مجله تعالی بالینی
سال نهم شماره 3 (پیاپی 24، زمستان 1398)

Ocular surface squamous cell neoplasia (OSSN) refers to a wide range of conjunctival and corneal epithelial tumors including: dysplasia, in situ carcinoma, and invasive cancer. The incidence of OSSN with human immunodeficiency virus (HIV) is increased due to its associated risk factors, such as human papillomavirus and exposure to sunlight. In this review, we discuss the epidemiology, clinical presentation, diagnosis, and treatment of OSSN associated with HIV infection. A search of the Google Scholar, Elsevier, Pubmed, ISI (Web of Science), Iran Medex, Scopus database in English from 1992 to 2018 was used to investigate the prevalence and prevalence of HIV positive squamous cell neoplasia. Eligibility criteria include any type of study that addresses the clinical manifestations of OSSN according to HIV status. Cases involving or screening for other types of malignancies in other groups were excluded. The 101 articles identified through the search were, in this review, OSSN reported as the first HIV / AIDS marker in 26 -86% of cases, and HIV positive testing in 38 -92% of patients with OSSN listed. The median age of onset of OSSN in HIV-infected patients in developing countries has dropped to the third to fourth decade. Those infected with HIV have shown larger invasive tumors, more severe malignancy, more invasive corneal, scleral and orbital invasion; more advanced stage tumors (T4), greater need for enucleation and wider exentration, and increased risk of tumor recurrence. It is noteworthy that current management of OSSN in HIV-positive people is based on the same standard treatment guidelines as described for OSSN in the general population. Most studies have shown that OSSN can occur at any time during the HIV / AIDS courses, and no significant association was found between CD4 count and severity of OSSN. In addition, the impact of antiretroviral treatment on OSSN is controversial. Based on the available evidence, HIV screening is recommended in all cases associated with OSSN to rule out HIV infection. The importance of the disease and the risk of relapse and its spread to patients should be counseled, with emphasis on regular follow-up and timely referral to the ophthalmologist for any unspecified ocular symptoms.

Providing training to enhance professional competence is one of the concerns of medical education. One of the common teaching methodology is Continuing Education in medical sciences universities. The purpose of the present study was to review current and effective educational methods in continuing medical education. This cross-sectional study was conducted through search of Persian and English articles in databases of Google Scholar Elsevier ISI (Web of Science), Barakatkns, Scopus during 2000-2018. Search was conducted by using the keywords of teaching method, individuals of continuing education, common teaching method, and education. The result of the search was 84 articles that after the title screening and abstract of 35 articles were recognized as inclusion criteria. The results showed that one of the most important factors affecting the impact of continuing education is teaching methods and teaching methods. Many studies have emphasized the importance of teaching methods in continuing education programs for physicians.The basis of continuing education should be the goal of sustainable learning and behavior change in the health care approach.Whereas the role of new methods and the emergence of education in influencing learning during health activities cannot be ignored, ttherefore, current approaches to medical science education along with new approaches are one of the most effective approaches to sustainable learning in employees, because sustainable learning will encourage individuals to continue and perform health care properly while sustained learning, it will provide stable performance. In addition to lectures, effective teaching methods such as group discussion, cooperative teaching model, problem solving method, e-learning, clinical education, evidence-based medicine, and simulation-based medical education can be used.

Today, researchers and health organizations consider emotional and psychological aspects of sexual well-being as one of the important aspects of sexual health, so that one of the important components of sexual health is sexual self-concept. Several factors can affect various aspects of female sexual self-concept. Therefore, the present study aimed to review factors related to female sexual self-concept.  During this study scoping review, researchers conducted computer search with keywords in databases such as Google Scholar, PubMed, SID, Magiran, ProQuest, Web of Science, Irandoc, library of Cochrane, Scopus databases. Finally, a complete overview of 30 articles has been used to write this article. The findings of this review study led to classification of data in three general categories including: biological factors (age, sex, marital status, race, disability and illness), psychological factors (body image, history of child sexual abused and mental health), and social factors (parents and peers and Relationship with spouse and the media). The findings of this review suggest that sexual self-concept is influenced by various factors as a key indicator of sexual activity and predictive of sexual behavior. Therefore, it seems that paying attention to the factors relevant to each person's characteristics can improve women's sexual health. Although it seems that the depth and breadth of our knowledge of the related factors influencing the sexual self-concept increase, qualitative studies are also recommended.

cleft lip and cleft palate are the most common congenital defect in neonatal period which are one of the removable defects in neonates that can be prevented and treated in time with other mental and physical disorders, by timely treatment prevention of the defectsThe aim of this study was to present therapeutic approaches for cleft palate and lip.The present study is a cross-sectional study conducted through searching databases of Sciencedirect, Pubmed, Magiran, SID, Proquest, Eric, Psychinfo, Springer, Ebsco, to collect articles in the 2018-2000. timeframe, after searching 36 sources Finally, 20 sources were selected for analysis. The results were selected and deduced using a cleft lip and palate approach. Findings have shown that accelerating treatment can prevent further physical and mental health complications. Treatment in neonatal period is a preventive approach in childhood, adolescence, and adulthood. Therefore, it is recommended that the effective treatment approach be closer to the neonate period.

Monogenic diabetes mellitus is a heterogeneous group of single-gene disorders that lead to diabetes. Maturity-Onset Diabetes of the Young is the most common type of monogenic diabetes, usually inherited as autosomal dominant or recessive. The prevalence of this type of diabetes starting at a young age is extremely rare. The present study is a report of an eleven year old boy with MODY. The patient is currently on a diet and MDI diet And his illness was in control.