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To evaluate the opinion of the ophthalmologists and optometrists in Guilan Province about different aspects of amblyopia treatment.

A questionnaire was designed to evaluate the opinion of 30 ophthalmologists and 20 optometrists about different aspects of amblyopia treatment, including the age of initiation and termination of treatment, different treatment modalities, and maintenance treatment used for children aged above 10 years. The questionnaire’s validity was confirmed by the content validity rate (CVR) of 0.33–1 and the content validity index (CVI) of >0.99 and its reliability was confirmed by test-retest Kappa of >0.9. The results were analyzed, using SPSS v.21.

The participants’ answers revealed that the first treatment choice in refractive amblyopia was using spectacles and patching; age <1 year was considered the most appropriate age for starting treatment, continued until 7–10 years of age. Fifty–three percent treated patients >10 years old and 51% suggested near/far training during amblyopia treatment. For maintenance treatment, everyday patching the eye for 1 hour with near/distance vision tasks and 0.5% atropine eye drop was suggested by about half of the participants (48%). The eye drop used for cycloplegic refraction was 1% cyclogyl. Mild cases were treated with spectacles, the indications of which depend on the isometropia and patients’ age.

The opinions of the ophthalmologists and optometrists about amblyopia treatment were different and it is required to increase the knowledge of these medical groups about the most appropriate treatment options, suggested by the recent guidelines.

Breast cancer is the most common type of cancer in women demanding accurate diagnosis to take remedial measures to treat.

Comparing the diagnostic capability of the computer regulation thermography (CRT), as a novel and safe diagnostic procedure, with common methods including sonography, mammography and clinical examinations for diagnosing breast cancer in suspicious patients against pathology as the gold standard.

In this prospective clinical trial study, out of 97 referred patients, 44 meeting the inclusion criteria were selected. The selected patients were subjected to mammography, sonography, CRT and clinical examinations. Then, the patients showing suspicious symptoms of breast cancer underwent pathological examinations.

CRT indicated a higher specificity compared to mammography and sonography (78.9% vs. 71.4% and 47.0%, respectively). However, CRT sensitivity was lower than those of mammography, sonography and clinical examination (52% vs. 70.6%, 82.4% and 84.0%). Furthermore, CRT accuracy was lower than mammography, sonography and clinical examination (63.6% vs. 70.9%, 64.7% and 88.6%). While CRT positive prediction value (PPV) was higher than those of mammography and sonography, it was lower than that of clinical examination (76.5% vs. 75%, 60.9% and 95.5%). The negative prediction value (NPV) of CRT was less than all other modalities (55.5% vs. 66.7%, 72.7% and 81.8% for the clinical examination, mammography and sonography, respectively).

Although CRT with a lower sensitivity and higher specificity, cannot be recommended to be used as a definitive diagnostic tool for breast cancer patients, it can be used as a complementary method with other methods to increase the diagnostic accuracy of suspicious patients.

Lumbar motion analysis is used as a clinical method in the diagnosis and treatment of low back pain (LBP). So far, no studies have shown if manipulating the sacroiliac joint (SIJ) will change spinal kinematics. The main objectives of this study were to investigate the effects of SIJ manipulation on the lumbar kinematics in subjects with innominate rotation and to compare lumbar kinematics among experiment and control groups. This study was a quasi-experiment-control trial study. 21 LBP patients with anterior or posterior innominate rotations in experiment group and 22 asymptomatic subjects in control group were evaluated. Lumbar kinematic variables (LKV) include lumbar range of motion (ROM) and speed, lumbar lateral flexion and rotation asymmetry were evaluated using Qualysis Track Manager (QTM) twice within two days in control group, and these parameters with pelvic asymmetry and disability were tested before and after intervention in the experiment group. While pre-intervention experiment group exhibited significantly lower lumbar lateral flexion (p=0.0001), rotation (p=0.008) ROM and lower lateral flexion speed (p=0.014), post-intervention experiment group exhibited significantly lower lumbar lateral flexion (p=0.01) ROM in comparison with control group. Pelvic asymmetry (p=0.049) and disability (p=0.01) significantly decreased in the experiment group after manipulation, but LKV did not change significantly after the intervention (p˃0.05). Experiment groups had different lumbar kinematics in comparison with control group before and after SIJ manipulation. Despite the changes in pelvic asymmetry and disability, intervention had no effect on lumbar kinematics.

To evaluate the results of one 60-degree block conjunctival limbal autograft (CLAU) surgery in patients with unilateral total limbal stem cell deficiency (LSCD). Five eyes of 5 patients were included. All patients had a history of chronic total unilateral LSCD due to a chemical injury. Two patients underwent one 60-degree block CLAU with amniotic membrane transplantation, two patients had been complicated by inadvertent trephination of one block of a previous successful two-block CLAU at the time of subsequent corneal transplantation, and the last patient had been complicated by one CLAU segment loss due to loose sutures and premature suture removal. The main outcome of the study was corneal epithelial healing. All patients developed persistent epithelial defect unresponsive to the conservative medical management. To restore epithelial integrity in cases with one-block CLAU, classic two-block CLAU was performed later. In two cases with inadvertent one segment trephination, corneal perforation occurred despite both conservative and surgical management. Tectonic keratoplasty was performed in these two eyes. These grafts developed persistent epithelial defect, which was covered with large sectoral vascularized corneal pannus in one eye and with mucous membrane grafting in the other eye. In the last patient with lost lenticule, cultivated limbal epithelial transplantation was performed to treat the epithelial defect. One-block (60-degree segment) limbal transplantation during conjunctival limbal autograft surgery is not sufficient for anatomical and visual rehabilitation of an eye with total unilateral LSCD.

Stroke incidence is 15 million people world wide annually and one third of these patients suffer from aphasia. Aphasia is often associated with significant disability in patients. Costs due to cerebrovascular diseases play an important role in national health expenditures. We aimed to assess the effect of piracetam in treatment of aphasia. Patients with acute ischemic stroke after completing informed consent form were divided randomly into two groups. The intervention group recieved standard treatment and 4800 mg piracetam daily for 12 weeks and the control group received standard treatment plus placebo. All patients on admission, and one, two, and three months post-stroke were evaluated using Nilipour Farsi aphasia test. A total of 40 patients with stroke and mean age of 60.1 ± 17.2 years were assessed. Among them, the Broca aphasia had the most frequency and global and Wernicke aphasia had the least. The aphasia test showed significant difference between the intervention and control groups at the first and second months of follow-up; but the difference was not significant at the third month. Totally, piracetam does not affect the rate of recovery from aphasia, despite increasing patient's early recovery.

To evaluate the efficacy and safety of topical tacrolimus 0.05% suspension for the treatment of long standing steroid resistant vernal keratoconjunctivitis (VKC). In this interventional case series, patients with refractory VKC were included. All patients had active symptomatic disease despite conventional medical therapy including topical steroids. After discontinuation of all the medications, patients were treated with topical 0.05% tacrolimus eye drop four times a day for at leastr 6 months. Changes in subjective symptoms and objective signs scores after treatment were evaluated one week, one month and 6 months after treatment. Development of possible ocular and systemic complications were also assessed. Twenty-eight eyes of 14 patients, 11 male and 4 female were included. Mean age of the patients was 22±8 years (11 to 38 years). Mean duration of VKC was12±6 years (5 to 23 years). Patients were followed for 10±2 months (6-12 months). All symptoms including itching, redness, photosensitivity, foreign body sensation and mucus discharge improved in all follow-up periods (P<.001). Conjunctival hyperemia was the first sign, which improved 1 week after treatment. Other objective signs including conjunctival papillary hypertrophy, limbal hypertrophy (including Horner-Trantas dots), corneal punctate epithelial erosions and corneal pannus decreased at least one month after treatment. There was no changes in corneal opacity during follow-up period (p> 0.05). No ocular or systemic complications was observed. Topical 0.05% tacrolimus is a safe and effective medication for steroid resistant refractory VKC. It might be better to apply it earlier in these cases before occurance of the complications including irreversible limbal stem cell deficiency and corneal opacity and steroid-induced complications. However, long-term use was needed to control the disease.

A 12 year-old boy and a known case of Job’s syndrome presented with a large conjunctival mass which represented coexistence of HPV and HSV infections.Case Report: The presence of HPV virus within these lesions was confirmed by biopsy and DNA analysis. The mass lesions did not respond to anti-HPV therapy with topical interferon-2b, oral cimetidine and oral acyclovir, but improved promptly with antiviral therapy with intravenous acyclovir administered for cutaneous herpetic lesions. HSV infection was diagnosed clinically by the typical extensive epithelial dendritic lesion over the conjunctival mass and its dramatic response to IV acyclovir. Based on our results and on the relevant literature we propose an immunological mechanism for this unique manifestation of coexisting herpes simplex virus and human papilloma virus infections in hyper-IgE syndrome.

It is a long time that rural conductor plans have been implemented in a large number of rural areas in Iran and a lot of them have been accomplished and there are considerable numbers of rural areas which are not yet completed. Bearing these in mind, qualitative and quantitative assessment of these plans seems quite necessary in regard to their effectiveness and efficiency in tackling rural issues. In the other hands, a lot of government funding, amounting to millions of dollar have been spent on different parts of these projects, such as mapping, studies and so on. Therefore, it is necessary for the inhabitants of the rural areas to get to know what achievements these projects have had for their life. Therefore, in this study we try to assess the effectiveness of these plans on rural physical development of Jahrom County from the villager’s view as a case study so that we may discover the advantages and shortcomings of these plans and make use of the study results in future development planning of rural areas of the country and increase their effectiveness. This study was carried out using the descriptive-analytical method. Some parts of the data were collected through field study, questionnaires, and interview. Other parts of the data, for example, data needed for theoretical and conceptual framework, documents and census were collected through library research. Statistical society included rural areas in which rural conductor plans have been concluded ten years ago. Thus, it included 12 rural areas with a population of 4025 households. To estimate the number of participants, Cochrane sampling formula was used with a confidence level of 70% and error level of 55 %.The sampling was carried out in simple random method. Accordingly, to investigate the effectiveness of rural conductor plans on physical texture and rural development, 298 husbandmen were questioned. Having collected and processed the data in ArcGis, and SPSS,…we turned to data analysis andexplicitation.The following hypotheses were proposed to account for the study questions:The main hypothesis: "It seems that implementation of rural conducted plans has made way for systematized physical texture for rural settlements."To prove the main hypothesis, we had to formulate three secondary hypotheses based on research questions: It seems that implementation of rural conductor plans has paved the way for increasing the quality of rural housing. It seems that implementation of rural conductor plans has increased the rural people access to public service and has facilitated their transportation. It seems that implementation of rural conductor plans has been successful in environmental health. To obtain the value of effectiveness of rural conductor plans in each of the aspects, single sample T-test was used and2.5 was selected as the assessment theoretical median for the effects of rural conductor plans. The study results show that public thoroughfare(2.88) and environmental health (2.51). as variablesof ruralconductor plans on rural physical developmentwere higher than what expected. The study results revealed that rural areas of Behjan and Jarmesht with averages of 2.8 and 2.67 had the highest rank among other rural areas of the study area and rural areas of Kenardaran, Tahooneh and Tadvan were the last three rural areas which had the lowest rank. In this study the value of Freedman statistic was 0.833 which had a significance level higher than what needed (0.05).Therefore, it is concluded that the value of effectiveness of rural conductor plans on rural physical development had not significance discrepancy and is almost homogeneous. In fact, the difference in the performance of rural conductor plans is not large enough to take into account. Based on distribution coefficients, we may conclude that among other rural areas of the study area, the rural areas of GolBerenji, Sagade, Mosaviyeh and Alaviyeh were more homogeneous in four discussed variables. To assess the effectiveness of different aspects on rural physical development, stepwise regression was used. The results show that the aspect of public thoroughfare with a determination coefficient of=0.766 had the largest effect on physical development in a way that it holds 77.6 per cent of the significant effects of conductor plans. Aspects of environmental health housing and land use were 13.3, 4.2 and 3.7 respectively. Assessment of rural conductor plans in 28 indexes at 12 rural areas of Jahrom County show that average effects of the plans were 2.43. Based on single sample T-test, there is a significant difference between average effects of the plans and 2.5 (p< 0.05). Therefore the effects of conductor plans in the rural areas of Jahrom are assessed as having low efficiency.To conclude we put the research hypothesis into test, and accordingly we have: Among the eight housing related indexes, there were only two indexes higher than what expected and had significant correlations. These two indexes were house reinforcement and facilitating getting title deed. Besides, the results of T-test showed that conductor plans were poorly efficient in increasing the quality of rural housing (2.19); thus this hypothesis is rejected. There were eight indexes for public thoroughfare, and except for quality of pavement and beauty of passages other six indexes were significant and higher than what expected. Furthermore, the results of stepwise regression are well indicative of more effectiveness of the variable of public thoroughfare. Thus, the second hypothesis is proved. Among the rural environmental health related variables, three indexes of surface water disposal, rural sewage disposal, quality of garbage collection enjoyed significant correlations. Besides, the results of T-test show that the effectiveness of the plans on rural environmental health was higher than what expected. Thus, the third hypothesis is proved. Finally, to confirm or reject the main hypothesis of the study, based on T-test, the effects of the conductor plans on rural physical development of rural areas of Jahrom County were lower than what expected (2.43). Therefore, the conductor plans have not been successful in making way for organized physical texture of rural settlements. Therefore, the main hypothesis of the study is not proved. According to research findings the following guidelines are proposed: executive approaches such as in institutional and legal capacity expansion in order to facilitate and increase people’s participation in rural physical development of rural areas, allocation of adequate funds and organized financial programs for full implementation of plans, preventing the uncalculated implementation of urban plans in the rural areas without any adjustment for use in rural areas and so on.

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal condition. Women with patellofemoral pain syndrome would present significant weakness in many of hip muscle groups when compared with the healthy group. The objective of the present study was to compare the strength of hip abductor، extensor and external rotator muscle groups in sedentary women with bilateral patellofemoral pain syndrome to a matched control group of sedentary women without patellofemoral pain syndrome.

Twelve women with bilateral patellofemoral pain syndrome as experimental group and other twelve matched women as control group participated in this study. Maximum isometric strength for three hip muscles including abductor، extensor and external rotator muscle groups was measured bilaterally in all subjects using a dynamometer fixed on a platform and finally averaged between two limbs and compared with the control group.

The hip abductor، extensor and external rotator muscle groups of experimental group were statistically weaker than that of the control group (p< 0. 001).

It seems that lower limb muscles including hip muscles of women with patellofemoral pain syndrome become weaker due to disuse conditions.

Keratoconus is a non-inflammatory, progressive thinning process of the cornea. It is a relatively common disorder of unknown etiology that can involve each layer of the cornea and often leads to high myopia and astigmatism.Computer- assisted corneal topography devices are valuable diagnostic tools for the diagnosis of subclinical keratoconus and for tracking the progression of the disease. The traditional conservative management of keratoconus begins with spectacle correction and contact lenses. Several newer, more invasive, treatments are currently available, especially for contact lens-intolerant patients. Intrastromal corneal ring segments can be used to reshape the abnormal cornea to improve the topographic abnormalities and visual acuity. Phakic intraocular lenses such as iris-fixated, angle-supported, posterior chamber implantable collamer and toric lenses are additional valuable options for the correction of refractive error. Corneal cross-linking is a relatively new method of stiffening the cornea to halt the progression of the disease. The future management of keratoconus will most likely incorporate multiple treatment modalities, both simultaneous and sequential, for the prevention and treatment of this disease.

The gas contained in the body cavities is effected by external pressure change، thus with decreasing atmospheric pressure، during ascent or loss of cabin pressure، the gas volume increases and during descent the volume of the gas decreases. The connection with the external environment is achieved in different manners for different cavities. During external pressure change the gas pressure inside the cavities has to reach equilibrium with the air pressure outside. In this review، the gas expansion and the theories of its effect on body cavities are discussed and the body cavities and classified in two distinct categories: Semi-closed cavities and closed cavities. The middle ear، the paranasal sinuses and the lungs are studied in the former and the alimentary canal and the teeth are discussed in the latter.

Photodynamic therapy is a treatment that uses photosensitizer and intense visible light. When photosensitizers get exposed to a specific light wavelength (preferentially in the red region), they produce reactive oxygen species that are toxic to cells. Recently, attention has been focused on porphyrins and their analogs as photosensitizers. Zn (II) tetrapyridinoporphyrazin complex is a water-soluble photosensitizer that has a good potential for application in photodynamic therapy. In this study, phototoxic effect of this complex on HeLa cancer cell line has been investigated. HeLa cell cultures were treated with different concentrations of Zn (II) tetrapyridinoporphyrazin. The cytotoxic effects were measured both in the presence and absence of light using the MTT assay. The light source was a 150W tungsten halogen lamp equipped with a red filter. Our data indicate that porphyrazine’s photocytotoxicity is remarkably more significant than its cytotoxycity in the dark. Statistical analysis showed the effective dose (ED50) values in the dark and light conditions were 8.6 and 4.2 µM, respectively. In addition, the results imply that in the range of 0-12 µM, the increase in the complex concentration correlates with the increase in the cytotoxicity effect. However, the cytotoxicity decreases at the higher concentration (50µM), which is likely due to aggregation of the complex. Our results show that Zn (II) tetrapyridinoporphyrazin complex may be a promising photosensitizer for innovative photodynamic therapy and may have a high potential application in cancer treatment. Furthermore, it seems to have more benefits compared to other known photosensitizers.

The Yo-Yo Intermittent Recovery Test 2 (YIRT2) that designed mainly to estimate VO2max in soccer players, it used to assess athletes abilities to repeatedly perform highintensity exercise. The purpose of the present study was to determine the validity and reliability of the Yo-Yo Intermittent Recovery Test 2 (YIRT2) to estimate maximal oxygen uptake (VO2max) in elite female futsal players. Subjects were Iranian elite female futsal players (n = 33: mean age 22.46±3.04 yrs, height 164.1±4.85 cm, and body mass 56.6±7.31 kg). All subjects performed a graded exercise test on motorized treadmill to examine VO2max by breath to breath gas analyzer apparatus (K4B2, COSMED, Italy) and the YIRT2 to estimate VO2max. The significant correlation found between VO2max measured by gas analyzer and estimated by YIRT2 (r=0.88, r2=0.77, P=0.001), indicating that the YIRT2 is valid test toestimate VO2max.Test-retest results showed that the YIRT2 is the reliable test to estimate VO2max (r=0.98, r2=0.96, P=0.001).Discussion and It is concluded that YIRT2 were a valid and reliable test to estimate VO2max in elite female futsal players. The YIRT2 appears to measure aerobic fitness but may also be used as a field test of the ability to repeat high-intensity efforts.

In order to investigate the phosphorus and iron absorption rate and some of the physiological parameters in bread wheat (Sardari cultivar) and it's ancestral wild species for inbreeding selections and gene transportation, a factorial experiment based on randomized complete block design was conducted. In this experiment, physiological characteristics and absorption rate of phosphorus and iron in bread wheat and it's ancestral wild species (Triticum Boiticum, Aegilops speltoides, Triticum diccocoides, Aegilops tauschii) were investigated under the influence of P fertilizer (in 2 levels) and spraying Fe chelate (in 2 levels). Results showed that there were significant differences amongst different species in terms of phosphorus and iron concentration of shoot. Triticum Boiticum and Triticum diccocoides had the greatest phosphorus absorption rate, while Triticum Boiticum and Aegilops speltoides had the greatest iron absorption rate. Results showed that the application of P fertilizer increased the content of proline and soluble carbohydrates at flowering stage in all species especially the crop species (Sardari cultivar) as well as Aegilops tauschii, so that these species had the greatest proline and sugar content. Interaction effect of P fertilizer by species type on proline and soluble carbohydrates rate was significant.

Breast conserving surgery (BCS) followed by local radiotherapy is the standard treatment for early stage of breast cancer. Margin status may have an important impact on local recurrence and overall survival of patients treated with BCS, but this has not been defined adequately. In this study, we investigated the relationship between microscopic margins and outcome of BCS. Three hundred eighty four patients treated with BCS between 1999 and 2010 were included in our study. All surgeries were performed by a single surgical team. Margins were defined as close if surgical margins were less than 2 mm, as free if surgical margins were more than 2 mm and as positive if malignant cells were present in one of the tissue edges. Demographic, clinical, and pathological factors as well as biological markers, recurrence, and survival rates were compared between the close and the free margins groups. The mean age of patients at the time of diagnosis was 54.2 years. There were 34 (9%) recurrence cases and overall survival was 128.7 months and ten years survival rate was 81%. There was no significant difference between the close and the free margins groups in terms of demographic parameters, tumor characteristics, biological factors (estrogen and progesterone receptor status) and lymphovascular invasion. Also recurrence rate did not differ significantly between these two groups. Our study indicates that there is no significant difference between the patients with close and the free margins in terms of treatment results. There is no clear consensus in the surgeons’ community over the definition of acceptable margin width in BCS, so additional studies are required to find the right answer.

Noise-induced hearing loss remains as the most common problem in industrial societies. This research was conducted to study noise-induced hearing loss by distortion-product otoacoustic emissions (DPOAEs). This study was carried out on 12 male New Zealand White rabbits including control (exposed to noise) and experimental (exposed to 95 dBA SPL white noise at 500-8000 Hz for 8 hours per day during 5 consecutive days). DPOAEs were measured and compared in days zero (before exposure as baseline), eighth (experimental: an hour after latest exposure to noise for Temporary Threshold Shifts: TTS), tenth (experimental: 48 hours after latest exposure to noise for Permanent Threshold Shifts: PTSs). The most and the least values of TTSs, PTSs and DPOAEs amplitude in noise group were correspond to frequencies of 5888.50 Hz and 588.00 Hz, respectively (p<0.05). There was a significant difference between TTSs, PTSs and DPOAEs amplitude at different frequencies in right and left ear of noise group (p<0.05). This difference was related to frequency 5888.5 Hz in each of right and left ear of noise group compared to other frequencies in same ear (p<0.05). There were not any significant difference between TTSs, PTSs and DPOAEs amplitude of right and left ear of noise group at different frequencies (p>0.05). Excessive noise can cause TTSs and noise-induced PTSs and decreased DPOAEs amplitudes. Therefore, DPOAEs can be attributed as a useful tool for study of noise-induced hearing loss.

Morphine effect on reaction to some microbial infections by modulation of immune response. To evaluate the effect of acute morphine injection on Leishmania major infection in sensitive (BALB/c) and resistant (C57BL/6) mouse strains. In this experimental study, a low dose (2mg/kg) and a high dose (10mg/kg) of morphine in two doses were injected to two groups of each mouse, the first concordant with parasite inoculation and the second 15 days later (N=5 for each group). As controls, groups of mice received naloxone before injections of morphine and also a group of mice received saline. Local reaction at the site of parasite inoculation was measured once a week. Local reaction at the site of parasite inoculation increased till fifth week, then decreased and back to the normal size, In contrast, local reaction increased continuously and became multiple in control groups and mice which received low dose morphine. Local reaction did not increase substantially in mice which injected with 10mg/kg morphine so that there was a significantly difference between them and control group (P<0.05). The results of this study showed that acute morphine injection didn’t have a significant effect on the reaction to infection with Leishmania major of C57BL/6 mice, but had a biphasic dose-dependent effect on BALB/c mice reaction to infection with this parasite.

Breast conserving surgery (BCS) is a widely accepted form of operation in patients with early breast cancer. Recurrence remains one of the greatest concerns in breast conserving surgery. It can provoke serious anxiety in the patient and, when treated by mastectomy, negate the objective of conservation. In this study we investigated the prognostic value of demographic, clinical and pathological factors and biological markers in breast cancer patients treated with BCS. This study was performed on 258 patients who underwent BCS from 2002 to 2010. All of the surgeries were performed by a single surgical team. Recurrence and its risk factors were evaluated. The mean age of the patients at the time of diagnosis was 50. The overall 10 year survival was 81%, 5 year survival was 88% and recurrence rate after surgery was 9%. Lymphovascular Invasion (LVI) was observed in 41 (16%) patients and in 11 (48%) patients with recurrence. Our study confirmed that tumors with estrogen receptor negative and LVI had more recurrence rate but other demographic, clinical and pathological factors and biological markers (progesterone receptor, P53, HER-2) did not have any significant effect on recurrence. We recommend considering LVI and estrogen receptor assay as a prognostic factor in the patients treated with BCS.

Lack of application of the nursing process can reduce the quality of care so this study aimed to diagnose the nursing process barriers from the perspective of the intensive care units’ nurses in the selected hospitals of Tehran. This cross-sectional descriptive study has been done on 63 male nurses (%44.4) and female nurses (%55.6) that were chosen from selected hospitals in Tehran, based on cluster-random sampling method. The data gathered using a researcher made questionnaire. The most important individual barriers from the perspective of nurses were lack of sufficient information about concept of the nursing process (79.4%) and lack of belief in doing the patient care according to the nursing process (74.6%) and inadequate learning about the nursing process in intensive care units (71.4%). In addition, the most important management barriers were lack of enough time for doing the nursing process due to excessive number of the patients (84.1%), lack of authoritie's support for implementation of the nursing process (76.2%) and submitting non-nursing duties to the nurses (76.2%). Health care authorities must help in promotion of the health care with employing sufficient nurses, educating them and providing necessary situations for nursing process.

Prefabricated posts have recently become more popular due to their satisfactory results while saving time and reducing costs. Glass-fiber prefabricated posts were paid more attention because of reducing the risk of root fracture as well as minimal allergic hypersensitivity and corrosion with satisfactory cosmetic results. Surface treatment is one of the various factors that might affect retention of a post. The purpose of this study was to evaluate the effect of surface treatment on the retention of an Iranian E-glass fiber post. Thirty two intact central maxillary incisors were selected. The coronal aspect of each tooth was removed and the remaining root received endodontic therapy. The specimens were then divided into 4 groups (n=8). Post spaces were prepared to a depth of 10mm. The posts (HtCo، Iran) received one of the surface treatments including cleaning with alcohol (Alc)، air borne-particle abrasion and cleaning with alcohol (Air-Alc)، cleaning with alcohol and conditioning with silane treatment (Alc-Sil) or airborne- particle abrasion، cleaning with alcohol and conditioning with silane treatment (Air-Sil). All the posts were luted with Panavia F after conditioning the canal dentin primer (ED-primer) according to the manufacturer's instructions. After cementation، the specimens were stored at 37°C for 30 days and subjected to simulated aging conditions، consisting of 7500 thermal cycles (5°C/55°C). Retention of the posts was measured with a universal testing machine with a crosshead speed of 2mm/min. The data were analyzed using one-way ANOVA and Duncan tests (α=0. 05). The mean retentive values (N) of the test groups were as follows: Alc=157. 63±39. 91، Air-Alc=171. 53±47. 80، Alc-Sil= 167. 87±42. 49، Air-Sil= 166. 53±40. 32. There was no significant difference between the mean values of the four groups. Treating the surface of HtCo Iranian post produced no significant improvement in the retention of the posts.

Hepatitis B vaccination has been included in routine immunization of all individuals according to WHO recommendations since 1991. Despite successful coverage, 3-5% of recipients fail to mount a desirable protection level of Ab. Vaccine failure results from: emergence of mutation, immune failure of individuals, decrease in vaccine potency, and etc. The quality of Hepatitis B vaccine should be evaluated by a reliable method. The amount of vaccine antigen was measured through the in vitro assay of Hepatitis B vaccines which consists of multiple dilutions of the reference material and samples. The preparations were evaluated by Elisa to determine the amount of HBsAg

Muscles that contribute in production of sound have an important role in specific language. Knowledge of normal activities of these muscles is very important in language dysfunction and pathologic conditions. Needle electromyography is complementary approach in clinical evaluations of above conditions but it is a painful method for evaluating of the patient. Surface electromyography can be used to neurophysiological behaviors and effect of treatment interventions and is accepted by scientific academies. The purpose of this study is appointment of new approach in this area. Sixty eight healthy subjects (34 female and 34 male) in range of 20-30 years old were contributed after supplement of questioner form in this study. Subjects sat in a chair with arm rest and recording electrodes placed on muscles of Thyroarytenoid and Cricothyroid of both side (right and left) at middle and lower parts of throat, near of 1 cm from midline. Silent activity and fricative voice (z-zh) and voiceless (s-sh) activities recorded randomly at 10 second with interval rest between them for 5 repetition. All of signals processed and then compared in time, frequency and non linear measurements. Non linear values such as Percent of recurrence, Entropy were reduced significantly in fricative voice (P<0.05). Surface activity recording of Thyroarytenoid and Cricothyroid muscles is possible and sensitive parameter is non linear values. Surface electromyography is new approach for assessment of above muscle in clinical evaluation of speech pathologic conditions.

This study compares the results of telephone consultations with the results of clinical examinations in a breast cancer clinic in Tehran, Iran to assess the value and accuracy of telephone consultations for the future planning. In 2500 telephone calls, 800 Symptomatic patients were identified and asked to visit the center for the further investigations by the specialists. The agreement between two observers data were compared by the Kappa statistic. Totally 174 patients complied with the recommendation and included in the study. The most common chief complaints of visitors were: breast mass (42%) and breast pain (35%). Kappa statistic showed a very good agreement (K = 0.62, P <0.001) between telephone consultant's diagnosis and the specialists visit findings. This agreement for breast cancer diagnosis, although lower, was also good (K = 0.55, P <0.001). The study findings indicate that consultants may diagnose and manage some common conditions via telephone, usually following the established protocols. More studies are needed to determine the economic and logistic advantages of telephone consultations. Practice Implication: By assessment of strength and weakness of this service, it is possible to develop an easy to use information system for women who need breast cares.

Today, psychological diseases like so many diseases, have an old history. Clinical Information System of psychological diseases resulting from war is a part of the information management system of mental illnesses, due to the management of mental patients from the war.This study is aimed to compare information management of psychological diseases in American, Australia and England with Iran.Methods and Materials: This research is a study. At first, the existing situation was studied in three Psychiatric Centers in Ahvaz and Tehran with the use of a cheek list. Then information system of psychological disease has been studied in elected countries and based on the need of our own country, proposing practical solutions for Iran. The results of this study showed that there was no a information system of psychological disease in Iran. Also, four factors of this system including (goals, content structure, informational elements, information registration criteria) are reviewed in four selective countries.Discussion and The design and implementation of this system in psychiatric centers is recommended to set two main goals including quality control and cost control in Iran.

Nitric oxide (NO) have a dual action in mouse oocyte meiotic maturation which depends on its concentration, but the mechanisms by which it influences oocyte maturation has not been exactly clarified. In this study different signaling mechanisms which exist for in vitro maturation of meiosis was examined in cumulus cell-enclosed oocytes (CEOs) after injection of pregnant mare''s serum gonadotropin (PMSG) to immature female mice. The CEOs were cultured in spontaneous maturation and hypoxanthine (HX) arrested model. Sodium nitroprusside (SNP, an NO donor, 10mM) delayed germinal vesicle breakdown (GVBD) significantly during the first 5 hrs of incubation and inhibited the formation of first polar body (PB1) at the end of 24 hrs of incubation. SNP (10-5M) stimulated the meiotic maturation of oocytes significantly by overcoming the inhibition of HX. Sildenafil (a cGMP stimulator, 100 nM), had a significant inhibitory effects on both spontaneous meiotic maturation and HX-arrested meiotic maturation. Forskolin (an adenylate cyclase stimulator, 6µM) and SNP (10mM) had the same effects on GVBD. Forskolin reversed the SNP (10-5M) stimulated meiotic maturation. These results suggest that differences in pathways are present between SNP-inhibited spontaneous meiotic maturation and SNP-stimulated meiotic maturation in mouse oocytes