanoparticles reduced the expression of fnbA and fnbB genes from 0.46 to 0.06. Conclusion: The results of our study showed that nanoparticles are highly effective on antibiotics- resistant isolates and these compounds can be used in the treatment of resistant bacteria. In addition, this study also demonstrates the promising potential of using nanoparticles as anti-biofilm formation agents.

Background: Dengue is a major health problem around the world and contributes in high rate of morbidity and mortality. The objective of the study was to determine the frequency, time and place distribution of the dengue fever epidemic in District Swat. Material & Methods: This hospital based, cross-sectional study was conducted in District Head Quarter Teaching Hospital Swat, KPK, Pakistan from August 07 to October 31, 2013, during dengue epidemic. Total of 9032 dengue suspected patients were registered on consecutive sampling technique. Demographic variables were gender, age groups and residence. Research variables were Dengue non-hemorrhagic and Dengue hemorrhagic fever. Blood samples were collected from non-hemorrhagic dengue and dengue hemorrhagic fever patients. Serum was obtained by centrifugation at 3000 rpm for 5 minutes after blood samples were properly clotted. Qualitative detection of dengue virus NS1 antigen was done on commercially available ICT-SD Dengue NS1 kit (Standard Diagnostic, South Korea) following manufacturer instructions. Data analysis was carried out by using SPSS version 19. All variables being categorical were analyzed by frequency and percentages. Results: Out of 9032 dengue suspected patients serum samples, 8638(96%) were found positive for dengue NS1 antigen. Out of 8638(96%) positive cases on NSI, 5889(68%) patients were males and 2749(32%) were females. The age group wise distribution of the male and female Dengue virus NS1 Antigen positive cases with the age group 21-30 was the modal age group. Conclusion: The highest incidence of dengue fever was observed in young people. Effective awareness campaigns should be initiated at local, provincial and national level by health departments.

Background and Objectives: Given that fasting can reduce calorie intake, and on the other hand, starvation and reduction of calorie intake are related to immune system, this study was conducted with the purpose of assessing some blood biochemical factors, which sre related to immune system in fasting individuals. Methods: This experimental study is a before-after study. This investigation was performed on 75 male and female fasting individuals aged 25-50 years. Blood samples were obtained once at the beginning of Ramadan and once at the end of Ramadan. The levels of C3, C4, blood sugar, serum leptin, cortisol, and WBC and RBC counts, were measured in the blood sample. Results: In this study, the levels of C3, C4, level, cortisol, and blood sugar were significantly increased during fasting period, but leptin level and blood cells counts had no significant changes. Conclusion: Due to a significant increase in some components of complement system, it seems that the immune system is strengthened by fasting.

purpose: The purpose of this study was to examine effectiveness of cognitive-behavioral therapy on mental health and psychological flexibility in individuals with overweight. Method: The present study was administered with a quasi-experimental design with pretest, posttest, follow up and control group. Statistical society included all of individuals with overweight that were clients of nutrition clinics and sport clubs of Esfahan city, in 2014 that among them 40 persons selected by convenience sampling and assigned randomly in one experimental group (n=20) and one control group (n=20). 8 sessions of cognitive-behavioral therapy (each of them was 2 houres) performed for experimental group while control group received no intervention. General Health Questionnair-12 (GHQ-12) and Acceptance and Action Questionnaire for Weight related problems (AAQW) used as the instruments of the study in pre-test, post test and follow up stages for two groups. Data analyzed through ancova and mann- witney u test. Results: Results showed that cognitive behavioral therapy caused to significant improvement of mental health and reduction of psychological flexibility in post-test. These effects maintained in follow up stage. Conclusion: Based on the results of this study, cognitive behavioral therapy can considered as an efficient intervention to improvement of mental health in individuals with overweight. However Based on the results of this study, the claim of acceptance and commitment therapy approach confirmed as reduction of psychological flexibility in procedure of cognitive behavioral therapy.

Abstract Judicial acts and facts are the sources of legal relationships and responsibilities among human beings. An analysis of judicial nature and cause of the creation of the judicial acts and facts can prevent us from confusion in these concepts and in a similar fashion in the effects and judicial decisions related to them. The purpose of this article is to recognize and compare the nature and the cause of creation of judicial acts and facts in the Iranian and the French law. In a general sense, in the Iranian law, judicial acts have arbitrary characters, whereas judicial facts look real. However, in the French law, the judicial acts are subjective, whereas judicial facts are objective. In the Iranian law, the cause of judicial acts is an intention to perform an action, which is a sensual interplay, while in the French law, jurists believe that intention and consent are different entities, and that consent which is the cause of judicial acts has a sensual quality. Additionally, intention in the intentional judicial facts is a simple and material intention.

Background and Objectives: Pseudomonas aeruginosa is a gram-negative bacterium and an opportunistic pathogen with several virulence factors. This bacterium is one of the common pathogens in nosocomial infections, particularly in patients with cystic fibrosis . Also, one of the important mechanisms of the survival of this pathogen in the pulmonary disease is biofilm formation. This study was conducted with the purpose of determining the sub-MIC concentrations of two antibiotics, ampicillin and gentamicin, along with the form conjugated with gold nanoparticles on the formation of biofilms in mucoid strain of Pseudomonas aeruginosa. Methods: In this study, gold nanoparticles were synthesized using trisodium citrate in a chemical reduction method, then the shape and size of gold nanoparticles were determined by transmission electron microscopy (TEM).Conjugation of gold nanoparticles with ampicillin and gentamicin antibiotics was performed by mixing them together. To test the effect of compound son biofilm formation, micro plate method was performed. Results: In this study, approximate size of nanoparticles was determined to be 10nm. In electronic image (in conjugated form), accumulation of nanoparticles was observed in the image. Also, gold nanoparticles conjugated with the drugs, had better effect on biofilm formation compared to free form of the drugs. Conclusion: According to the results of this study, gold nanoparticles by increasing the concentration of drug around themselves result in better inhibitory effect of drug on the biofilm formation compared to the free form of drug.

Background: Chronic obstructive pulmonary disease (COPD) is a spectrum of pathological changes in the respiratory system associated with dyspnea, cough and sputum production. The main objectives of management the disease are reducing the symptoms and improving quality of life. The present study aimed to determine the impact of respiratory symptoms on health-related quality of life in patients with chronic obstructive pulmonary disease. Methods: This cross-sectional descriptive study was conducted in 2013 with participation of 331 patients with chronic obstructive pulmonary disease in educational hospitals of Tehran city, Iran, chosen by available sampling. Data was collected using demographic variables questionnaire, St. George's Respiratory Questionnaire (symptoms section) and SF-36 health related quality of life questionnaire. Using independent t-test, Spearman correlation ratio, ANOVA and multivariate analysis of covariance, the data were analyzed. Findings: In presence of age and duration of disease variables, the symptoms of dyspnea, acute episodes of breathlessness and wheezing were significantly associated with physical health (P = 0.049). Reduced quality of life score and increased respiratory symptoms had a direct relation with chronicity of disease, concomitant usage of two drug categories and increase in the number of admissions (P = 0.011). Conclusion: The use of appropriate approaches to health care and quality of life in patients with chronic obstructive pulmonary disease is recommended.

مقدمه: حاکمیت بالینی ابزار کلیدی مدیریت و پایش اطلاعات است. هرچند استفاده از اطلاعات یکی از اجزای اساسی حاکمیت بالینی است، اما متاسفانه توجه چندانی به مدیریت اطلاعات در آن نشده است. هدف این تحقیق شناسایی وضعیت و ارائه مدل مفهومی برای مدیریت اطلاعات در راستای حاکمیت بالینی بوده است. روش بررسی: پژوهشي توصیفی مقطعی از نوع کاربردی در سال 1392 هجری شمسی انجام شد. جامعه پژوهش کلیه واحدهای حاکمیت بالینی بیمارستان­های تابعه دانشگاه علوم پزشکی کاشان (4بیمارستان کاشان و 2 بیمارستان شهر آران و بیدگل) بوده و نمونه گیری انجام نشد. داده ها از طریق پرسشنامه محقق ساخته و مصاحبه گردآوری شد. پایائی از روش آزمون- باز آزمون سنجش شد (89/0 = α). پرسشنامه روایی صوری و محتوی داشته و توسط اساتید صاحبنظر تائید شد. داده های يك بيمارستان بصورت پايلوت جمع آوري و مجدداً اصلاحات انجام و پرسشنامه نهایي تدوين گرديد. داده ها با آمار توصیفی و نرم افزار SPSS 16 تحلیل شد. با سناریوی منتج از پرسشنامه ها، نمودار موجودیت – رابط Entity Relation Diagram (ERD) و نمودارهای زبان مدل سازی یکپارچه (UML) Unified Modeling Language به ترتیب با استفاده از برنامه های Visio 2007 و Rational Rose 7 ارائه شد. یافته ها: نتایج پژوهش نشان داد 79/25 درصد شاخص ها در بیمارستان ها محاسبه شده بودند. در هیچیک ( صفر درصد) از واحد های حاکمیت بالینی بیمارستان های جامعه پژوهشی پایگاه داده ای طراحی نشده بود. 3/83 درصد از واحد حاکمیت بالینی بیمارستان ها اعلام نمودند که به پایگاه داده نیاز دارند. نتیجه گیری: واحد حاکمیت بالینی بیمارستان ها برای انجام رسالت خود به تمام شاخص های مورد نیاز دسترسی ندارند. تعریف فرایندها و ترسیم مدل های لازم و ایجاد پایگاه داده جهت طراحی سیستم های اطلاعاتی ضروری است.

Fascioliasis is one of the most important zoonosis with worldwide distribution, which causes great losses in livestock production. Serological methods are used for early detection of disease. The current investigation undertook to challenge dot-ELISA and ELISA techniques in diagnosing of Fasciola hepatica in sheep using excretory-secretory (E/S) antigen to select the most appropriate method. The serum samples (n=281) were collected from 50 cases of fascioliasis, 81 animals with parasitic diseases other than fascioliasis, and 150 healthy control cases. The E/S antigen used was obtained from infected livers (F. hepatica) of sheep slaughtered in Hamedan industrial abattoir (Iran). The result of dot-ELISA showed 100% sensitivity and 92.2% specificity. Also, positive and negative predictive values, and accuracy of assay were 73.52%, 100% and 93.59%, respectively. In the case of ELISA, the results were as follows: 98% sensitivity, 100% specificity, 100% positive predictive values, 99.56% negative predictive values, and 99.64% accuracy of assay. In both techniques, cross reaction with fascioliasis was not observed. In conclusion, although these two tests had very similar results, dot-ELISA was more acceptable with respect to its higher sensitivity, simplicity in practice and cheaper than ELISA. Therefore, dot-ELISA can be recommended as a routine test in paraclinical laboratories and epidemiological studies.

INTRODUCTION: self-medication can cause significant challenges for the individuals and community, especially in women during pregnancy. This study was aimed to compare the prevalence of self-medication before and during pregnancy among women in Iran.Methods: in this cross-sectional study, a total of 384 pregnant women were evaluated for the prevalence of self-medication and its associated factors before and during pregnancy. Stratified random sampling was used as the sampling method. Descriptive statistics and chi-square and logistic regression tests were used for statistical analysis of data.Results: the results showed that the prevalence of self-medication, in women who had become ill at least once, was 63.9% before pregnancy and 43.5% and during pregnancy. Variables such as lack of insurance, high school education and not having a child increased odds ratio of self-medication before pregnancy, while the variables of lack of insurance, not having a child or fewer number of children and no history of abortion increased the odds ratio of self-medication during pregnancy.Conclusion: although the prevalence of self-medication during pregnancy was less than that before pregnancy, but this prevalence during pregnancy was still significant. Therefore, it seems necessary to provide public trainings for all women of reproductive age and train them about the dangers and side effects of self-medication.

Background and Objectives: Vibrio species have been known as the cause of gastrointestinal and extraintestinal disorders, which usually appear epidemically in some seasons of the year. Since the sea has been known as one of the important ecosystems of Vibrio species, this study was carried out with the aim of determining the prevalence of Vibrio species and their microbial resistance in different coastal regions of the south of country in different seasons of year. Methods: In this descriptive cross-sectional study, 600 water samples taken from the coastal waters of Bandar Abbas were evaluated in terms of presence of Vibrio strains in two seasons of spring and winter. For primary detection, alkaline peptone water and TCBS were used, and the final identification was carried out using biochemical tests (oxidase, motility, Indole ring, KIA, and other biochemical tests such as 0% NaCl, 6% NaCl, VP, and ONPG). Results: V. harveyi (2.3%), V. cholerae (1.7%), V. parahaemolyticus (1.3%), V. furnissii (1.2%), V. metschnikovii (1%), P. shigelloides (1%), A. hydrophila (0.5%), V. vulnificus and V. mimicus (0.3%), and V. fluvialis (0.2%) had the highest prevalence. Also, in terms of the studied seasons, 71.2% of the contamination was related to winter season and 28.8% to spring season, which showed that the cases of contamination in winter was higher than in spring. Conclusion: Based on the study of researchers, the isolation of these species increases after rain. In the present study, this parameter had a positive effect on the isolation of Vibrio species.

Background: One of the most important factors in the fracture healing is the intracellular production of prostaglandins by osteoblast cells. Nonsteroidal anti-inflammatory drugs (NSAIDs) exert their effects through inhibition of prostaglandin synthesis. NSAIDs are widely used in orthopedic practices and their effect on bone healing is not fully understood yet. Objectives: The current study aimed at examining the effects of indomethacin and meloxicam on tibia fracture union in rats.MethodsThe current study was conducted on 60 male rats. Mid-shaft tibia fracture was induced in rats using bone-breaker device. The animals were randomly divided into 3 groups; a control group that received distilled water and 2 other groups that received indomethacin and meloxicam respectively for 28 days. At the end of weeks 1, 2, 4, 8 and 12, four rats were randomly sacrificed from each group, and histological evaluation, measurement of the calcium, phosphorus, and alkaline phosphatase plasma levels, as well as radiographic examinations were performed on them. Results: After 4 weeks, a thin layer of woven bone was observed in the vast spaces of the bone marrow in the fracture area in the control group. In the meloxicam group in the week 4, the formation of immature blades of bone was observed, which were less organized and more irregular. In the indomethacin group in the week 4, new bone formation was less immature and more areas of cartilage were still observed. In the radiographic evaluations, delayed union in indomethacin and meloxicam groups was observed, which was more significant in the indomethacin group. Conclusions: Indomethacin and meloxicam had impact on the process of bone repair and delayed union in both groups of drugs. This delayed union was more significant in non-selective NSAIDs (COX-I and = II inhibitors) rather than selective NSAIDs (COX-II inhibitor).

Organic−inorganic hybrid solar cells composed of p-type conducting polymer poly (3,4-ethylene-dioxythiophene): polystyrenesulfonate (PEDOT: PSS) and n-type silicon (Si) have gained considerable interest in recent years. From this viewpoint, we present an efficient hybrid solar cell based on PEDOT: PSS and the planar Si substrate (1 0 0) with the simplest and cost-effective experimental procedures. We study and optimize the thickness of the PEDOT: PSS film to improve the overall performance of the device. We also study the effect of ethylene glycol (EG) by employing a different wt % as a solvent in the PEDOT: PSS to improve the device’s performance. Silver (Ag) was deposited by electron beam evaporation as the front and rear contacts for the solar cell device. The whole fabrication process was completed in less than three hours. A power conversion efficiency (PCE) of 5.1%, an open circuit voltage (Voc) of 598 mV, and a fill factor (FF) of 58% were achieved.

Let G be a finite p-group and N be a normal subgroup of G with |N|=p^n and |M|=p^m. A result of Ellis (1998) shows that the order of the Schur multiplier of such a pair (G,N) of finite p-groups is bounded by p^(1/2 n(2m+n-1)) and hence it is equal to p^(1/2 n(2m+n-1)-t)for some non-negative integer t. Recently, the authors have characterized the structure of (G,N) when N has a complement in G and t≥3. This paper is devoted to classification of pairs $(G,N)$ when $N$ has a normal complement in $G$ and $t=4,5$.

‎‎In this paper‎, ‎the type-II matrices on (negative) Latin square graphs are considered and it is proved that‎, ‎under certain conditions‎, ‎the Nomura algebras of such type-II matrices are trivial‎. ‎In addition‎, ‎we construct type-II matrices on doubly regular tournaments and show that the Nomura algebras of such matrices are also trivial‎.

Background and objectives: Mycoplasma contamination is one of the major concerns in cell culture technology. They can cause undesirable effects on cell cultures. Higher rate of cell culture contaminations by Mycoplasma orale is transmitted by laboratory personnel. Thus, the identification and rapid diagnosis, in controlling and prevention of this contamination are important. The aim of this study was to investigate the detection of Mycoplasma orale using a rapid, sensitive and specific polymerase chain reaction (PCR) method in cell cultures.Materials and Methods: A 16S rRNA-based Mycoplasma genus and specific primers PCR method for Mycoplasma orale were developed. The sensitivity and specificity of this method were determined.The PCR test was used after the cultured isolates were DNA extracted.Results: A total of 62 cell cultures sample were sent to the Mycoplasma Reference Laboratory at Razi Institute in Karaj, for detection of mycoplasma contamination. The specific PCR method reacted positively for the M. orale whereas no response was observed for, other species such as Mycoplasma S., mycoplasma H.,Mycoplasma arginine, mycoplasma L.,mycoplasma F., Mycoplasma pneumoniae, which showed the high specificity of this test. 42 out of 62 samples (67%) were scored positive by Mycoplasma genus. From these 42 samples, 8 (19%) samples were reacted positively in the M. orale specific PCR method. Conclusion: The obtained results are shown that PCR technique is a suitable and valuable tool for the detection of high percentage of mycoplasma contamination in cell cultures. So a large number of samples can be processed more rapidly during less than 24 hours . In conclusion, the PCR method is a rapid process with the high sensitivity, specificity and low cost. Therefore, it can be used routinely in cell culture laboratories.

Background: Knowing the symptoms of heart failure and the way they are different among men and women can reduce decision making time in providing diagnostic and therapeutic measures. It can also improve the quality of the response. This study aimed to compare the type and severity of symptoms experienced by men and women with acute coronary syndromes. Methods: In this cross-sectional study, 175 patients admitted to coronary care and cardiac units of Imam Hossein Hospital (Shahroud, Iran) were evaluated. Data was collected via interviews and a checklist including demographic characteristics, symptoms, risk factors, disease history, and associated symptoms. Severity of subjective symptoms was measured through a visual analogue scale. Data was analyzed using chi-square test and independent t-tests. Findings: Out of 175 subjects with a final diagnosis of acute coronary syndrome, 100 subjects (57.1%) were women and 75 (42.9%) were men. Chest pain was significantly more common in men than in females (P = 0.004). Most patients (69.7%) reported pain in the central and upper regions of the chest. However, this symptom was significantly more prevalent among women than among men (P = 0.002). There were gender differences in some atypical symptoms but angina was similar. The mean scores of severity of pain, sweating, and palpitations were significantly higher in women. Conclusion: This study showed that symptoms of men and with acute coronary syndrome were somewhat different. Hence, excessive attention to typical symptoms of acute coronary syndrome can foreclose care in early stages. Keywords: Acute coronary syndrome, Clinical symptoms, Heart failure, Women, Men

Background Diabetes mellitus type 1 is one of the most prevalent endocrine diseases in pediatrics. Diabetic ketoacidosis is considered as one of the most threatening clinical pictures of DM1, especially if occurred as the first presentation of DM1 in children. Objectives The current study aimed to identify factors which may play a role in DKA onset in children. Methods This case-control study included all patients under 18 years old who referred to department of pediatrics endocrinology at Mashhad University Hospital (Imam Reza) from January 2013 to December 2015 as newly diagnosed patients with DM1. Patients who fulfilled DKA criteria at diagnosis were considered as DKA group and those who referred with other presentations were considered as control group (non-DKA group). Data were analyzed by SPSS software ver. 16. Results During the study period, 97 (39.2% male) newly diagnosed patients were included as DKA group. Accordingly 97 gender- and age-matched patients were added as non-DKA group. The most prevalent symptoms in both groups were polyuria (91.88%) and polydipsia (88.66%). Fever and cold symptoms were significantly higher in the DKA group (P < 0.001 and P =0.005, respectively). Hemoglobin A1c level was significantly higher in the DKA group (P = 0.001), while body mass index was significantly lower in the DKA group (P = 0.045). Fever and father’s education level were the most important risk and protective factors in the DKA onset in newly diagnosed patients with DM1 (adjusted OR = 10.1, 95% CI = 2.9-35.3; P < 0.001 and adjusted OR = 0.5, 95% CI = 0.3 - 0.9 and P = 0.019, respectively). Conclusions In conclusion, a recent febrile illness was found as the strongest risk factor and father’s education level as the main protective factor in the DKA to diagnose children with DM1. The study findings suggested that DKA is a severe form of DM1 instead of a neglected or misdiagnosed disease.

The present study investigates the degradation of Acid Red 14 (AR14), commonly used as a textile dye in aqueous medium through the oxidation process by UV /S2O82- under a set of variables concentration of S2O82-, Ag+, AR14 and temperature. Commonly Ag+, heat and UV light can excite S2O82− to sulfate radical form (SO4−•), a stronger oxidant (E0 = 2.60 V) than S2O82−, to enhance significantly the oxidation of contaminants. Also the changes in the absorption spectra of AR14 solutions during the photoxidation process showed that decrease of absorption peak of the dye at λmax = 514 nm indicates a rapid degradation of the azo dye. The results of this study suggest that the oxidative treatment of AR14 by peroxydisulfate with UV is a viable option for removal of the textile dyes from effluents.

Background and Aim: Changes in political, economic, social, scientific and technological circumstances have a major impact on organizational performance. In such circumstances, the success of organizations depends on their ability to cope and adapt to changing environmental factors. This study investigated the relationship between organizational participation(team orientation, capability development and empowerment) and the organizational adaptability (change, customer orientation and organizational learning) in Imam Khomeini Hospital staff. Materials and Methods: This cross-sectional study was performed on 114 staffs of Imam Khomeini hospital, Tehran University of Medical Sciences who were selected by random sampling. Data were collected by Denison questionnaire (2006 version), which was confirmed validity and reliability. Data were analyzed with spss17 and statistical methods like the mean, standard deviation and correlation coefficients. Results: The results showed that the rate of the organizational involvement and adaptability of the staffs was 53.44% and 52.37% respectively. The Pearson correlation analysis showed a positive correlation coefficient (p

Introduction: Evidence-based learning is an effective educational strategy. Assessment of nursing student’s viewpoints about this new method can increase its application. This research was conducted to find out student’s experiences toward evidence-based learning in clinical setting. Methods: This qualitative study was performed by grounded theory method in 2010. Eighteen nursing students were selected by purposeful sampling. Students were asked to use evidence for problem solving in their pediatric internship rotation and report their findings in the morning report sessions. Data was collected by interview and was analyzed using content analysis methods. Results: Five main themes categorized in this research including experiences of thinking, self efficacy, integrating theory and practice, group interaction and problem solving. Conclusion: In attention to positive experience of evidence-based learning, intergrating of this method in clinical nursing education is recommended.

Introduction: Educating Patients diagnosed with cancer about their disease and treatment is a vital component of their nursing care. Management of treatment side effects and maintaining the quality of life could be achievable only by adequate and organized self-care education. With regards to the importance of the concept of cost-effectiveness in health care providing system, this study aimed to assess the effects of patient education on the quality of life in patients receiving chemotherapy and also to compare these effects between individual patient education and group education methods. Methods: One hundred and two patients with breast, esophagus and stomach cancer referred to Chemotherapy Unit in Omid hospital were randomly assined to two groups: Group teaching and Individual teaching methods. Fifty-one received three individual teaching sessions. Three group teaching sessions were conducted for the other fifty-one patients. All subjects were interviewed by the same interviewer three times (before the first chemotherapy, second and third session) using EORTC QLQ-C30 quality-of-life questionnaire. Results: The mean age of the two groups were 46/6± 3/9 and 48/7±1/32 in the individual and group teaching groups, respectivly. Using repeated measure test, we observed a significant difference in the quality of life scores over time between the two groups (p=0.02, F=3.7). However, this effect was only evident after the third chemotherapy course. Conclusion: Group teaching could maintain quality of life better than individual teaching over time. Health care providers could use these two methods interchangeably according to institute condition and the patients' needs and preferences.

One of the most significant concepts in mysticism is the explanation of the relation between God and the universe. This issue which has been variously explained in mystic poetry has had a new view by the emergence of Ibn 'Arabi and the stabilization of pantheism. According to Ibn 'Arabi and his disciples, the universe is the Creator, who is demonstrated in his creation. Following Ibn 'Arabi, Shamsoddin Mohammad Shirin Maqrebi, the mystic of the 14th century, is among those who have their thought based on pantheism. In various parts of his Divan, he has mentioned that universe is a symbol of God and, in some cases he has transformed Ibn 'Arabi's words into poetry. This paper tries to study the influence of Ibn 'Arabi on Maqrebi in various aspects of pantheism, the emergence of God in symbols, the influences and characteristics and the reason of emergence, the relation between God and creation.

Background and Aim: Changes in political, economic, social, scientific and technological circumstances have a major impact on organizational performance. In such circumstances, the success of organizations depends on their ability to cope and adapt to changing environmental factors. This study investigated the relationship between organizational participation(team orientation, capability development and empowerment) and the organizational adaptability (change, customer orientation and organizational learning) in Imam Khomeini Hospital staff. Materials and Methods: This cross-sectional study was performed on 114 staffs of Imam Khomeini hospital, Tehran University of Medical Sciences who were selected by random sampling. Data were collected by Denison questionnaire (2006 version), which was confirmed validity and reliability. Data were analyzed with spss17 and statistical methods like the mean, standard deviation and correlation coefficients. Results: The results showed that the rate of the organizational involvement and adaptability of the staffs was 53.44% and 52.37% respectively. The Pearson correlation analysis showed a positive correlation coefficient (p

BACKGROUND: Treatment of significant coronary artery disease with primary percutaneous coronary intervention (PCI) seems better than angioplasty balloon; because the incidence of restenosis is lower in this method, however, a serious complication of PCI is stent thrombosis which would lead to repeated myocardial infarction (MI) and increase the mortality and morbidity. One of the frequent medications which is used to prevent from stent thrombosis is clopidogrel, but, stent thrombosis was seen in many of the patients despite given the conventional dosage of this drug. This study aimed to evaluate the effect of doubling the maintenance dose of clopidogrel to prevent from early stent thrombosis, MI and mortality rate. METHODS: This was a clinical trial study which was done in Shahid Chamran Hospital in winter 2010 in Isfahan, Iran. A total of 400 patients with PCI were prospectively followed-up for 30 days. All the patients were randomly allocated into two groups. The control group received a maintenance dose of 75 mg clopidogrel while the case group received 150 mg clopidogrel after the initial dosage of 600 mg for 30 days after the PCI. The incidence of primary outcome such as total mortality was recorded during the study. RESULTS: Early stent thrombosis was observed in 4 patients (1%) (One subject in the control group and 3 in the case group) during the first 30 days after PCI, but the difference was not significant between the two groups (p = 0.62). Mortality due to stent thrombosis occurred in 2 patients in the case group which showed no significant difference in this group (p = 0.5). In addition, MI occurred in 2 patients (1 in each group) which also showed no significant difference between the two groups (p = 1). Drug complication such as major bleeding had no significant difference between the two groups (p = 0.9). CONCLUSION: The present study showed that doubling dose of clopidogrel could not reduce the incidence of early stent thrombosis, mortality and myocardial infarction in comparison with conventional dosage; therefore it is recommended that more studies be done in Iranian and Asian race for clinical decision-making to prevent form stent thrombosis using high dose of clopidogrel.Keywords: Primary coronary intervention, Early stent thrombosis, Clopidogrel, Coronary stenting.

Horizontal Directional Drilling (HDD) is a trenchless technology provides an installation alternative that offers a lot of benefit compared to traditional open-cut method. It’s called HDD because its steering ability to avoid existing utilities or other obstacles either horizontally, vertically and even pulled back where she got its name. HDD was developed in California in the 1970s and was introduced in Europe in 1986. Since year 1992 up to 2016 there are about 40 thousand unit HDD machine were sold worldwide. Contractors, consultants, municipalities and decision makers are always in difficulties to determine the installation cost and the duration required when using the HDD method due to the presence of many qualitative factors. Understanding the HDD productivity factors will assist the stakeholders to overcome this matter. The aims of this study are to identify the existing HDD productivity factors, identify the factors that affect HDD productivity, identify the current tools that are used by current researcher, and identify the open problems and areas related to HDD productivity for improvement. Systematic Literature Review (SLR) was carried to previous related papers retrieved by a manual search, critically analysed and discussed. Researches regarding HDD productivity conducted by previous researchers were compared and discussed. The studies involved journal articles, conference papers, books, guidelines and etc. Consequently, these previous experiences and models can assist the contractors, consultants, municipalities and decision makers in preparing their costing and scheduling. The lacking factors on HDD productivity factors were highlighted and suggested for futre studies.

Objective:To compare the effects of aerobic and stretching exercises on severity of primary dysmenorrhea. Materials and methods:This randomized clinical trial was conducted on 105 female students who were suffering from primary dysmenorrhea. The participants were divided into aerobic exercise, stretching exercise, and control groups. The two intervention groups did the exercises three times a week for eight weeks (two menstrual cycles). The intensity of dysmenorrhea was determined using a modified questionnaire that assessed several symptoms of dysmenorrhea. After all, the data were compared between and within groups through analysis of variance. Results:Before the intervention, the mean intensity of dysmenorrhea was 40.38 ± 5.5, 37.40 ± 3.8, and 38.45±3.3 in aerobic, stretching, and control groups, respectively, but the difference was not statistically significant. After the intervention, however, a significant difference was found among the three groups regarding the mean intensity of dysmenorrhea in the first and second menstrual cycles. Also, a significant difference was observed between the aerobic group and the control group as well as between the stretching group and the control group. Within group comparisons showed a significant difference in the aerobic and the stretching group before and after the interventions. However, no such difference was observed in control group. Conclusion:Both aerobic and stretching exercises were effective in reducing the severity of dysmenorrhea. Therefore, women could choose one of these two methods with regard to their interest and lifestyle.