فهرست مطالب محمد واسعی

The neonatal period has a decisive role to play in the long term health of humans. To reduce the number of neonatal readmissions, due to reduced duration of early postnatal hospitalization for neonates, it is now considered that rate and cause should be evaluated as well as associated risk factors. That is why, from 2019 to 2021, this study will examine the rate and cause of readmissions for premature babies in Shahid Mostafa Khomeini Hospital, Tehran, Iran.

Health records of healthy infants born during the year 2019 through 2021 and readmitted to a neonatal unit 30 days after birth were examined in this cross-sectional study at Shahid Mostafa Khomeini Hospital, Tehran, Iran. Inputs and analyses of retrieved data were done within the SPSS version 21 software.

From totally 4951 neonates born during 3 years, 252 neonates (5.08%) were readmitted during first month of life. Jaundice (71%) and potential sepsis (16.3%) were most common causes of neonatal readmission. There's a big relationship between them. neonatal gender (P=0.010), gestational age (P=0.001), birth weight (P=0.019) and feeding type (P=0.001) with hospital readmission. The relationship between neonatal age and the cause of neonatal readmission is significant, P=0.001).

Readmissions occur in a number of neonates. In the first week of life, jaundice and feeding problems are usually the cause of neonatal readmission, and infections are a major cause of readmission after the first week. The risk factors for the readmission of newborns are male gender, lower birth weight and a gestation period not exceeding 37 weeks. While breastfeeding protects against these risks, maternal age is also an important factor.

Patients undergoing hemodialysis commonly experience discomfort due to the insertion of needles into their arteriovenous fistula. The aim of the study was to compare the effect of EMLA ointment and lidocaine spray, along with the use of rhythmic breathing on the intensity of pain caused by the insertion of needles in the arteriovenous fistula among hemodialysis patients.

Methods & Materials:

 This study was a randomized clinical trial conducted on a total of 80 patients who were referred to Imam Khomeini and Golestan hospitals in Ahvaz in 2022. The numerical pain measurement scale was used as the data collection tool. The participants were selected using the convenience sampling method and then randomly allocated into two groups. In the EMLA ointment group (n=39), a total of 2 grams of EMLA ointment was applied to the target area 60 minutes before the hemodialysis procedure. In the lidocaine spray group with rhythmic breathing (n=41), 2 puffs of lidocaine spray were administered along with rhythmic breathing 5 minutes prior to needle insertion. The pain intensity was then measured and recorded. The collected data was analyzed using descriptive and inferential statistics in SPSS version 20, with a significance level set at 0.05.

The group receiving EMLA ointment and the group receiving lidocaine spray, with rhythmic breathing had mean pain scores of 1.95±1.09 and 2.12±1.10, respectively. Although the mean pain score in the EMLA ointment group was lower than that in the lidocaine spray group with rhythmic breathing, the difference was not statistically significant (P=0.479).

The findings of this study indicate that both EMLA ointment and lidocaine spray, along with the use of rhythmic breathing, have comparable efficacy in reducing pain among hemodialysis patients. Therefore, considering the patient's condition, the utilization of either of these methods is recommended.

Urinary tract infection is one of the most common infectious diseases in women. This research was conducted with the aim of determining the pattern of antibiotic resistance in micro-organisms that cause office infection and the effect of common antibiotics in treating the disease in elderly women.

The current study is a cross-sectional study. The sampling method was a census and the target population included all female patients over 65 years of age with urinary tract infections who were admitted to the infectious and urology departments of Shahid Mostafa Khomeini Hospital, Tehran, Iran from April 2017 to March 2022 and received antibiotics during the treatment period. have done, a study was conducted on 150 elderly female patients aged 65 and over with urinary tract infection. After culture and final confirmation of infection, urine samples were analyzed for microbial sensitivity by standard disc diffusion method. The relationship between the infecting strain, the results of the antibiogram culture, and the demographic factors of age, underlying disease, and length of treatment were investigated.

Escherichia coli was diagnosed as the dominant strain in 120 patients. 11 types of antibiotics were identified in the antibogram culture, all patients (100%) were sensitive to Amikacin. The most resistant antibiotic was Cefalotin, which 83% of patients showed resistance to. The infecting strain and antibiogram culture results had no significant relationship with the demographic factors of age, underlying disease, and length of treatment (P>0.05).

The results of the study showed that the most resistant and sensitive antibiotics examined in the study were Cefalotin and Amikacin. Due to the high prevalence of urinary tract infection in the elderly, its correct diagnosis is important, and the use of effective antibiotics based on antibiogram culture is also a therapeutic strategy, and the short duration of treatment prevents drug side effects.

Injecting various blood products has potential risks for trauma patients. This study was conducted with the aim of determining the amount of blood product injection in the treatment of patients with acute trauma who referred to the Besat Medical Training Center in Hamedan in 2018-2019.

This cross-sectional study was conducted on the records of 227 trauma patients admitted to Besat Hospital in Hamadan during 2018-2019 based on the rate of their transfusion the rate of transfusions. The study data were analyzed with SPSS23 and appropriate non-parametric tests such as Mann-Whitney, Kruskal-Wallis and Spearman's correlation test. The significance level in all tests was considered <0.05.

In this study, the most common types of trauma and mechanism were penetrating (65.2%) and traffic accidents (70%); 62.1% of the damaged organs pertained to head and neck areas and 72.7% of the cases required surgery with 18.1% mortality. The frequency rates of administered units of PRBC) 4.70 ± 5.10(,  platelets )0.72 ± 1.37(, and FFP )1.98 ± 2.67(  were significantly higher in trauma patients who died and required surgery (P< 0.05). The mean and standard deviation of the patients' age was 45.63 ± 19 years; 67.40% of patients were male.

In trauma patients who underwent surgery and died due to head and neck trauma, the frequency of packed red blood cells, platelets and FFP injection and the mortality rate was significantly higher than other trauma patients. Optimal use of blood products in accordance with the updated guidelines is recommended.

After four years of the COVID-19 disease outbreak, despite the recovery of many patients, a significant number of them are still suffering from it and its complications. In this regard, many patients are struggling with its long-term effects and cannot return to normal life. These patients experience a wide range of life-disrupting disorders, which considers the importance of examining long-term symptoms and paying special attention to these patients.

This cross-sectional study was conducted in 1400 for three months on 280 COVID-19 patients of Shahid Mostafa Khomeini Hospital in Tehran, Iran. Those whose disease was confirmed by laboratory testing (RT-PCR positive). these patients were under observation from the onset time of infection until the end of quarantine. Long-term symptoms among discharged patients were collected and compared using a questionnaire containing demographic information and patients' statements. The data were analyzed with SPSS version 21 software and the results were reported.

45.7% of patients had at least one long-term symptom and 54.3% had more than one long-term symptom. The symptom of fatigue had the highest frequency (64.4%) and the lowest frequency belonged to diarrhea with 2.7%. Significantly (P<0.050), long-term symptoms were seen in women more than men, in old people more than young people, and in obese people more than thin people. The severity of the disease was directly related to the frequency of symptoms.

In general, it can be said that there are long complications in all patients. Since among demographic indicators, "obesity", "severity of illness" and "hospitalization" have been the most important factors in increasing the frequency of long-term symptoms, paying attention to these factors and considering possible solutions to prevent can lead to improving the quality of patient’s life and reduces the duration of long-term complications.

Corona virus is a single-stranded RNA virus that has affected places with high population density. Middle-aged and elderly patients with chronic diseases seem to be at risk of respiratory failure and may have a poorer prognosis. In order to diminish the mortality caused by this disease and determine the impact of underlying factors on the consequences of patients, we decided to investigate the frequency of underlying diseases and its relationship with the prognosis of patients.

This cross-sectional study was conducted on COVID-19 patients between of February 2020 to September 2021 at Shahid Mostafa Khomeini Hospital. After data collection, underlying diseases and their effect on prognosis during hospitalization of patients were studied and descriptive as well as analytical statistics were extracted.

In this study, 158 cases were examined. Most of the underlying diseases in the patients were hypertension and diabetes. Eighty point four percent of patients had at least one underlying disease. In the meantime, was a significant relationship between oxygen saturation level and deterioration criteria (P<0.05). Meanwhile, a significant relationship was observed between the age of patients with the need for mechanical ventilation and mortality (P<0.05). Kidney diseases, diabetes and high blood pressure as well as the presence and number of underlying diseases with poor prognosis the need for mechanical ventilation and also death had a significant relationship (P<0.05).

A high percentage of people with COVID-19 are elderly and have underlying diseases, some of which are associated with bad prognosis and high mortality. Multiple underlying diseases are also a predisposing factor for worse prognosis and high mortality. To this end, the care and treatment of these people is very important.

The emergency department is one of the most important departments of any hospital, where patients or their companions may not be satisfied with the services provided due to various reasons. This study aims to investigate the causes of the complaints of patients visiting the emergency department at Be’sat Hospital in Hamedan, Iran in 2018-2019.

In this cross-sectional study, all the complaints made over the years 2018 and 2019 from the emergency department of Ba’ath Hospital in Hamedan, Iran were investigated. Demographic information, causes of complaint, sources of complaint, results of complaints and the complaint section were collected.

One hundred and seventy complaints were filed in two years. One hundred and nineteen cases (68.4%) were filed by the patient’s companions. Half of the patients who complained had university education. The postponement in the visit and assignment of the patient by the doctor, inappropriate treatment of the treatment staff, medical malpractice and wrong diagnosis were the most important reasons for the client complaints. In 45% of the cases, the patient or the patient’s companion was right. Meanwhile, 39.1% of patients had no convincing reason to complain and 15.5% of their complaints were unsuccessful. A significant relationship was observed between the outcome of the complaint and education. Most of the registered complaints that were right with the patient were relevant to people with university education (P=0.001).

The findings of this study showed that postponement in the visit and assignment of the patient by the doctor, inappropriate treatment of the emergency personnel with the patient, medical malpractice, and wrong diagnosis are the most important causes of client complaints. Almost in half of the cases, the patient was right, which had a significant relationship with the level of education of the patients.

The risk factors for the death of covid-19 patients are not fully identified, and an accurate and robust risk assessment tool is needed to assess the prognosis of patients that is easy and affordable to implement. The purpose of this study was to compare the findings of the first Complete Blood Count in patients diagnosed with Covid-19 who were discharged with a favorable general condition, compared to those who died in the hospital.

This cross-sectional study was performed on 213 patients with a definite diagnosis of covid-19. The findings of the first CBC were compared to estimate the survival of discharged and deceased patients. Data were analyzed by using Medcalc.20.013 software .

The frequency of death was 35.2%. The increase of White Blood Cells in predicting death had a poor diagnosis (Receiver Operating Characteristic = 0.66). Hemoglobin decreases in predicting death had no diagnostic power (ROC=0.58). Platelet augmentation was not effective. The increase in Mean Corpuscular Volume had poor diagnostic power (ROC=0.60), but the decrease in lymphocytes in predicting death had good diagnostic power (ROC=0.70). An increase in Neutrophil-Lymphocyte Ratio in predicting death had good diagnostic power (ROC=0.70). The increased platelet-lymphocyte ratio in predicting death had poor diagnostic power (ROC=0.67). The increase in Systemic Immune-Inflammation Index in predicting death had poor diagnostic power (ROC=0.68).

The results of this study showed that based on the first findings of the CBC test, three factors for predicting the risk of death, increased neutrophils, decreased lymphocytes, and increased Neutrophil-Lymphocyte Ratio were identified with good diagnostic power, which indicates the diagnosticity of this test in predicting the tensity and survival of covid-19 patients.

Gram-positive bacteria, especially gram-positive cocci, such as coagulase-negative staphylococci and staphylococcus aureus, are necessary pathogens in the hospital, including urban hospitals and field hospitals during war and natural disasters. Gram-positive organisms have highly variable growth and resistance patterns. Incorrect use of broad-spectrum antibiotics increases hospital-acquired infections. This study aimed to investigate the frequency, risk factors, and antibiotic resistance pattern of hospital infections caused by grampositive cocci during 2014-2020 in Mustafa Khomeini Hospital in Iran.

This cross-sectional study was conducted on 263 patients with at least one positive culture of gram-positive cocci bacteria. These patients were hospitalized in the adult departments of Shahid Mostafa Khomeini Hospital in Tehran, Iran from April 2014 to April 2020. Isolates were separated by laboratory tests and were evaluated by the standard disc-diffusion antibiotic sensitivity and resistance method. Data were analyzed using Medcalc 20 statistical software .

The results of this study showed that the coagulase-negative Staphylococcus isolate was in the first rank with 36% infection. The highest risk factor for this bacterium was the vascular catheter. Staphylococcus aureus ranked second with 33% of infections and the most common cause was the endotracheal tube. Enterococcus isolates ranked third with 25% of cases, and the most common cause was urinary catheters. The best drugs affecting gram-positive cocci were vancomycin and ciprofloxacin, and the most resistance was seen in erythromycin, amikacin, and clindamycin. High length of hospitalization and hospitalization department were effective risk factors.

According to the results of the study, the use of effective antibiotics based on the patient’s antibiogram can be useful in improving the effectiveness of the treatment.

Appendicovesical fistula in patients suffering from cystic fibrosis is a rare condition. Although this situation is so rare it should be considered in the differential diagnosis, dealing with a patient with cystic fibrosis and chronic abdominal pain with no response to primary management. To the best of our knowledge, this is the third case of appendicovesical fistula in a patient with cystic fibrosis.

In this paper, we are reporting a bladder lesion of a nine-year-old Iranian girl, a known case of cystic fibrosis, who was referred to pediatric urology clinic, Children’s Medical Center, Tehran University of Medical Sciences. The girl is a known case of cystic fibrosis on regular follow-up who had chronic abdominal pain for about one year. While primary management had been failed for her, further workups were done by her pediatric pulmonologist. In her pelvic sonography, the radiologist reported a bladder lesion so she was referred to our clinic. Cystoscopy was done for her, but transurethral biopsy/resection was impossible according to the lesion location. The non-papillary nature of the lesion raised our concern about the possibility of genital rhabdomyosarcoma with bladder invasion. So, an Abdominopelvic CT scan and a pelvic MRI were also done for her. Intact uterus and vagina with an enhancing lesion at the dome of the bladder with some degree of inflammation/attachment around the adjacent GI tract were detected on her images. The urachal inflammatory/tumoral process could not be ruled out. So open surgical exploration was planned. During the attempt for surgical exploration and partial cystectomy, at the Children’s Medical Center in December 2021, we found that the mass, is actually her appendix which has invaded the urinary bladder, and presented as a bladder lesion.

Abdominal pain is a relatively common complaint of patients with cystic fibrosis. Every caregiver or physician should consider rare conditions, dealing with a cystic fibrosis patient whose abdominal pain does not respond to common management.

Background and Microfluidic systems are microstructures that could be used to improve the conventional cell culture protocols used in laboratories. The aim of this research was to design and construct the microfluidic system and evaluating its ability to produce IL-2 by jurkat cells. At first، the sketch of microfluidic canals was designed by Corel draw and was built on poly dimethyl siloxan using soft lithography. After embedding entry and exit pores، it was attached to glass slide via oxygen plasma technique. It was then connected to a pump containing RPMI1640 culture medium by 3 μL/hour speed. Afterwards، Jurkat cells were inoculated in the system. In the course of incubation، a continuous flow of culture medium and stimulants were encountered with cells in system canals. Simultaneously، the cells were cultured in flasks regarding proliferation and IL-2 production. The cultured cells were then compared with microfluidic system. The rate of proliferation and IL-2 production by jurkat cells was about twice in microfluidic system compared with that of the conventional cell culturing method and the system did not show negative effect on cell viability. Microfluidic system can create a condition similar to the in-vivo for proliferation and production of cell culture products due to dynamic condition resulted from continuous flow of food and waste removal. Moreover، this system showed higher performance and consumed less culture medium and materials، so it could be used as an alternative method for conventional cell cultures.

Poly lactic co- glycolic acid (PLGA) and poly caprolacton (PCL) are highly applicable polymers in the field of drug delivery and tissue engineering scaffolds. Therefore, this study aimed to design an insulin-loaded PCL/PLGA hybrid nanofiber scaffold in order to be applied in attachment and growth of chondrocytes. Moreover, it can provide a vehicle for the controlled release of active insulin in a certain time period. Chondrocyte cells were isolated from septum cartilage tissue utilizing collagenase and were also cultured in monolayer, then the third-passage cells were seeded on the scaffolds. Insulin release from the PCL/PLGA hybrid nanofiber scaffold was examined by Radio Immuno Metric Assay (RIMA) during 22 days. Adherence, distribution and morphology of cells were observed by H&E and alcian blue staining. PCL/PLGA hybrid nanofiber scaffold revealed a slow and sustain release of insulin within three weeks. Chondrocytes were distributed evenly throughout the scaffolds. In addition, they sank into the pores of scaffold and maintained their rounded morphology. Biological activity of insulin has been maintained during 22 days of controlled release from hybrid nanofiber PCL/PLGA scaffold. Chondrocytes were distributed evenly throughout the scaffold and revealed a rounded morphology. Therefore, this scaffold provides a suitable carrier for chondrocyte growth as well as formation of tissue engineered cartilage.

Wilm's tumor (nephroblastoma) is the most common renal malignancy of childhood. This cancer is considered as an embryonal neoplasm that arises from nephrogenic blastemal. Despite advances in therapeutic success, survival rate is still not satisfactory in tumors with unfavorable histology and recurrent cases. On the other hand, late adverse effects of chemotherapy threaten the life of Wilm's tumor survivors. The present study aimed to establish a patient-derived tumor tissue xenograft for utilizing in individualized chemosensitivity assay. Fresh tumor specimens of 4 patients with Wilm's tumor were obtained by cytoreductive surgery, and after primary culture and initial purification of neoplastic cells, the cells of each tumor were subcutaneously inoculated to 10 athymic nude mice. Growth characteristics of established models were assessed and the tumors were studied by light microscopy. Tumor take rate was reported 70%. Pathological examination illustrated the presence of all epithelial, stromal and blastemal parts in H&E staining. Immunohistochemical study with CK, desmin, myogenin, WT-1 and vimentin markers confirmed nephroblastoma. Histopathological study approved the validity of patient-derived tumor tissue xenograft model of Wilm's tumor. Since this model has been established for the first time in Iran, thus it can be considered as a useful research tool for personalized treatment of nephroblastoma and chemoresistance assays.

Transvers geniculate ligament does not exist in all people and in some articles it was mentioned as a normal variation. The aim of this study was to assess the prevalence of transverse geniculate ligament in an Iranian’s people sample. It was a descriptive-analytic and prospective study. It was conducted on one hundred and fifteen patients with different indication for knee MRI. Transverse ligament prevalence with 95% confidence intervals for its length and width were calculated through SPSS software. Finding showed that prevalence of transverse genicular ligament was 53. 9%. There was no statistically relationship between exist of this ligament and sex of patients (P=0. 5). Average length and width of this ligament were 30. 158; 95%CI [20. 0-42. 70] mm and 2. 299; 95%CI [0. 5-4. 20] mm respectively. There wasn’t statistically relationship between exist of this ligament and age of participants either (P=0. 161). Although our study sample possessed partly high frequency of transverse ligament prevalence، it still need to be more studies in different people in other races and countries to evaluate true prevalence of this ligament. Also physicians must be informed about this partly high frequency.

In diagnosing inflammatory bowel disease، one of diagnostic way is upper gastrointestinal endoscopy، which helps in differential diagnosis of unspecified colitis as well. The aim of this study was to investigate the necessity of upper gastrointestinal endoscopy in patients with inflammatory bowel disease. In this descriptive cross-sectional study، 30 children with definite diagnosis of Crohn''s disease and ulcerative colitis underwent upper endoscopy in Medical Center Hospital from October 2009 to March 2011 and the data were analyzed using SPSS software and T-test. Of 30 children with inflammatory bowel disease، 15 patients were diagnosed with Crohn''s disease and fifteen patients with ulcerative colitis. The present results demonstrated that esophageal، stomach، and duodenum involvements in patients were 93%، 87%، and 26%، respectively. Esophageal، stomach، and duodenum involvements with ulcerative colitis were observed in 80%، 66%، and 20% of patients، respectively. Patients’ involvements with Crohn''s disease were in esophageal (94%)، stomach (80%)، and duodenum (47%). Regarding the high percentage of upper gastrointestinal involvement in patients with inflammatory bowel disease، endoscopy and histopathological examinations seem necessary for all patients irrespective of the type and locality of involvement

In animal models، the results of studies have shown the efficacy of stem cells in repairing tissues and curing different diseases; however، in humans the effectiveness of cell therapy has proven in blood disorders and the immune system. Different phases of clinical trials on the other uses of stem cells are also underway. In this study، the published results of the clinical trials conducted were evaluated. For this purpose، at first، the stages of clinical trials، the guidelines for the clinical translation of stem cells، and the number of clinical trials on the use of stem cells were studied; then، the results of clinical trials using different kinds of stem cells were assessed. The data were obtained by selecting the key word of “stem cells” in the public clinical trials database “http: //www. clinicaltrials. gov” and using several review articles in the field of clinical trials of stem cells. This report demonstrates the safety of stem cell therapy in the primary phases of clinical trials; however، for the efficacy of the therapy to be established the final phases of clinical trials need to be accomplished and evaluated.

Nowadays, several indicators are used to evaluate scientific research outputs. The h index is one of the most common indices taken into account by many authorities to assess individuals and institutions, worldwide. In this study, the attitudes of medical sciences researchers towards significance of factors affecting the h index and citations were investigated. At the beginning of 2008, h-indices of all academic members of Iranian medical universities were screened based on the Scopus database. The attitudes of the faculty members who had an h index of one or more were investigated through a self-structured questionnaire in which increasing factors of the h index and paper citations was assessed. The data were analyzed using statistical methods. The r esponse rate was about 37%. The respondents’ attitudes toward the items were not different between the the group whose h-index was more than 6 to the other group whose h-index was less than 6. They respondents believed that publishing in high Impact Factor journals, well-designed researches considering the methodology, and to be the 1st study of its subject in the country and the world, are the most important factors in achieving citations. They did not believe that publishing review articles, contributing internationally, and having frequent paper topics were important in gaining citations. It seems that our researchers were not aware of the importance of publishing review articles and also in Open Access journals to increase citation rates. Proper interventions should be conducted to correct this attitude in order to increase the country’s and researchers’ citations.

Ovarian cancer is the most fatal gynecologic malignancy. New methods for detecting this cancer, has no significant effect on patients survival. One of the most important reasons is this fact that patients detect lately. Therefore identification of this cancer symptoms and signs can be effective in its early diagnose and reduction of mortality. This investigation was a cross sectional study that was performed on 89 patients with ovarian cancer and 89 people as control group. The collection of data was done to according of questionnaire of ovarian cancer risk factors and patients complains. Then data was compared between two groups and analyzed by SPSS version 16 software. The incidence of ovarian cancer was 0.67%. 20.8% of patient group had infertility or nulliparity history. Incidence of cancer in these patients significantly was more than other in this group (p=0.03). Using oral contraceptive has a prophylactic effect (p<0.01). The correlation between breast cancer history and incidence of ovarian cancer was significant (p<0. 01). Abdominal pain, sense of abdomen or pelvic mass, infertility, gastrointestinal problems and abnormal uterine bleeding must be considered as other important symptoms as well. According to results of investigation, incidence of mentioned symptoms must be noticed for rule out of ovarian cancer, specifically in patients who have ovarian cancer risk factors.

Iran has recently experienced a significant increase in the number of publications in the field of medical sciences. This has made authorship and other related ethical issues very important. Our aim was to explore the perception of Iranian researchers and medical journal editors about authorship and related ethical issues in medical publications.

A questionnaire was sent to editors of Iranian medical journals through e-mail, which included questions about definition of authorship, compliance of Iranian researches with this definition, possible reasons for the incompliance and their suggestions for improving the compliance.

Out of the 112 responses received, 52% agreed with the authorship definition suggested by the International Committee of Medical Journal Editors and they considered it applicable in Iran as well. They believed that this definition is applied in less than 50% of Iranian publications the most important reasons are: authors’ egocentricity (71%), pressures and limitations imposed by supervisors and line managers (50%), and unfamiliarity with the related principles and regulations. The most frequent suggested punishments were a formal warning and preventing the author from the benefits of the paper. Designation and implementation of appropriate regulations (52%), educational programs (39%), and other preventive actions (39%) were considered as the most important strategies for reducing this problem.

Most of the respondents agreed with the international standard definition of "author" and found it appropriate for Iran. They believed that implementation of relevant regulations, in addition to educational programs and appropriate rewards and punishments can improve compliance with these standards.

Many webometric studies have been done on Iranian universities, still there has not been conducted an overall research evaluating the changes in the webometric status of them over the time. The current study focuses on all Iranian universities’ and research centers’ websites and their national, regional and international webometrics ranks during 2007-2009. In a cross-sectional descriptive study, the websites of Iranian universities and research centers were retrieved via Google search engine. Then their national, regional and international webometrics ranks in webometrics.info at July 2007, January 2008, July 2008 and January 2009 were extracted and compared. The study showed that Tehran university website ranked first in the national level at the four time frames while ranked third in the region and 990th in the world in January 2009. Mashad University stood at the top of the other Iranian universities according to the overall promotion in the international webometric ranking. Iranian Information and Documentation Center (Irandoc) was the only Iranian research center among the first 1000 reported research and development centers in July 2008 and January 2009 webometric rankings of webometrics.info. In order to improve webometric ranks of Iranian universities and research centers, appropriate policies should be developed while being continuously monitored by Iranian education and research policy makers.

Most current hypotheses regarding the pathophysiologic mechanisms of preeclampsia point to early placental abnormalities. Therefore, we attempted to determine whether maternal human chorionic gonadotropin (hCG) levels in second trimester can predict preeclampsia. in this prospective study, 508 pregnant women who referred to Shahid Akbar Abadi prenatal clinic for prenatal care during 2007-2009 were enrolled. Maternal serum hCG was measured in all these women during 16-20 weeks of gestational age. All these women were followed and evaluated for preeclampsia. preeclampsia was detected in 47 women (9.3%). The mean log of serum hCG levels during second trimester of pregnancy were found to be significantly higher in severe preeclampsia, compared with controls (p<0.05). Furthermore, increase of maternal age enhances the risk of preeclampsia. our findings indicate that serum levels of maternal hCG during weeks 16-20 pregnancy, can be valuable for predicting preeclampsia.

Nosocomial infections are one of the problems that cause huge costs on patients and health systems. Therefore studying its prevalence, related factors and its prevention ways is especially important. This study was performed on 691 patients who were admitted in the ICU of Shaheed Mustafa-Khomeini hospital from 1385-1386. Data collection was done using the national nosocomial infection surveillance system (NNIS) questionnaire. The clinical signs and symptoms of patients were being checked frequently. Necessary laboratory tests and cultures were done in suspected patients. Data was analyzed by SPSS version 15. The incidence of nosocomial infections was 10.85 percent. The most common type of infection was pneumonia 77.3 %, UTI 18.3 %, surgical site infection 2.7 % and blood infection 1.3 %. The most common microorganism in pulmonary infections was Acinetobacter in pulmonary infections, E.coli in UTI, Staphylococcus aurous and Klebsiella in surgical site and Enterococci in blood infections. Pneumonia was significantly more common than other infections (p<0.01). Also there was a correlation between duration of ICU admission and incidence of nosocomial infection (p<0.001). But there was no significant relation between age, gender and invasive procedures with nosocomial infection. According to our results, prolongation of ICU admission time has a direct relation with the risk of infection. Infection control practices and sanitary methods are rational and essential part in the ICU. We suggest limiting invasive procedures to necessary times and the use of aseptic methods in treatment process.

Following two decades of intensive efforts work in IDD elimination, Iran has been recognized as an IDD free country in the Middle-East region. This study was performed to evaluate the adequacy of iodine intake, 17 years after universal salt iodization in Tehran and to compare the results with those of previous studies. In this cross-sectional study, 8 to10 year-old schoolchildren, randomly selected from Tehran province, were evaluated in year 2007, using data gathered on goiter prevalence, urinary iodine excretion, iodine content of household salts and thyroid volume measured by ultrasonography the results obtained were compared with those documented for 1996 and 2001. In this study, 1200 children were evaluated. Total prevalence of goiter was 2.3% no one had grade 2 goiter. The median urinary iodine in 120 schoolchildren was 94.1µg/L. Only 54.9% of Tehranian households were using iodized salt and salt storage was appropriate in 47.9% of households salt used by 62.5% of households had less than 15 µg iodide. Ultrasonic measurement of thyroid volume was performed in 464 schoolchildren, aged 7-15 years, and while the median thyroid volume of girls aged 7-11 years was slightly more than that of boys, the 97th percentile thyroid volume of both sexes was similar for all age groups. Thyroid volumes were significantly correlated with age, weight, height and body surface area. Goiter prevalence has decreased significantly in Tehran, the central province of Iran, 17 years after universal salt iodization. However the median urinary iodine of school children has decreased in comparison to results of studies conducted in 1996 and 2001. Continuous monitoring of national programs is essential for IDD elimination.