علی دواتی

Understanding patients' rights can lead to their observance and an increase in patient satisfaction with the received healthcare services. The aim of this study was assessing the level of awareness of clinical medical students at medical universities in Tehran regarding patients' rights.

This was a cross-sectional descriptive-analytical study conducted at medical faculties in Tehran. A total of 442 medical students were randomly selected. The "Patients' Rights Charter" questionnaire, provided by the Ministry of Health of Iran, was used for data collection. Data analysis was performed using SPSS software, version 19, and independent t-test, Pearson, and ANOVA tests were employed. Significance level was P < 0.05.

14.9% of the medical students had a poor level of awareness, 70.4% had a moderate level, and 14.7% had a good level of awareness. The lowest level of awareness was observed in respecting patient privacy and maintaining patient confidentiality, while the highest level of awareness was in the right to choose and make decisions freely. There was a significant relationship between the students' gender and age and their level of awareness. However, no significant relationship was found between academic level, university of study, prior knowledge of patients' rights, and the level of awareness.

The majority of medical students in this study had a moderate level of awareness. It is recommended to enhance awareness through more precise teaching of medical ethics courses and by conducting educational workshops for students, as well as organizing seminars and courses for medical practitioners, to improve their level of awareness.

: Respiratory distress is a syndrome that is caused by pulmonary, cardiac, infectious, blood, skeletal and metabolic diseases and may directly and indirectly involve the lungs. Due to the high prevalence of respiratory distress in neonates hospitalized in the neonatal intensive care unit and high mortality due to respiratory problems of neonates, with timely differentiation of cardiac from non-cardiac causes and supportive treatments, the mortality of this group can be reduced to some extent and the related prognosis can be improved. The present study was conducted with the aim of investigating the results of echocardiography in the evaluation of neonates with respiratory distress admitted to the neonatal intensive care unit. The present study was a retrospective study based on the medical information of 396 neonates with respiratory distress who were hospitalized in the intensive care unit and diagnosed with heart disease by echocardiography. The required information was extracted from the neonate files. And with the help of SPSS 20 software and univariate and multivariate binomial regression model, they were judged statistically. The most common cause of respiratory distress was RDS 42.2% and TTN 37.9% and the most common cardiac findings were 11.4% TR and 5.6% VSD. In all types of respiratory distress, the frequency of abnormal echocardiography increased. In order to diagnose cardiac and non-cardiac respiratory distress, echocardiography is essential, especially in neonates with chest retraction.

Maternal beliefs are influential in choosing the type of delivery. the study of determining factors in choosing the method of delivery using the health belief model can be helpful in predicting the type of delivery selected by mothers. the aim of this study was to investigate the factors affecting the choice of delivery method by nulliparous pregnant women.

A total of 73 nulliparous pregnant women referred to shaheed mostafa khomeini hospital in Tehran in 1400 entered a cross-sectional descriptive-analytical study. Data collection tool, two-part questionnaire including demographic characteristics and questions related to the health belief model including 7 self-efficacy factors, misconception of the benefits of cesarean delivery, exaggeration in the risks of vaginal delivery, perceived sensitivity, general beliefs, willingness to accept was the mindset of health professionals (physician, midwife). Data analysis was performed with SPSS software version 16.

Comparison of mothers with cesarean section and mothers with vaginal delivery were significantly different in mean scores of self-efficacy (p<0.005), misdiagnosis (p<0.001) and exaggeration of natural childbirth risks (p<0.001). Comparing the mean scores of perceived sensitivity, general beliefs, willingness to accept and the mindset of health professionals for mothers with the choice of cesarean section and natural delivery was not statistically significant.

The findings showed that perceived self-efficacy, misconceptions and exaggerations in the risks of vaginal delivery predict the type of childbirth selected. Education based on these factors can be useful in choosing the method of delivery.

Androgenetic alopecia is a type of androgen and genetic dependent hair loss and although it is more of a beauty issue, but in recent years studies have shown that this type of alopecia is associated with underlying disorders such as coronary artery disease. The aim of this study was to evaluate the frequency of androgenetic alopecia in hospitalized patients and its relationship with the history of coronary heart disease and its risk factors.

In this cross-sectional descriptive-analytic study, 250 patients (125 women and 125 men) admitted to Shahid Mostafa Khomeini Hospital in Tehran from October to December 2020 were examined and after examination and data collection, the data were analyzed using SPSS statistical software SPSS Statistics 25 version.

The prevalence of alopecia was generally 46.8% in hospitalized patients, 61.6% in men and 32% in women. The prevalence of coronary heart disease in hospitalized patients was 25.6%, 34.4% in men and 16.8% in women. In patients with alopecia, the frequency of history of coronary heart disease was 39.31%, the history of hypertension was 20.8%, history of hyperlipidemia was 17.2%, history of diabetes was 14.4% and the smoking history was 15.6%. All of these factors were significantly associated with alopecia, except for smoking.

According to the results of this study, the frequency of androgenetic alopecia in patients admitted to the hospital is common and its prevalence in men is more than twice that of women. History of coronary heart disease and its risk factors in patients with alopecia are high, and have a significant relationship with it. This can be important and help in screening and early diagnosis of coronary heart disease and its subsequent prevention.

The association between screening markers in the first trimester of pregnancy and an increased risk of pregnancy complications has been reported. The aim of this study was to determine the relationship between serum levels of PAPP-A and free βhCG in the first trimester with pregnancy complications.

During a prospective study on 200 pregnant women referred to Shahid Mostafa Khomeini Hospital in Tehran from July 2020 to March 2021, due to anoploid screening in the first trimester at 11-14 weeks, serum levels of PAPP-A and free β-hCG were measured. After providing the information, written consent was obtained and demographic and pregnancy information and test results were recorded. All subjects were followed up until delivery. Weight at birth and in case of abortion, preterm delivery, gestational diabetes, preeclampsia, information was recorded. The relationship between PAPP-A and βhCG in the first trimester with pregnancy complications was statistically analyzed using Fisher's exact test.

18.5% (n=37) had gestational diabetes, 9.5% (n=19) had preeclampsia, 5% (n=10) had preterm labor, and 1.5% (n=3) had abortion. There was no statistically significant relationship between PAPP-A with gestational diabetes (P=0.782), preeclampsia (P=0.059), preterm delivery (P=0.350) and low birth weight (P=1.000). Between serum β-hCG level and gestational diabetes (P=0.271), preeclampsia (P=0.365) and preterm delivery (P=1.000) and low birth weight (P=0.241), statistically significant relationship does not exist.

There is no significant relationship between serum   PAPP-A and βhCG levels with preeclampsia, gestational diabetes, preterm delivery and low birth weight.

Evidence suggests that there is a relationship between maternal stress during pregnancy and pregnancy complications. Coping styles are a set of cognitive and behavioral efforts are used to correct a stressful situation and cope with problems and play an essential role in physical and mental health. Effective coping strategies reduce high levels of stress. One of the most important concepts on how to deal with problems and tensions is spiritual health. This study was designed to examine coping styles during pregnancy based on spiritual health.

During a cross-sectional study, 151 pregnant women who were referred to Shaheed Mostafa Khomeini hospital in Tehran in 2020 were selected. Data were collected using Dr. Azizi Spiritual Health Questionnaire, Billings & Moss Coping Questionnaire (1984), perceived stress scale (PSS-14) questionnaire and Demographic Information Questionnaire and entered into SPSS 22 software. Pearson correlation coefficient, t-test, and linear regression analysis were used to analyze the data.

The mean age and gestational age of pregnant women were 30.85±4.26 and 28.81±8.58, respectively. There was a linear inverse relationship between spiritual health and perceived stress (P=0.03) and a positive relationship between spiritual health and problem-oriented coping style (P=0.004).

In pregnancy, spiritual health is positively related to problem-oriented coping style and inversely related to perceived stress.

Patients' complaints against doctors and medical malpractice is one of the most serious and challenging issues in the medical profession. Due to the importance of this issue and the lack of sufficient information about skin and beauty complaints in the medical system. The purpose of this study is to investigate and identify skin and beauty complaints referred to the Tehran Medical System Organization.

In this descriptive-analytical and retrospective study, all cases of complaints of medical malpractice in the field of dermatology in the medical system of Tehran province from 2014 to 2019 were reviewed and after collecting information, the data were analyzed using SPSS statistical software (SPSS Statistics 25).

Of the total cases, 1.6% were related to skin and beauty. Most of the plaintiffs were female (79.8%) and single (59.6%). The attending physicians were mostly male (79.8%) and general practitioner (48.1%). The most common type was private medical center (95.2%). The most common complaints were treatment complications (36.7%), most of which were related to the side effects of Botox or fat injections (15.4%) and then laser complications (12.5%). The most common type of negligence was carelessness (30%) and 20.7% of cases were declared negligent. The highest percentage of verdicts was written reprimand and inclusion in the file (42.3%).

Physicians should avoid engaging in unrelated disciplines and unscientific practices. Reducing financial relationships and emphasizing the physician's proper interaction with the patient and adhering to a professional commitment are helpful in preventing complaints.

Background and Purpose:

Ulcerative colitis is an inflammatory bowel disease (IBD) and one of the problems of the world's medical system. Huge financial and spiritual costs, disease complications, long-term use of drugs, and inadequacy of conventional therapies in complete control of symptoms, reveal the need to focus on and use complementary therapies. The purpose of this study was to prioritize and introduce the medicinal plants mentioned in Persian Medicine (PM) resources to find new ideas for producing a suitable and effective drug in the treatment of ulcerative colitis.
 

In this narrative library study, the search for effective medicinal plants on ulcerative colitis, with the keywords "Sahj-e-am’a, Ghorouh-e-am’a, Ghorouh-e-me’a, and Ghorheh-am’a" in five authoritative pharmaceutical books of PM, including: “Al-Qanun fi al-Tibb, Al-Abnyia 'an Haqa'iq al-Adwiya, Al-Aghrāḍ al-Ṭibbīyah wa al-Mabāhith al-Alāīyah, Tuhfat ul-Momineen, Makhzan al-Adwiya”; was performed. After scoring and prioritizing based on the frequency of use and the degree of effectiveness from the perspective of physicians, related studies in scientific databases investigating the effect of the highest rated items on inflammatory and ulcerative diseases of the gastrointestinal tract, their mechanism of action and their active components were reviewed.
 

59 plants were found and the highest scores were related to “Oryza sativa L., Rumex acetosa, Plantago major L., Vicia faba, and Tragopogon graminifolius DC.”. The effects of these herbs on inflammatory and ulcerative diseases of the gastrointestinal tract have been confirmed in modern animal and clinical studies.
 

Considering similar symptoms of the two diseases “Sahj-e-am’a and ulcerative colitis”, it may be possible to propose them as equivalent terms. Concerning the anti-inflammatory and wound healing effects of most of the medicinal plants mentioned in this study, it seems that they can be used in designing clinical studies and formulating new drugs to propose therapies that improve symptoms of ulcerative colitis and inflammatory diseases of the gastrointestinal tract based on PM approach.

The population of the elderly has been on a rise, which shows more attention to ensuring the health and well-being of the elderly. On the other hand, the growth of the elderly population and its impact on the social and economic conditions of society leads to more attention to the issue of aging in society. In addition, physical and psychological abilities decrease with aging, which affects the quality of life of people. Overall, quality of life and well-being assessed by indicators such as health, happiness, and loneliness. Happiness is one of the most important needs of human beings, which considerably affects their psychological and physical health that helping the elderly cope with stressful situations. Another factor affecting well-being is self-transcendence, which is a powerful coping mechanism and can lead to personal transformation and improvement of the quality of life, thereby facilitating the process of understanding life changes such as aging. Therefore, self-transcendence is defined as a positive trait in relation to the expansion of one’s outlook on life. This issue includes factors such as spirituality, finding a purpose in life, optimism for the future, coping with problems, using power-based approaches, and connecting with others. In the elderly, by restoring the concept of aging and accepting disability, it reduces stress and focuses more on ability than disability. Therefore, happiness and self-transcendence are important factors in the elderly’s health dimensions. The present study aimed to determine the relationship between happiness and self-transcendence in the elderly of Khoshkrud, Zarandieh City.

This descriptive-correlational research performed on the elderly selected from those who referred to the health center to receive elderly-related care using sequential sampling. Data collection continued for three months (October-December, 2019), and 84 elderlies who were willing to participate in the research were selected. The inclusion criteria were the age of more than 60 years, the ability to respond to questions physically and mentally, having psychological health  which assessed  by Abbreviated Mental Test (obtaining a score above 7) and not losing a family member or experiencing a stressful situation in the past two months. Abbreviated Mental Test used to diagnose cognitive impairment, including dementia and delirium in the elderly, applied to assess concentration, attention, short-term and long-term memory. Notably, the Cronbach’s alpha of the tool was 0.76 in Iranian society. The Oxford Happiness Index has 29 questions that scored in a range of zero to 87 and includes five components of life satisfaction, self-honor, subjective well-being, satisfaction, and positive mood. Internal consistency was used to determine the reliability of the instrument. The Cronbach's alpha coefficient for the components of life satisfaction, self-honor, subjective well-being, satisfaction, and positive mood estimated at 0.85, 0.71, 0.74, 0.79, and 0.77, respectively. On the other hand, the self-transcendence questionnaire included 15 items scored in a range of 15-60, where a higher score was indicative of higher self-transcendence. Internal consistency was used to determine the reliability of the instrument and its Cronbach's alpha coefficient estimated to be 0.69. Researcher with questions from the elderly completed all tools and it took an average of 45 minutes for each elderly person to complete the tools. In addition, data analysis was performed in SPSS version 16 using descriptive statistics (to describe demographic variables and variables of happiness and self-transcendence) and parametric inferential statistics (Pearson’s correlation coefficient, independent t-test, and analysis of variance).

In this study, the mean age of the elderly was 65.7±4.8 (60, 79). Moreover, 55 subjects were female (65.5%), 81% were married, 59.5% were illiterate and 64.3% were homemakers. In addition, the mean number of children of the participants was 6.2±1.6 (0, 14). Furthermore, 66.7% had an underlying illness, 56% had a moderate economic status, 61.9% had a family support system and 79.8% lived with their spouse. According to the results, the mean of happiness and self-transcendence in the elderly were 54.42±14.3 and 39.4±5.9, respectively. There was a significant and direct relationship between self-transcendence and happiness (r=0.263, P=0.016), components of life satisfaction (r=0.348, P=0.001) and satisfaction (r=0.325, P=0.003). In addition, a significant difference was observed between the level of education (P=0.038 and P=0.009, respectively) with happiness and self-transcendence and between occupational status and happiness (P=0.039). Moreover, a significant difference was found between the number of children (P=0.037) and residential status (P=0.028) with self-transcendence.

According to the results of the study, happiness and its components were more than the average level in the elderlies. In addition, the results were indicative that level of education, job, and economic status had significant differences with happiness. A proper education, job and economic status creates safety in the individual, which improves happiness. Self-transcendence was moderate and economic status, level of education, residential status and number of children had significant differences with elderly’s self-transcendence. Good economic situation causes security in the person and the person can try to help himself without worry and play a role in promoting self-transcendence. On the other hand, the level of education promotes awareness and the ability to obtain information from various sources, which can empower the elderly in self-care and increase their adaptation to old age, and ultimately lead to the promotion of self-transcendence. The presence of children, their support, and care for parents cause security for the elderly, who in return try to adapt to the current situation in order to calm their children and accept their situation and ultimately improve their self-transcendence. In general, self-transcendence promoted by having a good friend and a person to talk to, and in the traditional society of Khoshkroud, communication with children, relatives, and neighbors can promote self-transcendence. Although in the present study, the economic situation was moderate and most of the elderly were illiterate, the level of happiness and self-transcendence of the participants was above average, which can be attributed to the existence of social relations at the family and traditional society and respect for the elderly. These factors played a key role in individual satisfaction and support of the elderly and covered the educational and economic states. Moreover, there was a direct and significant relationship between happiness and self-transcendence. Happy people feel more in control, think more about their abilities rather than inabilities, better cope with life stressors, have higher self-esteem, value themselves, and love themselves. Overall, happiness can affect the scope of life and the way people relate and interact with the environment. As such, happiness promotes other life aspects, including self-transcendence. In Khoshkroud, where the elderly and families adhere to their religious and traditional beliefs and the family has a special position, the elderly enjoy health in all dimensions, and they can accept the conditions of old age and use effective adaptation mechanisms to improve well-being. It recommend that the families and authorities by meeting the economic, social and spiritual needs of the elderly to increase their ability to understand and accept themselves, create a sense of satisfaction and happiness, which increases their health. By creating a happy and lively environment, their performance will be improve, which has positive consequences for the elderly, family, and society. Furthermore, conditions should be provided for them to benefit from each other's experiences and to be present in public to improve their health.

Pregnancy is one of the most important and vulnerable periods in women's Life. One of the common side effects of pregnancy is anxiety. Despite its relative high prevalence in childbearing-aged women, little specific attention has been directed to anxiety disorders in pregnancy. Various studies have shown the effect of spiritual health and spirituality on mental health. It is important to identify the factors affecting anxiety such as spiritual health. Typically, at least one evaluation is recommended for depression and anxiety and attention to mental health during pregnancy. The purpose of this study was to investigate the relationship between spiritual health and anxiety in pregnant women. A cross-sectional study was conducted on 170 pregnant women referred to Shaheed Mostafa Khomeini hospital in 2018. After obtaining consent, demographic characteristics were recorded.  By using the questionnaire anxiety, depression and stress DASS-42 and Dr. Azizi spiritual health questionnaire, anxiety and spiritual health information were recorded. Chi-square and student t tests were used to compare the data The frequency of anxiety in the pregnant woman was 69.4%. The relationship between spiritual health and anxiety was not statistically significant (p= 0.483). The frequency of anxiety was not significantly different based on maternal age, gestational age, gravidity, pariety, abortion history, education, maternal satisfaction, type of pregnancy, gestational age and gender. Regarding the high prevalence of anxiety in pregnant women, more attention to screening and risk factors in order to identify pregnant women at risk for anxiety is essential.

Physician- patient communication is essential for good medical practice and leads to patient satisfaction and subsequent following of prescribed therapeutics and health promotion. There is limited study on this subject in Iran. The purpose of this study was to evaluate patients' satisfaction of the physician-patient communication and factors influencing it to provide useful information for decision-makers within the health services. This research was an applied field cross-sectional study among hospitals in Tehran. Satisfaction was assessed by 22 questions after obtaining consent from the patients. The level of patient's satisfaction with physician's communication among 1200 patients in order of priority was: medium 63.4%, high 15.1%, low 14.4%, very high 4.7%, and very low 2.5%. Mean patients’ satisfaction was 76.35±13.99, maximum and minimum satisfaction was 110 and 30, respectively. There was a significant relationship between patient satisfaction and patients’ gender, age, marital status, occupation, physicians’ age, sex and timely presence of the physician in the clinic and good deal of communication between patient and physician’s receptionist. Overall patient satisfaction with the patient -physician communication is medium that is not desirable. Factors such as gender, age, material status, and occupation of patients and age and sex of physician, timely presence of the physician in the clinic and a good deal of communication between patient and physician receptionist had a positive correlation with patient's satisfaction. According to important role of communications’ skills in patients’ satisfaction, it is necessary to put more emphasis on training and assessment of communication skills of physicians and health care personnel.

Psychiatric disorders such as depression during pregnancy are associated with poor delivery and infant outcome. Typically, at least one evaluation is recommended for depression and anxiety and attention to mental health during pregnancy. The definition of health in the World Health Organization currently includes three areas: physical, mental and society. Various studies have shown the effect of spiritual health and spirituality on mental health. Moreover, so far, no significant studies have been done on spiritual health and depression in pregnancy. Therefore, this study was conducted to determine the relationship between spiritual health and depression in pregnant women.   This cross-sectional study was done on 189 pregnant women who referred to Mostafa Khomeini hospital in Tehran in 2018. The data were collected by Dr. Azizi's Spiritual Health Questionnaire, Edinburgh Depression Inventory and Demographic Questionnaire. Data were analyzed by descriptive and analytical tests in SPSS software.   The frequency of depression with an average score of 7.69 was 73.3%. The average score of spiritual health was 21.49% and 85.9% of cases had a high spiritual health level. There was no statistically significant relationship between spiritual health and depression (p = 0.215).   High prevalence of depression during pregnancy indicates more attention for screening and identification of risk factors for depression in pregnancy.

Headache has a high prevalence. Iranian Traditional medicine is a valuable treasure of the knowledge and experience of our country's scientists and it contains valuable solutions in the field of lifestyle modification for the treatment of diseases called science of Tadabir. The aim of the study was to identify gastric headache managements, what one of the of headache types mentioned in the books of
hokama. This study has been conducted as library method. Recommended strategies of the Iranian traditional Medicine and the scientific evidences of Conventional medicine in the field of headache management were collected and topics were classified in the six necessary principles (setteye zarurieh) are described and presented. Some of the Gastric corporate headache measures, in Iranian Traditional medicine approved by conventional medicine practice. Iranian Traditional medicine has valuable doctrines and strategies for healthy lifestyle and nutrition, in the case of all diseases, especially gastric corporate headache. Use of these measures can be useful in preventing, treating or reducing the number of headache attacks, reducing the duration of headaches, reducing the severity of headaches, and improving the quality of life of patients with headache and paying attention to these strategies will reduce direct and indirect costs of primary headaches.

A 62-year-old man referred to the emergency department 48 hours ago with chief complaint of repeated bloody vomiting. The patient is admitted and the necessary measures are taken. Within 24 hours, he received 6 units of blood. The patient has undergone endoscopy, but endoscopic endorsement has failed to stop the bleeding. The surgeon consulted and visited the patient. He considered urgent emergency laparotomy. The patient is alert and refuses surgery. The hemodynamic status of the patient is not stable and gastrointestinal bleeding continues. These questions are posed to medical staff and hospital managers: "What is our duty”? "Should we respect the choice of the patient and witness the progress of the disease and deterioration of the patient's condition"? "Can he be discharged from the hospital on the basis of the patient's refusal to take medical treatment"? "Can we take appropriate diagnostic and therapeutic measures with the use of legal capacity and support despite patient’s opposition? "How can one regard autonomy, beneficence, and nonmaleficence at the same time, in this situation "? In this study, which is one of the problems of medical ethics, the ethical, legal, and health aspects of the presented patient are discussed.

this study aimed to determine and compare the viewpoints of nurses in the field of patient safety culture in the hospital Mostafa Khomeini in Tehran.
This cross-sectional descriptive study in 1394 by using the questionnaire "Hospital Survey on Patient Safety Culture" was performed. The study population consisted of all nurses working in university hospitals control. Data analysis was conducted in two levels of descriptive and inferential statistics.
94 of 120 nurses participated in the study. Dimension scores patient safety culture was related to the department of nurses (61/2), patient safety (39/2), safety Hospital (26/2), communications (21/2), the frequency of reporting of adverse events (14 / 2), and the lowest supervisor department (85/1), respectively. Overall, the mean scores of all dimensions at a low level (less than 5.2 average) have been reported. The strongest correlation was found between the department of nurses and supervisors (p=0.000, r=0.44).
Senior management support of patient safety, teamwork approach, measure the effectiveness of changes of patient safety, and personnel dealing respectfully with each were of the strengths of the hospital in the field of patient safety culture. Also according to the results Blame culture, lack of personnel, long working hours, lack of encouraging a culture of patient safety, lack of attention to personnel suggestions, the absence of a culture of prevention, inadequate coordination among hospital departments and units were weaknesses that affecting to reduce patient safety culture dimensions. Such studies can clear the way for improved patient safety culture and seeks to improve the quality of health services.

Infertility threatens the mental health of infertile couples. Society should have sufficient knowledge of the implanted embryo resulted of in vitro fertilization in the surrogacy as a therapy method. This study was performed with aim to determine the knowledge and attitude of patients in Mostafa Khomeini hospital on the use of surrogacy as a treatment method.
This cross-sectional and analytic study was performed on 216 patients referred to Mostafa Khomeini Hospital in 2016. Data collection tool was a researcher-made questionnaire consisting of two parts: the first part was demographic questions and the second part included the questions about knowledge and attitude. Data were analyzed by SPSS software (version 16) and statistical tests of correlation test, independent t-test, Mann-Whitney, Kruskal wallis and ANOVA. P 185 subjects (85.6%) stated that they have information about surrogacy. While according to the results, only 31 subjects (14.8%) had good and very good knowledge of surrogacy. 99 subjects (43.5%) had no religious perception about this method. 90 (41.7%) had negative attitude to the priority of surrogacy from family and friends. 144 (66.7%) agreed about insurance protection. Independent t-test showed that the mean attitude of men and women was not different. ANOVA showed a significant difference between the attitudes of subjects in different educational groups (P=0.04).
Most people had negative attitude toward emotional, legal, and religious issues of surrogacy, but they had positive attitude to solve problems and financial costs and insurance support.

Thyroid papillary carcinoma (PTC) is the most common thyroid cancer. BAX gene is the first known pro-apoptotic member of the Bcl-2 protein family. The aim of this study was to investigate the relationship between BAX expression and some prognostic factors in PTC and papillary microcarcinoma (PMC).
In this cross-sectional, descriptive – analytical study, we obtained data from the records of 105 patients who had undergone thyroidectomy with a final diagnosis PMC and PTC, in Mostafa-Khomeini Hospital, from 2012 to 2014. The data included age, gender, tumor size and lymph node involvement. We investigated BAX expression by immunohistochemistry staining and capsular invasion by hematoxylin – eosin staining. Considering the percentage of positive tumor cells, BAX grading was done. Data were analyzed by Fischer's ¡Chi-Square and T tests.
In this study, 87.5% of patients were female. 81.9 % of patients had no lymph node involvement. There was only a significant association between the type of tumor and lymph node involvement (P= 0.02). We found no significant difference between papillary and micropapillary carcinoma in regard to BAX expression. Different grades of BAX expression had significant relationship with tumor size, lymph node involvement, and capsular invasion (P BAX expression is associated with lymph node involvement, capsular invasion and mean tumor size; and can be used to estimate the prognosis of PMC and PTC.

Empathy plays an important role in the interaction between physician and patient. This study aimed to assess the empathic attitudes of medical students that studing in Medical Sciences schools of Tehran city, in 2015.
In this cross-sectional study, 373 medical students were selected using stratified random sampling. Data was collected using the Jefferson Scale of Empathy-the Student Version. Data was analyzed using descriptive and inferential statistics via the SPSS v.16 software. The significant level was set as pEthical Considerations: Participants verbal consent was obtained and anonymously and confidentiality of the completing questionnaires was assured to them.
Findings: According to the empathy scale (20-140), the medical students had a mean empathy score of 82.94 (SD=±7.08), with the highest level for perspective-taking dimension (26.81±2.80). Empathy scores among students varied depending on gender, age, and marital status (p Empathy with patients was different among medical students in various years of education. Such, the rate of empathy with patient was reduced with increasing the students’ age and educational level. Regarding to significance of empathy as a moral virtue, it is recommended planning to strengthent empathy with patients and inclusion of it in medical students’ curriculum, in order to improve the mental and spiritual health of patients.

Candida albicans (C. albicans) composes 25-75% of oral microflora in healthy individuals. Oral candidiasis is an opportunistic infection, which is caused by the presence of predisposing factors in host. In recent years, increase in the resistance of C. albicans to standard antifungal drugs resulted in special attention to herbal plants as alternative natural compounds. The anti-fungal and anti-bacterial properties of Cuminum cyminum (C. cyminum) and mouth aromatic property of Melissa officinalis (M. officinalis) have already been illustrated in Iranian traditional medicine. Also, the anti-fungal and anti-caries properties of Camellia sinensis (C. sinensis) were demonstrated in recent investigations. The aim of this study was to determine the anti-fungal effects of compound mouthwashes (C. cyminum, M. officinalis and C. sinensis) on standard strain of C. albicans. The essential oil from C. cyminum and the aquatic extracts of C. sinensis and M. officinalis were prepared using hydrodistillation and boiling methods, respectively. Subsequently, five different groups of compound mouthwashes containing various concentrations of C. cyminum essence and C. sinensis and M. officinalis extracts were categorized and used for antifungal susceptibility test. Anti-C. albicans effect of different kinds of compound mouthwashes was assayed by punched-whole method. Nystatin was used as the positive control drug. The data was analyzed by ANOVA and Tukey test (α=0.05). The mean values of growth inhibition diameter were 6.33 millimeter (mm) for aquatic extract of C. sinensis and 40.33 mm for essential oil of C. cyminum. No growth inhibition was observed by aquatic extract of M. officinalis after 48 h. The results of compound mouthwashes 1 to 5 showed that the mouthwash 5 was the most effective compound on C. albicans (P<0.001, F=184.911). C. cyminum essential oil and compound mouthwash 5 containing 40% C. cyminum essence, 33.34% C. sinensis extract and 26.66% M. officinalis extract had the highest efficacy in growth inhibiting of C. albicans and could be used as herbal mouthwash after once confirmed by clinical trials in the future.

Sexual health problems are common in the postpartum period but despite the abundance this problem; is the lack of professional recognition. After delivery, many women have experience reduced sexual desire, reduced vaginal lubrication and shorter and weaker orgasm than before. Therefore, this study aimed to determine the pattern of sexual intercourse (resumption of sexual intercourse and number of sexual intercourse in the week) after delivery in nulliparous women. This study was a longitudinal study with aspects of descriptive and analytical study of the sexual intercourse pattern (resumption of sexual intercourse and number of sexual intercourse in the week after delivery) and its influencing factors in 322 primiparous women at least two months after delivery. Samples were selected from archives of Mustafa Khomeini hospital in the summer of 2013 through a phone call. It was found out that out of 322 primiparous women that were participated in this study, 163 women had cesarean section and 159 cases had vaginal delivery. Their mean age was 25.49±4 and 145 (45%) of the subjects have not had sexual intercourse within 8 weeks postpartum. Findings indicate a reduction in the number of sexual intercourse after childbirth. In addition, between the number of sexual intercourse in the week before delivery and number of postpartum sexual intercourse in the week and between the type of delivery with resumption of sexual intercourse and number of sexual intercourse in the week, a relationship exists.

Motivating student’s research and removing the obstacles are the basic steps in establishing an efficient research system. The present research has been carried out by aiming at determining the personal and organizational barriers in performing research plans from the viewpoint of students of medical sciences in Shahed University. The present study is a cross sectional type by adopting descriptive and analytical aspects which was performed in 2014 among 640 students at Shahed University of Medical Sciences. The data was collected by the author-developed questionnaires that contained three parts; namely, demographic information, personal and organizational barriers. The results were analyzed by Chi-square Test. The findings show, the intensified curriculum (2.1) the most important personal obstacle and disregarding students’ rights (2.21) and not allocating sufficient budget (2.39) as organizational barriers. Base on the results, there are personal and organizational obstacles in students’ research which could be solved by planning and improving students’ capabilities.

Informed consent do not only ensures the protection of the patients against unwanted medical treatment , but it also makes possible the patientʼs active envolvement in his medical planning and care.In this paper dimensions of informed consent obtained perior to surgery were studied.
This is a descriptive analyctical study .In this study 380 pateints hospitalized in surgery departments of Shahid Mostafa Khomeini Hospital were interviewed within questionare.Date analyzied with SPSS.
Consequences indicated that only 29/7% of patients signed informed consent forms themselves.Only 22% were read the forms and 19/5 % belived that form was comprehensible.Pateints did not get any explanation about diagnosis(8/9%) , treatment (11/8%), possibility of treatment success (22%) , possibility of treatment failure (36/3%) , alternative treatments (37/7%), possible complications of surgery (47/3%) , cosst (50/7%) , prognosis (20/7%) and duration of hospitalization( 27/3%).Less than half of the patients (42/1%) would like to get more information.
As for influence of the process of informed consent on the treatment process patients ,defects in this context shoud be considered and it shoud plan for augmentation of the relationship between physician and patients to obtain proper informed consent.

The present study is an attempt to study the ethical intelligence of the medical students of state universities in Tehran. A total 359 the medical students (basic science, physio pathology, stagiaire and intern) from Tehran, Shahid Beheshti, Baghiatolah, Shahed were randomly selected. The present research is a descriptive survey was done in 91-92. The required data was collected with the help of MCI questionnaire to examine 10 factors and 40 variables. Data analysis was done by SPSS-16 version. In this study using descriptive tests and correlation test to analyze the data. The findings of the study indicate that moral competencies such as consistently with principles, values and beliefs, telling the truth, standing up for what is right, keeping promises, taking responsibility for personal choices, admitting mistakes and failures, embracing responsibility for serving others, actively caring about others, ability to forgive one’s own mistakes and ability to forgive others’ mistakes were below average. Results showed that there is significant difference between moral intelligence factors. Furthermore, the results of correlation test demonstrate a significant positive relationship between age and level of education with ethical intelligence. Moral intelligence is an acquired ability that can be promoted. Medical sciences’ educators can be helpful in the promotion of moral intelligence through ongoing training in the classroom and practice and encouragement of ethical behaviors. There is a need to develop education of moral intelligence.

Thyroid cancer is the most common endocrine malignancy; and papillary carcinoma is the most common thyroid cancer. There are different biologic markers which are used for prognosis determination one of which is a cell binding molecule، E-cadherin.. The purpose of this study was to determine the frequency of E-cadherin expression in papillary thyroid cancer and its relation with gender، tumor size، and lymph nodes involvement. This study was performed on 73 tissue samples from patients with papillary thyroid cancer who referred to Mostafa Khomeini Hospital in Tehran، Iran (2005- 2008). The method of staining for determination of E-cadherin expression was immunohistochemistry. We evaluated the size of tumor، lymph nodes involvement، and their relation with E-cadherin expression. The mean age was 41. 85± 16. 65 years. 67% of samples were positive for E-cadherin and 21. 9% had lymph nodes involvement. The mean size of patients’ tumor was 3. 86± 2. 38 cm. There was not any significant relationship between E-cadherin expression and tumor size and gender but there was a significant and reverse relationship between E-cadherin expression and lymph nodes involvement (P<0. 05). Concerning of the role of the E-cadherin in patient prognosis، it seems that as proportion of E-cadherin decreases in tumor cells، the probability of lymph nodes involvement increases. More studies in this area with patients’ follow-up are recommended.

Inappropriate use of fat in diets is a significant risk factor that can cause cardiovascular diseases، morbidity، and mortality in the world. This study was designed to determine the fat consumption pattern in east Tehran habitants. In this cross sectional study 500 east Tehran habitants were evaluated. Data was collected by a questionnaire designed by the authors of the present study. The validity and reliability of the questionnaire was confirmed in a pilot study. The Data was analyzed with SPSS software. The average of family members was 3. 9±1. 4. The highest amount ofoil consumed was that of solid candy oil، while The lowest was animal oil. For cooking، 36. 8% and 31% of samples were using liquid oil and solid candy oil، respectively. For fraying 33. 8%، 20%، 32. 4% of samples were using liquid oil، solid candy oil and frying oil، respectively. a relationship was found between higher educational level and mothers working out of the house and higher consumption of liquid oil، fraying oil and olive oil (p<0. 001). High age، housekeeper mothers and higher family span were associated with the higher consumption of solid oils، butter and ghee (p<0. 02). This study revealed that the significant portion of daily oil consumption of Tehran habitants consist of solid oils. It seems to be necessary to organize proper training programs to increase social awareness about the hazards of solid saturated fats.