فهرست مطالب مجید میرمحمدخانی

One of the most important complications of the nursing job is burnout which is associated with a decrease in mental health, quality of medical care, and a decrease in patient satisfaction with the treatment process. We aimed to assess the prevalence of burnout in nurses working in Semnan Universities.

A total of 151 nurses working in two hospitals affiliated with the Semnan University of Medical Sciences were included in the present cross-sectional study. Demographic characteristics of the participants were gathered using researcher-based questionnaires. Burnout was assessed using the validated Maslach Burnout Inventory questionnaire. Values of continuous and categorical variables were presented as mean standard deviation and numbers, respectively.

The mean age of the study participants was 36.4±8.8, of whom 128 participants (85%) were female. The average work experience was 12.4±7.8 years. The prevalence of moderate burnout in the study participants was 75.5%. The prevalence of burnout subdomains including moderate emotional exhaustion, moderate depersonalization, and moderate personal accomplishment was, respectively, 70.9%, 82.1%, and 58.9%. The score of the Maslach Burnout Inventory questionnaire and its subtypes did not differ significantly across subgroups defined by age, sex, education status, working experience, medical ward, and marital status.

The prevalence of moderate burnout is relatively high among nurses working in Semnan hospitals. There is a need for further investigations to assess the underlying causes of burnout to design and implement intervention strategies to reduce the high prevalence of nursing burnout.

Human health is a fundamental right and a valuable asset for all members of a society at any level and social class. The existence of a strong and stable health system in a country displays the all-round stability of that society. The three main characteristics for evaluating the performance of the health system include the health status of the community, citizens' satisfaction with the services provided by the health sector, and protection against financial risks. Therefore, the aim of the current research was to design an efficient model for cost management of non-surgical cancer treatment in Iran.

This was a descriptive-analytical study with a survey method conducted in 2018. The method of data collection was a library (through examining hospital records) and the tool used was a questionnaire. For this purpose, an available sample consisting of 50 elites from the fields of health service management and health economics was selected and were asked to answer the designed questionnaire. The data collected by means of the main statistics used in the Delphi technique were the central measurements (mean, median and mean) and dispersion index, standard deviation and interquartile range.

The amount of extracted variances was 0.529 after management of visit costs, 0.518 after management of diagnosis costs, 0.494 after management of hospitalization costs, 0.496 after management of chemotherapy costs, and 0.501 after management of radiation therapy costs. These results indicated that the amount of extracted variances was higher than 0.5; moreover, all the AVE values of the model dimensions were lower than the combined reliability, as a result the, condition of convergent validity was established.

The results of the present study indicated that the costs of non-surgical cancer treatment could be classified into 5 main indicators, including the cost of visits, diagnosis, hospitalization, radiation therapy and chemotherapy.

The healthcare referral system is one of the main factors for improving the health conditions, especially in developing countries. The present study aims to investigate the main factors for the improvement of the family physician referral system in Bojnord, Iran.

This is an analytical (quantitative-qualitative) survey that was conducted in 2021. In the qualitative phase, the related components were first extracted through interviews with a panel of experts (n=24). Then, a questionnaire was created based on the extracted items (n=30). In the quantitative phase, according to the experts’ opinions, the items were weighted using the fuzzy hierarchical analysis, where higher values indicate higher weight. The reliability of the questionnaire was evaluated using Cronbach’s α coefficient in SPSS software. Also, AHP software was used to perform the fuzzy hierarchy analysis.

Twenty components were identified by experts, which were divided into three categories including organizational/managerial requirements, human resources management requirements, and information technology requirements, with the weight values of 0.486, 0.213 and 0.301, respectively, indicating that organizational/managerial requirements were more important. Among the organizational/managerial requirements, the component of “design and implementation of service quality improvement cycles in the referral system” had the highest weight (0.159). Among the human resources management requirements, the component of empowering human resources had the highest weight (0.412). Among the information technology requirements, improvement of the information technology infrastructure had the highest weight (0.372).

The use of clear procedures and regulations, the digitalization of the referral system, and the staff training are among the very important factors that can lead to improving the referral system in Bojnord City.

Treatment with Extracorporeal Shock Wave Lithotripsy (ESWL) is a low-cost method with a short hospitalization period. However, several complications have been reported for this method. This study was designed to investigate the efficiency and side effects of ESWL.

In a cross-sectional study, all available files of cases in the stone crusher unit were evaluated according to the inclusion and exclusion criteria from April 2013 to April 2016. Preliminary information before lithotripsy, including patients' demographic characteristics and also treatment success, and complications, was assessed.

The success rate of ESWL was 81.4%, which had no significant relationship with gender, age, and body mass index. The mean size of the stones was 10.9±5.4 mm, which was associated with the success rate. In terms of stone location, the highest frequency was observed in the right lower calyx, followed by the left pelvis. The most common complications were ecchymosis (84.3%), hematuria (20.6%), and severe pain (15.3%). There was a significant difference in the incidence of complications in patients with different stone sizes (p<0.01). The occurrence of complications had a significant relationship with the location of the stone (p<0.01). Stones located in the pelvis and lower calyces caused the most complications.

The results showed that ESWL had a high success rate and was a suitable method for the treatment of urinary stones. The success rate was associated with the stone size, which, therefore, is an important factor in choosing this approach.

Since conflicting results have been reported about the relationship between the level of vitamin D in people with polycystic ovary syndrome and related metabolic disorders, the present study was performed with aim to determine the effect of vitamin D administration on the clinical and laboratory symptoms of adolescents with polycystic ovary syndrome with vitamin D deficiency.

This double-blind randomized controlled clinical trial study was performed on 50 patients with sonographic evidence of polycystic ovary syndrome with vitamin D deficiency in two control and intervention groups. The intervention group was given vitamin D and the control group was given placebo. Clinical, laboratory and sonographic symptoms before and after the intervention were compared in two groups. Data were analyzed by SPSS software (version 16), Man-Whitney U and Wilcoxon test. P<0.05 was considered statistically significant.

The intervention improved the level of vitamin D in the case group (P<0.001). There was significant difference between the case and control groups in terms of fasting insulin level (P=0.001), serum testosterone level (P<0.001), free testosterone level (P=0.042), LH to FSH ratio (P<0.001), LH level (P<0.001), diastolic blood pressure (P=0.027), and severity of hirsutism (P=0.016). Polycystic ovary syndrome and Oligomenorrhea was more in the control group (P <0.01); However, there was no significant difference between the two groups in terms of fasting blood sugar, triglycerides, HDL, systolic blood pressure, acne severity, and ovarian volume (P>0.05).

Considering the role of vitamin D in ovum development and its relationship with the reduction and regulation of insulin, the use of this supplement is recommended to improve the clinical and laboratory symptoms of polycystic ovary syndrome and subsequently correct menstrual disorders and hyperandrogenism. Also, in this study, vitamin D consumption did not cause a significant difference in insulin resistance between the two groups after the intervention.

Despite the widespread use of progesterone in pregnancy, there is limited information on its effect on uterine-placental blood circulation and especially on the fetal blood circulation system in the second half of pregnancy. The present study was conducted with aim to investigate the effect of different dosages of progesterone suppositories on Doppler ultrasound indices of uterine, umbilical, and middle cerebral arteries of the fetus and the incidence of preterm delivery in women at risk of premature delivery.

This double-blind randomized clinical trial study was performed in 2018-2020 on 90 pregnant women with gestational age of 24-33 weeks and diagnosis of preterm labor. The subjects were randomly divided into three groups. All three groups underwent Doppler ultrasound of uterine, umbilical, and middle cerebral arteries of the fetus at admission. Then, in the first group progesterone 400 mg and in the second group progesterone 200 mg were prescribed vaginally and the third group was studied as a control group. All the three groups underwent Doppler ultrasound again 48 hours later. Vascular resistance was measured based on RI (resistance index) and PI (pulsatility index) Doppler parameters. Data analysis was done using SPSS statistical software (version 16) and one-way analysis of variance, Kruskal-Wallis, Chi-square, Fisher's exact, paired t-test, Wilcoxon, Man-Whitney, and logistic regression tests. P<0.05 was considered statistically significant.

There were no significant differences among the three groups in terms of maternal age, parity, gestational age, cervical length, history of preterm delivery, RI and PI of the uterine, umbilical, and middle cerebral arteries of the fetus at admission (P>0.05). In both progesterone groups, RI and PI significantly decreased in all three fetal uterine, umbilical, and middle cerebral arteries (P<0.05) in 48 hours after the intervention compared to the beginning of hospitalization. The reduction of PI and RI indexes of all arteries except PI of uterine artery (P=0.105) was significant in 48 hours after intervention in progesterone groups compared to the control group (P<0.05).

The administration of a single dose of 200 or 400 mg of vaginal progesterone in women with gestational age of 24-33 weeks with diagnosis of preterm labor causes a significant decrease in the resistance of the uterine, umbilical, and fetal vessels after 48 hours.

flat foot is a disorder that reduces performance in people with different age groups. One of the new treatments is whole-body vibration. The main question is whether there is a significant difference according to the isokinetic muscle strength after whole body vibration intervention in different ages of growth and adults.

64 people with flexible flat feet were included in the study. People were divided into 4 intervention and control groups based on the age groups of growth and post-growth age. Then, in the intervention groups, 10 sessions of whole body vibration were applied 3 sessions per week in a standing position. In all participants, the isokinetic torque of the invertor and evertor muscles at angular velocities of 30 and 120 degrees/s were evaluated before and after the vibration intervention in two stages before and after applying general fatigue.

The results showed that before applying the whole-body vibration intervention, there was no significant difference between the control and intervention groups according to the maximum isokinetic torque parameter (P>0.05). The effect of fatigue parameter and angular velocity of isokinetic torque on the inverter and inverter muscle torque was significant (P<0.05). The isokinetic torque of the invertor and evertor muscles at both angles of 30 and 120 degrees after applying 10 sessions of whole-body vibration showed a significant improvement compared with before the intervention in both with and without fatigue (P<0.05).

This study showed that whole-body vibration can be effective as a relatively new modality in reducing the effects of fatigue during running and increasing the strength of ankle muscles in two age groups during growth and adulthood.

Low back pain is one of the most common musculoskeletal disorders and an important cause of early retirement due to disability in employees in industrialized and developing countries. The present study aimed to determine the work ability index and its relationship with low back pain among employees of the Tehran offset printing industry.

A cross-sectional study was performed within six months in 2020.  Data from 220 employers working in the offset printing industry were collected through survey questionnaires including Nordic Musculoskeletal Questionnaires (NMQ) and Work Ability Index (WAI). Data analysis was performed using SPSS software version 24 with a significance level of P-Value <0. 05.

In general, more than half of the participants (%62.5) indicated high symptoms of Low Back Pain. Also, the results of the Pearson correlation test showed that there is a positive and significant correlation between the level of work ability and the severity of low back pain (p<0.001).

The high incidence of low back pain among printing workers makes it necessary to provide safety and health training programs on managing and improving workability.

Vaccines are the most successful and cost-effective public health tools that have helped control, eliminate, or eradicate many infectious diseases, and are the key intervention to end the COVID-19 pandemic. Therefore, the World Health Organization recommends that to increase the acceptance of vaccination, each country should identify and provide appropriate strategies to increase the motivation and desire of people and also to solve the challenges created to receive the vaccine. The purpose of this qualitative study was to identify the motivations and challenges of the participants in the COVID-19 vaccination program, particularly with PastoCovac which was jointly developed by the Finlay Institute of Vaccines in Cuba (IFV) and Pasteur Institute of Iran (PII), and to achieve a better understanding of the challenges of vaccination in the Iranian society, and to find ways to increase and strengthen the motivations.

A purposeful sample of people who visited a major urban health center in Semnan were approached for this qualitative study to reach data saturation (30 people) with open questions in a 30-minute interview. Relatively, after conducting the interview, the audio file was listened to carefully and if necessary intermittently by the interviewer and transcribed. The overt and hidden content of data obtained from the statements were checked and then the traditional content analysis was used to develop meaningful clusters of themes.

The main themes of people's motivations identified in the current research include controlling disease and reducing mortality, protecting health and establishing collective safety, improving social and economic conditions, advancing medical knowledge, trust and credibility of the Pasteur Institute of Iran (PII), acceptable possible side effects and The high effectiveness, local production of the vaccine are the unique characteristics of the vaccine, while the obstacles identified are: false and ignorant beliefs, lack of trust in the vaccine, people's fear and worry of side effects, the unique characteristics of the vaccine, lack of universal acceptability, insufficient recognition of vaccine characteristics.

PastoCovac as one of the major vaccines against COVID-19 developed jointly by PII and IFV, was acceptable to the Iranian population in every aspect. PastoCovac, therefore, played an important role in achieving e acceptable levels of safety in the country during the pandemic.

The road accidentsis one of the most comprehensive health problems in the world This reasearch is doe with ths purpose developing the etiology patterns of road accident in Gilan province.

This reasearch was a descriptive sectional and cross- analytical study that was done in two stages. At the first stage, a questionnaire was developed by searching sources and experts. Then, the important components and desired  dimensions were identified in the initial models, then the initial questionnaire was developed and submitted to the expert for approval. The Finak questionnre responses and  used Likert scales. Validity and reliability of research contents were measured by experts, and 670 drivers were interviewed person or by calling to the phone numbers for integration of  questionnaire. The data was entered into SPSS and PLS software and used statistical methods of exploratory and confirmatory factor analysis, the final pattern was extracted.

The model as presented with six human factors-visual view barriers – the cause of traffic – the cause space- type of accident and the defect of the road, which can inclue 64.406 of the variable variances of the cause of road accidents.Human factors have the greatest influence 0.774 and road defects have the least influence 0.03 in the proposed pattern.

Based on the result of researches about human factors –vehicle and roads have important and significnt role in causes of road accidents and by knowing these factors, managers can be enable to do necessary actions for controling and reduction of road accidents.

The present study qualitatively investigated the main components that should be considered for the implementation of the referral system in Bojnord city.

In this study, data were collected through doing interviews with experts, and finally, the importance of all the extracted components was evaluated using a researcher-made questionnaire. Also, the exploratory factor analysis method was used to classify the components in main sets. Kolmogorov-Smirnov, one-sample t-test, performed in Excel and SPSS software, was used for statistical analysis.

The most frequent noted components by the experts included "empowerment (knowledge, skill, psychological) of human resources involved in the referral system", "paying attention to the motivation of human resources involved in the referral system", and "developing suitable processes for the referral system and re-engineering the processes to meet the conditions". Finally, the main requirements in the referral system of Bojnord city were divided into three categories included organizational and management, manpower, and technology-based requirements.

Briefly, some components may lead to improvement of the referral system, which can be categorized into organizational and management, manpower, and technology-based requirements. Detailed planning to improve the referral system can lead to the improvement of the health system.

Mental health of the medical staff as care providers has a significant impact on the quality of service delivery. Accordingly, happiness is considered one of the important components of mental health. Considering the importance of mental health for medical staff, especially during COVID19, the present study is designed and carried out with the aim of investigating the level of happiness and associated job factors among hospital staff.

This was a cross-sectional and analytical study conducted on 280 people from the teaching, research and treatment staff of Kowsar hospital in Semnan through census in 2019. To collect data, a checklist including demographic and occupational variables was used along with Oxford Happiness Questionnaire by Hills and Argyle (2002). After that, relevant data were analyzed through SPSS26 software. 

The mean and standard deviation regarding age of the personnel were 53.53 ± 8.09,  62.1% of whom were women. 47.5% were in low status, and only 10% were in high status in terms of happiness score distribution. People in the age group of 51 to 60 (P >0.001), PhD graduates (P<0.001), working doctors (P<0.001), official workers (P=0.008), personnel with fixed work shifts (P <0.001), personnel who do not need to work overtime (P =0.044), people with good interaction with colleagues (P <0.001), and employees with good job satisfaction (P<0.001), had a good or excellent happiness status.

Most of the medical personnel working in the hospital did not have an optimal level of happiness; therefore, it is recommended that authorities design and implement programs to improve the level of happiness by focusing on the related factors.

There are mechanical and pharmacologic methods of cervical ripening that combination of these methods had better results. This study was performed aimed to investigate the effect of extra-amniotic dexamethasone infusion on cervical ripening and Bishop score, labor duration and maternal and neonatal complications.

This randomized clinical trial study was performed on 60 term pregnant women with unripe cervix who were candidates for induction of labor in Amiralmomenin hospital of Semnan in 2019-2020. The subjects were randomly assigned into intervention (extra-amniotic dexamethasone infusion through the intracervical catheter) and control groups (extra-amniotic normal saline infusion). Both groups underwent labor induction and the information about the delivery process including latent and active phase duration, time needed for catheter removal, bishop score after catheter removal, cesarean rate and first and fifth minutes Apgar score of neonates entered in a checklist. Data were analyzed by SPSS (version 23) and T-test, U-Man-Whitney and Chi-square tests. P<0.05 was considered statistically significant.

  After the intervention, there was significant difference between the two groups in terms of initial Bishop score and the Bishop score after catheter removal (P=0.028), but duration of catheter removal (P=0.45), mean time of induction onset to delivery (P=0.14), duration of active phase (P=0.84) and latent phase (P=0.83), first and fifth minutes Apgar score (P=0.19) and cesarean rate (P=0.76) were not significantly different between the two groups. 

Extra-amniotic Dexamethasone infusion improves the Bishop score more than the control group, and facilitates cervical ripening for induction of labor.

More than two years have passed since the epidemic of Covid-19, this disease is still a global crisis. Antibiotic resistance is a global challenge. Therefore, this study aimed to identify and determine the antibiotic resistance of bacteria isolated in the blood samples of patients with Covid-19 hospitalized in the special corona ward of Kosar Semnan Hospital during 2020-2021.

The current study is a retrospective cross-sectional descriptive study that was conducted in Semnan. In this study, 22 blood samples with positive bacterial cultures related to patients with Covid-19 were included in the study. The average age of the studied patients was 74.09. 13 patients were male and 9 were female.

Klebsiella was the most common bacteria among the cultured samples. The average length of hospitalization of patients with positive culture Covid-19 was 16.09 days. Antibiogram results showed that among gram-negative bacteria, the highest sensitivity is related to gentamicin, and the highest resistance is related to meropenem, and among gram-positive bacteria, the highest sensitivity is related to oxacillin and coamoxiclav, and the highest resistance is related to meropenem.

Secondary infection caused by bacteria has increased the mortality rate of patients with Covid-19 and antibiotic resistance is high in bacteria isolated from patients with Covid-19.

Human immunodeficiency virus/Acquired immune deficiency syndrome (HIV/AIDS) is an emerging disease that has a close relationship with high-risk behaviors and affected different age groups, gender, race, culture, and social and economic classes. The aim of the present study was to investigate the mediating role of demographic variables in the relationship between high-risk behaviors and HIV/AIDS.

This descriptive study was conducted using the census method on 3838 people referred to behavioral disease counseling centers of Shiraz University of Medical Sciences in 2020. The data collection tool was the national software for registering behavioral diseases consultation, including demographic variables and high-risk behaviors in two groups of HIV/AIDS identified as positive and negative. Structural equation modeling was used to analyze the data.

According to the final model, demographic variables explain 13.46% of disease cases, but high-risk behaviors explain 44.40% of disease cases. Therefore, the explanatory power of demographic variables in contracting the disease is lower than high-risk behaviors, so demographic variables do not play a mediating role. The relationship between demographic variables and high-risk behaviors and HIV/AIDS was statistically significant (p<0.001).

According to the findings, demographic variables do not play a mediating role, and considering the significant relationship between demographic variables and high-risk behaviors and AIDS, demographic variables play a confounding role. Therefore, continuous educational programs in the field of prevention and control of high-risk behaviors will be very helpful in reducing the incidence of AIDS. 

The present study was conducted with the aim of investigating the quality of life and its predictive factors in patients with occupational hand eczema.

In this cross-sectional-analytical study, 244 patients with occupational hand eczema were examined through convenience sampling. The tools of data collection included the standard questionnaire of quality of life index in skin diseases (DLQI) and visual analog scale (VAS). Data analysis was done by Stata14 and the raw and adjusted odds ratio (OR) with a 95% confidence interval (95% CI) was reported.

46.7% had severe eczema. Multivariable logistic regression model showed the age over 30 (OR=5.40; CI 95%: 2.92 – 9.98), female gender (OR=2.02 ; ; CI 95% : 1.14 – 3.06), housekeeping (OR=5.25 ; CI 95% : 1.94 – 14.24), work experience over 5 years (OR=4.59 ; CI 95% : 2.13 – 9.85), working more than 8 hours (OR=4.71 ; CI 95% : 2.57 – 8.62) and severity of hand eczema (OR=2.14 ; ; CI 95% : 1.28 – 2.56) were the most important predictors of low life quality in patients with hand eczema (P-value>0.05).

Hand eczema has a significant effect on the life quality of most patients; therefore, designing and implementing care and preventive programs considering the above-mentioned factors are necessary to improve the quality of life regarding these patients.

 Cost management of inpatient records can directly and indirectly affect the management and control of hospital costs. Therefore, the present study was conducted with the aim of designing and validating the cost management model of inpatient records in the global system.

 The present mixed method study was conducted in 2021. Senior and middle managers composed the statistical population in the qualitative section and the senior, middle managers and staff of Niknafas Hospital in Rafsanjan were the quantitative section statistical population. In the qualitative section, in-depth interviews were conducted with 33 experts using the purposive sampling accompanied with snowball method. A researcher-made questionnaire with a random sampling method was used to assess the model among 210 people in the quantitative section. Qualitative data were analyzed by Atlas.ti software and quantitative data were analyzed by exploratory and confirmatory factor analysis using SPSS and SmartPLS version 3 software.

 The results of the qualitative section indicated that the cost management model includes 15 sub-categories and 6 main categories. "Information and awareness", "sensitivity", "risk-taking and motivation", "control and supervision", "experience and skill", and "factors beyond the hospital's control" were the main categories. The SRMR fit indices (0.069), R2 (>0.67), GOF (>0.36) showed that the fit of the measurement, structural and general models were appropriate and approved.

 The present study showed that the designed model of cost management of inpatient records in the global system has a good fit and can be used in medical centers.

Different types of death among people indicates both the extent to which people use different types of health care and the growth and development of a society. Premature mortality imposes a heavy burden on society in terms of health, economy, and mental issues. Given the preventability of these deaths, efforts are being made to reduce premature deaths by 25 percent ın hıgh level plans by 1404s.

The purpose of this descriptive-analytical study, using death registration data, was to perform zoning of premature deaths in the cities supervised by Semnan University of Medical Sciences in Iran, it also investigated the factors affecting the premature deaths in order to reduce premature mortality especially among people at the age range of 30 to 69. Data were extracted based on the information of death certificates entered in the death registration system from 2013 to 2018. We, thus, studied 3619 registered deaths. The data were analyzed through SPSS software, using descriptive statistics (Relative Frequency, Mean, and Standard Deviation) and inferential tests (chi-square and independent t-test) according to the type of variables. The level of significance was set at 5 percent.

The mean and standard deviation of premature mortality was found to be 55.7 ± 10.6 and most of the deaths occurred in the seventh decade of their life. Premature mortality was more common among men, employed people, and urban residents. The major causes of premature mortality included cardiovascular diseases, cancer, and accidents.

The results showed that accidents are the major cause of premature mortality at younger age, but they are gradually replaced by chronic and non-communicable diseases at the middle age. Therefore, in order to reduce the risk factors regarding premature mortality, collaboration of the related organizations is essential.

It is very important to calculate the costs of inpatient services covered by the global tariff and compare it with the approved tariff in hospitals in regard to the financial profit and loss. In this regard, this study was conducted with the aim of comparing the costs of global inpatient services bills with their approved tariffs in Niknafs Obstetrics and Gynecology Hospital in Rafsanjan.

In this descriptive study, the population included all the invoices of hospitalized cases subjected to the global tariff in 2019 in Niknafs Hospital in Rafsanjan. The required data were collected from the patients' accounts and analyzed using descriptive statistics and SPSS 20 software.

In 2019, out of the total inpatient services related to the obstetrics and gynecology group, 6 services subjected to the global tariffs were performed in Niknafs Obstetrics and Gynecology Hospital in Rafsanjan. A comparison of the average costs incurred in these services with their approved tariffs showed that in all of them, hospital costs were between 10.74% and 20.54% higher than the approved global tariffs. The highest difference (20.54%) was related to cesarean section, and the lowest (10.74%) was related to hysterectomy.

The results of this study showed that the global services of this hospital have no economic justification and global tariffs lead to losses of the hospital. Therefore, it is suggested that hospital officials focus more on managing the costs of global services, and approved tariffs be reviewed in a timely manner, commensurate with the growth of inflation and taking into account the different conditions of patients.

Psoriasis is an inflammatory disease with skin and joint manifestations. This disease can be associated with ocular complications and reduce vision and quality of life. The aim of this study was to determine the prevalence and type of ocular involvement in patients with psoriasis to prevent unwanted complications by identifying the disease at the right time.

A cross-sectional study was carried out in 40 patients with psoriasis in Semnan Kowsar Clinic affiliated to Semnan University of Medical Sciences, 2019. The participants were selected via census sampling and underwent systemic and ophthalmic examination. Patients aging 10-80 years old with at least 6 months of disease onset were included.

The mean age of patients was 43.33 ± 17.05 years, and there were 17 (42.5%) males and 23 (57.5%) females. The ocular diseases included dry eye (57.5%), posterior blepharitis (50%), conjunctival hyperemia (27.5%), cataract (20%), and anterior uveitis (7.5%). The presence of ocular disease was found to be significantly associated with the duration of psoriasis (P = 0.03).

In this study, ocular surface diseases such as dry eye and posterior blepharitis were common in patients studied and were associated with the duration of psoriasis. Therefore, patients with psoriasis should undergo periodic and regular eye examinations to identify ocular diseases in a timely manner and prevent unwanted complications.

Previous researches show that there is a meaningful relationship between forward head posture and dysfunction of proprioception. The purpose of this study was to compare the immediate, late and last effect of kinesio taping (KT) and stabilization exercise (SE) on neck proprioception in people with forward head posture.

In this clinical trial study, forty three women with forward head posture (18-35 years old) were randomly assigned into 3 groups: KT group (n=15), SE group (n=12), KT with SE group (n=16). Joint repositioning error angle changes were measured in three positions: neutral to full neck flexion, neutral to 50% of full flexion, 50% of full flexion to neutral position through a digital dual inclinometer in four sessions including: first session (pre-intervention), second session (immediately after intervention), third session (end of 4 weeks intervention) and fourth session (one month after the last intervention to evaluate the persistency of intervention). In the KT group, kinesiotape was used 3 times a week, in the SE group, stabilization exercises administered 3 times a day, and in the KT + SE the intervention was the same as the two groups. The intervention was performed for 4 weeks. Persistency of the treatment was evaluated one month after the intervention.

the results of ANOVA test showed no significant difference between the three intervention groups (P>0.05). In the within-group study, a significant difference was observed in the repositioning error angle changes before and one month after the intervention (P<0.05). But no significant difference was observed in the study of the immediate effect of the intervention (P>0.05).

It seems that KT, SE, and KT plus SE are effective in reducing repositioning error angle of neck and improving proprioception in people with forward head posture.

HIV infection has spread over the last 30 years and is undoubtedly the major public health challenge in worldwide. The aim of this study was to determine the epidemiological status of HIV/AIDS infected under the Covered of the Behavioral Diseases Counseling Center of Shiraz University of Medical Sciences during 1994 to 2020.

In this descriptive study, 3710 people living with HIV/AIDS in Fars province, covered by the Behavioral Diseases Counseling Center of Shiraz University of Medical Sciences, were selected as a sample by census method. The source of data collection was the national behavioral disease counseling software. Data analyzed by Fisher test, Chi square test and ANOVA test using SPSS19 statistic software.

78.32% of the infected were men. The mean and standard deviation age of infected was 44.61± 10.36 and the highest age group was 35-44 years old, 1488 people (40.1%). In terms of marital status, 1338 single people (36.06%) were the most and dead spouses were 229 (6.48%) were the lowest. The highest route of transmission injected drug abuse 2383 cases (64.2%) and the lowest was 71 cases (1.9%) from mother to child. Compared to the first and last high-risk behaviors, Heterosexual contact increased from 41.50 to 43.82% and only 5.37% used condoms continuously.

According to the findings, the transmission of the disease sexual contact is increasing. Therefore, designing and formulating effective control programs in the field of sexual behaviors is felt more than before.

Mental health in students is related to several factors. The study was conducted to investigate the mental health problems of talented students in special schools and students from ordinary ones in Semnan province in Iran (2019).

In a cross-sectional study using cluster sampling, a group of junior high school students were evaluated using the strengthens and difficulties questionnaire (SDQ) for evaluation of mental health in five domains: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems and prosocial behavior.

From 24 selected public schools, 624 students (304 boys and 320 girls) participated in the study. The relative frequency of problems in special schools (291 people) was 18.6% (95% CI: 14.1 to 23.0) and in ordinary schools (331 people) was 30% (95% CI: 25.1 to 34.9) (P<0.001). The overall prevalence of problems after population weighting was estimated at 28.8%. Talented students showed better status in the areas of emotional and conduct (P<0.001). Adjusting for other variables education in ordinary schools was associated with a significant increase in the chance of having mental health problem (Adjusted OR=1.90, 95% CI: 1.06, 3.42; P=0.032)

Differences in the prevalence of mental health problems may be partly related to individual and the school environment differences. However, the role of socio-economic differences should not be ignored. Given the relatively high prevalence of mental health problems, it is recommended that more attention be paid to effective and periodic screening and monitoring of students, especially in ordinary schools.

Infection is a vital problem in intensive care units. Currently, chlorhexidine solution is used to reduce oral colonization. This study aimed to determine the efficacy of chlorhexidine solution on oropharyngeal bacterial colonization in hospitalized patients in the intensive care units.

This descriptive study (from August 2018 to May 2019) was performed on 60 patients who administered in medical and surgical intensive care units (ICUs) in one of the university hospitals in Semnan city. Patients admitted to (ICUs) were selected according to inclusion criteria. At the time of admission to the intensive care unit, oropharyngeal colonization of patients was assessed. Forty-eight hours after admission and using the chlorhexidine solution 0.2% three times a day, oropharyngeal colonization was assessed again. Data analysis was performed with SPSS software, version. 22 in the significant level of 0.05.

This study showed most of the patients in this study were male (80%) with mean age of 45.23±15.19 years. Most patients were transferred from the emergency department to intensive care units and had endotracheal tubes. At the time of admission to the intensive care unit, 8 patients were infected with E. coli and 6 patients were infected with Klebsiella. The results also showed that the use of chlorhexidine 0.2% had no significant effect on the reduction of micro-organisms in the oropharyngeal area. Forty-eight hours after admission to ICUs, the incidence of E. coli infection increased (P=0.01) but there was no significant increase in the klebsiella infection rate (P=0.25).

This study showed that the use of chlorhexidine solution 0.2% did not affect the reduction of micro-organisms in the oropharyngeal areas of patients. Therefore, oral care protocols that include mechanical movements and toothbrushing should be considered to reduce the occurrence of micro-organisms. This study also found that most patients who were referred to the intensive care unit were contaminated with pathogenic micro-organisms. Therefore, consideration should be given to appropriate strategies to reduce infections in the emergency department.

The objective of this study was to compare two methods of dry needle treatment in active trigger points of Gastrocnemius muscle on pain and height jump in non-professional athletes.

Forty male athletes were selected with active trigger points in each Gastrocnemius muscle. Relatively, subjects were assigned randomly in two conventional dry needle piston method groups and rotational method groups. Vertical jump and pain were evaluated before, after, the first, second and third days of intervention by visual analog scale and the motion analysis system.

There was a significant difference in pain intensity and jump height in both groups (P<0.001). Also, the behavior of pain intensity was different in the needle rotation group from the piston group (P<0.001). But the height of jump between the two groups was not significant (P=0.304)

Needle rotation had a strong antinociceptive effect and little annoyance in trigger points. However, both techniques reduced pain and improved vertical jump in non-professional athletes with active trigger points in gastrocnemius muscle.