فهرست مطالب حمید چوبینه

The World Health Organization defines infertility as a disease of the male or female reproductive system characterized by the inability to conceive after twelve months or more of regular unprotected sexual intercourse. In female, medications that suppress the immune system and reduce inflammation may be a factor in inhibiting ovulation and infertility. Other contributing factors to female infertility, include endometriosis and polycystic ovary syndrome.  Laboratory diagnostic tests include hormonal assessment of androgen levels, clinical hirsutism using the Freeman-Galloway method, ultrasound examination of antral follicle count, ovarian volume, and anti-Müllerian hormone. Amenorrhea is the most common disorder of the menstrual cycle and is an indicator of diseases such as polycystic ovary syndrome and endometrial lesions. This syndrome generally results from chronic inflammation and altered cellular profile of the immune system, as well as increased circulating levels of inflammatory cytokines. Therefore, the inflammatory factors such as TNF-alpha, interleukin 6, interleukin 18, and interleukin 22 play an important role in regulating ovarian function. Other evidence suggests that changes in the gut microbiome are also involved in the development of this syndrome. It is important to provide supportive strategies to enable these female to make lifestyle changes, including reaching a normal weight, adopting a nutritious diet, and maintaining regular exercise habits. Additionally, early diagnosis of this syndrome can eliminate the risk of permanent infertility, especially in adolescents.

Human resources are the center of sustainable development in advanced management. Health, Safety and Environment (HSE) is a system that consistently and by means of human resources, facilities and equipment and tries to create a healthy, pleasant, fresh environment away from accident, damage and waste. This study was conducted to assess the health performance, Safety and Environmental Indicators (HSE) in the field of human resources development of Tehran Municipality.

This study was conducted as a descriptive cross-sectional and, the study base was all 22 districts of Tehran municipality. After designing and validating of HSE performance evaluation protocol, HSE status was evaluated in 22 districts of Tehran. The aforementioned protocol contained seven sections: leadership and commitment, policy and strategic goals, organization and documentation, risk management, planning, implementation and monitoring, audit and review). Its validity and reliability were determined by obtaining corrective opinions from specialists and experts inside and outside the municipal organization.

In most areas of Tehran municipality, the inter-organizational communication index was the highest score. The highest score (68%) is related to this index. The mean overall score for performance evaluation was 46.6.

The HSE situation was undesirable (less than 70%) in more than half of Tehran's municipalities. Regions 4 and 7 were in desirable status (above 70%). Thus, for current situation improvement, we should use long-term strategy planning in the field of HSE.

The outbreak of Coronavirus Disease 2019 in the world has raised not only public health concerns but also several psychological problems, including anxiety, fear, depression, and posttraumatic stress disorder. The main goal of this study was to investigate the effectiveness of online Stress Management on the mental health status of employees with COVID-19 from Tehran Municipality.

In this semi-experimental study conducted in 2020, for the mental health status of 370 personnel of Tehran municipality who were affected by COVID-19, a rapid screening questionnaire and General Health Questionnaire-28 were used. Among those whose General Health Questionnaire-28 score was higher than cut-off point 6, 60 individuals were randomly selected and divided into two groups (experiment and control). The experimental samples had six sessions of online stress management training (each one took about an hour), based on a cognitive-behavioral approach. The control group did not receive any intervention during the study period. Data were analyzed by SPSS 24 using MANCOVA.

The results showed that 38.4% of the subjects suspected a mental disorder (35.7% of males and 47.6% of females). The mean scores of the General Health Questionnaire-28 and its subscales were significantly higher in women than men (p<0.05). Multivariate analysis of covariance on the mean score of individuals in the General Health Questionnaire-28 questionnaire showed that cognitive-behavioral stress management could statistically improve the mental health of samples from the experimental group compared to control.

Online cognitive-behavioral stress management can be used in the COVID-19 crisis and can improve the mental health aspect of employeechr('39')s health.

The purpose of this study was to investigate the status of HSE indices in a number of organizations affiliated with Tehran Municipality.

In this cross-sectional study, the study population included all organizations affiliated with Tehran Municipality HSE performance was assessed through an 18-item checklist. The content validity of this checklist was examined by obtaining the opinions of experts in the field. The data of this study were analyzed using the SPSS software version 22.

The results of this study showed that three organizations, namely Suburbs Bus Company, Urban Planning Organization, and Terminals and Parks Organization had the best HSE performance with indexes of 63.6%, 57.485 and 52.59%, respectively. Among the 18 items of HSE performance, the HSE policy had the highest score (68.6%).

Based on the findings of this study, the value of the HSE index was not complete in any of the fields. The results of this study showed that although the foundation of the HSE system was implemented in many units of Tehran Municipality, it is still a long way before the desired point is reached. Therefore, it is necessary to formulate and implement appropriate action plans and to evaluate the effectiveness of control measures to improve the HSE indicators.

Infertility is a chronic disease with a long-term treatment and self-care leads to an increase in the level of knowledge and awareness about the disease. Moreover, smartphones provide access to information at any time and place; therefore, by using the mobile-based assisted reproductive technology, a self-care application program can be a good choice to help people gain awareness and improve the treatment. 

Library resources and related and similar applications were studied. Then, data items and the sections required for applied program were identified. To study their importance, a survey was performed on the working members of Iran Helal Infertility Specialty Center. Out of the 35 members of the research community, 20 were randomly selected. The survey questionnaire was made with 32 questions in three sections. In this survey, the data model framework was confirmed; however, the basis of the tools framework didn't need the confirmation of validity and reliability since the data model was designed based on the reference. With summarization of responses, data items and sections specified in designing the program were applied.

The mean of the scores showed that the respondents had identified most of the items as essential. This survey had three main axes. The mean scores of axes of patient information, patient education, and disease management tools are 4.205, 4.402 and 4.275, respectively. The mean scores above 4 show that their effectiveness is very high.

Considering the results, the designed application program can be helpful for patients.

Recurrent pregnancy loss(RPL) is known as two or three pregnancy losses before 20th week of pregnancy. RPL accounts for 5% of abortions in women and has a devastating effect on the marital status of families. One of the reasons for RPL is hemostatic complications; thus, we studied the correlation between factor XI polymorphism and RPL in patients who referred to Helal Infertility Center(Rouyesh).
In this case-control study, 144 patients with a history of miscarriages(at least two) and 150 healthy female with a minimum of one successful birth and no abortion were enrolled. DNA extraction was taken from leukocytes of whole blood. To investigate the polymorphisms, polymerase chain reaction was run, and the presence of polymorphism was analyzed using RFLP method.
Regarding FXI polymorphism, TT, CT, and CC genotype frequencies were 59.7%, 36.1%, and 4.2%, respectively. In healthy control group, the TT, CT, and CC frequencies were 45.3%, 49.4%, and 5.3%, respectively.
TT homozygote genotype could be an RPL risk factor(p<0.05); however, in its CT heterozygote form, C allele could have a protective role against RPL.
Keywords: Recurrent Pregnancy Loss, Thrombophilia, Factor XI Polymorphism

Infertility is a major problem of modern medicine as it affects almost 20% of reproductive-aged couples. The cause of this problem is attributed to the male partner in nearly 40%-50% of these cases. The role of herpes simplex virus (HSV) in male infertility has been investigated using the sensitive methods. The aim of this study was to determine the prevalence of HSV-1, 2 DNA in the semen, blood and urine of idiopathic infertile men and its association with altered semen parameters.
A total of 150 semen, blood and urine samples from infertile men were collected in the Shariati hospital, Tehran (2012-2014). Sample analysis and diagnostic PCR using specific primers was performed for detection of HSV-1, 2 DNA in the specimens.
Analysis showed six groups of infertile men, including HSV-1, 2 positive and negative groups in semen, blood and urine samples. HSV-1, 2 DNA was detected in 38 (18.66%) semens, (6.66%) 10 in blood and 2 (1.33%) in urine. Only HSV-1, 2 positive samples of semen had abnormal semen parameters.
Using a powerful molecular method, we detected a high prevalence of HSV-1, 2 DNA in the semen of asymptomatic infertile patients. Although HSV-1, 2 infections were not associated with motility and morphology defects of the sperms, it was related with decreased sperm count in the semen fluid. In addition there was not a significant role for detection of HSV-1, 2 DNA in blood and urine samples of infertile men and abnormal semen parameters.

Data registration is one of the principal infrastructures of health promotion and social development programs. Infertility is one of the most important medical issues nowadays.
This study has been performed by reviewing electronic and non-electronic information sources to identify the infertility registries in developed countries as first step of national infertility registry design.
Finding: «Infertility Registry» has been performed in five countries systematically. We studied three of them from the view of history¡ structure and facilities.
Despite favorable progress in many health fields and management of data diseases in Iran¡ systematic registration of infertility data based on international standards has been neglected yet.

Along with the constant increase in world population and consequently, the growing need to provide cellulose, as the most abundant organic substance in nature to produce cellulose products, concerns regarding the possible contamination of these products might cause skin, and genital and urinary infections. The aim of this study is to determine the possible microbial contamination of these products supplied in the city of Tehran. This is a descriptive study on 200 samples of unexpired cellulose products including napkins, nappies, sanitary napkin, and cardboard boxes to carry sweets. Fifty samples were obtained in the city of Tehran during six months from September 2011 to February 2012. Microbial contamination was investigated according to the procedure proposed by the Institute of Standards and Industrial Research of Iran. The results obtained indicate that 18 samples (9%) exceeded the level allowed for aerobic bacteria and molds in one gram of specimens. Besides, 16 samples (8%) were contaminated with at least one of the following bacteria: Streptococcus Group D, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. A total of 34 samples (17%) could not be consumed. The least and the most contaminated products were sanitary napkins (0.5%) and cardboard boxes to carry sweets (5%), respectively. The presence of pathogenic bacteria in cellulose products that could cause skin, and genital and urinary tract infections asks for more control over such sanitary products.

Cream is a rich dairy product with the pH close to neutral and limited preservation capability. Cream is suitable and rich for microbial growth. In the past few decades, there was a great concern in contamination of food products. Salmonella and Yersinia species are two important pathogens causing food poisoning and human gastroenteritis. The aim of the present study is to investigate the quality of traditional cream for bacterial contamination. This is a cross-sectional study. In total, 100 unpasteurized cream samples were collected from 5 regions in Tehran. The Salmonella was enriched in Selenite-F broth, and Yersinia in phosphate buffer in two weeks in cold condition according to CDC, and then were inoculated in MacConky and CIN agar for 24 hours. The suspected colonies were examined for phenotype and their identification was confirmed by API-20 E. In general, 29% of tested cream samples were contaminated with at least one kind of bacteria, 3% with Yersinia (1strain Y.enterocolitica, 1 Y.intermedia, 1 frederiksenii), and 2% with Salmonella paratyphi B. The other bacteria like Escheichia coli, Enteobacter, klebsiella, and Citobacter were also isolated. Five samples were contaminated with two kinds of bacteria. The results of this study indicate that more quality control should be applied on the cream produced in the city of Tehran by health control office for food products.

Cytomegalovirus (CMV) is a prevalent infection in humans. Recent studies have shown the role of CMV infection in male infertility disorder. Here we aimed to study the role of CMV infection in men with idiopathic infertility. We performed a case-control study of CMV serology in 200 patients attending male infertility clinic of a university hospital. There were 154 men diagnosed with infertility and 46 men without infertility. The patients were asked to donate their sperm, blood, and urine. The presence of CMV infection was studied using quantitative polymerase chain reaction. CMV infection was present in 25 of all the studied participants. Controls had a higher sperm count and sperm motility and sperm morphology compared to patients. There were no significant differences in the studied variables between those with and without CMV infection, nor in patients, neither in controls. Sperm morphology was negatively correlated with cigarette smoking (r=-0.15; p<0.03). Even though the prevalence of CMV infection was higher in patients with infertility in control and patient (5/46 vs. 20/154) respectively, this was not statistically significant. We did not show a significant role for CMV infection in male infertility. Based on the previous studies, it could be assumed that CMV infection is an important part of the male infertility and its treatment would improve the sperm quality, however this was not confirmed by the present study.

Today, many families either have pets or work in animal husbandry units. It is very important to investigate the mental outcomes of animal care and also to study their keepers’ personality traits. This study aims to perform a comparative examination of owners’ mental health and character specifications or those of animal husbandry units’ personnel. In this descriptive study, about 500 people were selected through available sampling technique. They had contact with animals or worked in a husbandry unit in the suburbs of Tehran. After referring to the veterinary clinic of Tehran University, they were studied using a general health questionnaire and an international personality question bank. The collected data were analyzed using SPSS software as well as multivariate and follow-up tests. The results of the present study show that all general mental health sub-scales except for anxiety are different in these groups. However, no difference was observed regarding responsibility and extroversion. Meanwhile, the adaptability of dog owners was lower than that of sheep owners; moreover, cattlemen were more irritable than sheep owners. In sum, the mental health of pet owners of the present study is at a lower level compared to that of those in other countries. It seems that the difference is due to religious and cultural differences existing between the two.

About 50% of causes of infertility are partly or completely attributable to male factors. Some factors affecting men''s infertility are related to genetic and environmental factors. The aim of this study was to examine demographic characteristics of infertile men.

This was a descriptive study was conducted on200 infertile men who were referred to Shariati Hospital Infertility Clinic، Tehran، Iran، November 2010 to May 2011. Data were collected by face-to-face interviews based on a questionnaire. Spermiogram test was performed for all patients by a laboratory manual method. Data were analyzed using SPSS software version 16 and t-test، chi-square and linear regression tests. P value less than 0. 05 was considered significant.

Mean age of patients was 34. 1±5. 7 years. Mean number of years after marriage was 3. 6±1. 3 years. Most patients (68%) were self-employed and the majority of them were dealt with chemicals in their jobs. The risk of diabetes، mumps and varicocele were higher in workers than patients who had official jobs. Sperm analysis showed that the most common problem in infertile men was decreased sperm motility. So that،sperm motility was lower than 40% in 162 participants (81%). 84 cases (42%) had a decrease in sperm count and 39 patients of them (46%) were azoospermic.

No relationship exists between body mass index، occupational status، smoking، history of any disease and sperm parameters in infertile men.

Although vancomycine is used for the treatment of methicillin resistant Staphylococci, but vancomycine alone might not be effective for the treatment of methicillin resistant Staphylococci in compromised host. In the same time antimicrobial activity of cefepim on gram positive bacteria especially Staphylococci is well known. In this study the synergism effect of cefepim and vavcomycin on positive and negative coagulase Staphylococci in vitro condition was investigated.

In total, 100 clinical samples of coagulase positive and negative Staphylococci were isolated from urine and blood samples from patients in Imam Khomeini Hospital during one year and identified. The modified Bauer-Kirby were used for the antibiotic susceptibility and macrodilution method for the MIC according to NCCLS procedure.

The results showed that after adding vancomycin to cefepime in concentration from 0.05+ 0.5, to 0.8+8, growth reduction reached from 3.5% to 100%.The synergism effect of the two mentioned antibiotics on coagulase negative Staphylococci resistant to methicillin were shown that from concentration of 0.05+ 0.5 to 0.8+8, a reduction in growth from 4.5% to 100% was observed.

The results of this study showed that vancomycin and cefepime has synergic effect on Staphylococci.

The disabled people are a part of our society (1%) and a disabled will face incorrect behaviors from childhood that is caused by an incomplete understanding of the society, but family can play a constructive role to increase the disabled abilities.This study was conducted to determine the views of deaf, blind and physical motor handicaps and their families regarding disability in the family in the Qazvin and Karaj.

One hundered and fifty handicaps and their families from handicaps center, welfare office, the disabled school students, the Mostazafan and Janbazan foundation were enrolled in this study. Information was collected by using 2 questionnaires. T test and Analyses Of Variance have been applied for data analysis, using SPSS software.

The results show that among different disabilities, the deaf ones and their families had more positive view than other disabled ones about their disabilities.Also, increasing the number of family members can cause more negative view about disability (p<0.05). This study shows that there isnt a significant relationship between the disabled view and his / her gender, cause of disability and parents high education

With regard to the similarity of the disables and their families views about disability and also their need to obtain more awareness about disability, the disable's needs and complications, it is necessary to stress on correct training of disabled person, his/ her family and the society.

Introduction &

UTI is one of the most common bacterial infections and Ecoli is known as an important cause of UTIs. Since bacterial resistances of antibiotics are increasing, reliable methods of antimicrobial resistance detection are of paramount importance in treatment and management of UTIs. The objective of the present study is to compare and to evaluate the performance of disk diffusion agar (Iranian and Italian) and E.test (Epsilometer test) (Sweden) for antimicrobial susceptibility testing of Ecoli isolated from UTI.

This study was done on 250 Isolates of Ecoli from patients with UTI in Shariati Hospital, Tehran University of Medical Sciences during 2004. Antibiotic susceptibility testing was performed by disk diffusion method using Iranian and Italian disk for Trimetoprim sulfamethoxazole, Gentamysin, Ceftazidim, Nitrofurantoin and Ciprofluxacin and Minimum Inhibitory concentration (MIC) determination was performed by E.test for the same set of antimicrobial. All tests were performed on muller hinton agar.

Comparison of E.test and Iranian disk diffusion agar showed that paramount differences in antibiotic agreement (Max 37.8 %) those differences in case of Ceftazidim and Gentamysin were respectively 76.8% and 62.2% whereas comparison of E.test and Italian disk diffusion agar showed less difference of antibiotics agreement (Max 11.2%).

The results of this study showed that Iranian disk diffusion agar may be used as a preliminary screen for antibiotic susceptibility testing of E.coli and is less sensitive than Italian disk diffusion and E.test. Comparison of 3 mentioned methods have showed that E.test is the most sensitive and shows the effective dose of antibiotic for treatment and prevention of antibiotic resistance.

To assess of human force and population's programming at high level, is very important that we know rates and characteristics of population. Growth of population has direct relationship with fertility rate of women in community. To control of population and arrive to index of N.R.R.(Net reproduction rate) equal to one, each family must be has one or tow children. Thus, in families that they have more over tow children, we must be search about factors affected and attempt to reduce of population's growth, until arrive to a stationary population. The cross-sectional study upon 500 women that are married and have 45 years old and more in Bushehr. Tow-stage random sampling was used in this study. First, Bushehr divided into 23 hypothesis blocks of 1000 households and thus, 20 points from each of blocks were selected by chance. Also, from each of 20 pointes, 25 families were selected by chance. In this study, a questionnaire was used for collecting of data, that questioners were asked of chief of households. The data was analyzed with SPSS package version 13. To find relationship between variables together and with response variable, was used kendall's tau test and chi-square for trend test. The multiple-logistic regression was used to find factors affected on parity progression ratios. In this study 181 persons(36.2%) of women had illiterate, 229 persons(45.8%) had primary education and 90 persons(18%) of them had high and more education. The age of the first marriage of 456 persons(91.2 %) of women were under 25 years old and the age of the first pregnancy of 196(39.2 %) of them were under 20 years old. Probability of arrive to the first child in Bushehr was equal 0.98,and probability of arrive to second, thirst and fourth children was equal 0.92,0.81 and 0.72 respectively. This study shows that the factor like the age of the first marriage of women has a negative effect on PPR (parity progression ratio) from zero to one child, and the factors like the women's education and having a dead child have a positive effect on it. The results indicate that the factor like having a dead child has increasing effect on PPR from one to tow children, and the factors like the women's education, the age of the first pregnancy and marriage have a decreasing effect on it. In this research it is observed that having a dead child has a positive effect on PPR from tow to three children, and the factors like the age of the first pregnancy and marriage, education of women and their husbands have a negative effect on PPR from tow to three children. Also it is observed that sexually and having a dead child has increasing effect on PPR from three to four children, and the factors like, the women's education, job and education of husband, and the age of the first pregnancy of women have decreasing effect on PPR from three to four children. The results indicate that probability of arrive to third and fourth children are high. Thus it is show the controlling of family planning in Bushehr dose not good carry out within families belong lately decades.

With due attention to the prevalence of thalassemia in Iran and patient's importunate needs for blood intake, this study aimed to inspect contaminations due to repeated blood transfusion which does not sift in blood donation. One such contamination is cytomegalovirus infection, which is an important pathogen in immunosuppressive patients or receivers of transplanted organs. This cross sectional study was conducted on 311 thalassemia patients under age of 15 yr who was receiving blood from Hospitals in Tehran and Noorabad Mamasani repeatedly. To determine active infection (presence of IgM antibodies) of cytomegalovirus, ELISA method was used. In addi­tion, 225 healthy people under age of 15 yr were studied as testified group and finally all data were analyzed using SPSS ver. 11.5. 12.9 % of patients were positive from the view point of active infection. Regional separation of patients showed that the patients resided in Tehran are more contaminated to this virus than patients of other cities. The range of cytomegalovirus active infection in thalassemia patients is high. One reason might be the infected blood intake or immunosuppressant (weakness of immune system) in patients, there­fore immunity care of these patients and negative serologic blood intake with respect to and also he­matic parents (parents with the same blood) are important.

Introduction & Many Iranian families manage to keep pets at home. Examining psychological consequences and personality traits of pet owners is important. The aim of this study was to examine mental health status and personality traits of pet owners. In this descriptive study, 612 pet owners (143 cat owners, 162 dog owners, 155 bird owners and 152 other pet owners) were asked to complete General Health Questionnaire (GHQ) and IPIP Personality Scale from January to December 2006. Bird owners had the highest (234 cases (38.3%)) and other pet owners had the lowest (129 cases (42.3%)) mental health problems. In general, 188 cases (30.7%) of all groups had mental health problems. 122 cases (20%) of them had somatic compliance, 182 cases (29.7%) had anxiety, 149 cases (24.3%) had social dysfunction and 84 cases (13.7%) had depression. Bird owners had significant high level of social dysfunction than other pet owners. With respect to personality traits, dog owners had low level of agreeableness and openness to experience than other groups. Other pet owners had high level of emotional stability than other groups. Contrary to other countries, it seems that having a pet in home enhances the probability of mental disorders in Iran. It is possible that lower mental health persons were keeping pets in Iran. In personality perspectives, dog owners are more disagreeable people and other pet owners are more emotionally stable ones