فهرست مطالب ابراهیم شیرزاد

. The new methods of the teaching of cardiovascular system have been surface anatomy educate is necessary for physical examinations in clinic. . The purpose of the present study was to identify of the effectiveness surface in the anatomy education of heart auscultation. A descriptive analytical study was conducted on 34 of the medical students were into divided two group according to sex then separately instructed to the small groups 17 (n=2) the students for teaching of the surface heart auscultation. Before and after education of heart auscultation the surface anatomy, they exactly find proper exact location for heart.. The collected data were analyzed by using pair and t tests. Out of 34 students 10 were male and 24 female , the average age of the students was 21.54± 1.63 in the males whereas it was 20.56± 1.6 in the females. Mean of time to the find correct foci for mitral , tricuspid, aorta and pulmonary of heart auscultation after surface anatomy education was significantly lesser compared with the current or before applying new education method (P < 0.001). Results showed heart auscultation for mitral, pulmonary and aorta was significantly compared better when compared with the result before surface anatomy education. The results showed that teaching of the surface anatomy heart auscultation for medical students result in better finding of exact heart auscultation and decreased the time taking for finding such location.

The childbirth is one of the most crucial and important services provided by health care systems in all societies and like any other services, it should be provided in a proper way, with a lower cost and least physical-psychological complications. The choice of delivery type has a great impact on these kinds of physical and psychological complications. This research is a quasi-experimental study to determine the effect of education on the opinion of pregnant women in choosing the method of delivery. This study has been conducted among pregnant women admitted to the Fatemieh polyclinic in Urmia in 2015.
In this study, after approval of the ethics committee and obtaining the required permits, 160 pregnant women admitted to the Polyclinic Fatemiyeh in Urmia who fulfilled the inclusion criteria were chosen using convenience sampling, and they were divided randomly into two equal groups: intervention (education) and control (non-education) groups. To collect the data, a two-part self-administered questionnaire was utilized which had been previously prepared by the researcher and it included the personal information as well as the mindset assessment. The first part included demographic questions (26 questions) and mindset assessment on cesarean section (containing 15 items with Likert scale). The validity of this measurement tool and reliability of the results were determined by Content Validity and Cronbach's alpha methods, respectively. After completing the questionnaires, the data collected was entered into SPSS version 20, using descriptive statistics and chi-square tests were analyzed.
The mean age of pregnant women used as subjects were 29.04 ± 5.31. Statistically, no significant difference in demographic characteristics between the two groups was observed. Pregnant mother's opinion about labor practices in both intervention and control groups before the educational intervention showed no significant difference with Pvalue=0.536. The post-test scores were 45.61 in the control group and 29.44 is in the intervention group. With independent t-test, the difference of the mean scores of two groups after the intervention is statistically significant (Pvalue The results of this study showed that training can impact the pregnant women’s mindset and can change their opinion about cesarean section from a positive to a rather negative point of view. Therefore, it is recommended that the relevant authorities consider the necessary policy and plans to provide courses on preparation for childbirth, and also improve the quantity and quality of existing courses.

Refractive errors are the most frequent reasons for which patients refer to ophthalmologic clinics. The previous studies have found that the factors of the environment and the type of light to illuminate it could have positive effects on the prevalence rate of refractive errors. Since there is little research about this relationship at industrial workers in Iran, we decided to investigate the industrial workers’ refractive errors and their relationships with the types of light and the visual work environment.We carried out a descriptive-analytical study on 292 male and female workers working in Mashhad industrial factories. Using clustering sampling, the subjects of the study were selected to go under investigation for their age, sex, and years of working background. Then, the study examined the relationship between these factors and refractive errors. In addition, the effects of outdoor and indoor working environments as well as natural and artificial (florescent) light on refractive errors were determined by a specialist. Interesting results were obtained through statistical analyses such as Chi-Square, Fisher Exact Test and ANOVA.The results suggest that the subjects of the study ranged from 23 to 63 years old with an average age of 40±9.1. Also, their working background of an average of 16±9.3 years has showed a positive effect on refractive errors (P=0.039). Among the subjects of the study, 30 (10.3%) were diagnosed as suffering from refractive errors in one eye, 150 (51.4%) in both eyes and the other 112 subjects (38.3%) had no refractive errors. The results of investigating the symptoms accompanying refractive errors were found in the following order of prevalence: Red eye (28%); Ptergyume (17.5%); Hyperemia (16.1%); Burning (12.4%); Lacriamtion (11%) and others (15%). There was no significant difference, in terms of age, between the subjects having refractive errors and those without them (P=0.842). There wasn’t any significant relationship between age and refractive errors, either (P=0.896). However, outdoor environment (P=0.014) as well as natural light (P=0.016) were found to have had positive effects on the subjects’ refractive errors.Although the duration of working background has found to be positively effective on refractive errors, the subjects’ age hasn’t showed such effect. Natural light and outdoor work environment have had significant relationships with the subjects’ refractive errors. As for accompanying symptoms, Red eye (28%) was the most frequent.

As refractive errors are the most common ocular disorders, which are usually corrected with eye-glasses and the client's satisfaction is of general and global significance in the modern world, this study was intended to cross-sectionally describe and analyze the intensity of refractive errors and the satisfaction of people suffering from refractive errors about glasses prescribed for them to correct their errors. The subjects of the study were 150 patients with refractive errors. The study data were collected through (1) interview checklist to record the demographic details of the patients and the satisfaction of the patient and the person who accompanied him/her and (2) observation and examination checklists to determine the type and intensity of refractive errors. 34.7% of the subjects were male and the rest female. Their mean age was 29.06±14.57 63.8% of the patients and 67.2% of their mates were dissatisfied with glasses. The most common refractive disorders in descending order were myopia, astigmatism and hyperopia. No significant relationships were found to exist between myopia, factors such as sex and job with dissatisfaction from eyeglasses. However, a significant relationship was observed between age groups and satisfaction from eyeglasses (P<0.01). In order to gain the satisfaction of the people using eyeglasses, contact lenses and surgical procedures which are associated with advantages and disadvantages, to correct for refractive errors a number of factors including medical diagnosis, the patients’ attitude and socioeconomic status, and the dominant social culture, are to be taken into consideration.

Eye color is of a genetic origin and is basically characterized by the accumulation and distribution of melanin and lipochrome pigments in the iris. Pigments in the iris cause its blue color turning to green, hazel and brown with the increase in the iris pigmentation. Although normally Cup/Disc (C/D) ratio can range from 0 to 0.8, normally the ratio is less than 0.3. This study is mainly intended to examine the relationship of iris and pupil margin pigmentation with optic Disc CUP in subjects with no primary or secondary ocular disease. Materials and Methods The target population of this descriptive analytical study included women referring to Sabzevar Eye Clinic. They were examined by slit lamp for the color of their iris in three groups: dark brown, medium brown (green) and light brown (blue). Their pupil margin pigmentations were qualitatively divided into five groups: those with one, two, three or many rows of pigmentation and those with no pigmentation. C/D ratio was qualitatively estimated upon funduscopy by direct ophthalmoscope. The obtained data were statistically analyzed using Chi-Square and Fisher's exact test. Total sample was 227 mean OD and OS CUP were 0.1617 ±0.1178 and 0.1648 ±0.1197 respectively. CUP ranged from 0 to 0.5 but the most frequent OD and OS CUP were 0.2 and 0.1 respectively the least frequent in both eyes was 0.5. The most common iris color was dark brown (55.9%) the most common pigmentation of the pupil margin was 47% in two rows. 4.5% of the subjects were observed to be asymmetric as for the CUP of their eyes it was 0.9% for CUP of 0, 0.1 and 0.2 it was 0.5% for CUP of 0.3 also 1.3% for CUP of 0.4 no asymmetry was observed for CUP of 0.5. No significant relationship was observed to exist between OD and OS CUP with iris color and pupil margin pigmentation. But OD CUP 0 indicated a correlation at P=0.041 while no such relationship was found in the left eye. Significant relationships were also observed for OD CUP of 0.1, 0.4 and 0.5 with eye color at p-values of 0.004 for blue, 0.038 and 0.035 for medium brown (green). Relationships of CUP and OD pupil margin pigmentation were also obtained for CUP of 0.1 and three rows (P=0.048), CUP of 0.2 and two rows (P=0.020) and no pigmentation (P=0.036). In the left eye, relationships were obtained for CUP of 0.1 and pupil margin pigmentation for two rows (P=0.024), and three rows (P=0.03) for CUP of 0.2 and two rows (P=0.018), three rows (P=0.024) and with no pigmentation (P=0.031). As no significant relationships were observed in the relationships of CUP, eye color and pupil margin pigmentation, except for some particular CUP, iris color and pupil margin pigmentation which indicated significant relationships, the issue demands more research to help make scientific predictions of these relations on the basis of certain landmarks.