فهرست مطالب میترا رحیم زاده

Transferring a patient from the intensive care unit to the general ward is an anxiety-inducing process that is associated with feelings of insecurity, discomfort, dependency, and increased need. The most important goal of any care program is to satisfy the patient's needs and create a feeling of comfort. The aim of this study was to determine the effect of designed transitional care program on anxiety and general comfort of the patients undergoing coronary artery bypass graft during transfer from open-heart surgery intensive care unit to general ward.

This study was a non-randomized clinical trial with a control group which included 62 patients who were candidates for transfer from the open-heart surgery intensive care unit of Imam Khomeini Hospital in Tehran to the general ward in 2021. The patients were selected by convenient method. The control group received the routine care and were followed up. The experimental group pursued the designed transitional care program in addition to routine care. This program had 4 dimensions: 1-waiting for transfer, 2-support, gradually reducing dependence and increasing independence, 3-communication and strengthening the care triad, and 4-continuity of integrated and need-based care which was implemented by selected and trained nurses in cooperation with the researcher, physician, patients and families for 5-7 days.  Spielberger's anxiety Questionnaires and general comfort scale were completed before the transfer and on the day of the patient's discharge. Using SPSS version 26, the results were analyzed by Fisher's exact, Chi-square, paired and independent t-tests at a significance level of 0.05.

The results showed that the designed transitional care program could significantly reduce anxiety and increase the general comfort of the patients undergoing coronary artery bypass graft (p≤0.000).

Considering the impact of the intervention on the variables under study, use of the designed program as a suitable care program during patient transfer can be suggested.

One of the evaluation methods is based on the performance of objective structured clinical examination. Passing this exam is necessary for medical students to graduate, practice medicine and participate in a specialized course. This study is designed to analyze the quality of these tests using psychometric indicators.

In this cross-sectional descriptive study, the test of three periods of clinical competence, respectively, were analyzed. Average (standard deviation), the cut-off score was (by borderline regression method), rejection rate, R2 determination coefficient, root mean square error to estimate the the cut-off score, difficulty coefficient, neatness coefficient were calculated in individual stations and the whole test.

64 medical students along with 26 expert examiners from each station were present in this exam. According to the cut-off score in the 31st exam, all students got a passing grade and we did not fail. The total RMSE was equal to 0.55 and the value of R2 in different stations was obtained from 0.46 to 0.85. The hardest and easiest stations based on the difficulty coefficient were gynecology, social medicine and orthopedics respectively. In the 32nd exam, the rejection rate was one person (0.23%). The total RMSE was 0.57 and the value of R2 in different stations was obtained from 0.38 to 0.87. The most difficult and the easiest stations based on the difficulty coefficient were radilogy, emergency medicine and surgery respectively. In the 33rd exam, all students got a passing grade. Total RMSE was equal to 0.76 and R2 value was obtained in different stations from 0.39 to 0.95. The most difficult and easiest stations based on the difficulty coefficient were internal glands and surgery respectively.

To improve the quality of the OSCE exam, measuring its quality is vital. The use of several psychometric indicators can be an important step in determining the quality of the test. The results obtained during the three test periods indicate that the quality of the test is acceptable in most of the stations and some cases need to be reviewed and improved.

Abstract Introduction and A long wait to give birth and constant concern for the health of the baby accompany the mother during all pregnancy periods. The aim of the present study was to compare the efficacy of cognitive-behavioral therapy and metacognitive therapy on anxiety and biological indicators in pregnant women. The present study was a semi-experimental study with a pre-test-post-test-follow-up design with a control group. The statistical population of the present study consisted of all pregnant women in the second 3 months of pregnancy who referred to the hospitals and pregnancy clinics of Tehran in 2020-2021. 45 people were selected in a purposeful way and randomly assigned to two experimental groups and one control group. The tools of this research included Cattell's anxiety questionnaires (1957), special armband for sphygmomanometer and glucose test kit. For the first experimental group, German - Canadian - Iranian system metacognitive therapy and for the second experimental group cognitive behavioral therapy were held in 8 sessions of 90 minutes, but the control group did not receive any intervention. The data were mixed using analysis of variance and analyzed through spss-26 software. The results indicated that metacognitive therapy and cognitive behavioral therapy increased psychological well-being and decreased blood pressure and blood sugar at the end of the interventions and the follow-up period (p<0.05). The method of metacognitive therapy has caused a further decrease in biological indicators and a further increase in anxiety (p<0.05). Due to the effect that metacognitive therapy has on correcting metacognitive beliefs affecting anxiety and increasing blood sugar and blood pressure in pregnant women, it can be effective alone or with complementary treatment in reducing biological indicators and reducing anxiety in pregnant women.

Pregnancy is one of the most sensitive periods ofhuman life. A long wait to give birth and constant concern forthe health of the baby accompany the mother during allpregnancy periods. The aim of this study was to compare theeffectiveness of cognitive-behavioral therapy and metacognitive therapy on psychological well-being, BloodPressure and Blood Sugar in pregnant women.

The current study was a quasiexperimental study with a pre-test-post-test-follow-up planwith a control group. The statistical population of the presentstudy consisted of all pregnant women in the second 3 monthsof pregnancy who referred to the hospitals and pregnancyclinics of Tehran in 2020-2021. 45 people were selected in apurposeful way and randomly assigned to two experimentalgroups and one control group. The tools of this research wereRyff's psychological well-being questionnaires (1989) and aspecial armband for a sphygmomanometer and a glucose testkit. For the first experimental group, German, Canadian, andIranian system metacognitive therapy (Malihialzackerini et al.,2003) and for the second experimental group cognitivebehavioral therapy (Greenberg and Padesky, 1995) were heldin 8 sessions of 90 minutes, but the control group did notreceive any intervention. The data were analyzed using mixedanalysis of variance.

The results indicated that metacognitive therapyand cognitive behavioral therapy increased psychologicalwell-being and decreased blood pressure and blood sugar atthe end of the interventions and the follow-up period (p<0.05).The method of metacognitive therapy has caused a furtherdecrease in blood pressure and blood sugar components, and afurther increase in psychological well-being (p<0.05).

Due to the effect that metacognitive therapy hason correcting metacognitive beliefs, it can be effective aloneor with complementary therapy in reducing Blood Pressureand Blood Sugar and increasing psychological well-being inpregnant women.

Men are more likely than women to have cancer and die from it. In addition, the likelihood of using healthcare services and preventive measures, such as screening for cancer, is much lower among men than women. This study aimed to determine the predictors of cancer screening behavior in middle-aged men employed in universities using the Health Belief Model.

This is a descriptive-analytical study conducted on middle-aged men employed in Karaj University. The sampling was done through a census and all male employees (400 persons) who had the inclusion criteria were entered into the study. The data collection tool was a researcher-made questionnaire, the validity and reliability of which had been confirmed.

The results showed that 10.2% of the men had undergone one type of cancer screening, and the logistic regression indicated that perceived barriers and self-efficacy were predictors of screening behavior in men.

Given the very low rate of screening behavior in Iranian men and the increasing prevalence of cancer, there is a need for educational interventions to make men aware of cancer. According to the results of this study, self-efficacy and perceived barriers were introduced as predictors of screening behavior, and taking them into account through interventions could lead to improve screening behavior in men.

Proper knowledge, attitude and practice of pregnant women about vaccination during this period will have a significant impact on their and their baby’s health. The aim of this study was to determine the knowledge, attitude and practice of pregnant women toward flu and Td vaccination.

This study was a descriptive-analytical and cross-sectional study on 312 pregnant women referred to Imam Ali Hospital in Karaj with an age range of 15 to 40 years. Data were collected using a questionnaire. The method of sampling was convenience sampling. The data was analyzed using SPSS software.

The mean age of the women was 27.6±6.54 years. 198 (63.5%) of the subjects were housewives and 114 (36.5%) were employed. 248 (79.5%) and 282 (90.4%) of the subjects had appropriate attitudes and knowledge about vaccination with Td vaccines and Influenza, respectively. Also 293 (93.9%) and 137 (43.9%) of the subjects had practice well against both Td and Influenza vaccines. In women with higher education and better economic conditions, and in working women, the practice of both vaccines has become more suitable. As women get older, knowledge and practice about Td vaccination decreased.Also, the most common source of information for pregnant women about the vaccination program were 73.4% of health care workers, 12.5% ​​of the Internet, 10.3% of radio and television, 3.5% of friends and acquaintances, and 0.3% of family members, respectively. In the relationship between knowledge, attitude and practice towards Influenza and Td vaccination, there was a direct and significant relationship between them so that with increasing or decreasing one, the other also increased or decreased. Most of the relationship between awareness and practice items was related to Influenza vaccine (r=0.304) and the lowest relationship between knowledge with practice items was related to Td vaccine (r=0.146).

In this study, it was found that with increasing awareness and attitude, vaccination has increased. Regarding Influenza vaccination, due to the significant relationship between the source of information and vaccination, it is recommended that more serious recommendations to be made by the health care staff to pregnant women regarding Influenza vaccination.

In recent years, there has been significant increase in the number of diabetic patients, the rate of hospitalization and non-traumatic lower limb amputation. The last two mentioned are known as the major complications of diabetes.  In addition to it, there has been a considerable tendency among the medical therapist in applying  apitherapy a branch of alternative medicine that deals with natural agents containing effective chemical compounds in this specialized field. Following what was explained we decided to reexamine the effects of Bee pollen as a natural support to promote the process of diabetic pressure ulcer healing.

This study is a one-blinded clinical trial study included 84 diabetic patients suffering from diabetic ulcers. These patients were referred to the wound clinics under supervision of Alborz University of medical sciences in Karaj. The study group was divided into two groups: experimental group (E.G), the patients who were given Bee pollen and control group (C.G.), those whom were given placebo .patient educated to solve one tea spoon powder in milk or water  three times a day and drink, preferably before meals. Equal care was provided to all patients by wound experts over a twelve week period of time. During this time the PUSH questionnaire was completed for each patient by wound experts twice weekly.

To match the research, we selected these two groups from similar demographic variables such as: age, gender, education, marital status, underlying disease, body mass index, fasting blood sugar, hemoglobin and the size of the wounds. Comparing the PUSH score at the end of sessions 6, 12, 18 resulted in lower scores in E.G., while at the last session of 24 the PUSH score in C.G. was reported lower than E.G.Yet, no significant difference between the two groups was founded.

In this study, Bee pollen as a nutritional supplement in diabetic ulcer healing stimulation has not been proved. Hence, more studies are needed.

Test anxiety is an important factor that negatively affects nursing student's success during the education process. Concerning the prevalence of test anxiety among students, this study was conducted to determine the effect of aromatherapy on test anxiety among nursing student in Islamic Azad University, Karaj branch 2019.Materials &

 This single blinded randomized clinical trial consisted of last year nursing students (n=60) at faculty of nursing and midwifery, Islamic Azad University Karaj Branch. Participant randomly divided into the experimental and control groups. In pre-test, demographic data and Sarason anxiety questionnaires were filled by all students. Then inhalation aromatherapy was performed for students in the experimental group. The control group received no intervention. After 15 minutes, sarason test anxiety questionnaire was filled by two groups again. The collected data were analyzed by the statistical tests (i.e. χ2, paired t-test, independent sample t-test and analysis of covariance) using SPSS 18.

 The results showed a statistically significant reduction in the anxiety score in the both group. The rate of decrease in anxiety score in the control and treatment group was 1.13 and 3.8 respectively (p-value=0.029 and p-value<0.001). Furthermore the results of analysis of covariance showed, the amount of anxiety score before treatment have great effect on the anxiety score after treatment (p-value<0.001) also the treatment have little effect on the anxiety score (p-value=0.049).

The result showed, aromatherapy may be an effective method to reduce test among nursing students. Using aromatherapy in testing environments for students who have test-related anxiety may be a good option to help students. Further evaluation is needed to correlate the impact of aromatherapy on anxiety before a definitive conclusion can be drawn.

The birth of a premature neonate causes increasing possibility of postpartum depression in mothers. The most important parental needs of infant admitted to the neonatal intensive care unit are communicational and informational needs, the present study aimed to investigate the effect of Interpersonal psychotherapy on postpartum depression  in mothers of infants admitted to neonatal intensive care unit.

This randomized interventional study investigated 92 primiparous women with a newborn admitted to neonatal intensive care unit. of Kamali Hospital. Sampling method was available and samples were randomly assigned into 2 groups of control and intervention by four blocks randomization method. In addition to routine care, the intervention group received 3 IPT counseling sessions. The data collection tool in this study was Edinburg Questionnaire.

There was no statistically significant difference in demographic characteristics between the control and intervention groups. The results of repeated measure test indicated that the postpartum depression  had a significant change over time (p = 0.000) with significant differences between the two groups (p = 0.000).

Considering the impact of IPT on postpartum depression, as well as the limited duration and cost of this program and the possibility of training it by midwives and medical staff, it is suggested to include this training program in the routine interventions for mothers with a newborn hospitalized in neonatal intensive care unit.

Infertility is one of the most important crises in marital life that affects other aspects of personal life. The aim of the present study was to compare the sexual self-concept in fertile and infertile women referring to community health centers and infertility in Karaj, Iran.

This study is a causal-comparative and cross-sectional study. The study population included all fertile women who were referred to community health centers and infertile women referred to the infertility center of Karaj. To select the sample group, a sampling method was used to select the sample of infertile women and a two-stage cluster randomized cluster sampling method was used for the fertile women. A total of 280 subjects were selected as the research sample. For data collection, a questionnaire was used for demographic characteristics, fertility and infertility characteristics and the multivariate sex-self-concept questionnaire (MSSCQ) for both groups.

The results showed that fertile women in relation to the components of positive sex self-concept include prevention of sexual problems, sexual satisfaction, sexual self-esteem, sexual behavior management, sexual motivation, sexual desire, motive for avoiding high-risk sexual relationships, sexual alertness, sexual self-efficacy had a better situation compare to infertile women (p <0.05). Fertile women were better than infertile women in terms of negative sex self-concept components, including sexual anxiety, sexual and sexual patterns, and internal control of sex (<0.05).

Infertile women referring to infertility centers should be assessed about positive and negative sexual self- concepts to receive proper training by highly qualified counselors.

Unwanted pregnancy affects the physical and mental health of the mother and her child. Unwanted pregnancy may lead to an increase in gestational hypertension, diabetes, preterm delivery, low birth weight, and postpartum depression. The aim of this study was to investigate the relationship between the incidence of pregnancy and pregnancy complications,  and postpartum depression in women referred to selected health care centers in Robat Karim in 2018-19.

This cohort study was carried out with the participation of mothers referring to health care centers of Robat Karim in 2018. A total of 240 pregnant women entered the study after the completion of the London questionnaire in the 26th week of the week, of which 120 were unwanted pregnant and 120 were asked in the pregnancy group. Data were collected using demographic questionnaire, Edinburgh postpartum depression and a checklist for collecting complications and pregnancy outcomes. Data were analyzed using SPSS-21 software, Chi-square and Chi-square tests.

The mean (SD) of mothers' age in the wanted pregnancy group was 30.1 (7.1) and 29.9 (7.2) in the unwanted group. The mean ± SD of depression scores 10 days after delivery in wanted group was less than unwanted group (10.1 ± 0.3 vs.13.1 ± 2.5, P <0.001) and, 30 days after delivery in the wanted group was less than unwanted pregnancy group (9.4 ± 3.2 vs.13.4 ± 2.5, P <0.001). Breast feeding in unwanted pregnancy was significantly less than wanted group (24.3% vs. 71.7%). The mean(SD) of newborn weight in wanted group was more than unwanted group (3135.3(220) vs. 3001(209.7), P<0.001). Hypertetion, diabetes, postpartum hemorrhage, NICU hospitalization and maternal hospitalization in ICU were not different in both groups but pre-eclampsia (7.5% vs. 1.7%, P=0.03) and preterm labor (17.5% vs. 5%, P=0.002) in unwanted group was more than wanted group.

The study showed that preterm delivery, lack of breastfeeding, preeclampsia, and postpartum depression were more in unwanted. Therefore, it can be concluded that wanted pregnancy is related to pregnancy complications, childbirth consequences and postpartum depression.

Inguinal herniotomy is the most common surgery performed by pediatric surgeons. Due to the lack of sufficient studies comparing herniotomy methods, this study aimed to compare two herniotomy methods with and without incising external oblique muscle fascia in terms of intraoperative and postoperative complications and operation time.

This single-blind randomized clinical trial study was conducted on 111 male-children with inguinal hernia who referred to Imam Ali Alborz hospital from September to December 2020, by convenience sampling method. 102 patients had unilateral hernia (91.89%) and 9 patients had bilateral hernia (8.11%) which each side was operated by different method, finally total number of surgeries was 120 cases. In the first group, 60 patients were operated with incising and in the second group, 60 patients without incising external oblique muscle fascia. Recorded data were analyzed using Chi-square and Mann-Whitney U test with a significance level of less than 0.05 in SPSS-21 software.

The complication incidence rates, based on the type of surgery - with and without incising external oblique aponeurosis - the results were, respectively: a) Ileoinguinal nerve damage, n=1 (1/7%) vs. n=0; b) scrotal edema, n=3 (5%) vs n=1 (1.7%); c) fever, n=0 vs n=1 (1.7%). complications between two method had no significant difference. Average of with incising method time was longer and had significant difference.

Herniotomy without incising the fascia has a shorter operation time (2.35 minutes). There was no significant difference in terms of complications, so without incising method can be the appropriate choice than with incising oblique aponeurosis.

This research paper aimed at to study the factors in relevance to the performance of screening behavior in per diabetes based on the stimulus model of preserve from the overweight and obese personnel of Karaj education administration.

the research method of the study is descriptive-analytical one and the statistical community of survey, are including of overweight and obese personnel of Karaj education administration of without diabetes. The sampling method is accessible one and350 individuals have been selected for gathering of data from the scholar-made inventory the analysis of data performed by exploitation from analytical and descriptive statistics (t-test of regression Modell).

the results indicating that 58.6% of samples (men) and 38.3% of them women have took part in the tests. and autonomous t-test is indicating of meaningful disagreement among the overage scores of apprehension sensitivity, fear ,prepones amount, and reward in two groups of including of test and without test and three prediction variables statistically had the ability for Explanation of standard variable (apprehension sensitivity ,response mount, and reward.)The obtained level of significance for each of these variables were less than (p<0. 01) and the strongest construct of motivation theory of preservation for the prediction of possibility of screening of Pre-diabetes with the conduct of experiment of hemoglobin HbA1C has been the apprehension sensitivity.

Based on the results, it can be concluded that protection motivation theory is an appropriate framework for predicting diabetes screening behavior.

Medicine students must learn clinical skills besides learning theory in classes. Skill lab is a safe place for students to achieve that goal with educational facilities under observe of a master. The purpose of this study was to investigate the effect of simulation training in clinical skill lab center on clinical knowledge and practice of medical interns in Alborz University of Medical Sciences in 1397.

The present study is a semi-experimental study with 46 medical interns in the field of gynecology. In this study, all trainees first attended routine workshops at the Clinical Skills Center and were trained in lectures, slides and practical work in the 8 core skills of the gynecologist, They received a quadruple written pre-test and an OSCE Practical Assessment (OSCE). Then students were randomly divided into two groups of case and control. The control group was referred to the womenchr('39')s ward for training and the case group participated in simulated training workshops then they were introduced to the womenchr('39')s ward for training. After completing the course, the written and practical tests were repeated for both groups and compared.

There was no significant difference between the mean scores of pretest in case and control groups before intervention. But after the intervention and the establishment of simulated workshops and completing an internship,the mean scores after the written test showed a significant difference in the case and control groups(P-value= 0.027). In the performance evaluation section, there was no significant difference between the mean scores of pre-test OSCE in the case and control groups but after intervention, the mean of OSCE scores in case and control groups showed a significant difference(P-value= 0.009). The results showed that in the basic knowledge, the mean increase in post-test scores in the written test was 2.39 more in the case group than in the control group, and in the practical part the mean increase in the mean scores of the case group was 19.48 higher than the control group.

By examining the findings and paying attention to the increase of the written and practical test scores in the case group it is found that the teaching of obstetrics and gynecology skills by simulation method has more effect on increasing the level of basic knowledge and enhancing studentschr('39') abilities in the field of gynecology.

DMFT index and Oral Hygiene Index Simplified (OHI-S) are diagnostic indicators of oral health. The aim of this study was to determine the DMFT and OHI_S indexes at Alborz University of Medical Sciences in 2018.

This cross-sectional descriptive-analytic study was conducted among 381 students of Alborz University of Medical Sciences during the academic year of 2018. The numbers of decayed, filled and missing teeth were recorded. Students were also evaluated for the debris and calculus index.

In this study, 38.1% of the subjects were males with an average age of 20.51±2.01 years old and 61.9% were females with an average age of 20.59±2.2 years old. The average of DMFT index in students was 6.48±3.4, which the highest DMFT index was related to the number of decayed teeth. The mean OHI-S index of the subjects was 0.66±0.63, which 84.3% of students had a good status, 15.5% moderate and 0.2% had a bad condition. There was no significant difference between boys and girls regarding DMFT and OHI-S indexes (P>0.05). The relationship between the numbers of studentschr('39') brushing was reversed with DMFT and OHI-S indexes, but this relationship was not statistically significant (P>0.05). There was a significant difference in DMFT and OHI-S indexes between students’ different educational fields.

The results of this study showed that the students were desirable condition in OHI-S index and relatively favorable in the DMFT index.

With respect to the outbreak probability of dangerous infections among the patients, the water sources of dentistry units were taken into consideration, in view of microbial contamination. The objective of this study was to assess of pathogenic organisms of the water used in the dentistry units at Alborz Dental School.

In this study, 120 samples from high speed handpieces before and after flushing, syringes, drinking water of units and also 5 samples of tap water were taken as control. Then the samples were cultured on EMB and Blood agar plates and the number of the bacterial colonies were counted. The data were analysed using Descriptive statistics.

A total of 125 samples were examined for bacterial contamination. The mean bacterial count of primary turbine before flushing was 5463.33±6921.156 Cfu/ml, the mean bacterial count of turbine after 30 seconds of flushing was 3090.00 ±4354.336 Cfu/ml, the mean bacterial count of syringe was 2733.33±2666.307 Cfu/ml, the mean bacterial count of drinking water of unit was 1996.67±1060.411 Cfu/ml. Also the mean bacterial count of tap water was 83.666±280.00 Cfu/ml. Microorganisms isolated were as follow: Escherichia coli (41.64%), Klebsiella (30.83%), Non-pathogenic Staphylococci (26.6%), Micrococus (25.83%), etc.

The result of this study demonstrated that bacterial contamination level of dental unit waterlines is high, and the microbiological quality of the water must be monitored regularly. Flushing decreases the contamination of DUWL, but in surgeries and in persons with immunedificiency, the use of other methods of DUWL decontamination is recommended.

Clinical education is one of the most important parts of medical and paramedical education that prepares students for practicing clinical skills. Evaluation of the clinical learning environment with a suitable instrument plays an important role in increasing student motivation and learning. This also applies to the assessment of the clinical environment of the operating room. In search of such a suitable instrument, this study aimed at investigating the psychometric properties of Surgical Theatre Educational Environment Measure (STEEM) among surgical technology students of Iran University of Medical Sciences and Alborz University of Medical Sciences in 2018. This was a descriptive-analytic study conducted from July 2017 to July 2018. After translation and retranslation of the STEEM tool, its face validity and content validity were measured by the relevant experts panel. Then, it was distribute damong 201 surgical technology students. The construct validity of the instrument was investigated using exploratory factor analysis and its reliability was confirmed using Cronbach's alpha and Pearson correlation coefficient. Data were analyzed using SPSS 19. The study of face, content, and construct validity resulted in providing STEEM questionnaire with 5 subscales and 30 questions covering 55.6% of the total variance. The findings of this study indicated that the Persian and native versions of STEEM had appropriate validity and reliability, and could be used to measure the operating environment of the Iranian Operating Room from the standpoint of surgical technology students. Keywords: measurement, Educational environment, Operating room, Educational measurement, STEEM.

Exclusive breastfeeding is an important factor for neonatal and maternal health and several factors affect it. The theory of planned behavior provides a suitable framework for study in this field. The purpose of this study was to determine the effective factors on the intention of exclusive breastfeeding in pregnant women based on the theory of planned behavior.

This descriptive-analytical study was conducted on 312 pregnant women covered by health centers of Karaj city through multistage sampling method. The data gathering tool was a questionnaire based on constructs of the theory of planned behavior. Data were analyzed through SPSS (version 19) and using Pearson correlation coefficient, independent t-test, one-way ANOVA and linear regression tests.

Mean score of attitude, subjective norms, perceived behavioral control and intention of exclusive breastfeeding were 46.2, 31.1, 15.9 and 13.07 respectively. Linear regression showed that previous child feeding type, subjective norms and perceived behavioral control had a positive effect on the intention of exclusive breastfeeding in mothers and these variables were able to explain 22.3% of its variance.

Theory of Planned Behavior had a good framework for explaining the intention of exclusive breastfeeding in pregnant women. Therefore, through improving attitudes and subjective norms, as well as increasing perceived behavioral control, increase of exclusive breastfeeding would be more promising.

 

Aluminium phosphide (ALP) is a highly effective insecticide and rodenticide used frequently to protect stored grain. Acute poisoning with this compound is common in some countries including India and Iran, and is a serious health problem. The objective of this study was to survey ALP poisoning and the outcome in hospitals in Karaj, Iran.

The study was a retrospective study from April 2006 to April 2011. Records of all patients admitted and hospitalized to hospital during the five-year period were collected. Information including gender, age, amount of ALP consumed, route of exposure and outcome were extracted from the patients notes.

During the five-year period, 67 patients, 53.7% men and 46.3% women were admitted with ALP poisoning. Most poisoned people were under the age of 21 years.The most common signs and symptoms at admission were nausea (79.4%), vomiting (76.5%), abdominal pain (31.4%) and metabolic acidosis (41.1%). Suicidal intention was the most common cause of poisoning leading to 44.8% deaths and most cases were male (P<0/05).

Due to high mortality, follow poisoning with ALP best treatment is prevention. It should be noted that although in previous years, hospitals did not record all cases of poisoning cases but data indicate a high consumption of this poisoning as a suicidal factor in Karaj city. Withdrawal of ALP tablet from the market and the monitoring of their performance can reduce the rate of poisoning in society

Medication errors are the factors threatening the safety of patients. Medical errors led to increased mortality, prolonged hospital stay and increased healthcare costs is in the hospital. The aim of this study was to determine of medication errors in operating rooms staff with Some organizational and demographic characteristics
This is a descriptive-analytic study conducted on 201 operating rooms staff of selected hospitals of Alborz University of Medical Sciences. The study population members are staffs who working in the operating room of the Hospital of Alborz University of Medical Sciences. The sampling method wa census and its conducted in 2016. The data were collected using questionnaire. After collection, data analysis was performed by using descriptive- analytical statistical and SPSS version 19.
Findings: The average number of medication errors as in three months per staff was 2.2 and the average of medication errors reported was 0.06. Medication errors (p=0.048) and errors reported (p=0.000) by the operating room staff were significantly correlated with working conditions. The demographic characteristics of employment in different sectors and work experience were associated with medication errors.
Regarding the relationship between working conditions with medication errors, Review and understanding of working conditions and adjusted them help reduce medication errors. It seems that health care authorities, in order to reduce these errors should identify the causes and apply strategies.

In recent years, has been created many concerns about the entry of antibiotics in aquatic environments. The aim of this study is to Investigation of The effect common ions in water sources to remove cephalexin using absorbent mineral pumice (pumice).
This study was Foundation – Applied. In the first stage, absorbent properties were determined using techniques (XRD, BET, XRF, FTIR and SEM) before and after absorption And then, in the second stage, Performance of pumice by changing variables such as time, PH, concentration of pumice, concentrations of cephalexin, different concentrations of calcium, magnesium, copper, sulphate, and carbonate were studied.
The results showed that pumice has a high efficiency in the absorption of cephalexin from aqueous solutions. For cephalexin, maximum efficiency in the contact time of 150 minutes, PH = 5, adsorbent dose of 5 g/l, concentrations of antibiotics 10 mg/l was observed respectively 44.75% (using raw pumice) and 55.66% (using modified pumice).
According to the results obtained with increasing adsorbent dosage and the contact time efficiency increased. When PH and concentrations of cephalexin are increased efficiency is reduced. In this study, the modified pumice with hydrochloric acid in comparison with raw pumice has better efficiency in the absorption of cephalexin. According to the results of this study ions had little effect on the absorption of cephalexin. In this study, adsorption Cephalexin on to pumice follow of Frondlykh isotherm and pseudo-second order.

Diabetes and depression are among diseases highly associated with life style, urbanism, and industrialization. The concomitance of the two of them costs the patients many years of their lives. Many researchers have been done on the outbreak of depression among diabetics in Iran. The principal purpose of this study is to determine the outbreak of depression among diabetics using the Meta-analysis method.
This study is a systematic review. The prevalence rate of depression among diabetics estimation was determined using Meta-analysis method on the data extracted from English and Persian data bases. To analyze the information obtained, we used STATA 11.2 and the random effect model.
Among 32 eligible researches 7135 patients with type I and II diabetes were chosen for this study. Using Beck’s self-report scale 65% of the cases shown mild to severe symptoms of depression. 64% of the patients were female and the prevalence rate of depression was reported 71.3% in the female and 60.3% in the male cases.
The prevalence rate of depression among Iranian diabetics is higher in comparison with other countries. Considering the fact that the concomitance of the two of these diseases results in a raise in medical costs, it is recommended to the doctors to check for depression symptoms in diabetics and recommend health solutions to the patient and the one accompanying them.

Breast-feeding is one of the priorities of public health and the best starting in the life of every child. Considering the importance of parent's knowledge and attitude about the benefits of breastfeeding, this study was performed with aim to examine the effect of parent's education on their knowledge, attitude and performance in breastfeeding up to four months.
This randomized clinical trial was conducted on 76 couples who had 3-5 days neonate and referred to Rastravesh Health Center in Karaj to receive health care services in 2015. The subjects were randomly placed in the control or intervention groups. Demographic and obstetrics, knowledge, attitude and performance questionnaire was completed by the parents. The educational intervention consisted of two 40-minute sessions with a week interval at first visit and one week later. Data were analyzed using SPSS software (version 21) and independent t-test, Chi-square, Mann-Whitney and covariance with repeated measures. P There was significant difference between intervention and control groups in terms of knowledge, attitude and performance of mothers and fathers at three times, including before the intervention, a week later and four months after the intervention (P Education has a significant effect on improving knowledge, attitudes and performance among parents on how to breastfeed the child; so using educational programs regarding correct breastfeeding practice can have an important effect on the growth and health of the neonate.

Heart attacks are the cause of 40% of deaths in Iran and due to its upswing in Iran and the world, the determination of its short-term survival rate in order to assess treatment methods is of great importance. The purpose of this study is to estimate patients’ short-term survival rate after heart attacks by Meta-analysis method.
This study is a systematic review. The analysis was based on data extracted from English and Persian data bases. To analyze the information obtained, including the average age of patients, and one-month and one-year short-term survival rates, the STATA 11.2 and the random effect model were used.
The results of the study on 18 studies entering the Meta-analysis including 62486 patients, demonstrated that one-month and one-year short-term survival rate in Iran are respectively 87.7 and 85.2 percent and no significant difference was observed between the two genders. The average age of patients was reported 62.43 years and no significant difference was observed between the two genders in the occurance of health attack.
The results of this Meta-analysis showed that although the survival rate of an Iranian patient after a myocardial Infarction is the same as patients in developed countries, the average age of the patients in Iran is lower, which indicates that the load of disease in Iran is greater than in other countries regarding the years lost to the disease.