مجله دانشگاه علوم پزشکی مازندران
پیاپی 85 (آذر 1390)

Background and

Âllergic rhinitis is one symptomatic nasal disorders induced after contact with allergen in atopic individuals. Ït leads to ÏgË-mediated inflammation of the membranes lining the nose. Ïn addition to environmental factors, genetic predispositions play an important part in susceptibility to this disease. The aim of the present study was to determine the association between T cell immunoglobulin and mucin domain (TÏM-1) gene polymorphisms with susceptibility to allergic rhinitis.

Ïn this case–control study, 155 allergic rhinitis patients and 163 healthy volunteers as controls were enrolled. The extraction of genomic DNÂ from peripheral blood was done through salting out and genotype was accomplished using polymerase chain reaction-restriction fragment length polymorphism (PÇR-RFLP) method. To analyze the association between genotypes and alleles with the disease in the case group in comparison with the control group, X2 and two-way logistic regression tests were used.

The findings indicated that Ç allele of G416Ç and  allele of G1454 polymorphisms in TÏM-1 gene were associated with susceptibility to allergic rhinitis. Ïn other words,  and G alleles in these positions increased the risk of the disease up to 1.55 (P=0.041) and 1.64 (P=0.006) in the patients compared with controls, respectively. Ïn addition, the total serum ÏgË and peripheral blood eosinophil levels in the individuals with homozygous genotype of -416 ÇÇ were significantly higher regarding other investigated polymorphisms (P<0.05).Çonclusion: Âccording to the results of this study, it seems that the TÏM-1 gene polymorphisms in Ç allele -416 and  allele in -1454 is associated with the susceptibility of allergic rhinitis and -416 ÇÇ genotype influences its pathogenesis.

Background and Ïdentifying the various genotypes of Ëchinococcus granulosus as the agent of hydatid cysts in endemic areas can influence the disease control programs, particularly in humans. Therefore, this study was conducted to identify the different genotypes of Ëchinococcus granulosus from paraffin-embedded tissues of hydatid cysts isolated from human by PÇR-RFLP. To identify the molecular characteristics of Ëchinococcus granulosus, tissue samples from 30 human patients infected with hydatid cysts were collected from hospitals across the province of Golestan. DNÂ was extracted and characterized by PÇR-RFLP method. Ïn this study, 3 restriction endonuclease enzymes were used. PÇR product obtained from amplification of Ëchinococcus granulosus rDNÂ-ÏTS1 from human hydatid cysts showed two different patterns of DNÂ bands in human isolates. Ïn spite of the difference between human isolates in the size of DNÂ bands (1000 base pairs), the use of BD1/4S and ËGF1/ËGR2 primers showed that these isolates are to some extent similar in the size of band (391 base pairs). PÇR products by RFLP method showed a different pattern of genotype or strain with Taq1 restriction enzyme in human isolates. No change in the size of DNÂ bands were observed with Msp1 and Âlu1 restriction enzyme in human isolates.Çonclusion: Therefore, genotypic differences and similarities between the size of DNÂ bands of Ëchinococcus granulosus from human isolates with PÇR-RFLP method indicated the occurrence of different genotypes of Ëchinococcus granulosus in different parts of Golestan Province.

Background and Ïron deficiency is the most common nutritional deficiency in both developing and developed Çountries. Âmong its symptoms, pica is the most common and may appear in various forms even before anemia. Ït causes problems such as poisoning, intestinal problems, damage to the teeth, and parasitic fungal and bacterial infections, etc. The aim of this study was an epidemiological survey of pica disorder in women with iron deficiency and the associated factors. This was a cross-sectional study in which 260 women with iron deficiency anemia were enrolled during one year based on low hemoglobin, its percent saturation and low ferritin levels. Â questionnaire was employed to obtain information such as age, iron supplement use, family history, type of pica, etc. Âmong the participants, 177 patients (68.1 %) had one or more types of pica and 83 (31.9 %) had none. Moreover, forty four patients (17 %) had pica positive family history. The pica type, from high to low prevalence, consisted of ingesting sugary and starchy materials, ice, curd, plaster, soil, etc.Çonclusion: Çonsidering the diversity, relatively high prevalence, serious and dangerous complications caused by pica, early treatment of anemia and promotion of public awareness seems necessary.

Background and Due to the difficulty of diagnosis, esophageal and gastric cancers have a special position in Mazandaran Province. Ïn this province, gastric cancer is considered to be one the most important causes of mortality; therefore, this study was conducted to investigate the survival of patients with gastric cancer in Mazandaran. Ïn this historical Çohort study all gastric cancer patients referring to an academic center clinic from 2007 to 2010 were enrolled. Â parametric model was fitted to the data. Parametric survival models, Kaplan-Meier and life table were applied for estimating the survival probability and investigating the effect of different variables. The mean age of the participants was 64 years and 68.3% of the patients were men. Âmong the patients, 48.4% were in the most advanced stage i.e.: stage 4. The survival probability of more than 2 years was calculated 27.7% in the patients, using Kaplan Mayer method. Çox hazard proportional model revealed that variables like the stage of the disease, metastasis and surgery status, and age influenced the survival probability of patients.Çonclusion: Low survival time of the participants of the study may be due to the late diagnosis and lack of medical facilities.

Background and Çhronic neck pain is one of the most common musculoskeletal problems. Generally, around 67% of adults will experience neck pain some time during their life. The aim of this study was to investigate the changes of neck muscles myoelectric activity in patients with chronic neck pain during flexion-extension movement. This case-control study was conducted on 43 participants, that is, twenty two patients (23± 1.8 years) with chronic neck pain history who were matched against twenty one healthy people (23 ± 2.6 years) with no history of neck pain. They had to accomplish 5 trials of a cervical flexion and extension in sitting position. The electromyoghraphic (ËMG) activities of cervical paraspinal and trapezius muscles were bilaterally recorded. To study the difference in muscle strength and range of motion (RÔM) between the two groups, cervical RÔM and maximum voluntary isometric contraction (MVÏÇ) were also recorded. Data were analyzed using independent t-test and correlation coefficients (ÏÇÇ). Results of the study showed that ËMG activity of cervical erector spine muscles was significantly higher in the patients with chronic neck pain in the first static phase and full flexion one (P≤0.05). However, no significant differences were observed in activity of these muscles in flexion and extension phases (P≥0.05). Moreover, there was no significant difference in the ËMG activities of trapezius muscles between the two groups (P≥0.05). The MVÏÇ of cervical paraspinal was significantly higher in the healthy group (P<0.05), whereas the full flexion range of motion was not statistically significant between the two groups (P>0.05).Çonclusion: Based in the results of the present study it is likely that pain has changed myoelectric activity of cervical muscles. Âpparently, the neck extensor muscles should work with more intensity to maintain better control force in the patients with neck pain.

Background and Pulmonary hypertension (PH) has been reported in hemodialysis patients, but there are scant studies about its prevalence and mechanisms. The aim of this study was to determine the prevalence of pulmonary hypertension in hemodialysis patients and to study some of its possible etiologic factors. Ïn this cross-sectional study, the prevalence of pulmonary hypertension was determined by Doppler echocardiogram in 100 patients on hemodialysis via arteriovenous fistula at least for 6 months. Âll the patients underwent a thorough clinical evaluation. The laboratory findings including mean of three-month hemoglobin and serum level of calcium, phosphorus, albumin, alkaline phosphatase, parathormone (PTH), triglyceride and cholesterol were all recorded. Pulmonary hypertension was defined as systolic pulmonary artery pressure higher than 35 mmHg. Pulmonary hypertension was detected in 44 patients (44%) with a mean systolic pulmonary artery pressure of 52.09±7.33 mmHg. No significant differences were found between those with and without pulmonary hypertension with regard to age, gender, duration of hemodialysis and all the biological parameters.Çonclusion: This study demonstrates a high prevalence of pulmonary hypertension among patients receiving chronic hemodialysis via arteriovenous fistula.

Background and Polycystic ovary syndrome (PÇÔS), a common endocrine disorder with lipid disturbances, is associated with increase in the risk of cardiovascular disease and central obesity. The aim of this study was to determine the relationship between the postparandial lipid level with waist-to-hip ratio and insulin in women with PÇÔS in comparison with a control group. This case-control study was conducted at Fatemat Zahra Ïnfertility Çenter in Babol on 20 women with PÇÔS and 20 healthy women as controls who were matched according to age and had a body mass index between 20 to 23 kg/m2. Waist-to-hip ratio, insulin, glucose tolerance test, the levels of fasting and postparandial triglyceride, cholestrol and HDL-cholestrol were all measured and compared between the two groups. Ïn comparison with the control group, women with PÇÔS had higher levels of postparandial triglyceride (203.6±121.5 mg/dl VS 117.7±41.5 mg/dl, P=0.018), postparandial cholestrol (210.1±36.9 mg/dl VS 169.9±29 mg/dl, P=0.001), FBS (91.6±11.7 mg/dl VS 81.8±14.2 mg/dl, P=0.023), insulin (131.7±25.2 ÏÜ/dl VS 75.2±18 ÏÜ/dl, P=0.033) and waist-to-hip ratio (0.87±0.06 VS 0.74±0.14, P=0.001). The levels of fasting triglyceride (158.1±68.9 mg/dl VS 118±35.9 mg/dl, P=0.029) and cholesterol (189.9±32.6 mg/dl VS 154±25 mg/dl, P=0.000) in PÇÔS women were higher than that of the control group. There was no relationship between the level of lipids with insulin level and waist-to-hip ratio.Çonclusion: The levels of insulin, fasting and postparandial triglyceride and cholesterol in women with PÇÔS were higher than the healthy group. Ït seems that waist-to-hip ratio and insulin level had no effect on this relationship.

Background and Rheumatoid arthritis is a chronic inflammatory disease characterized by articular destruction and systemic complications. The aim of this study was to investigate the effect of bromocriptine on clinical and laboratory findings of rheumatoid arthritis. Ïn this randomized double-blind placebo-controlled cross-over clinical trial, 10 patients with rheumatoid arthritis were recruited. Âlthough these patients had consumed modifying anti rheumatoid drugs (DMÂRDs) and prednisolone, they did not show a satisfying response to the drugs. The patients randomly received bromocriptine or placebo for three months and after two weeks as a washout period during which none of the treatments were done, the second course of treatment was started with the alternative drug. Serum level of prolactin, erythrocyte sedimentation rate and clinical criteria of disease activity including the number of swollen and tendered joints, morning stiffness and consumption of analgesics were measured at the beginning and at the end of each course of the treatment. Âmong the patients enrolled in the study, two did not continue because of the side effects of bromocriptine. Ïn comparison with the placebo, bromocriptine was significantly more effective in reducing the severity of disease (P<0.05) and the use of analgesics (P<0.05). However, no clear decrease was observed in prolactin level and other clinical parameters.Çonclusion: This study showed relative improvement in the laboratory and clinical findings of rheumatoid arthritis with bromocriptine. Thus, more studies on this and other prolactin inhibitors in rheumatoid arthritis are recommended.

Background and Leptospirosis is a zoonotic disease caused by spirochetes of the genus Leptospira. Pulmonary involvement is common in these patients but it often has few clinical symptoms. Ïn some cases however, pulmonary leptospirosis can develop a severe respiratory involvement with high mortality. The aim of this study was to investigate the frequency of lung involvement in leptospirotic patients. Ïn a cross-sectional study, the records of leptospirotic patients hospitalized in a third class hospital were investigated from Âpril 2009 to Âpril 2010. Leptospirosis diagnosis was done based on clinical symptoms and positive serology (ÏFÂ>1/180). Â total of 107 patients with confirmed leptospirosis were recruited in the study. Âmong them 64.7 % were males and 82.4% were farmers. The chief complaint in 105 patients was fever and in 2 was jaundice. Âmong the patients, 15.9% had abnormal chest X-ray and the most common radiographic finding was bilateral reticular infiltration. The mean age of patients with pulmonary involvement was significantly higher than that of the patients with normal chest X-ray (P<0.05), while no significant differences were found (P>0.05) between the two groups regarding their gender, occupation and laboratory findings (except ÇPK). The level of ÇPK was significantly higher in the patients with pulmonary involvement than in normal patients (P<0.05). Çonclusion: Patients with leptospirosis can infrequently develop severe pulmonary involvement and respiratory symptoms and this involvement is mostly seen in higher ages.

Background and Hepatitis Ç Virus (HÇV), one major factor causing chronic liver disease, has been classified into six major genotypes based on the variation in the genome sequencing. Various genotypes of this virus are associated with the intensity of liver tissue changes in patients with hepatitis Ç. Therefore, this study aims to investigate the relationship between the HÇV genotypes and liver damages. This cross-sectional study was conducted on 86 HÇV positive patients referring to Razi Üniversity Hospital in Qaemshahr from 2007 to 2010. Real time polymerase chain reaction (RT-PÇR) test was employed in order to determine the genotypes of HÇV. Moreover, histological activity index of the biopsy (Knodell score) was calculated through staining and the amount of ÂLT and ÂST Sera were measured. Âmong the samples taken from the patients under study, 3a genotype was seen in 58.2% and 1a/b genotype existed in 41.8% of them. The mean serum levels of ÂST and ÂLT were 89.5 ± 60.8 and 103.7 ± 79.4 ÏÜ/lit, respectively. The histological activity index in 13.1% was at low level, in 41% at moderate level, and in 45.9% at high level. No significant difference was observed in the mean scores of Knodell in different HÇV genotypes (P<0.05), while there was a positive correlation between ÂST and ÂLT level and the mean score of Knodell (P<0.05).Çonclusion: The findings of this study indicated that there was no significant correlation between HÇV genotype and histological activity index of the patients. However, the serum levels of ÂST and ÂLT increased with the increase in the histological activity index.

Background and There is no specific standard on the compost maturity time of biosolids of wastewater treatment plants in Ïran; therefore, the researchers made an attempt to employ different chemical and biological methods to assess the compost maturity time. Ïn this study, the sludge was obtained from the drying beds of South Ïsfahan Wastewater Treatment Plant and was then mixed with sawdust and windrow type of composting was performed to stabilize the sludge. The height, width and length of windrow were 1.2, 1.5, and 2.5 m, respectively. The windrow turning was done manually for 7-10 days. The results showed that, Ç/N ratio after 100 days of composting reached 15.1 and the NH4/NÔ3 ratio decreased with increase in the time of dewatered sludge compost. The content of volatile solids decreased up to 28.8 percent with composting time and the number of fecal coliforms reached 898 MPN/gram of total solids.Çonclusion: Thus, biosolids compost in this study was mature and ready for use as an agricultural substrate after 100 days of composting.

Background and

Studies have indicated that phytoestrogens in soybean can influence the reproductive system. The aim of this study was to investigate the effect of hydroalcoholic extract of soybean on testicular tissue and pituitary-gonad axis in male rat.

Forty adult male Wistar rats were randomly allocated into five groups including control, sham, and three experimental. Ânimals in the experimental groups received soybean extract for 48 days at doses of 30, 60, and 120 mg/kg by gavage, respectively. The rats in the sham group received only water by gavage for the same period, as well. Ïn the control group received no treatment. Ânimals’ weight was measured before and after the intervention. Âfter that, the animals were anesthetized and the levels of LH, FSH, and testosterone hormones were measured by collecting blood from their hearts. Ïn the end, the left and right testes were removed and weighed. Quantitative and qualitative studies were done on the left testis of each rat.

Âdministration of soybean hydroalcoholic extract at doses of 30, 60, and 120 mg/kg did not have any negative effect on body weight, gonads, testicular function, and histometric parameters. Âdministration of extract with the highest dose used in this study (120 mg/kg) significantly decreased the plasma LH level, germinal epithelium length, and repopulation index (P<0.05). Furthermore, histopathologic studies did not show any damage on testicular tissue.Çonclusion: The results indicated that soybean in routine doses that used in this study did not exert considerable negative effects on testicular tissue and hormone secretion in the rats.

Background and Ïnfants’ exposure to cigarette smoke is one of the most crucial public health concerns. Smoking ban in enclosed spaces are a simple way to reduce exposure to cigarette smoke and its harmful effects. This study was conducted to determine the prevalence of cigarette smoking, car smoking ban and the related factors in families with infants living in Tehran. This cross-sectional study was conducted on 1112 families with infants referring to health centers in Tehran in 2010. These families were selected based on multi-level sampling. Â questionnaire containing demographic and social factors, cigarette smoking, and car smoking ban was completed through interviewing the parents. Ït was found that 0.4% of the mothers, 19.5% of the fathers and 9.7% of other family members were smokers and in 1.7% of the families both parents were smokers. Âmong the participants, 77% completely obeyed the smoking ban in the car. The prevalence of complete smoking ban in the car in smoker families was 42.3%, while it was 84.5% in nonsmoker families. Ânalysis of multiple logistic regression showed that odd ratio for the car smoking ban increased (ÔR= 3.3, ÇÏ95%: 1.2-8.7) and the number of cigarettes decreased (ÔR= 3.3, ÇÏ95%: 1.2-8.7) in educated fathers in comparison with less educated ones.Çonclusion: This study suggests that complete smoking ban in the car in most of the smoker families is not obeyed. Regarding the factors related to car smoking ban, health interventions are essential for decreasing infant’s exposure to cigarette smoke.

Background and

Nursing is a profession that establishes various cultural and social communications in the context of work environment. The purpose of this study was to determine the description and perception of the nurses working in educational hospitals about the professional communication experiences.

This study is a qualitative research using phenomenology method. Thirteen semi-structured interviews were carried out with 11 female and 2 male nurses. They described their experiences related to professional communication. The interviews were recorded and transcribed and the data were then analyzed using the Çolizzii analysis method.

Seven themes emerged from the data showing the nurses perception and description of the communication with patients, colleagues, nursing supervisors and physicians. The following themes showed the experienced patterns of communication by the nurses: being special, altruism, psychosocial support, updated knowledge and skills for interactions management, reaction to actions related to different factors, complement of patient-physician communication deficiency, and professional identity and socialization basis of communication.Çonclusion: The findings revealed a clear image of participants’ experiences of communication in their profession. Recognition of nurses, description and perception of communication can present valuable data for professional planning and decreasing or eliminating the communication problems. Âlso improving the professional communication can guarantee the quality of professional services to the patients.

Background and Transition from high school to university is a stressful phenomenon for most students, so it is imperative that they gain a variety of skills to adapt with the new situation. This study aimed at investigating the effectiveness of teaching life skills including: stress management, self-consciousness, and effective communication on the general health of freshmen. This study employed quasi-experimental method and had a control group as a standard of comparison. Âmong the undergraduate freshmen of Ïslamic Âzad Üniversity, Ürmia Branch, 100 students were selected through a multi-stage sampling method and were randomly divided into four equal groups (three experimental groups and one control group). Then, three types of instructions, namely, stress management, self-consciousness and effective communication were offered to them in six sessions (each 1.5 hours). Finally, the difference between the pre-test and post-test scores of general health questionnaire was compared. Ôverall, the difference between pre- and post-test scores related to general health components was significantly meaningful in favor of experimental groups (P<0.05). Ït was found that two elements i.e. anxiety and insomnia in stress management and self-consciousness groups, and the element of body indications in effective communication group improved more than the other elements. Âltogether, the means of dyadic analyses showed that teaching effective communication skills influenced all components of general health and the total scores achieved in effective communication skills resulted in better improvements in comparison with other two instructions.Çonclusion: Ôur findings showed that teaching the life skills to students resulted in improved general health. Thus, it is suggested that these types of skill instructions, particularly communicative skills be included as a part of the university mental health programs.

Background and Ëxternal fixation is currently considered as a standard treatment for open tibial fractures; however, due to the long-term hospitalization and some other complications, some researchers have proposed intramedullary nailing as the alternative surgical treatment. This study was conducted to compare the treatment of open tibial shaft fractures by external fixation and intramedullary nailing. This randomized controlled clinical trial was conducted on 113 patients with open tibial fractures type Ï and ÏÏ (Gustilo classification) during a two year period. These patients were divided in two groups and 59 cases were operated using external fixation and 54 fractures were fixed with intramedullary nailing. The patients were compared for complications such as union time, delay in the union, nonunion and infection. Ône hundred and thirteen patients (95 males and 18 females) with the age range of 18-50 years (average age: 34.3) were enrolled in this study. Âmong the 59 patients treated with external fixator, 8 had delayed union. Three of these eight patients suffered from the nonunion and did not have any progress in callus formation till 6 months after the treatment. Ôn the other hand, among the patients (54 cases) treated with intramedullary nailing, 2 cases suffered from the delayed union and one had nonunion. The difference between the two methods of treatment in delayed union and nonunion situation was not statistically significant (P>0.05).Çonclusion: Due to the reduced hospital stay in intramedullary method and the necessity of doing repeated surgery and applying intramedullary nailing when the patients are not treated with external fixation, the researchers recommend intramedullary nailing as the first option in treating such patients.

Background and Çognitive reserve is a hypothetical construct which is widely used to explain how individuals vary considerably in the severity of cognitive aging and clinical dementia, despite the similar nature and extent of neurodegenerative changes. This study was conducted to investigate the current and premorbid ÏQ in the elderly with dementia in comparison with those without it. Ïn a cross-sectional study, using convenience sampling in nursing homes and the psychiatric clinic of Hafez Hospital in Shiraz, 70 participants were recruited and divided into two groups (35 patients and 35 healthy people) with the age range of 65-90 years. To gather data, the researchers used PÂRT (Persian Âdult Reading Test), four subtests of WÂÏS-R (vocabulary, arithmetic, block design, and picture completion), and Mini-Mental State Ëxamination. The results of an independent t-test showed that current and premorbid ÏQ (verbal and performance) in the elderly with dementia were significantly lower in comparison with those without dementia. Âlso results obtained from paired t-test indicated that dementic participants had lower current ÏQ in contrast to their premorbid ÏQ scores.Çonclusion: Ït seems that premorbid ÏQ is a considerable factor for cognitive reserve and it is a basic criterion for evaluating the severity of cognitive decline. Âs a result, it helps predict the risk of developing dementia, to some extent.

Background and The purpose of the study was to asses the natural and clinical course of isolated ventricular defect in children. Patients and From 1997 to 2011 we prospectively studied a total of 218 infants and children diagnosed as isolated ventricular septal defects. The Çhi-squar or Fisher exact Test and ÂNÔVÂ were used to compare the differences where appropriate. Â valve less than 0.05 was considered statistically significant. The patients who had an additional hemodynamic significant heart defect were excluded. Â total of 218 patients, 125 females VS 93 males (57% VS 43%) were followed up for the mean time of 55.7 months (Range 12-170 mo)The distribution of perimembranous, muscular, subarterial and inlet type VSD were 65.1%, 32.1%, 1.4% and 1.4% respectively.Regardless of type of VSD, spontaneous closure was observed in 86 (39.5%) cases. Forty four (31%) perimembranous VSD and forty two (57.2%) muscular defect closed spontaneously. Ïnlet or subarterial defects were not closed spontaneously. Regardless of type VSDS, 71 (52.6%) of small and 15 (25%) of moderate size defect closed spontaneously.Fifty (24.3%) cases needed surgical Treatment. Âortic regurgitation developed in 11 (5%) patient.Ïnfective endocarditis was observed in 3 (1.7%) in patients. Ôther complications were pulmonary hypertension in 39 (17.9%), congestive heart failure in 12 (5.5%), sub pulmonic stenosis in 16 (7.3%) mitral regurgitation in 6 (2.8%) and sub aortic ridge in 7 (3.2%) patients.Çonclusion: Ït is concluded that patients with VSD should be followed closely through life because the complications such as pulmonary hypertension, Ëisenmenger syndrome, infective endocarditic sub pulmonic stenosis, aortic ridge and aortic regurgitation may develop, although spontaneous closure of the defect is to be expected in many cases (39.51%), a significant percentage of defects may need surgical treatment (24.3%).

Kawasaki disease (KD) is an acute febrile vasculitis mainly affecting children, with two types of presentation, namely, typical and atypical. Ït is the most critical cause of coronary artery complications and if not treated on time and appropriately, complications may occur in up to 25% of the patients will get. The occurrence of coronary artery complications increase in atypical presentation of the disease. However, punctual and appropriate treatment will decrease the complications up to 2-4 percent. This study reports four rare cases of incomplete KD. The first one is an 18 month baby girl with prolonged fever and atypical signs and symptoms of KD such as swelling of lateral mid thorax (5 × 10 cm). The second one was a 12-month baby boy presented with a 7-day history of fever without any other symptoms who showed coronary artery involvement in echocardiography. Finally, two cases, one was 4-and the other was 12-years old, who were hospitalized with appendicitis and later were diagnosed as affected by Kawasaki with coronary artery involvement. Âtypical presentation of the disease led to misdiagnosis and prolonged process of diagnosis. Due to the increasing number of atypical Kawasaki cases and the probability of coronary artery disorder, it is recommended that atypical Kawasaki be considered in the differential diagnosis of the disease in the patients with fever of over five days without any clinical cause.

Patient safety is the key element of quality in healthcare. Ïmproving patient safety involves identifying the incidents, analyzing the trend of events and developing corrective solutions for promoting the system. Health care organizations can not judge the safety of the care without data and information related to patient safety. Therefore, patient safety information system (PSÏS(is used in identifying and recording patient safety incidents, determining and analyzing their causes, hypothesizing corrective solutions, and finally, implicating and monitoring the improvements. Âccording to the importance of this system, this study was conducted to explain the different components of the PSÏS. Ïn this review study, we reviewed the materials searched via Web of Science, Pubmed (Medline), Ôvid, Science Direct and Google Scholar. There were varieties of data collection methods, the incidents, and participants involved in data collection in patient safety information system. Moreover, some specific methods such as patient safety indicators were defined for data analysis. These analyses should be done by the experts in the field and the output of the PSÏS including statistical reports, alerts, recommendations and corrective actions should be provided for internal or external users such as healthcare executives and healthcare providers so that they can use them for improving the processes and learning from the incidents. Therefore, developing such a system in Ïran requires a framework for patient safety information system.