mehrzad lotfi

To investigate whether the bone age (BA) of Iranian children could be accurately assessed via an artificial intelligence (AI) system. Accurate assessment of skeletal maturity is crucial for diagnosing and treating various musculoskeletal disorders, and is traditionally achieved through manual comparison with the Greulich-Pyle atlas. This process, however, is subjective and time-consuming. Recent advances in deep learning offer more efficient and consistent BA evaluations.

From left-hand radiographs of children aged 1–18 years who presented to a tertiary research hospital, 555 radiographs (220 boys and 335 girls) were collected. The reference BA was determined via the Greulich and Pyle (GP) method by two radiologists in consensus. The BA was then estimated to use a deep learning model specifically developed for this population. Model performance was evaluated using multiple metrics: Mean square error (MSE), mean absolute error (MAE), intra-class correlation coefficient (ICC), and 95% limits of agreement (LoA). Gender-specific results were analyzed separately.

The model demonstrated acceptable accuracy. For boys, MSE was 0.55 years, MAE was 0.59 years, ICC was 0.74, and the 95% LoA ranged from -0.8 to 1.2 years. For girls, MSE was 0.59 years, MAE was 0.61 years, ICC was 0.82, and the 95% LoA ranged from -0.6 to 1.0 years. These results indicate stronger predictive accuracy for girls compared to boys.

Our findings demonstrate that the proposed deep learning model achieves reasonable accuracy in BA assessment, with stronger performance in girls compared to boys. However, the relatively wide 95% LoA, particularly for boys, and prediction errors at the extremes of the age range highlight the need for further refinement and validation. While the model shows potential as a supplementary tool for clinicians, future studies should focus on improving prediction accuracy, reducing variability, and validating the model on larger, more diverse datasets before considering widespread clinical implementation. Additionally, addressing edge cases and specific conditions that a human reviewer may detect but the model might overlook, will be essential for enhancing its clinical reliability.

The widespread utilization of high-resolution computed tomography (HRCT) for diagnosing and management of COVID-19 during the pandemic has prompted worries regarding a potential rise in future breast cancer cases. We aimed to estimate the Life Attributable Risk (LAR) of breast cancer in Shiraz, Iran, linked to HRCT use during the COVID-19 pandemic.

A cross-sectional study was conducted at Namazi Hospital in Shiraz from February 2, 2020, to December 31, 2022.The Imaging Performance Assessment of CT Scanners (ImPACT) patient dosimetry calculator was used to determine organ doses. LAR was computed utilizing the Biological Effects of Ionizing Radiation (BEIR) Committee models.

The sample size was 666, with ages spanning from 15 to 95 years. 25% (168) had HRCT more than once (2 to 8 times). The mean and 95% uncertainty limits (UL) for Total LAR of breast cancer, considering both single and multiple doses of radiation exposure, was 217 (95% UL, 194-244) per 100,000 persons.

According to our research, the risk of potential breast cancer should not be overlooked. It is advised to use the ultra-low-dose protocol over the low-dose in HRCT. Physicians, pulmonologists, and infectious disease specialists are advised to avoid unnecessary and repeated requests for chest HRCT in a short period.

Given that COVID-19 spreads worldwide, it has become a public health priority. This study aims to investigate the correlation between social capital and the epidemiological indicators of COVID-19. 

This survey is an ecological study, so all studied variables are aggregated. To collect the variables in the study, a data set was provided, which included the information of each country based on the cumulative deaths, case fatality rate, recovery rate, and the number of performed COVID-19 tests. We drew scatter plots of the social capital for the studied countries based on COVID-19 indices. 

In all the studied countries, the highest cumulative incidence rate of COVID-19 cases was in Montenegro (60310.56 per million), while the lowest cumulative incidence rate of cases was in Tanzania (8.42 per million). The highest and lowest cumulative incidence rate of death due to COVID-19 was in Belgium (1425.15 per million) and Burundi (0.08 per million), respectively. Also, social capital has a significant direct correlation with the cumulative incidence rate of cases (r=0.42, P<0.001), the cumulative incidence rate of death (r=0.31, P<0.001), and the number of performed COVID-19 diagnostic tests per million. Social capital was correlated with recovery and mortality rates (r= -0.21, P=0.007).

Considering that social capital has a statistically significant relationship with the indices of case fatality and recovery rates, it is possible to increase social capital with appropriate interventions by relevant individuals and organizations to improve the pandemic management in different countries.

Reinfection with Coronavirus Diseases 2019 (COVID-19) has raised remarkable public health concerns globally. Therefore, the present retrospective cohort study intended to investigate COVID-19 reinfection in registered patients of Fars province in Iran from February 2020 to April 2021. The patients’ data, including the COVID-19 infection, symptoms, comorbidities, and demographics, were collected using the Health Information Systems (HISs). The patients were divided into three groups in terms of the duration between the initial infection and reinfection, including 28-44, 45-89, and more than 90 days. Following the univariate analysis, logistic regression was used to investigate the factors effective on COVID-19 reinfection.  A total of 213768 patients had a positive Polymerase Chain Reaction (PCR) test. The reinfection rate was 0.97% (2079 patients). Of these re-infected individuals, 14.9%, 18.5%, and 66.6% had their second positive test 28-45, 45-89, and ≥90 days later, respectively. The mean duration between the initial infection and reinfection was 130.56 days (29-370 days). The chance of reinfection was significantly higher in the youths (Odds Ratio (OR)=2.055; P<0.001), men (OR=1.283; P<0.001), urban population (OR=1.313; P<0.001), and healthcare providers (OR=4.453; P<0.001). The patients with chronic pulmonary diseases, chronic kidney diseases, and malignancy were 1.421 (P=0.036), 2.239 (P<0.001), and 3.437 (P<0.001) times, respectively, more likely prone to reinfection.  The results of this study showed that there is a higher risk of reinfection in several vulnerable groups including healthcare providers, young individuals, residents of urban areas, men, and individuals with underlying diseases.

According to the hypothesis, COVID-19 is less prevalent in regions with warm climates. Contradictory results have led us to investigate the correlation between temperature and the cumulative COVID-19 incidence rate.

We obtained COVID-19 data from CRONALAB, COVID-DASHBOARD, and MCMC databases of Fars Province, Iran, linked the data and finalized daily COVID-19 cases. The daily data on the temperature was gotten from meteorological stations’ reports from March 21, 2020, to March 21, 2021, for each county of Fars Province, Southern Iran. The daily weighted cumulative incidence rate of COVID-19 cases was calculated for all counties, separately. Initially, for uniform data visualization, the average air temperature data were transformed into ranked percentiles. Then, to visually assess the study hypothesis, the distribution of COVID-19 cumulative incidence was visualized on percentiles of temperature. Given the non-linear distribution of the data, we performed exploratory analyses using the generalized additive models and locally weighted (polynomial) regressions to choose the best response function. Then, the generalized linear models were used to parametrically build the model.

The generalized additive models showed a small decreasing, near horizontal, linear pattern for COVID-19 incidence rate as the function of temperature (pseudo R2: 0.001, deviance explained: 0.13%, coefficient: -0.02). The GLMs showed head-to-head results (deviance explained: 0.13%, coefficient: -0.02], supported by similar Akaike information criteria (AICs) (34945). However, according to the locally weighted regressions model’s curve, lower COVID-19 incidence rates were recorded on days when the temperatures ranged from 60 to 80 percentiles, equal to 20°C to 25°C in a cold climate and 25°C to 35°C in a warm climate. This is while the rates increased at lower and upper temperatures.

Daily COVID-19 incidence rate cannot be explained as a function of daily temperature in Southern parts of Iran. Higher rates of disease transmission out of the range of 20°C to 25°C for cold temperatures and 25°C to 35°C for warm climates might be linked to people’s indoor gatherings, coupled with insufficient ventilation.

The coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide and becoming a pandemic. Since the diagnostic tests are relatively expensive, simple diagnostic tests are valuable for quarantining individuals suspicious of COVID- 19. This study is designed to predict the potential contributing factors of COVID-19 diagnosis. It was a referral-based historical cohort study. 363358 individuals referred to the health centers from February to November 2020 in Fars province were entered in the study. The collected data before the lab test were symptoms, underlying diseases, some conditions, risk factors, and demographic information. The Reverse transcriptase polymerase chain reaction test was performed to identify the COVID-19 virus. Chi-square and T-tests were used to compare the variables. A logistic regression test was used to identify predictor variables. Positive COVID-19 test was reported for 119,324 (% 34.9) participations. The positive group result was compared with that of the negative group (n=244,034). The studied symptoms were significant in positive patients. According to the odds ratio (OR), smell disorder (OR=3.80, P<0.001), taste disorder (OR=3.17, P<0.001), and fever (OR=2.65, P<0.001) were common. However, diarrhea, chest pain and dyspnea showed the lowest odds ratio. According to the results, DM (OR=1.46, P<0.001), HTN (OR=1.42, P<0.001), and CVD (OR=1.27, P<0.001) were common in patients with positive COVID-19 tests. Cases whose Body Mass Index (BMI) was more than 40 (excessive obesity) showed a higher odd (OR=1.45, P<0.001) for being positive. According to the results, the symptoms and underlying diseases are effective factors in predicting COVID- 19 disease. Identifying these factors for Covid-19 disease helps health policymakers to make quick decisions and take timely action.

on the one hand, very limited studies were performed on identifying the active regions during swallowing among healthy individuals and those with dementia. On the other hand, to the best of our knowledge, no research has yet compared the injured areas in the brain of patients with dementia with and without dysphagia, such that damage to specific regions in dementia causes dysphagia may be found using this approach. The present study was performed to evaluate the atrophic changes in the internal temporal lobe (hippocampus), frontal (anterior cingulate cortex), and parietal (posterior cingulate cortex), and insula cortex in these patients. the present study is a retrospective cross-sectional study. 54 patients with dementia were investigated. The data were collected using a checklist, including information related to the dysphagia, and the brain MRI findings to determine atrophy. The extent of atrophic changes was recorded in the checklist using the median temporal lobe atrophy (MTA) score, Koedem score scale, and the global cortical atrophy (GCA) scale. To present the results, descriptive statistics, and data comparison, chi-square tests were used. The mean age of the examined patients was 72.01 with a standard deviation of 10.64 years, and range of 50-95 years. Out of them, 32 (59.3%) were male, and 22 (40.7%) were female. The degree atrophy of hippocampus (p=0.12), frontal lobe (P=0.46), parietal lobe (P=0.83), and insular cortex (P=0.91) in the patients with and without dysphagia did not show significant differences. The frequency distribution of the degree of atrophy based on the site of the development of atrophy was significant in the patients with dysphagia (P=0.033). In general, the findings showed that individuals with dementia who had dysphagia had more hippocampal and frontal lobe (and anterior cingulate) atrophy than dementia patients who did not have this impairment.

The objective of this study was to investigate the influence of iterative reconstruction (IR) algorithm on radiation dose and image quality of computed tomography (CT) scans of patients with malignant pancreatic lesions by designing a new protocol.

The pancreas CT was performed on 40 patients (23 males and 17 females) with a 160‑slice CT scan machine. The pancreatic parenchymal phase was performed in two stages: one with a usual dose of radiation and the other one after using a reduced dose of radiation. The images obtained with usual dose were reconstructed with Filtered Back Projection (FBP) method (Protocol A); and the images obtained with the reduced dose were reconstructed with both FBP (Protocol B) and IR method (Protocol C). The quality of images and radiation dose were compared among the three protocols.

Image noise was significantly lower with Protocol C (10.80) than with Protocol A (14.98) and Protocol B (20.60) (P < 0.001). Signal‑to‑noise ratio and contrast‑to‑noise ratio were significantly higher with Protocol C than with Protocol A and Protocol B (P < 0.001). Protocol A and Protocol C were not significantly different in terms of image quality scores. Effective dose was reduced by approximately 48% in Protocol C compared with Protocol A (1.20 ± 0.53 mSv vs. 2.33 ± 0.86 mSv, P < 0.001).

Results of this study showed that applying the IR method compared to the FBP method can improve objective image quality, maintain subjective image quality, and reduce the radiation dose of the patients undergo pancreas CT.

Recently, people have recognized the post-acute phase symptoms of the COVID-19. We investigated the long-term symptoms associated with COVID-19, (Long COVID Syndrome), and the risk factors associated with it.

This was a retrospective observational study. All the consecutive adult patients referred to the healthcare facilities anywhere in Fars province from 19 February 2020 until 20 November 2020 were included. All the patients had a confirmed COVID-19 diagnosis. In a phone call to the patients, at least three months after their discharge from the hospital, we obtained their current information. The IBM SPSS Statistics (version 25.0) was used. Pearson Chi square, Fisher’s exact test, t test, and binary logistic regression analysis model were employed. A P value of less than 0.05 was considered to be significant.

In total, 4,681 patients were studied, 2915 of whom (62.3%) reported symptoms. The most common symptoms of long COVID syndrome were fatigue, exercise intolerance, walking intolerance, muscle pain, and shortness of breath. Women were more likely to experience long-term COVID syndrome than men (Odds Ratio: 1,268; 95% Confidence Interval: 1,122-1,432; P=0.0001), which was significant. Presentation with respiratory problems at the onset of illness was also significantly associated with long COVID syndrome (Odds Ratio: 1.425; 95% Confidence Interval: 1.177-1.724; P=0.0001). A shorter length of hospital stay was inversely associated with long COVID syndrome (Odds Ratio: 0.953; 95% Confidence Interval: 0.941-0.965; P=0.0001).

Long COVID syndrome is a frequent and disabling condition and has significant associations with sex (female), respiratory symptoms at the onset, and the severity of the illness.

Skin rashes, mostly seen in children and adolescents, are considered among the most common side effects of azole antifungals. Although therapeutic concentrations of voriconazole (VCZ) have been documented for infected skin, there is no evidence specifying whether specific dermatologic side effects could predict high VCZ serum concentration, especially in high-risk leukemic children.

Herein, we report a unique skin side effect of VCZ in a 5-year-old boy with T-cell acute lymphoblastic leukemia (ALL) referred to Amir Medical Oncology Center in Shiraz, Iran. The patient experienced erythroderma and macular rashes shortly after VCZ consumption, leading to generalized exfoliative skin rashes. Concurrent to these skin manifestations, VCZ serum concentration reached the supratherapeutic levels despite the recommended VCZ doses. As a result, VCZ was withheld, and the patient was treated with caspofungin. The lesions were resolved gradually within 2 weeks, and the patient successfully completed his treatment course with caspofungin.

The unique case presented in this study emphasizes the need for a high index of suspicion for VCZ toxicity in any patient with atypical dermatologic manifestations, especially generalized exfoliative skin rashes. Based on this report, VCZ supratherapeutic concentration could be predicted early in the course of treatment. Additional therapeutic dose monitoring should be considered to establish a confirmatory diagnosis. It is required to further investigate the toxic effect of high VCZ concentration on the skin epithelium.

Thalassemia is a common hemoglobinopathy in our region. Iron overload is a major complication of thalassemia, and an accurate quantification of iron deposition is the mainstay of treatment planning. The liver is the main organ for storage of iron, and quantification of hepatic siderosis is a reliable estimation of total iron overload.

The aim of this study was to determine the accuracy of chemical shift sequences (CSS), especially a water only sequence (WOS), to estimate hepatic siderosis in thalassemia patients. Patients and

During a seven-month period, from May to December 2016, one hundred and two known cases of thalassemia major and intermedia underwent liver MRI. The liver iron concentration was estimated using T2* MR relaxometry. The iron signal percentage and fraction were calculated using chemical shift sequences and correlated with estimated liver iron concentration (LIC).

The correlation coefficient of in-phase and opposed-phase sequences was 0.566 in estimating hepatic siderosis, which was improved by employing water only sequence (0.640). The sensitivity, specificity and positive predictive value were 90.5%, 94.4% and 98.7% for the in-phase and opposed-phase sequences and 82.1%, 94.4% and 98.6% for the water only sequence, respectively.

Chemical shift sequences, including a water only sequence, are accurate for the assessment of hepatic siderosis. Water only sequences can effectively minimize the confounding effect of fatty liver.

In late December 2019, a viral pneumonia known as coronavirus disease 2019 (COVID-19) originated from China and spread very rapidly in the world. Since then, COVID-19 has become a global concern and health problem.

We present four patients in this study, selected from among patients who presented with pneumonia symptoms and were suspicious for COVID-19. They were referred to the intended centers for COVID-19 diagnosis and management of Shiraz University of Medical Sciences in southern Iran. Two nasopharyngeal and oropharyngeal throat swab samples were collected from each patient and tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using real-time reverse-transcriptase– polymerase-chain-reaction (RT-PCR). The samples were also tested for influenza viruses and the complete respiratory panel.

In the present report, four patients were diagnosed in the starting days of COVID-19 disease in our center in southern Iran with co-infection of SARS-CoV-2 and influenza A virus.

This co-infection of COVID-19 and influenza A highlights the importance of considering SARS-CoV-2 PCR assay regardless of other positive findings for other pathogens in the primary test during the epidemic.

Prostate cancer is the most common malignancy among the male population in the United States and the 3rd most common non-skin cancer among men in Iran. Its prevalence has shown a rising trend in recent decades. The aim of this study was to report the epidemiological features of prostate cancer in patients referred for prostate biopsy in the south of Iran and to evaluate the accuracy of the levels of the prostate-specific antigen (PSA) and the PSA-density (PSAD) as well as the extension of the disease in the prediction of the biological behavior of prostate cancer.
This is a retrospective study on the medical records of 1982 consecutive patients who underwent transrectal ultrasound-guided biopsy due to an abnormal digital rectal examination and/or an elevated PSA level following referral from the Urology Ward to the Radiology Department of Shahid Faghihi Hospital in Shiraz, southern Iran, between December 2003 and July 2014.
The overall cancer detection rate was 33.1%. Although the cancer was more prevalent among the elderly patients, a significant fraction (7%) of the patients were aged Our study underlines the relationship between age and the frequency of cancer; the levels of the PSA and the PSAD and the Gleason score; and the extent of tumor involvement and the grade of prostate cancer and also highlights the significance of screening, especially in younger patients.

Schizophrenia is a common psychiatric disease and is characterized by changes in several brain metabolites detectable by magnetic resonance spectroscopy (MRS). Electroconvulsive therapy (ECT) is a general method of management for most severe psychiatric conditions that may play a role in changing the brain metabolites. This study examined the effectiveness of adjuvant ECT with oral medication compared to that of oral second generation antipsychotic medication alone on brain metabolites in patients with chronic schizophrenia.
This study was conducted on 20 patients with chronic schizophrenia who were admitted to a hospital; of them, 10 underwent ECT as an adjuvant therapy with oral medication at least 8 times, and 10 patients were given a second- generation antipsychotic therapy drug (risperidone and olanzapine) without ECT for at least 4 weeks. MRS was used to assess brain metabolites, including N-acetyl aspartate (NAA), choline (Cho), creatine (Cr), myoinositol (MI), and Glx (glutamate [Glu] and glutamine [Gln]), in the left prefrontal cortex, left thalamus, left hippocampus, and left occipital cortex. Differences between the 2 groups were not significant, except for method of treatment.
The NAA/Cr ratio in the left prefrontal cortex was significantly higher in ECT-treated patients (P = 0.035). In addition, the Cho/Cr ratios in the left prefrontal cortex and left thalamus were statisticaly lower in the ECT-treated patients than those treated with oral antipsychotic drugs alone (P = 0.019). No statistically significant changes were observed between the 2 groups in other sites of the brain. In addition, no statistically significant differences were detected between the 2 groups in SAPS and DES scores.
Compared to oral antipsychotic drug treatment, ECT had improving effects on at least 2 metabolites in the brains of patients with schizophrenia. Therefore, ECT may have a neuroprotective effect in these patients.

To investigate the correlation between T2* values of different regions of interest (ROIs) in myocardium with the means of semi quantitatively estimating the myocardiac iron content in the thalassemia major patients. In the same setting we tried to design a model to predict T2* value of interventricular septum (septum) based on T2* values of other convenient ROIs in myocardium.
130 patients underwent ECG-gated cardiac magnetic resonance imaging (MRI), and T2* values were measured in different ROIs. Full-thickness ROIs are drawn manually in septum, entire left ventricle (LV) wall, the region of the best visual conspicuity (sharp), and LV free wall. The relation between T2* values of these four regions are investigated. Depends on the grade of siderosis, the patients are divided into four groups; Severe: T2* ≤ 10, Moderate: 10 20. The statistical analysis carried out using Matlab R2015b.
In patients with the cardiac T2* ≤ 20, the statistical analysis confirms a significant correlation (α = 0.001) between T2* values of septum and the ROIs named above. Moreover, the statistical results become more concordant with decreasing T2* values. In addition, for patients with a T2* > 20, a weak correlation is noticed between T2* values of different ROIs. Three predictor models are provided to estimate T2* value of septum using T2* values of entire LV wall, sharp region, and LV free wall.
The T2* values of the LV free wall and the entire LV wall are reliable alternatives to estimate the T2* value of septum. The predictor model based on T2* value of entire LV wall provides the most reproducible estimation.

Color Doppler study of carotid and vertebral arteries is a non-invasive, reliable and also easily available, cost-effective method for screening and follows up of patients at risk of stroke to differentiate patients need surgery or intervention from whom could be followed by medical management. I reviewed anatomy of cervical arteries and different techniques such as B- mode or gray scale scanning, color flow mapping and spectral analysis for evaluation of both carotid and vertebral arteries.

Some evidence, not in large study populations, suggests that nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) share common interactions. We aimed to determine the prevalence of NAFLD and MetS in a large population registered to Kavar Cohort Study center. We also assessed the role of each component of MetS in NAFLD existence.
Data were obtained from 3415 volunteers who called and refereed to our center. Complete anthropometric and laboratory measurement and abdominal ultrasonography was done for these individuals to screen NAFLD and its grade. A questionnaire was also used to obtain information on demographical and medical history and alcohol consumption. MetS was defined in all participants based on the National Cholesterol Education Program Adult Treatment Panel III (2001) (NCEP/ATP-III) and criteria for clinical diagnosis of metabolic syndrome in Iranian adults (CCDMIA).
Among the refereed individuals, 2980 peoples were aged ≥18 years with male to women ratio of 1:2.45. NAFLD was diagnosed by ultrasound in 32.9% and 27.4% of men and women, respectively. MetS was detected in 65.9 and 64.6 of the patients with NAFLD (based on NCEP/ATP-III) and in 30.1% and 73.7% (based on CCDMIA) of men and women, respectively. There were no significant differences between two gender in none of the components (P>0.05). Although, OR for hyperglycemia and abdominal obesity were approximately high in CCDMIA criteria (0.9613 and 1.2082, respectively), the differences were not statistically significant.
NAFLD was associated with MetS. However, it was not possible to determine whether NAFLD predating the development of MetS.

Osteoarthritis is a progressive joint disease. Mastic fruit has antioxidant and anti-inflammatory properties. Bone marrow stem cells have the ability to differentiate into chondrocyte. The purpose of this study is to evaluate the effect of Pistacia atlantica hydro alcoholic extract with bone marrow- derived stem cells on induced knee osteoarthritis in rat.
Fifty male Wistar rats were divided into 5 groups of 10. Then, under anesthesia on days zero and 3, fifty μl collagenase type 2 was injected in the left knee. After 10 weeks, osteoarthritis was induced. The rats were divided into 5 groups: control, Pistacia atlantica hydro alcoholic extract therapy, treatment by stem cell and Pistacia atlantica hydro alcoholic extract, stem cell therapy alone, and treatment with hyalgan. After 12 weeks of treatment for osteoarthritis, radiographic and histopathologic surveys and also measurement of antioxidant properties as MDA-TAC were performed.
The results after 12 weeks revealed that the group with stem cell and pistacia atlantica extract had a significantly different and favourable results compared the other treatment groups (p It seems that Pistacia atlantica hydro alchoholic extract with bone marrow-derived stem cells are effective in knee cartilage repair.

The present study is a utilization review of outpatient services offered by specialists and underlying social factors among urban families in Fars Province, Iran. The present study conducted among 1900 residents in urban areas of Fars Province in January 2013. Sampling was carried out through a three-step method, which was designed based on utilization of health services survey. Data were analyzed using statistical tests. About a quarter of the sample group expressed the need for outpatient services of specialists, of whom about 83% received medical attention of a specialist. Among the main reasons for not referring to specialists were financial issues as the top reason followed by refusal to visit the physician, long distances and high costs of the services. About 17% of the participants who needed outpatient services of specialists failed to receive the service. This indicates the necessity of measurements to improve the access to outpatient services of specialists among different social groups.

It is undoubtedly, the today business world is the world of organizations and custodians of organizations’ creation, management and development, are human. Among humans, the role of managers as designers, navigator and administrators of the organization is no secret, so effective application of the system of selection, recruitment, retention, evaluation and development of them is important and special. This longitudinal and intervention study is based to determine the effect of 360-degree feedback evaluation in Shiraz University of Medical Sciences managers in 2012 and 2014. The study sample consisted of a total of 7 Managers and 418 questionnaires have been completed. Each manager were evaluated by himself, superiors, colleagues and subordinates. Data Analysis showed the status of each manager in the first and second stages. In first stage, results of one-way ANOVA test showed no statistically significant difference between the results of the managers and others, but in the second stage, significant differences were observed. Consequently, the results showed that result feedback have had an impact on performance.

Measurement of common carotid artery intima–media thickness (IMT) is considered a safe, inexpensive, precise and reproducible measure of atherosclerosis. It is also considered an early predictor of vascular events such as cerebrovascular and cardiovascular complications.. This study aimed to determine the predictors of common carotid Intima-Media Thickness (IMT) and cardiovascular risk factors in a sample of Iranian general population..Patients and This cross-sectional study was performed on a randomly selected sample of Iranian general population in Shiraz, southern Iran, during a 10-month period from November 2010 to September 2011. All patients underwent anthropometric and blood pressure measurements and medical history assessment and physical examination were also performed. Laboratory measurements included Fasting Blood Glucose (FBS), lipid profile, Complete Blood Count (CBC) and thyroid hormones. Moreover, IMT was measured in the subjects with a cut-off point of 0.8 mm and its correlation with other risk factors was assessed.. From a total of 777 eligible subjects included in the study, 326 cases (42%) were male and 451 (58%) were female with the mean age of 42.64 ± 13.89 (ranging from 18 to 88) years. Overall, 78 (10.1%) subjects had hypertension, 51 (6.5%) were diabetic and 158 (20.3%) had metabolic syndrome. Moreover, IMT was found to be normal in 605 (77.9%) subjects while 172 (22.1%) subjects had thick IMT. Patients with IMT thicker than 0.8 mm were significantly older (P < 0.001) and had a higher prevalence of hypertension (P < 0.001), Diabetes Mellitus (DM) (P = 0.016), smoking (P = 0.002), higher levels of Triglyceride (TG) (P = 0.022), higher Body Mass Index (BMI) (P = 0.005) and larger waist circumference (P < 0.001). Thicker IMT was associated with higher risk of metabolic syndrome (P = 0.008). Women had also a higher prevalence of thick IMT compared to men (50.6% vs. 49.4%; P = 0.027).. The prevalence rates of cardiovascular risk factors as well as metabolic syndrome are relatively high in our region. Intima-media thickness is affected by age, hypertension, DM, smoking, BMI, waist circumference and TG levels and is an appropriate predictor of atherosclerosis. Appropriate policies and actions should be undertaken to prevent the cardiovascular events in our regions..

Health care systems depend critically on the size, skill, and commitment of the health workforce. Therefore, researchers have a close observation on the subjects which leads to an increase in the productivity of human resources. This study aims at determining the relationship between the quality of work life and the productivity of knowledge workers of the central field of Shiraz University of Medical Sciences, in order to determine the factors effective in the quality of their working life. This cross-sectional study was conducted on 300 individuals selected by stratified random sampling method. On 761 knowledge workers of the central field of Shiraz University of Medical Sciences by using Timossi questionnaire of Quality of Work Life and Knowledge Worker Productivity Assessment questionnaire of Antikainen, during May and June 2011. The collected data were recorded by SPSS version 15 software and then it underwent statistical analysis using Pearson correlation. The P value level for statistical significance was set at 0.05. In general, 50% of the knowledge workers were dissatisfied about their quality of work life, and the other 50% had little satisfaction. 18% of the staff were in an unfavorable condition and 82% had a poor productivity. Also, the quality of work life had a positively significant relationship with the productivity of human resources (r=0.568; P>0.001). Most of the knowledge workers in the central field of Shiraz University of Medical Sciences had low productivity and quality of work life. Considering the relationship between the two variables, taking measures to improve the quality of work life can lead to more creative and profound planning in presenting services and, as a result, improving the productivity of the knowledge workers.

Human resources impose a vast expense on health organizations. Therefore, improvement of the productivity of human resources is of considerable concern to executive managers of every country.
In the present study, first, the knowledge workers’ productivity assessment questionnaire was localized. Then, the knowledge workers of the central field of Shiraz University of Medical Sciences were investigated regarding productivity and affecting factors thereof.
In this analytic and cross-sectional study, the questionnaire designed by Antikainen et al, was used as the pattern. 300 knowledge workers of the central field of this University were selected through the stratified random sampling in June 2011. Moreover, the data were analyzed through factor analysis, and etc.
Factor analysis led to the identification of eight main components of the knowledge workers’ productivity. The reliability of the new version of the questionnaire was confirmed by the Cronbach’s alpha coefficient of 0.945. Additionally, in this sample, productivity level of 19.3% of employees was low and 80.7% was favorable. In this regard, attempts must be made in order to improve the productivity.

As any decision making for improving the quality of clinical education depends on recognition of the present problems، as well as the inadequacies and faults from the stakeholders` points of view، this study was conducted to evaluate all the stakeholders in educational process comprehensively and estimate their satisfaction from the present system in order to illustrate a general framework of strengths and weaknesses of Shiraz University of Medical Sciences. This was a cross sectional descriptive analytic study conducted in 2011. Three separate teacher-made questionnaires were designed according to the study purpose. The first questionnaire was related to interns and residents (under and post graduate students)، the second one for clinical teachers and the third belonged to the head nurses. Expert views were used in order to assess the content and face validity and test-re-test was applied for reliability checking. SPSS version 17 was used for descriptive statistics and relevant tests of t-test and Anova at the significant level of 0. 05. Findings showed that residents، interns and head nurses attending this study agreed more with fixed professors in only one educational center rather than the view of the professors whom had equal perspectives toward fixed or rotation status. As the present educational framework in Iranian educational theraputic centers can not meet the demands of the new needs and provide standard educational environment، and also according to the results of the present case in regard to the status of clinical education in Shiraz University of Medical Sciences، it seems that along with attention to the recommendations of the present study change in the present system could improve the quality of education، research and therapy status in various university centers.