فهرست مطالب eskandari a

Communication with patients has a vital role in nursing and medical profession that health care planning is depending on it. Patient relationship management is an approach with a view of organizational and strategic change process which an organization attempt to achieve patients satisfaction. This study was performed to evaluate patients’ satisfaction with hospital staff’ manners with them in Sina hospital affiliated by Tehran university of medical science in year 2010. In this analytical-descriptive cross-sectional study a sample of 100 patients were selected through simple random method that consisted of the patients being discharged from Sina hospital during a 15-day period. The patients were interviewed at discharge time. The data were gathered using a valid questionnaire which was approved by the experts in this field by 57 questions. SPSS 19 software is used for statistical analysis of data’s. To determine the association between each variable and satisfaction status Fisher test and T test analyses were carried out. patients’ satisfaction with hospital services concerning medical، nursing، paraclinical and discharge services، selection and Patients’ general satisfaction with hospital services were in general، 13. 2، 45، 20. 1، 7. 6 and 2. 8 % were quiet satisfied، satisfied، rather satisfied and quiet dissatisfied respectively. The results showed that there was a significant statistical relation between the age of the patients and the degree of their satisfaction with the nursing staff treatment (p = 0. 012) and that of service staff (p = 0. 009). In order to increase patient satisfaction with hospital services، should improve hospital services. Also، using a model based on patient relationship management، in order to increase patient satisfaction seems to be essential in hospitals

To determine the prevalence and to describe the demographic pattern of congenital cataract surgery performed at a referral hospital in Iran during four consecutive years with respect to sex inequality in receiving eye care. All children aged 15 years or less who had undergone congenital cataract surgery between 2006 and 2009 in Labbafinejad Medical Center were enrolled in this cross-sectional study. Data were retrieved from the electronic medical records of the hospital admission data bank (Fox PR 6.2. Clipper 5.2) using the ICD-10 coding system. The prevalence of cataract surgery, age and sex proportion were the main outcome measures. Overall, 314 eyes of 259 patients with congenital cataract including 14 eyes of 115 girls (45.2%) and 172 eyes of 144 boys (54.8%) were operated on during the study period; 55 (17.5%) of which had received cataract surgery in the second eye. Mean age at the time of operation was 2.9±2.7 and 3.5±3.2 years in girls and boys, respectively (P= 0.62). The procedures were performed before the age of 1 and 5 years in 33.2% and 75% of the cases, respectively. The operation of the second eye was performed significantly later in girls as compared to the boys (4.2±3.3 vs. 2.6±1.7 years, respectively, P=0.012). During the study period, the rate of operation for congenital/infantile cataract was higher in boys by about 10% as compared to girls. Age at the time of operation for the second eye which comprised 17.5% of total surgeries was significantly different between two genders. Overall, one third and two thirds of surgeries were performed under the age of 1 and 5 years, respectively.

Surface water pollution by chemical, physical, and biological contaminants all over the world can be considered as an epidemic problem. To decrease the negative impact of these pollution sources, offering a suitable model for water quality management is known as a key step to improve the quality of water resources system. In this study, given that Sefidrood River is one of the most polluted rivers of Iran and studies in this area has been very limited, we provide a framework for managing the river's water quality based on the canonical correlation analysis (CCA). For this purpose, data from 13 stations, located from the next of the Sefidrood Dam to the Caspian Sea, was used by CCA to determine the parameters of the relationship between physical and chemical pollutants in two period of wet (March) and dry (September). In general, our results suggest a strong relation between physical and chemical parameters in both wet and dry seasons. Therefore we can say as a result that the source of the both pollutant parameters in both high-water and low-water can be the same. Due to the fact that the source of chemical pollutant parameters in a basin is often caused by human induced sources, we can conclude that the origin of physical pollutant parameters, according to the CCA results, is the same as chemical pollutant parameters. So based on the results of this study reducing the human induced pollution sources is an important step in monitoring maintenance and quality improvment of this important river.

The die-back of pistachio is one of the most important diseases affecting pistachio trees reducing yield production. In commercial fields, sampling was done from nine different pistachio production areas in Mahvelat, Khorasan Razavi province during 2008-2010. In each orchard, samples were taken from tree branches with canker during spring and summer seasons. Fungal species were identified based on the micro and macromorphological features, reverse and surface characters of colonies. The ability of the isolates to produce disease was assessed on two year-old pistachio branches. The effect of Mancozeb, Benomyl, Metalaxyl, Rovral TS, Bordeaux mixture and Propiconazole was evaluated on radial mycelia growth of P. variotii, N. mangiferae and Stemphylium spp.. In most orchards, the samples were positive for fungal species and in only a few orchards no fungal isolates could be detected. Based on micro and macro- morphological features; P. variotii, N. mangiferae, and Stemphylium spp. were identified in most sampling areas with different frequencies. In pathogenicity tests, most isolates of N. mangiferae and Stemphylium spp. were able to establish disease, while about 43 % of P. variotii isolates produced die-back on inoculated branches. The results of fungicides produce different levels of control on mycelia growth of fungal species which was varied according to the kind of fungicide and fungal species. Overall, the differences between fungal isolates, biotic and a biotic factors to produce disease as well as contradictory results were obtained by different researchers as described in literature.

eisseria meningitidis is a leading cause of bacterial meningitis and other invasive bacterial infections، both in the United States and worldwide. The role of the meningococcus as a cause of bacterial meningitis has become more important in recent years with the declines in meningitis caused by Haemophilus influenzae type b and Streptococcus pneumoniae because of the introduction of new conjugate vaccines، Listeria because of efforts to reduce the contamination of food with L. monocytogenes، and group B streptococcus because of the use of chemoprophylaxis during parturition in women. The development of a pneumococcal vaccine six decades ago demonstrated the feasibility of vaccine prevention of invasive encapsulated bacterial diseases. Purified polysaccharide vaccines for serogroups A and C N. meningitidis were developed several decades later. Early vaccines were poorly immunogenic apparently because the polysaccharides that were used were of low molecular weight، whereas vaccines made from polysaccharide with a molecular weight over 100،000 had excellent immunogenicity. Meningococcal conjugate vaccines، are typically T-cell dependent، which as regards of immunologic improvements over polysaccharide vaccines. The carrier proteins used for meningococcal conjugate vaccines have included tetanus toxoid protein، diphtheria toxoid، and diphtheria cross-reactive material (CRM) 197. The immunogenicity of a variety of outer membrane protein- based serogroup B vaccines has been studied. In an evaluation of three doses of a Cuban B: 4: P1. 15 vaccine and a Norwegian B: 15: P1. 7،16 showed that more than two-thirds of children and adults had at least a fourfold rise in SBA، as did at least 90% of infants.

To investigate the proportion and time trend of second-eye senile cataract surgery (SECS) in a high-turnover academic center in Iran. In this cross-sectional study, Samples were selected among all records of senile cataract surgery based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) during four consecutive years (2006-2009). Utilizing hospital's computer-based records, 15% of records were included by systematic random selection. Patient’s demographics as well as surgical data were assessed. The proportion of annual SECS was considered as the main outcome measurement and the time trend was calculated through linear regression model. Of total senile cataract surgeries (N=10517) performed over a 4-year period (between 2006 and 2009), 1585 (15%) were retrieved randomly. Among these, 1139 records [71.8%: 95% confidence interval (CI): 69.5-74.1] were related to the first eye operation and 446 (28.2%; 95% CI: 25.9-30.35) were related to the second eye. The proportion of SECS was increased from 24.6 % in 2006 to 33.4% in 2009 (p=0.01), with a linear increase in the trend of SECS (b=0.031, P=0.003). Overall, median (inter quartiles range) of time interval between two cataract surgeries was 9 (4-24) months which remained unchanged during the study period. SECS rate and time interval were independent of age, sex, and the type of insurance during the study period. SECS was 10.4% higher (P=0.01) and time interval was 13 months lower (P=0.007) in patients who underwent Phacoemulcification in the first eye as compared to those who had extra capsular cataract extraction in their first eyes, (29.9% vs 19.5%, P= 0.01). Recently, there has been an increase in the number of senile cataract surgery and SECS which contributed one-third of total cataract surgeries.

Complications in diabetes mellitus are associated with free radicals and oxidative stress. The human body copes with these complications through antioxidant defense mechanisms. This study aimes at assessing the effect of aqueous extract of sumac (Rhus coriaria L.) fruit on catalase (CAT) enzyme activity and the histopathological changes of liver in diabetic rats. In this study، 30 adult male Wistar rats، with average weight 180-230g were divided randomly into 5 groups of 6 rats. Physiological serum was injected to control rat group with the same volume of injection material. The second group of rats، became intraperitonally diabetic by injecting 120mg/kgbw dose of Alloxan monohydrate. The third، fourth and fifth groups of rats in addition to the same treatment of the second group، were fed aqueous extract of Rhus coriaria respectively، 50، 100 and 250mg/kgbw doses for 4 weeks. At the end of treatment، the role of extract on CAT enzyme activity was assessed. The serial sections of liver were prepared and stained with H & E for microscopic investigations. Data were analyzed using the test one way ANOVA and Tukey test. Significant level (p<0. 05) was considered. CAT enzyme activity decreased in diabetic group significantly (p<0. 05). Moreover، CAT enzyme activity in group treated with extract (250mg/kgbw) was significantly different as compared to diabetic group (p<0. 05). Also those treated with extract، (250mg/kgbw) indicated a significant improve in side-effects of diabetes mellitus on liver tissue in diabetic rats. These results show that Sumac can be effective in decreasing diabetic complications and it can be used as an antioxidant and food supplement in diabetic patients.

IntroductionFive-day biochemical oxygen demand (BOD5) is one of the key parameters which is widely applied to evaluate the biological and chemical conditions of rivers, and to study the effects of releases in rivers from wastewater treatment plants, factories, farms, etc. Measurement of this parameter requires about 5 days. However, 5 days is a long time for the determination of BOD5. Therefore, in the present research two software sensors, i.e. artificial neural network (ANN) and support vector machine (SVM) are developed for the online estimation of BOD5. To achieve this goal, the Sefidrood River in Iran was selected. It is pointed out that although ANN models have been used to predict BOD5, but using SVM techniques for the online estimation of this parameter have never been reported.Materials and Methods ANN and SVM models are two well known artificial intelligent techniques which have frequently been used for modeling nonlinear parameters in engineering problems. In this research, a feed-forward ANN technique and a regression model is considered for online prediction of BOD5. To optimize ANN parameters, three optimization algorithms, i.e. Levenberg-Marquardt (LM), resilient back-propagation (RP), and scaled conjugate gradient (SCG) are used. Besides, two-steps grid search algorithm is considered for the optimization of SVM parameters, i.e. ε, C and γ.Results and DiscussionTo achieve the best network geometry according to the highest correlation (R), and the lowest root mean square error (RMSE) of the testing sets for online estimation of BOD5, various structures of NN model with different training functions are investigated. Finally, the network with LM algorithm (ANN (LM) model) is selected as the best ANN model. The results of training and testing steps for developed ANN models with different training functions are given in Table 1.In addition, for SVM model development, first, ε, C and γ should be determined. In this research, the best fitting value was obtained by trial and error procedure. Therefore, this parameter was set to several values. Thus, 14 models were developed (ε and C are considered to be varied). The RMSE value has been assessed on different values in the different -SVM regression models. Obtained results indicated that the SVM model including the value equal to 1.472 has the least RMSE. Therefore, it can be chosen as the best SVM model for the online prediction of BOD5. However, optimal values for C and using two-step grid search were 13 and 0.037, respectively. Finally SVM model is trained and tested using the determined best fitted values.

To assess various aspects of integrating a virtual reality (VR) simulator in the training of ophthalmology residents

In this qualitative study, some aspects of the VR EYESI simulator as a health technology were assessed. Data was collected using a multiple-choice questionnaire and several deep interviews addressed to users and administrators of simulator training. Face and construct validity were measured as a score out of 100. Scores were given by 19 novice residents and 4 experienced fellowship candidates.

Residents gave a score of 85.08 for face validity and a 70.87 for the construct validity of the EYESI simulator. Fellowship candidates scored its face and construct validity at 60 and 80.66, respectively. 63.2% of residents believed that the simulator is a very useful training tool and 75% of fellowships viewed it as useful. Eighty percent of interviewed attending physicians believed that the simulator reduced the time and improved the quality of training. They also stated that residents who were trained with the simulator were adequately prepared for entering the operating room and showed better eye-hand coordination. All the stakeholders strongly believed that simulation is a necessary method of education.

The EYESI simulator is an up-to-date virtual reality medium that enjoys good face and content and face validity. It was also shown to be an effective method of training since it decreased the time and improved the quality of training.

Nano-SiO2 solid acid efficiently and selectively catalyzed the cyclocondensation reaction of arylnitriles with 3-amino-1-proopanol or 1,3-diaminopropane to afford their respective 2-substituted oxazines and tetrahydropyrimidines in high yields under thermal conditions and microwave irradiation. This methodology works effectively for the selective synthesis of mono-1,3-oxazines and mono-tetrahydropyrimidnes from dinitriles. The catalyst could be recycled and reused several times without a noticeable decrease in its activity.

One of the most successful procedures in root coverage is free connective tissue graft combined with coronally advanced flap. The assessment of mucogingival junction (MGJ) changes during healing period is of great importance. The aim was to assess the positional changes of MGJ following use of connective tissue graft in combination with coronally advanced flap in - 6- and - month intervals.In this cross sectional and interventional study, 9 cases of gingival recession in 0 patients with Miller class I and II defects ≥ mm were treated with connective tissue graft and coronally advanced flap. After phase I therapy, an acrylic stent was made. Clinical parameters monitored in this study included clinical attachment level (CAL), mucogingival junction (MGJ), keratinized gingival (KG) width and attached gingival (AG) width. Each parameters were measured at baseline, and - 6- and - month intervals. For comparison, statistical analysis was performed using Paired-T test at p < 0.05.The mean distance from MGJ to acrylic stent at baseline was 5.9± 0.88 mm which during surgery, was moved coronally by. 9 ± 0.65 mm. Distance from MGJ to CEJ immediately after surgery was. 55 ± 0.58 mm. This distance during healing periods at, 6, and months changed to. ± 0.87,. ± 0.66, and. 65 ± 0.6 mm, respectively indicating a gradual regression of MGJ to presurgical position. Keratinized gingival width had remarkable changes in -, 6- and month intervals in comparison to the baseline. Mean presurgical width of keratinized gingiva was. 55± 0.76 mm which increased to. ± 0.9 mm (p <0.05). Mean presurgical attached gingival was 0.6± 0.6 mm and months after surgery it was increased to. 8± 0.50 mm month after surgery (p <0.05). Presurgical clinical attachment level was 5.8± 0.88 mm which was decreased to. 55 ± 0.57 mm, month after surgery.Based on the findings, it seems that mucogingival junction has a gradual tendency to moved back to its presurgical position after use of free connective tissue graft with coronally advanced flap technique.

Alveolar bone level measurement in periodontal disease is very important because it may affect planning of forthcoming surgery, treatment response and prognosis. Surgical approach is the most accurate procedure for obtaining this measurement. Nowadays, transgingival probing as a non-invasive and accurate method, has been claimed to be a proper substitution for surgical measurement and direct visualization.This study aimed at evaluation of diagnostic value of bone sounding technique in estimation of bone level in I, II and III- wall periodontal defects.Ninty vertical defects in 37 individuals with chronic periodontitis having either one, two or three-wall defects were assessed. Bone levels were measured by UNC-15 probe. The resulted values were compared with the values obtained during surgery. Collected data were analyzed using Paired samples T test and Pearson’s correlation coefficient.High and significant correlation was found between the results of transgingival probing and surgery methods (0.97, 0.94 and 0.95 in one, two, and three-wall defects respectively (p<0.001)). The mean bone levels measured by transgingival probing were 0.21, 0.53 and 0.19 mm less than their assigned values in surgery and there was no significant difference between one and three- wall defects (p<0.001).The findings of this study indicated a high correlation between the two procedures, bone sounding and surgery, in detection of bone level. Due to the negligible difference, it seems that transgingival probing could be considered as a feasible replacement for invasive surgical approach in detection of alveolar bone level.

Statement of Problems: Helicobacter pylori (H.pylori) is considered to be a pathogen responsible for gastritis and peptic ulcers as well as a risk factor of gastric cancer. Recently, H.pylori has been detected in dental plaques, hence oral cavity has drawn attention to be the second site for H.pylori. However, it is not yet clear whether the oral cavity acts as a reservoir for this bacterium.The aim of this study was to clarify whether the oral cavity is the reservoir for H.pylori, and to find out any relationship between gastritis and dental plaque the infection.In this study, PCR was used for detection of Helicobacter pylori as a non-invasive method with higher sensitivity and specificity. Samples of the supragingival and subgingival dental plaque were collected from 67 patients (44 with periodontitis, and 23 suffered from both gastritis and periodontitis). Using sequences of different H. pylori genes, four pairs of oligonucleotide primers were designed to optimize a sensitive and specific protocol for diagnosis and detection of H.pylori. The data were analyzed using Chi Square and Fisher statistical tests. The level of significancy was considered at p 0.05. According to the results of this study, prevalence of H.pylori in dental plaque of the whole samples was low (5.9%), but there showed to be a significant relationship between H. pylori infection in dental plaque of pateints with gastritis (p<0.05).Although the prevalence of the Helicobacter pylori in dental plaques was shown to be very low, it might be necessary to pay close attention to dental plaques as the possible source of re-infection after treatment of gastritis. It is recommended that in treating gastritis, along with antibiotic therapy, attempts should be made in dental plaque removal and educating patients with proper health practices.

Statement of problem: Although bacterial plaque is the primary ethiologic factor in the initiation of chronic periodontitis, there is some predisposing factors such as smoking which may aggravates disease process and its roll appears to be considered more important recently. The purpose of the present study was the evaluation of the effect of the quantity of cigarette smoking on periodontal tissue response following phase I therapy. Thirty patients (26 male and 4 female) with mean age of 48±11 years participated in this interventional and cross-sectional study. All patients suffered from generalized moderate chronic periodontitis. The patients were divided into three equal groups of 10 (heavy smokers, light smokers and non smokers), according to the number of cigarette consumption. The smoker groups had a history of cigarette consumption at least for the past two years. Clinical probing depth, clinical attachment level and bleeding on probing were evaluated for the patients at baseline and eight weeks following completion of phase I therapy. The results were analyzed using Wilcoxon rank and Kruskal- Wallis tests. No statistically significant differences were found in the evaluated variables between the groups except for BOP at baseline. All parameters decreased significantly eight weeks after completion of phase I therapy, but in comparison between three groups, only differences of CPD reduction and CAL gained between heavy and non-smokers were statistically significant The present study indicated that heavy cigarette smoking have a negative effect on periodontal tissue response to phase I therapy. This effect depends on the number of daily smoked cigarettes and is increased with more than 20 cigarettes smoking per day.

Statement of problem: Many risk factors cause progression of peridontitis. Smoking is one of these factors and due to increasing rate of smokers, there is need to study more about the effect of smoking on periodontal indicators. The aim of this study was clinical evaluation of smoking effects on periodontal tissues in referring patients to oral medicine and periodontics department in Tabriz dental faculty. This study was an analytical, cross-sectional study. Sample size consisted of one hundred patients with chronic periodontitis. Of these patients, 50 smoker patients (34 Heavy smokers and 16 Light smokers) entered into case group and 50 non-smoker patients entered into control group. After ensuring age matching between smokers and non-smokers, periodontal measurements such as clinical probing depth (CPD), gingival recession (GR), clinical attachment level (CAL), tooth mobility (TM) and bleeding on Probing (BOP) were obtained and recorded in special questionnaires. Data analysis was performed by SPSS soft ware and Tukey and Pearson tests. Clinical probing depth, gingival recession, clinical attachment loss and tooth mobility increased significantly in Heavy smokers compared with non-smokers and Light smokers (p<0.05), while no statistically significant differences were found between non- smoker and light smoker groups.Considering bleeding on probing, there was declining trend in BOP in Heavy smokers compared with non-smokers and Light smokers (p=0.00). There was not significant differences upon the effect of cigarette consumption (based on pack years) in the mentioned indices (p>0.05) between the two groups. Based on the results of this study which showed an increasing rate of intensity in periodontal indicators in smokers group compared with non-smoker, specific programs to increase public awareness on the effect of smoking should be recommended.