زهرا عطرکار روشن

The COVID-19 pandemic caused changes in daily life and disrupted hospital performance and the provision of medical services, especially in the organ transplant departments.

This study aims to compare the frequency of organ donation and transplantation before and after the COVID-19 outbreak in the transplant centers of northern Iran.

This cross-sectional study was conducted on 75 donors with brain death from 2018 to 2021 in Rasht. Demographic data, underlying diseases, history of smoking and drug use, causes of brain death, type of donated organ, number of donated organs per patient, type of transplanted organ, and the location of transplantation (in or out of the province) were recorded. Then, these factors were compared between two time periods: Before the pandemic (from July 2018 to February 2020) and during the pandemic (from February 2020 to August 2021). The recorded data was analyzed in SPSS software, version 21. The significance level was set at 0.05.

The mean age of donors during the pandemic was significantly higher than that of patients before the pandemic (P<0.001). The most common cause of brain death in donors before the pandemic was trauma; after the pandemic, cerebrovascular causes were more common (P=0.01). The frequency of organ donation and the mean number of donated organs per donor during the pandemic were significantly lower than before the pandemic (P<0.001).

The COVID-19 pandemic has significant impact on the process of organ donation and transplantation in northern Iran.

The study of retirement of professional athletes and its consequences in recent years has attracted the attention of researchers. Disease monitoring and epidemiological studies are one of the basic elements of comprehensive efforts to protect the health of athletes.

A researcher-made questionnaire was used to record musculoskeletal diseases in volleyball, football and basketball sports. In this questionnaire, important and severe musculoskeletal diseases were recorded based on priority. Registration of diseases was according to the region and type of disease.

The rate of musculoskeletal diseases per 1000 hours of training among the studied groups showed that veteran basketball athletes per 1000 hours of training (2.40±1.30) were less than volleyball athletes (3.46±1.17) and football (3.98±0.84), had musculoskeletal diseases. The most common area of the disease in all three disciplines studied was the knee (9.4% of all recorded diseases). Musculoskeletal pain was also shown as the most common disease in athletes (15.69% of all recorded diseases).

The changes that occur in the muscular-skeletal structure of people with age can make people prone to musculoskeletal diseases, and this possibility is more in people who engage in sports for the elderly than in other people. Considering that the data collection of the present study included 2 years of the corona disease pandemic, it is possible that this had an effect on the results of the research and caused changes in the type of activities and even the lifestyle of the athletes. Brought therefore, the need to study the epidemiology of musculoskeletal diseases in the post-corona era is felt.

Toxoplasmosis is a common parasitic infection with high prevalence and worldwide distribution. It may cause severe disease in the fetus of newly infected pregnant women.

This study aimed to evaluate the seroprevalence of toxoplasmosis and its related risk factors among pregnant women in Ramsar city, Mazandaran province, north of Iran, from October 2017 to March 2018.

In this analytical-cross sectional study, specific anti-Toxoplasma gondii IgG and IgM antibodies were measured in 191 pregnant women by ELISA method. The length of T. gondii infection was estimated by the IgG avidity test. Demographic and behavioral information about pregnant women and possible risk factors of toxoplasmosis were collected through interviews.

Specific IgG antibody against T. gondii was detected in 46.1% and IgM in 5.8% and both IgG and IgM antibodies were detected in 4.7% of pregnant women. The IgG avidity test did not show any acute case of toxoplasmosis. None of the demographic characteristics, such as age, occupation, place of residence, education, income, trimester of pregnancy, frequency of pregnancy, and history of abortion was correlated with toxoplasmosis. Moreover, behavioral characteristics, such as the source of consumed water, contact with soil, presence of cats in the household, consumption of vegetables, type of meat consumed, and the way of cooking meat had no significant correlation with toxoplasmosis seropositivity.

More than half of the pregnant women (54%) were toxoplasmosis-free and therefore at risk of acquiring this infection. Increasing the knowledge of pregnant women about toxoplasmosis prevention may reduce the risk of this infection during pregnancy.

The high use of pesticides has increased the concern about its possible harm to individual and environment health. Chronic exposure to pesticides has serious effects on different body organs even before the onset of clinical symptoms. In this study, we aim to evaluate clinical and biochemical characteristics of male workers in a pesticide production factory in Guilan province, Iran.

This cross-sectional study was conducted on 99 male workers exposed to pesticide and 107 people without exposure who were employed in a pesticide production factory in Guilan and selected using a convenience sampling method in 2020. Their demographical data as well as clinical characteristics such as respiratory symptoms (cough, shortness of breath, etc.), neurological symptoms (fatigue, tremors, cramps, muscle weakness, etc.), psychological symptoms (sleep disorders, anxiety, etc.) and skin symptoms (redness, itching, etc.) were collected from the occupational health records of the workers. Finally, the biochemical parameters were compared between the two groups. Statistical analysis was performed in SPSS software, version 16.

This study was approved by the Research Ethics committee of Guilan University of Medical Science, Rasht, Iran (Code: IR.GUMS.REC.1399.632). Informed consent was obtained from all participants in this study.

The frequency of symptoms such as headache, itchy skin, cough, and sleep disorders was higher in the exposed group (P<0.05). Based on the biochemical findings, blood urea level, creatinine level, alkaline phosphatase, and fasting blood sugar level were significantly higher in the exposed group (P<0.05). Thrombocytosis was observed in 9.09% of exposed workers, which was higher in those with more than 11 years of work experience.

Chronic exposure to pesticide can cause thrombosis, changes in biochemical parameters, and clinical symptoms. It is recommended that biological monitoring should be conducted in exposed workers at a shorter interval.

The significant increase in the use of pesticides has increased the concern about its possible harm to individual health and the environment. Chronic inflammation with some pesticides and insecticides has serious effects on different organs of the body even before clinical symptoms appear. In this study, we aimed to evaluate biochemical findings in the insecticide production factory in Guilan province, Iran.

This cross-sectional study was conducted on 99 workers exposed to insecticides and 107 people without exposure in an insecticide production factory in Guilan with an available sampling method during 2020. Demographical data and clinical charaterictics of participants, such as symptoms of chronic insecticide poisoning, focusing on the respiratory system (cough, shortness of breath, etc.), neurological system (fatigue, tremors, cramps, muscle weakness, etc), the psychological system (sleep disorder, anxiety, etc.) and the skin system (redness, itching, etc.) were collected from the occupational health records of the employees. Statistical analysis was performed using SPSS software (version 16).

The results of this study showed that the frequency of symptoms such as headache, skin itching, cough, and sleep disorder was higher in the exposure group (P<0.05). Based on the biochemical findings, blood urea and creatinine, alkaline phosphatase, and fasting blood sugar levels were significantly higher in the exposure group than in the non-exposure group (P<0.05). Thrombocytosis was observed in 9.09% of workers in the exposed group and it was more common in workers with more than 11 years of work experience.

Chronic exposure to insecticides may cause thrombosis and changes in biochemical indicators such as increased blood urea and creatinine, alkaline phosphatase, and fasting blood sugar, and may be associated with clinical symptoms such as headache, itching, cough, and sleep disturbance. Be it is suggested that various types of biological monitoring should be done in workers exposed to insecticides in various time duration.

 Various drugs are used as adjuvants to improve the quality of supraclavicular block method. 

 This study aims to investigate the effect of adding dexmedetomidine to lidocaine in the supraclavicular block method in patients candidate for upper extremity surgery.

 This double-blind randomized controlled clinical trial was conducted on 61 patients candidate for upper extremity fracture surgery receiving the supraclavicular block method from 2017 to 2018. They were randomly divided into two groups of lidocaine-normal saline (30 mL of 1.5% lidocaine plus normal saline) and lidocaine-dexmedetomidine (30 mL of 1.5% lidocaine plus 1 μg/kg of dexmedetomidine). The supraclavicular block characteristics and intraoperative hemodynamic changes were measured.

 There was no statistically significant difference between the two groups regarding the demographic factors. The mean age of patients was 43.09±10.92 years, and most of them were male. The mean onset time of sensory-motor blockade was faster and the duration of sensory-motor blockade and analgesia were longer in the lidocaine-dexmedetomidine group than in the other group. These differences were statistically significant. There was significant differences in hemodynamic parameters among nine assessment times in each group and between the two groups.

 Adding dexmedetomidine to lidocaine in the supraclavicular block method accelerates the blockade onset and increases the duration of blockade and analgesia after surgery without causing any considerable side effects.

Obtaining informed consent (IC) is essential for any diagnostic or therapeutic procedure. IC is an important legal communication process between the patient and physician.

This study was performed to evaluate the quality of IC process in patients undergoing spinal anesthesia (SA) in gynecological surgeries.

During 2021 this cross-sectional study was performed in Alzahra Hospital.
Eligible patients over 18 years old, who were candidates for elective gynecological surgeries under SA, enrolled the survey. A questionnaire containing demographic data and 20 specific questions divided in to 4 areas; providing information, Comprehensibility of the consent form, Voluntary of informed consent, Communication with the doctor, was filled out via a direct interview.

Finally the data from 259 eligible patients were analyzed. In terms of providing information to the patient, comprehensibility of the consent form, and the voluntary of obtaining consent were in poor conditions .But, in terms of communication with the physician, 46.3% of the patients were in a good state and 20.1% excellent. It was also found that there was significant relationship between the level of education and the quality of obtaining IC (P= 0.034).

It was concluded that the IC process was not acceptable in this academic center, and effort should be made to improve the current conditions.

Indoor air quality can lead to health problems such as Sick Building Syndrome among nurses who spend many hours in intensive care units.The aim of this study was to determine the relationship between Sick Building Syndrome in nurses and indoor air quality of intensive care units in educational hospitals in Rasht.

This cross-sectional analytical study was performed on 144 nurses in intensive care units who were randomly selected by quota random sampling. Some of the physical and chemical factors affecting indoor air quality including volatile organic compounds (Ethyl benzene, Xylene, Toluene), carbon monoxide, dust, temperature, humidity, brightness, noise,and airflow velocity were measured by calibrated equipment and symptoms of building syndrome were assessed by the MM040EA questionnaire.

The chemical factors were lower; temperature, humidity and noise were higher and brightness was lower than the recommended minimum. However, no statistically significant relationship was observed between indoor air quality and Sick Building Syndrome.

Although the measured physical and chemical factors in intensive care units were often at the occupational limits. The studied nurses reported poor physical conditions in their workplaces. Identifying and controlling occupational hazards in intensive care units can improve nursing performance by increasing job satisfaction.

Physical activity, especially in women, decreases with age, which can lead to disabling fractures in the elderly. In this study, we investigated the factors related to physical activity based on the theory of planned behavior in retired women in Rasht City from 2017 to 2018.

This analytical cross-sectional study was included 196 female members of ten active retirement centers in Rasht City in 2017. We designed a questionnaire on the basis of Ajzenchr('39')s planned behavioral model which included ​​regular physical activity, perceived behavioral control, behavioral intention, attitude, and subjective norms. A standardized physical activity questionnaire was used for the elderly. The method of data collection was an interview. Using SPSS software version 16, data were analyzed by a descriptive statistical method and Pearson correlation coefficient. p<0.05 was considered significant.

The results showed that the mean value for the physical activity of the elderly was 329.18±28.18, which was about %82 of the PASE tool score. Planned behavior theory constructs and underlying demographic variables had no significant effect on PASE. We found a significant relationship between behavioral intention and perceived behavioral control, and also between attitude and perceived behavioral control. Attitude had significant correlations with behavioral intention and subjective norms.

Although the relationship between planned behavior model constructs and physical activity were not significant in this study, planned behavior theory constructs had significant relationships with one another.

Reduction of renal function in elderly is associated with decreased cognitive function, especially in the fields of general cognitive ability, abstract reasoning, and verbal memory. Recognition of cognitive impairments can be helped by rehabilitation interventions for the patient and his family. The aim of present study was to compare MoCA, MMSE and AMTs questionnaires in diagnosing the cognitive status of the elderly undergoing hemodialysis of medical centers of Guilan University of Medical Sciences in 2019.

The present study is a cross-sectional descriptive study that was performed on 84 elderly people aged 60 years and older undergoing hemodialysis in Guilan University of Medical Sciences during a multi-stage sampling. The research instruments included MoCA, MMSE and AMTs questionnaires whose validity and reliability were confirmed in various studies. Data were analyzed using descriptive statistics (number and percentage) and Spearman correlation coefficient by using SPSS software version 20.

Findings showed different cognitive status of patients with these three tools (MoCA, MMSE and AMTs) so that with the MoCA test, the majority of the elderly (94.05%) had mild cognitive impairment; with the MMSE test, the majority of the population (61.90%) had mild cognitive impairment; however, with the AMTs test, the majority (84.52%) had natural cognition. The findings also showed a positive and significant correlation between these three tests (P = 0.001).

Based on the results, it seems that the AMTs tool has not been able to identify elderly people with cognitive impairment compared to the MoCA and MMSE. Given the differences in the results of cognitive tools, it is recommended that similar research be conducted with other tools that measure cognitive functions, and it is suggested that a more complete tool with combination of different tools be designed for cognitive assessment.

The world is now in the process of passing on health to Non-communicable diseases, is a major cause of changes in the lifestyle of people. The purpose of this study was to identify the relationship between socio-economic status of living environment and health related lifestyle.

This study was performed on 1000 residents of 55 neighborhoods of Rasht by analytical cross-sectional method. Data were collected using a questionnaire including demographic characteristics, International Behavioral Health Questionnaire and a questionnaire from the British General Household Survey (GHS) Social Capital questionnaire. Data analysis using descriptive statistics indexes and Statistical tests Pearson correlation coefficient, independent t-test and linear regression.

According to the results of the present study, the average age of the samples were (43.73 ± 15.55). According to the linear regression model among environmental indicators, dissatisfaction with facilities were introduced as a predictor of physical activity (B=-0/17، P<0.001), smoking (B=0/07، P<0.001) and alcohol consumption (B= 0/08، P <0.001).

The current study shows living environmental indicators play a significant role in health related lifestyle among people. Hence, there is a need for more attention to both physical and social aspects of living places to strengthen healthy lifestyle of people.

Elderly are vulnerable individuals in society, and are mostly exposed to mental disorders especially depression. Using non-medical factors to manage the depression, like perceived social support, can reduce the incidence of adverse reactions in such a vulnerable population. The current study aimed to determine the relationship between social support with depression among elderly in the eastern cities of Guilan.

This study was a cross-sectional, descriptive -correlational study conducted by the elderly living in the eastern cities of Guilan, in which 168 people were selected from two-stage, cluster random and available sampling.   Data was collected with using two standard tools include, Philips social support questionnaires (23 Items), and Geriatric depression scale (15 Items) Data were analyzed using SPSS, version 19, software, T-test, ANOVA and Pearson tests.

The mean of social support in elderly living in the eastern of Guilan was 73/25±9/18 (total score range of 23-92) and the mean of depression for them was 3/20±3/58 (total score range of 0-15). The analysis of the data indicated that there was a negative significant correlation between social support and depression (p<0/01, r=-0/47).

This study confirmed the role of social support in the development of depression in the elderly, so it is important to provide the conditions for promoting social support to reduce depression and thus improve the quality of life of the elderly.

A ppropriate nutrition is a major health objective in children’s early years. Eating problems among children as well as low awareness and the unsuitable function of mothers in this regard could result in complications for children and their families.

We aimed to determine the effect of an integrated training on the mothers of 1- to 3-year-old children with eating problems.

This was a two-group quasi-experimental study. In total, 70 mothers of 1 to 3-year-old children with eating problems visiting health centers in Rasht City, Iran, participated in this research. They were selected through a nonrandom sampling method. Then, the samples were assigned into the case and control groups by random block sampling technique. The case group received integrated training. The training sessions were held during three consecutive weeks as two in-person sessions along with presenting an educational CD. Moreover, a virtual session was provided to the study subjects through text messages. The children’s eating problems’ data were recorded using food preference questionnaire (FPQ) measuring eating problems in toddlers (including 5 areas of water satisfaction with eating, mother tension during eating, eating different food types, eating behavior, and food dependence physical signs) before, immediately after, and one month after the intervention by the mothers. Data analysis was performed using descriptive and inferential (t-test, Chi-squared test) statistics.

The achieved results indicated no significant difference in the eating problems of toddlers before the intervention in the case and treatment groups. Such lack of difference was in terms of mothers’ satisfaction with child’s eating, and the child’s eating behavior, stress during the child’s eating, and eating different food types. However, immediately and one month after the training, the t-test and Chi-squared test results indicated improved mothers’ satisfaction with children’s eating (P=0.0001) and reduced stress in mothers during children’s eating (P=0.0001). Nevertheless, in the two areas of eating behavior and eating different food types, no significant differences were observed.

The obtained results suggested that toddlers’ eating problems could be improved by providing integrated training programs to their mothers.

Lifestyle is a way that a person chooses throughout life and is an indicator that can affect physical and mental health. This study was conducted to determine the lifestyle of people in Rasht and its predictive factors. 

This analytical, cross-sectional study was conducted in 1000 residents of 5 districts of Rasht. Data were collected using a demographic questionnaire and the Behavioral Health Questionnaire. SPSS software version 20 was used to analyze the data. Pearson correlation coefficient, independent t-test and linear regression were applied. 

The result showed that 50.3% of the participants were male and 49.7% were female. According to lifestyle, the rate of using alcohol, physical activity, breakfast, red meat, fruits, salt, and ready meal was 13.4%, 54.3%, 95.6%, 87.7%, 98.4%, 59.6%, and 45.9%, respectively. The majority of the research units (70.1%) never smoked. The mean sleep time was 7.45 ± 63/1 hours. 

Based on the results, promotion of nutritional knowledge, increased awareness of the disadvantages of smoking, availability of healthy food at a reasonable price, and physical activity are important factors for lifestyle improvement.

Hopelessness is one of the most important psychological problems in hemodialysis patients in severe stages of the disease. Hope plays an important role in confronting with the problems and their tensions, and is effective as a potentially powerful factor in improving and adapting patients. The aim of this study was to determine the relationship between hope and demographic characteristics in hemodialysis patients.

This cross-sectional descriptive study was conducted on 103 patients undergoing hemodialysis in the Rasht Razi Dialysis Center in 2017. Data were collected using Snyder’s Hope and Demographic Characteristics Inventory. The data were analyzed using descriptive (tables of frequency distribution, mean and standard deviation) and analytical statistics (ANOVA and T-test) on SPSS 16, considering the significant level of p<0.05.

A majority of patients (54.36%) had high hope. Moreover, the mean and standard deviation of hope value was higher in patients with academic education (41.67%±10.0), history of dialysis <1 year (40.11±9.5), sufficient income (45.62±11.3) and history of kidney transplant (40.0±7.9) as well as in patients who were self-employed (40.82±12.2) and married (36.86±8.8). A significant difference was found between the hope value and variables of education level, income status and hypertension (P<0.05).

According to the results, the patients' hope level is influenced by some demographic characteristics including gender, education level, occupational status, income and history of dialysis. The results of this study can be taken into consideration by the authorities to provide the necessary planning and measures to promote the hope and improve the health of hemodialysis patients.

Considering the effective role of nutritional behaviors in the health of individuals, the family and society also importance of the health volunteers as a one of the most important circles of community health care system in providing education to individuals; developing of these volunteers’ competence in order to promote public health is critical. This study aimed to determine the effectiveness of educational intervention based on PRECEDE PROCEED Model on Nutritional Behavior in Health Volunteers. This research was a randomized controlled trial conducted on 153 health authorities in Rasht. The research instrument was a self-report, reliable and valid and based on the PRECEDE PROCEED model, completed in two periods before and two months after intervention by the groups. Using this tool, predisposing factors (knowledge and attitude), enabling factors, reinforcing factors and nutritional behavior were measured. After pre-test, 4 educational session classes were performed in intervention group. Data were analyzed by SPSS18 and one-sample and two-sample Kolmogrof-smirnov, Chi-square, T-Test, Paired T-Test, Mann-Whitney U and Wilcoxon. Linear regression test showed that PRECEDE PROCEED Model structures altogether account for 40 percent of healthy dietary behavior changes (R2=0.400, P<0.0001). Among the structures, Attitude (β=0.396, P<0.0001) was the most important predicting factor. The mean scores of Knowledge (P<0.0001), Attitude (P<0.0001), Enabling factors (P<0.0001) and health nutritional behavior (P<0.0001) in the intervention group were significantly different from those of control group after the educational intervention. The study results indicate a positive effect of educational intervention program based on PRECEDE PROCEED Model and components (Predisposing and Enabling factors) on the promotion of health Nutritional Behavior of Health Volunteers.
Conflict of interest: non declared

Physical inactivity as a reason of 6 percent of mortality is identified as the fourth leading risk factor for global mortality. Women are more inactive than men. Health volunteers are one of the most important loops of primary health care networks for educating the urban community. Applying the Stage of Change Model as an integrated pattern in behavior change is a good guide to exercise interventions. To determine the effect of intervention based on Stage of Change Model on the promotion of physical activity of Health Volunteers in Rasht as pineers in learning healthy lifestyles. This randomized controlled trial was conducted on 176 Health Volunteers in Rasht that randomly assigned into experimental and control groups by multistage sampling. Data were collected by a valid and reliable self-administered questionnaire including demographic data, Stages of Change Model constructs, and International Physical Activity Questionnaire (IPAQ-long form) before and 3 months after intervention in two groups. Data were analyzed by Independent T-Test, Paired T-Test, Wilcoxon, Mann-Whitney U, McNemar, Chi-square, one-Sample and two-sample Kolmogrov-Smirnov in SPSS-18 software. After educational intervention, there was a significant difference in the movement toward physical activity in the experimental group (p=0.005). Also, there was a significant difference between the mean score of physical activity after intervention in the experimental group (p=0.03). The results indicate a positive effect of intervention based on Stage of Change Model on the promotion of physical activity of Health Volunteers. Conflict of interest: non declared

In chronic diseases, the religious belief of the patient is at risk and the spiritual crisis arises in the person. The aim of this study was to determine the spiritual health and its relationship with demographic characteristics of hemodialysis patients in 2018. This cross-sectional study was conducted on 103 hemodialysis patients referred to the Razi Hemodialysis Center in Rasht and selected through a simplified random sampling. Data were collected using demographic characteristics and spiritual health questionnaires. The psychometrics of this questionnaire has been confirmed in the national studies. The data were analyzed through descriptive and analytical statistics (Mann-Whitney and Kruskal-Wallis) using SPSS 16, considering the significant level of P <0.05. The findings showed that the total mean score of spiritual health was 227.92 and its standard deviation was 19.01, indicating the high spiritual health among hemodialysis patients. The spiritual health was high among patients older than 60 years with college-level education, farmers, patients with a history of transplantation and a history of dialysis less than one year, income above 2.000.000 Tomans and without underlying disease. There was a significant difference between spiritual health with history of dialysis and income level (P <0.05). In this study, the spiritual health level of patients was influenced by some demographic characteristics. Knowledge of the results of the current study can be considered by the managers to provide context for improving the spiritual health of patients through planning and providing the necessary arrangements.

Loneliness is one of the negative outcome of children to hospitalization. In this regard, the use of non-pharmacological techniques to relieve loneliness is of paramount importance. The present research was conducted aiming to determine the effect of storytelling on loneliness hospitalized children. This clinical trial was conducted on fifty six 8 to 12-year-old children Hospitalized in 17Shahrivar Hospital in Rasht, Iran in 2017. The subjects were chosen by sequential sampling method and divided into two groups of 28 to experimental and control group. In the intervention group, the storytelling program was conducted. The control group received the routine measures in the ward. Loneliness was measured in the two groups on the first and sixth day of hospitalization Data were collected by demographic characteristics questionnaire, as well as with Asher loneliness questionnaire. results showed a significant difference between children's loneliness the two groups before and after the intervention (P = 0.0001) and Control group (P = 0.02).Results showed that the mean score of children's loneliness was 22.86 ± 7.9 in the experimental group and 31.57 ± 10.5 in the control group. Independent t-test showed a significant difference between the two groups (P = 0.001). The finding of this study show the effectiveness of storytelling on relieve loneliness of hospitalized children. This method is non-pharmacological, easy and simple; it can be used for deceasing the rate of negative feeling, especially loneliness. This study introduced storytelling as an interesting technique for attracting children to nurses and hospitals.

Balance impairment is one of the major issues in the elderly that can influence the activities of daily living; thus, treatment of balance impairments is the leading scope of the specialists in this field. The present study identified the valid functional balance assessment scales for clinical purpose.
Methods & Materials: Electronic searches of PubMed, Embase, CINAHL, Magiran, Iran Medex, and Iran Doc databases were conducted using keyword combinations of “assessment or evaluation or result assessment or instrument assessment” and “balance or equilibrium or posture control or sitting or standing” and “older adults or resident” and “fall or fall risk or fall prediction or balance impairment”; also manual searches and gray literature were assessed. Inclusion criteria were as follows: stated objective to assess balance, evaluation of validity and reliability properties, standard protocol and evaluation criteria and published in English or Persian.
A total of 41 balance tests was selected. Among these, BBS, short BBS, TUG, FAB, BST, functional reach test, CTSIB, POMA, and FGA that showed the favored features of this study were selected.
Selected tests in this study consisted of the items for use in clinical issues and fall prediction.

Aims: The aim of this study was to examining the Factors affecting the duration of weaning from mechanical ventilation based on nurses guide in the intensive care units.
In this sectional -analytic study and single group , 65 intensive care unit patients who required mechanical ventilation for more than 72 hours were selected by convenience sampling. Patients with Burns Wean Assessment Program tools with the nurses guidance in three shifts were investigated. Patient's age, sex, the cause of the connect to mechanical ventilation, The level of awakening based on the Ramsay sedation scale,and duration of mechanical ventilation were recorded. The SPSS22 was used for conducting statistical tests such as the Descriptive statistics and Indipendent T- tests.
The mean duration of mechanical ventilation based on Burns Wean Assessment Program (the nurses guidance) was 111/75±33/46. The test results showed that confounding factors of Sex (p=0/03) and Ramsay sedation scale scor (p=0/0001) had significant effect on the duration of mechanical ventilation but Age (p=0/2) and the cause of the connect to mechanical ventilation (p=0/319) No significant effect on the duration of mechanical ventilation.
To weaning from mechanical ventilation , more attention should be paid to reducing the time of mechanical ventilation and the impact of confounding factors.

Sedation after coronary artery bypass graft surgery can prevent the side effects of the treatment. The purpose of this study was to determine the effect of controlled sedation based on the Richmond scale on the duration of mechanical ventilation and the changes of blood pressure in patients following coronary artery bypass graft surgery.
Methods & Materials: In a single blind randomized clinical trial (IRCT2017050517693N2) from June to August 2017, a convenience sample of 80 patients after coronary artery bypass graft surgery, hospitalized in the intensive care unit of Heshamat Center, Rasht, were selected and randomly allocated into two groups (each group=40). Sedative drug dose was determined using the Richmond agitation sedation scale in the intervention group and determined routinely (based on hemodynamic changes) in the control group. Pain as a confounding variable was evaluated using CPOT tool. Data were analyzed by descriptive statistics and Chi-square, Mann-Whitney, independent t-test and repeated measures ANOVA using the SPSS software version 22.
The mean age of samples was 59.89±7.53 and 66.7% of them were male. There was a significant difference between two groups in the duration of mechanical ventilation (P Utilizing the Richmond tool can reduce the patient’s dependence on ventilator and changes in arterial pressure. Also, using this tool can prevent unnecessary and early administration of sedative and vasopressor drugs in patients.

Aim and Intra operative bleeding is an inevitable complication of endoscopic sinus surgery (ESS), besides it is worring for both anesthesiologist and otolaryngologist. The aim of this study was the survey of relationship between tranexamic acid (TA) dose and the amount of bleeding and duration of surgery in patients with chronic rhinosinusitis.
Methods and Materials: This randomized double-blinded clinical trial was performed on 100 patients with class I and II ASA )American Society of Anesthesiologists( who were scheduled for endoscopic sinus surgery under general anesthesia.50 patients )groupL( received 5 mg/kg of TA, and another 50 patients )groupH( received 10 mg/ kg of TA after tracheal intubation. Anesthesia plan was the same in both groups.Intra operative bleeding, systolic and diastolic blood pressure(BP), and heart rate (HR) at 15th, 30th, 60th, 120th, 150th minutes, surgeon satisfaction rate, duration of surgery, and complications were documented. Data was analyzed by SPSS-19 software.
Findings: Statatistical analysis showed that there was no significant difference considering demographic data between the groups.Surgical time was not significantly different between the groups (p=0.83), but the mean blood loss amount based on mililiter and the percent of maximal allowable blood loss (MABL) were less in group H.And the surgical field was better in group H.
In this study it was shown that administration of 10 mg/kg TA intravenously has been effective to achieve less blood loss, and to improve the quality of surgical field during endoscopic sinus surgery without any significant side effects.

Health and behavior are related to each other and many diseases are originated from individual's unhealthy behavior and habits. Therefore prediction or determination of the behavior is useful to explore effective measures to promote health and reduce risk of the diseases. This study was aimed to determine the effective factors on healthy nutritional behavior of health volunteers based on precede proceed model.
This research was a descriptive, analytical and cross-sectional study. Research population was all the 153 active health volunteers in Rasht urban health centers and health posts in 2015. Data collection tool was a self-report, reliable and valid questionnaire. Data were analyzed with descriptive and analytical statistics using SPSS18.
The mean age of the health volunteers was 43.03±9.11. All Precede Proceed model structures including: knowledge (β=0.296, p Attitude, knowledge, reinforcing, and enabling factors were respectively the most effective factors on nutritional behavior. Attitude and enabling factors status were desirable and other constructs were in moderate level. Considering positive correlations between Precede model constructs and nutritional behavior of health volunteers; appropriate educational intervention based on Precede Proceed Model is recommended to promote nutritional behaviors.

Salmonella spp. is important in medicine. Most related infections are self-limited. Antibiotics are used for high risk patients such as children, old individuals and immune-compromised patients. Overuse of antibiotics has led to increased emergence of multi-drug resistant bacteria which are life-threatening. Phage therapy is an alternative method to reduce antibiotic use.
Waste water samples were collected from sewage system of Rasht City twice a month. Prepared suspensions of Salmonella reference collection A (SARA) number 1, 6 (S. typhimurium) and 46, 48, 51 (S. paratyphi B) and double LB broth were mixed with filtrated waste water. After centrifugation and filtration, serial dilutions were prepared and phages were isolated. Morphologic characteristics were determined using TEM (Transmission electron microscopy). Finally, to assess the spectrum effect of the bacteriophages, we determined host range against 19 SARA strains.
Clear plaque formation on double layer LB agar indicated lysis of the test strains by isolated phages. The results of host range showed that some of the phages were able to lyse a number of other bacteria of SARA collection. Imaging with TEM indicated that the isolated phages against SARA collection belonged to Siphoviridae and Podoviridae families.
This is the first report of phage isolation against Salmonella reference collection in Iran. SARA no. 51 (S. paratyphi B) was lysed by S. typhimurium phage. It means that the isolated phage may lyse S. typhi, which is an important human pathogen.