فریبا عباسی

Dairy products are one of the most valuable foods that contain almost all the necessary ingredients for the growth and continuation of human life. Among Iran's food products, the dairy products occupy the first place in exports and play an important role in the country's foreign exchange. Iran has a self-sufficiency of about one hundred percent in milk and that is why the government and the dairy sector tend to aim at exporting milk to other countries. Iran is a young player in dairy exports but has already reached an annual export level of 600,000 tons of dairy products. The country aims to be a regional key player in the dairy exports. This requires top quality milk and techniques. Finding markets for export is a big challenge for the government. A good condition for export over large distances would be the dairy products with internationally recognized brand names. This study aimed at investigating the impact of effective exchange rate on the export of Iranian dairy products. For this purpose, firstly, the current conditions of dairy products export as well as the effective exchange rate fluctuations during 1991-2021 were identified as the factors affecting the export development. Then, these factors were tested using the Markov switching model. After performing the static test, the Hodrick-Prescott filter was used to examine currency shocks and the production gap. The study findings showed that the variables of real exchange rate and domestic production of milk positively and inflation negatively affected the export of dairy products; the real effective exchange rate in both regimes had a positive and significant impact on the export value of the dairy products; in addition, in both regimes, the domestic milk production had a positive and significant effect on the model, while the inflation in the both regimes of the estimated model had a negative but significant impact on the dairy exports. The way of managing Iran's economy, the characteristics of policy making, the commercial influence on the supply and demand of currency through export and import as well as the management of the currency market by the government and the central bank, according to the fundamental changes in these two institutions, have all had a significant impact on the behavior of the exchange rate in the country. Therefore, according to the concerned results, an increase in the real exchange rate could lead to an increase in the export of dairy products. Although in the current situation, one of the main drivers of the government to increase imports and exports is to stabilize the exchange rate, but due to the different effects of exchange rate changes on different products, it is recommended that the real exchange rate calculated in this study be used to evaluate some economic policies such as agricultural policies.

Resilience is one of the most important factors in achieving the sustainability of rural settlements. As resilience increases, the vulnerability of settlements to hazards decreases. The purpose of this study is to analyze the resilience components of rural settlements against earthquake risk. The present research is applied and its method is descriptive-analytical and library and field methods have been used to collect data. The statistical population of this study is the heads of households in 20 villages and rural specialists in Ijroud city. Using Cochran's formula, the required number of samples to complete the questionnaire has been calculated in a total of 342 cases (305 rural heads of households and 37 rural specialists). Face validity was evaluated by 35 faculty members of the Department of Geography, University of Zanjan and averaged 1.7. The reliability of the variables was calculated by Cronbach's alpha coefficient of 76%, which indicates its acceptability. For quantitative analysis of data, statistical tests such as (one-sample t, path analysis, analysis of variance) were used. The results show that the resilience situation in the studied villages of Ijroud city against the occurrence of a possible earthquake in all components, with an average of 3.33 is unfavorable and the values tend to be vulnerable. Also, among the four components, the physical component with a total of direct and indirect effects explains 56.5% of alpha and is the most effective component in the resilience of Ijroud city. The four dimensions of resilience, in total, could explain 74.9% of the resilience of Ijroud city.

In recent years, the Iran Commodity Market has always been associated with price destabilizing fluctuations. Thus, it is need to use machine Learnings in the form of forecasting methods to recognize early events and prevent damage caused by these fluctuations. Considering the important position of the pistachio trading ring in the Iran Commodity and also the need to use appropriate tools to correctly diagnosis the future price, The purpose of this study is to design and build a suitable hybrid model based on XGBoost and compare its performance with other machine learning models in order to accurately forecast the future price of pistachio. In this study, software’s of Matlab, Rapid Miner and Scikit learn were used to build the proposed hybrid model. The results of applying the wavelet theory showed that the error value of price data was reduced and the data had a stable trend (white noise). Also, the results of the Performance of Auto-Encoder network and the Genetic algorithm showed that the optimal lag of one is the best input variable for forecasting the future price of pistachios in the period under review. Based on goodness of fit indices, the proposed model of this study, Wavelet-XGBoost in comparing to other data mining models, had a better performance in forecasting the future price of pistachios. Also, out-of-sample forecasting with the selected model showed that the forecasted new prices have little difference with the real data, which indicates the efficiency and accuracy of the selected hybrid model. According to the obtained results, it is strongly recommended to use the proposed model based on XGBoost algorithm to forecast the price of other agricultural products.

Environmental and structural factors have a significant effect on the concentration of bioaerosols in the indoor air; however, this issue has not received enough attention in research. . Therefore, this study aimed to determine the distribution of bioaerosols and environmental factors affecting the concentration of bioaerosols by using an artificial neural network.

In this study, the concentration of bioaerosols was determined using the inactive method for one hour in the human respiratory tract. The teypticas soy agar and sabouroud dextrose agar were used to culture bacteria and fungi; then, they were incubated at 15, 25, and 37° C. The independent variable includes three categories of structural variables (number of ward beds, room dimensions, and window dimensions), hospital management and management variables (ward air change per hour), and analytical variables (incubation temperature and type of culture medium). The effect of these variables was modeled by an artificial neural network with Levenberg–Marquardt algorithm.

This study showed that the distribution of bioaerosols in dialysis and surgery wards was higher than in other wards. Also, the artificial neural network can predict the effect of environmental and structural factors of the hospital on bioaerosols, especially fungi because the maximum and minimum concentrations of bacteria and fungi in the actual data were similar to the data predicted by the artificial neural network. In addition, the correlation coefficient for the fungi was 0.95, and the correlation rate between the actual data and the data predicted by the artificial neural network was higher than 0.92.

ANN could be a desirable and reliable method for detecting bioaerosol in hospitals based on the environmental and structural parameters.

Since 1995, Iran has been striving to liberalize its trade regime in order to increase its growth and trade performance. Despite a long period of liberalization, imports are still growing faster than exports, widening the trade deficit. Therefore, this study aimed mainly at investigating the effects of trade liberalization on the growth and trade of agricultural products using the Markov-switching model approach and annual time series data (from 1986 to 2018). The results showed that liberalization, by reducing the import tariff rate, increased exports by 1.56 percent in the short run, but reduced imports by about 7.65 percent in the long run. In addition, the results of growth pattern estimation showed that the liberalization index in both regimes had a significantly positive effect on agricultural growth, meaning that the implementation of trade liberalization policy in the studied period had a positive effect on agricultural growth by 1.98 percent. Thus, trade liberalization in the short run leads to growth in exports and in the long run, by increasing production, increases the volume of exports and decreases imports, and hence, leads to economic growth. According to the obtained results, in order to increase the trade potential of the agricultural sector, it is suggested that tariff policies on trade liberalization be developed in line with the objectives of the Perspective Document Programs of the country.

Cancer is the most common cause of death in developing and developed countries, accounting for nearly 13% of world death. In Iran, gastrointestinal cancers are common. Therefore, this study was conducted to evaluate the gastrointestinal tract tumors in Urmia Imam Khomeini hospital.

In this cross-sectional study, pathology reports of 741 patients with gastrointestinal tumor were evaluated.

Of 741 reported tumor, 705 cases (95.14%) were malignant, 36 cases (4.85%) were benign. 61.8% of patients with malignant tumors were men and 38.1% were women. The mean age of patients with malignant tumors was 60.2±13.35 and the mean age of patients with benign tumors was 47.7±10.49. The most abundant malignant tumor was adenocarcinoma with 481 cases (68.22%) followed by squamous cell carcinoma with 137 cases (19.43%) and the most frequent benign tumor was lipoma(52.7% of cases). The malignant tumors were observed mostly in the ages of 71 or higher (232 cases (32.9%)). In the evaluation of anatomical location of the malignant tumors, in esophagus, the precise location was not reported in most cases (63.7%). In the stomach, the cardia with 29.27%, in the small intestine, the duodenum with 66.6%, and in the colorectal region, the rectum with 41.9% were the most involved locations.

The results of our study indicated that the most abundant malignant tumor of the gastrointestinal tract was adenocarcinoma and the most abundant benign tumor was lipoma. Malignant tumors were observed mostly in men while benign tumors were mostly observed in women. The high frequency of malignant tumors in the ages of 71 and higher indicates the importance of early-onset screening for the prevention of malignant tumors in older ages.

Histologic tumor grading is a well-documented useful, inexpensive and easily done prognostic factor but it shows many differences when viewed by multiple pathologists. The aim of the present study was to determine the interobserver differences in tumor grading among pathologists in Urmia, Imam Khomeini Hospital.

In this descriptive, analytical retrospective study, 50 cases of breast carcinoma, urothelial papillary tumor and soft tissue sarcoma were evaluated. Three pathologists reviewed all slides and graded the tumors after codifying and without any knowledge of the opinion of each other. The interobserver concordance was determined by K statistics. A p< 0.05 is considered significant.

The interobserver concordance was fair in grading of breast, and bladder carcinoma and moderate in soft tissue sarcoma (Kappa was 0.3, 0.13 and 0.603, respectively). Based on the evaluation of factors included in histologic grading, the agreement was higher for pleomorphism in breast cancer, cellular thickness layer in bladder tumor, and cellular differentiation in soft tissue sarcoma (Kappa was 0.8, 0.28 and 0.65, respectively(.

According to our results, interobserver concordance in the grading of different tumors was fair. To solve this problem, it is suggested to do grading more than one time and in different microscopic fields. Simultaneous grading by two pathologists with multi-head microscope or considering the average of what two pathologists achieve separately can be useful.

The purpose of this study is to investigate the physical challenges of tourism development in rural areas using the basic theory in the target villages of tourism in Zanjan province. The present research is in the group of qualitative research in terms of purpose, development-application and in terms of paradigm, and in terms of method, it has used the basic theory. Library documents, photographs and videos, in-depth interviews, and direct and non-participatory observations were used to collect information. The statistical population of this study is the local managers of eight villages targeted for tourism in Zanjan province. The collected data were analyzed through content analysis. By linking the codes (open coding), concepts (axial coding), categories (selective coding) and validation of the concepts obtained from the focal method research by experts, the conceptual model of the research was drawn and the approval of experts validated the model. . The results show that the target villages of tourism in Zanjan province face physical challenges such as the destruction of the traditional texture and architecture of the village, environmental issues, lack of facilities-services, weakness of infrastructure and transport fleet. Recognition of the situation, capabilities,s.

The aim of this study was to investigate the effect of seasonal variation on the diversity of fungal airborne species in the composting process.

Samples were taken based on the 0800 NIOSH method at a height of 1.5 m above the ground during the waste separation, turning of windrow and stabilization of compost. Air samples were collected in two various seasons; summer (108 samples) and winter (108 samples) at the composting plant in Shiraz. The culture media consisted of Sabouraud Dextrose Agar with chloramphenicol for the selective isolation of fungi, which was further incubated at 37 and 45°C. The results were analyzed by a t-test method using MATLAB 2018.

The highest mesophilic fungi density was related to the segregation process of composting. The variation of fungi observed was higher during summer throughout separation and stabilization process (p < 0.05). The predominant species were found to be Aspergillus flavus (4449.8 CFU/m3) (p < 0.05) and Paecilomyces (1850.9 CFU/m3) (p < 0.05), respectively. Furthermore, the highest varieties of fungal species in the turning of windrow mass were observed during winter (p < 0.05) and the predominant species was yeast (420.6 CFU/m3). At all stages of composting, the varieties of thermophilic fungal species were higher during summer with the large number of Aspergillus fumigatus, Mucoral, and Paecilomyces.

The density and diversity of mesophilic fungi during summer was higher than winter. The concentration of Aspergillus, was beyond the guidelines set by the EPA, ACGIH, NIOSH and EU. Thus, the use of self-protection is essential.

Rural tourism has been suggested as a strategy for the development of rural areas due to its diverse functions and high ability to communicate with other sectors of the economy. The purpose of the present study is to analyze the economic barriers to tourism development in rural areas using the basic theory of tourism target villages in Zanjan province. The present study is a qualitative research group in terms of purpose, development-applied and paradigm. Library documents, photo and video preparation, in-depth interviewing and direct and non-participatory observation were used to collect information. The statistical population of this study is local managers (experts in tourism, villagers and members of Islamic councils) in eight villages of Zanjan province. The purposive sampling method (36 people with snowball method) was performed until theoretical saturation. Guba and Lincoln's evaluation method (including four stages of validity, portability, stability, verifiability, reasonableness) was used to validate the research. The collected data were analyzed through content analysis. By linking open source coding, concepts (axial coding), categories (selective coding) and validating the concepts obtained from the focal method research, the conceptual model of the research was drawn by experts and validated by the experts to validate the model. . The results show that tourism target villages of Zanjan province are facing economic challenges such as: restricting tourism seasons, vulnerability of agricultural economy, weakness of individual abilities, inappropriate economic environment, lack of risk-taking, lack of recognition. The market is faced with a lack of technical business knowledge.

The present research is applied and its method is descriptive-analytical and library and field methods have been used for collecting data. The statistical population of the study is 11 villages with second homes tourism in Ijrud township. According to the census of 1390, the total number of households in these villages is 1849; that, using the Cochran formula, the number of samples needed to complete the questionnaire has been calculated 282. With regard to access to local authorities, 60 questionnaires were completed among them. The formal validity of the questionnaire was examined from experts' point of view and the reliability of the variables was calculated by Cronbach's alpha coefficient of 77%. For quantitative analysis of data, statistical tests such as one-sample and two groups t, one-way ANOVA and factor analysis have been used. The results show that the development of second homes tourism in sample villages has had a positive effect on economic indicators. Also, the result of variance between the two groups is significant in the indicators of land price, housing and employment creation. In addition, based on the results of factor analysis, which were categorized into 6 factors, the first factor, according to its constituent variables, was named the investment factor and by explaining (19.237) percent of variance was introduced as the most important factor. This factor, along with the factors of variability of economic activities, land use changes, population growth, tourism services improvement and technology transfer, explained 67% of the variance in total.

Gastrointestinal diseases are common clinical conditions and due to the fact that in a significant number of endoscopic cases, the only finding is mucosal erythema,, this study was performed to evaluate the histopathological findings of gastrointestinal diseases with only mucosal erythema. In this analytical-descriptive and retrospective study, all gastrointestinal pathology reports of endoscopy samples with only mucosal erythema in endoscopy were studied in pathology department of Urmia Imam Khomeini Hospital during March 2016 to March 2017. The histopathological type of lesions were categorized in two major groups (neoplastic and non neoplastic) according to the anatomical site (esophagus, stomach, small and large intestine), age, and gender. Among the 4345 gastrointestinal endoscopic samples, 1072 cases, with endoscopic finding of only erythema were studied. The mean age of the subjects was 44.8 ± 16.02 years. The frequency of neoplastic lesions was 0% and of non-neoplastic lesions, 100%. The frequency of non-neoplastic lesions according to the anatomical site was 53.45% for large intestine, 23.9% for small intestine, 19.12% for stomach, and 3.5% for esophagus. In the esophagus, stomach, small, and large intestine, the most common lesions were chronic inflammation (44.7%, mostly in women), chronic gastritis without H. pylori (58%, mostly in men), non-specific change (80.5% frequently in women), and nonspecific change (68.9%, more frequent in men), and the p values were 0.45, 0.67, 0.55, and 0.1, respectively. Erythema is a very common finding in endoscopy and due to its association with non-neoplastic, precancerous lesions such as GERD, H. pylori infection and ulcerative colitis, it is recommended to take biopsy from all patients with erythema in endoscopy to detect and diagnose any probable precancerous lesions.

Paper is a strategic commodity that about 85-90% of it, comes from natural forest trees and planting hands and has assigned a large quota of domestic, administrative and commercial waste. Therefore, the purpose of this study was to investigate the effect of education on knowledge, attitude and practice of female students of Abarkouh Paramedicine School on saving paper consumption, so if necessary, further education to be considered. This descriptive cross-sectional study was carried out in 2017 by census method on 90 female students of Abarkouh Paramedicine School. Data were collected through a researcher-made questionnaire consisting of four sections: demographic information, 17 knowledge questions, 16 attitude questions and 14 practice questions. The reliability and validity of the questionnaire before distribution were confirmed by Cronbach's alpha of 0.887. Before distributing questionnaires, buckets were placed in the dormitory and college two months ago and the amount of paper collected through weighing was obtained. The questionnaires were distributed before and after education through a brochure. After data collection, data were analyzed by SPSS21 and descriptive statistics, T-test, ANOVA, Pearson correlation coefficient and comparison of the effectiveness of education before and after education using Paired sample test. The mean age of participants in the study was 27.54±7.59. As the age increased, knowledge increased, but the attitude and practice decreased. But in general, their differences were not significant. The mean score of knowledge and practice after education increased and the attitude score increased slightly. Based on Paired sample test, there was a significant difference between the knowledge and practice scores before and after training (P-value ≤ 0.001). There was no statistically significant difference for attitude (P-value = 0.363). Due to the weakness of the knowledge, attitude and practice of students as an influential group in the future of society, planning for the institutionalization of the culture of saving paper consumption and the necessary education to increasing knowledge and practice Community members is recommended.

Gastric diseases are common clinical conditions mostly diagnosed by endoscopy. Due to the high prevalence of stomach diseases in Iran and the world, this study was performed to evaluate the frequency of gastric diseases in Urmia Imam Khomeini Hospital. In this analytical-descriptive retrospective study all 2754 gastric pathology reports of endoscopy, derived from samples referring to Urmia Imam Khomeini Hospital during March 2016-March 2017, were studied and histopathologic type of gastric lesions were categorized into four major groups (neoplastic, non-neoplastic, polyps and dysplasia) according to age and gender. The mean patients’ age was 52.65±17.85 years. The frequency of gastric lesions was as follows: non-neoplastic (89.3%), neoplastic (6.9%), polyps (2.4%) and dysplasia (1.4%). All of them were more frequent above the age of 50. The neoplastic lesions were more frequent in men and non-neoplastic lesions in women (p<0.001). The most frequent non-neoplastic lesion was chronic gastritis (87.4%), mostly without accompanying H.pylori (53.2%). The frequency of gastric ulcer was 6.1%, mostly (79.3%) without accompanying H. pylori. Of neoplastic lesions, 99.5% were malignant (frequently adenocarcinoma) and only one case of benign neoplasm (leiomyoma) was reported. Regarding the known role of H. pylori in occurrence of gastric ulcers and cancer and the conflicting results obtained in this study, we suggest to use other diagnostic tools such as respiratory test in addition to histopathology in evaluation of H.pylori. Also, the high frequency of gastric lesions over the age of fifty indicates the importance of screening for early diagnosis of neoplasms, especially adenocarcinoma in this age group.

Rural tourism has been discussed with regard to various functions and high ability to connect with other economic sectors as a strategy for socio-economic development of rural areas. The purpose of this study was to assess the role of tourism on sustainable development of rural areas of Zanjan province. The present research is applied in a descriptive-analytical manner and library and field methods have been used to collect data. The statistical population of the study is 8 villages of tourism target of Zanjan province. According to the census of 1395, the total number of households in these villages is 2,584 households. Using Cochran formula, the sample size was calculated to complete the questionnaire of 243 samples. The face validity of the questionnaire was examined from experts' point of view and the reliability of the variables was calculated by Cronbach's alpha coefficient of 76%. For quantitative data analysis, statistical tests such as (single instance t, regression, Kruskal-Wallis) have been used. The results show that tourism development has a positive effect on economic, socio-cultural and physical indicators and negative impact on the environmental index. Also, in the regression fit model, the coefficient of determination was equal to (0.842), which indicates the positive effect of rural tourism on the dimensions of independent research variables. The ranking of Kruskal-Wallis test also shows that the villages of Maire, Sokrizi, Hajji Siran, Sheyt, respectively, have been most influential in rural tourism in the region.

Rural tourism as a socio-economic activity can play an important role in diversification of rural economy by creating job and income opportunities; this can also help to improve and enhance the quality of life in rural communities. The purpose of this study was to investigate the effects of second home tourism in quality of life of permanent residents in rural areas of Saidabad County in Ijrud Township. In this applied research we have used descriptive- analytical methods. For data collection field techniques such as questionnaire and interview were used. For data analyzing, statistical tests such as one sample t-test, correlation and multiple variable regression were used. The sample includes villages in Saidabad County and from the total number of 818 households, 216 cases were chosen. The results of study show that tourism developments in the last decade have had positive impacts on the quality of life measures in rural areas. On the other hand, results of regression according to R square coefficient (0.924), indicates the positive effect of second home tourism development in improving the resident's quality of life indicators in the study area; so that among the impacts of expanding tourism second homes on the quality of life, economic index (0.450) and physical- infrastructural aspects (0.349) respectively have the highest impact and institutional and decision making dimension (0.078) has the least amount of impact on quality of life index from the viewpoint of local residents; and these effects, in all cases are significant at 99% level.

Lung cancer as the most common cancer leads to 30% and 26% of deaths in men and women, respectively. Most patients with lung cancer are diagnosed in advanced stages, so their surgical procedures are not often successful. Therefore, early diagnosis has the key role in treatment and life expectancy of patients. The aim of this study was to determine sensitivity, specificity, positive and negative predictive values and accuracy of bronchial washing cytology in comparison with biopsy in diagnosis of lung cancer.
In this study, the diagnostic accuracy of bronchial washing was evaluated on 215 consecutive cases whose bronchial samples were taken in Urmia Imam Khomeini hospital during March 2012- March 2015.
Among 215 bronchial samples, 52 cases (24.2%) were female and 163 cases(75.8%) were male. Sensitivity, specificity, positive and negative predictive value and accuracy were 32.1%, 96.47%, 89.65%, 59.85% and 65.06%, respectively.
According to the results, bronchial washing cytology has low sensitivity to diagnose of lung tumors, so we recommend other cytological procedures such as bronchial brushing or combination of bronchial washing and bronchial brushing to diagnose lung tumors.

Object recognition in cluttered background is a challenging problem in computational modeling. When objects are present on natural backgrounds, the performance of object recognition models drop significantly. However, humans recognize objects accurately and swiftly despite this challenging condition. It seems that, our visual system achieves this ability based on lateral connections and feedback connections from higher areas.
One of the computational object recognition models that recently has achieved a remarkable performance in object recognition is convolutional neural network (CNN). It resembles feed-forward sweep of visual information processing. In this study, based on CNNs and inspired by biological evidence we proposed a recurrent object recognition model. The model simulates recurrent dynamics of visual object processing by implementing feedback and lateral connections. Evaluating the model to recognize objects on natural background, we showed that the proposed mechanisms significantly improves performance. In addition, visualizing the representations of layers indicatedthat deeper layers of the CNNs remove the background much better than the lower layers. According to the results, using both mechanisms -the feedback from higher layers and the interlayer surround suppression mechanisms- simultaneously in structure of CNN, the performance improvement was more than when either one was usedalone. This observation is in accordance withthe biological evidence from the human visual system.

Rabies is anacute viraldisease ofthe central nervous systemand themortality rateis veryhighand one hundredpercent.Rabies transmitted to-human through the bite of a rabid animal, especially canine and feline. Annual, 40 to 70 million deaths occur worldwide from rabies. Rabiesincubation periodwas reported of 5 days toayearand an average of 3-1months. The aim of this study was reported a rare case of rabies death by the marten bites.
Report of Case: patient's was a46-year-old with symptom such as headache, fever, pharyngitis and tingling and burning refer to doctor. History of animal bite (bites probable marten) about 50 days ago, doctor was suspected rabies. The clinical symptoms of rabies appeared in patients after hospitalization, then patient getting loss of consciousness, trismus, hydrophobia, photophobia, increased salivation andmuscle paralysis. Biopsies taken after the patient's death was confirmed rabies by Institute Pasteur. Eventually, after 6 days hospitalization patient was death.
Usually, rabies progresses during the 14-7 days. After theonset of symptoms, injection of vaccine and serum cannot prevent for rabies. Therefore any animal bites consider the suspected rabies and injected vaccine.

Intra-operative diagnosis of ovarian tumors is mandatory because various types of tumors with different optimal management are seen in ovary. This study was done to determine the accuracy of scrape cytology in intraoperative diagnosis of ovarian tumors. In this prospective study, we studied scrape cytology smears of 75 consecutive ovarian tumors received in department of pathology during September 2010 to September 2012. Then, we compared the results with frozen section and permanent section results in each case. Accuracy, sensitivity, specificity, positive and negative predictive values of both methods were calculated Overall accuracy of scrape cytology was 96% and of frozen section 97.34%. Sensitivity, specificity, positive and negative predictive values of scrape cytology were 92.30%, 96.77%, 85.71% and 98.36%, respectively. These figures were 92.30%, 98.38%, 92.30% and 98.38% for frozen section. It seems that scrape cytology can be used as a simple inexpensive method for intraoperative diagnosis of ovarian tumors as complementary or an alternative to frozen section, however, combination of both methods is more reliable.

According to the importance of the family physicians program results in rural areas and government decision to apply this program in urban areas of Iran, This study aimed to determine the quality of care and blood sugar control, blood pressure and blood lipids in diabetic type ΙΙ patients in rural areas covered by family physicians. In this study, 380 patients 30-76 years old with medical records in the health centers of the malekan-Iran in rural areas in 2013, after informed consents were enrolled. Data were collected by interview and HbA1c examinations and using a standard questionnaire. Data analyzed by SPSS19 version. Multivariate logistic regression was used to estimate odds ratios adjusting for diabetes complications and related risk factors. Results showed that 68% Study participants was women’s and average age of patients was 57.86±11.9 and sex ratio of females to males was almost 2.2 with 1. Final analysis showed that HbA1c levels more than 7% (PHbA1c=0.002), cholesterol over 240 mm/dl (Pcholesterol=0.04) and hypertensive over 140/90mm/Hg (PHTN=0.007) 1.52, 2.44 and 1.44 times increased risk of diabetes complications, respectively. The quality of care and blood sugar control in diabetic patients was lower than compared to the American Diabetes Association (ADA) standards, but our results are near to results of Country studies.

Frozen section is a high- risk procedure with important consequences. As the histopathologic diagnosis of the frozen section may have serious consequences for the treatment of the patient، a high degree of accuracy is mandatory and quality control is important. The aim of this study was the evaluation of accuracy of frozen section by revision of slides in teaching hospitals of Urmia University of Medical Sciences including Imam Khomeini and Shahid Motahari hospitals. Methods & Materials: In this cross sectional study، the slides of all frozen section samples in teaching hospitals of Urmia University of Medical Sciences during 2003 to 2009 revised by two pathologists and compared with their final permanent section diagnoses. A total of 155 neoplastic specimens in Imam Khomeini hospital and 83 neoplastic specimens in Shahid Motahari hospital were studied. Sensitivity، Specificity، positive and negative predictive values and accuracy in Iman Khomeini hospital were 95. 6%، 100%، 100%، 96. 5% and 96. 7% and in Shahid Motahari hospital 100%، 98%، 96. 2%، 100% and 98. 9%، respectively. We had 8 discordant diagnoses، 3 cases (37. 5%) were due to macroscopic discordance، 1 case (12. 5%) of microscopic discordance and 5 cases (62. 5%) of both macroscopic and microscopic discordance. As different studies showed accuracy of 91. 5% to 97. 4% for frozen section so we concluded that frozen sections are interpreted with acceptable accuracy in Urmia University Of Medical Sciences.

It has been shown that contraceptive pills, which are commonly used orally, have some side effects, such as vomiting, nausea, high blood pressure. Vaginally usage of the contraceptive pills reduces these side effects. This study aimed to evaluate and compare the effect of orally and vaginally usage of low dose contraceptive pills on bleeding pattern in dysfunctional uterine bleeding. In this clinical trial study, 100 women who had been referred to the Shahid-Beheshti and Al-Zahra hospitals of Isfahan as having dysfunctional uterine bleeding were divided into two equal groups. Groups 1 were given contraceptive pills orally and group 2 vaginally. Using pictorial bleeding assessment, the amount and duration of uterine bleeding were measured at the beginning and end of the study. In addition, the side effects of the pills were evaluated at the end of the study from both groups. Data were analyzed using Chi- square test. Low dose contraceptive pill in vaginal route decreased bleeding amount and duration of bleeding more effectively than oral rout (P<0.05). The side effects of contraceptives, such as nausea and vomiting was significantly higher in orally-used group compared to the vaginally-used group (P<0.05), but vulvo-vaginitis was significantly higher in vaginally-used group (P<0.05). Using the contraceptive pill by vaginal rout is a safe method with few side effects compared with the oral rout.

Alkaptonuria is a rare autosomal recessive disorder characterized by deficiency of homogentisic acid oxidase. This deficiency leads to accumulation of homogentisic acid in tissues and its urinary excretion and resulting in characteristic features like ochronosis, darkening of urine, and arthropathy. We describe a case of alkaptonuric ochronosis in a 62 year old man, who had alkaptonuria, degenerative arthropathy of hip and knees, spinal abnormalities similar to ankylosing spondylitis and renal calculi.Total replacement of hip joint was done. Total replacement of hip joint was done.