فهرست مطالب ansari sh

In this study the morphotectonic indices for a specified length of the Sefidrud River, which is located in the meizoseismal area of the 1990 Rudbar earthquake, have been investigated to constrain the activity of a gap between the Rudbar Fault segments. The Digital Elevation Model (DEM) with 30 m resolution was used to obtain the elevation data. Fifteen km of the Sefidrud River also was divided into 100 -meter segments to calculate the morphotectonic indices. The morphotectonic indices include the sinuosity (SI), stream-length gradient (SL) and river long profile. The sinuosity in this region, where the trend of the Rudbar fault cut across the river, is approximately 1-1.5 and has a lower value relative to the other segments of the river. This indicates that the uplift possibly affected this region and then indicates the high tectonic activity. The stream-length gradient in the target region is approximately >3000 and has a higher value in the region which may be related to the lithological and active tectonic effects. The high value of SL can be used for determining the regions with high potential for the landslides along the strike of the Sefidrud River. The Sefidrud long profile, in aforementioned area, has a bulge or convexity. Such convexity together with the high value of stream-length gradient can indicate that the tectonic activities are significant in this region. By comparing the morphotectonic analysis with the seismotectonic studies such as the Coulomb stress changes due to the 1990 Rudbar earthquake, in which the high stress zones were detected in this region, it can be cluded that the studied region has high tectonic activities and consequently its monitoring to prevent the seismic hazard is essential.

To compare anterior segment indices measured by two Scheimpflug camera; Galilei and Pentacam. In this observational case series, myopic patients scheduled for refractive surgery underwent corneal and anterior segment analyses using Pentacam (single Scheimpflug camera) and Galilei (dual Scheimpflug camera). Analyzed parameters included anterior and posterior best-fit spheres (BFS), axial curvature, true corneal power, central corneal thickness (CCT), anterior chamber (AC) depth, AC volume, AC angle and pupil diameter. Statistical analysis was performed using paired t- test and Bland-Altman plots. The study comprised 176 eyes of 88 patients. The mean radius of the anterior BFS was 7.79 ± 0.34 mm measured with Pentacam and 7.75 ± 0.39 mm measured with Galilei (r=0.877,p 0.001), and the mean radius of posterior BFS was 6.42 ± 0.32 mm and 6.47 ± 0.38 mm, respectively, (r=. ,p<0.001). Anterior axial curvature was 43.8 ± 1.9 D with Pentacam and 43.8± 2.4 D with Galilei (r=0.905,p 0.003). Posterior axial curvature was 6.3 ± 0.3 D and 6.3 ± 0.4 D, respectively (r=0.873, p<0.001). True Corneal power was 43.9 ± 1.9 D with Pentacam and 43.5± 2.3 D with Galilei (r=0.909,p<0.001). CCT was 537±44 μm with Pentacam and 553±51 μm with Galilei (r=0.796,p<0.001). Anterior chamber depth was 3.29±0.4 mm and 3.3±0.38 mm (r=0.85, p<0.001), anterior chamber volume was 207±50 mm³ and 129±39 mm³ (p=0.004), anterior chamber angle was 39.7±9.2 degree and 54.2±5.2 degree (p=0.051), respectively. Average pupil diameter was 3.91±1.77 mm with Pentacam and 3.34±0.89 mm with Galilei (p=0.007). There was a significant correlation between all measured parameters except for CCT, AC volume, AC angle, and pupil diameter. There is a significant agreement between Galilei and Pentacam Scheimpflug analyzers in most of the measured indices. However, the correlation can be low in some parameters. Therefore, these two devices cannot be used interchangeably.

Abnormalities of the thyroid gland are among the most frequent endocrine complications observed in childhood cancer survivors. We report an 11 years old girl who developed central hypothyroidism and ACTH deficiency during the chemotherapy for CNS relapse of acute lymphoblastic leukemia before receiving radiotherapy.

Autoimmune hemolytic anemia is a hematologic disorder that is rarely observed in infants and young children. Most of the cases are associated with viral or bacterial infections. In some cases, AIHA can be characterized by a chronic course and an unsatisfactory control of hemolysis, thus requiring prolonged immunosuppressive therapy. Case report: Especially in children younger than 2 years of age, the clinical course of the disease may show either resistance to steroids or dependence on high-dose steroids. We report here an infant fatal autoimmune. This case suggests that investigation for the presence of CMV infection in infantile AIHA should be considered. Severe hemolysis is rare but could be a potentially life-threatening complication of CMV infection described mostly in immune compromised adults and children.

With modern medical management، thalassemia major is now extending into adulthood and it is expected to have a negative impact on the quality of life (QOL) of the patients. The aim of this study was to evaluate quality of life in patients with thalassemia major. This is an analytic case control study. Two hundred and fifty patients and 51 participants as controls were assessed using WHOQOL- BREF (Farsi version) questionnaire. All questions were answered based on the self-evaluated status in the past 2 weeks before enrollment and were rated on a five-point Likert scale. Therefore، the raw item score ranged from 1 to 5 and scaled in a positive direction and 6 dimensions including overall QOL، overall health، physical، psychological، social، and environmental relationship were assessed. Results showed that the QOL in all 6 dimensions was lower in patients compared to the controls (P< 0. 05). Also age، higher education level، lower ferritin level and using oral iron chelator were associated with better QOL scores. On the other hand، cardiac disease، hepatitis C and history of psychiatric disorders were associated with impaired QOL scores. These findings were important for future refinement of national thalassemia program. So، we recommended regular screening for psychiatric disorders and facilitated access to oral iron chelators. Regular monitoring and treatment of complications especially cardiac disease and hepatitis along with strict quality control of blood products were also mandatory. Also، higher education of the patients may improve quality of life.

Concept of organizational health allows us to have an extensive image of organizational health. Manager's awareness of organizational health level can play an effective role in staff and official's success and succulence. This research was aimed to examine and determine established organizational health index in Isfahan University of Medical Sciences (IUMS). This is a descriptive study. Its statistical population are 872 persons from 7 headquarters assistance of IUMS in 2009. Simple random sampling is used, and 150 subjects are selected. Researcher's questionnaire was used for confirmation or rejection of hypothesis. Scoring was assigned by Lichert approach; its validity determined by college masters and experts, and its reliability by using of Cronbach's alpha coefficient (0. 89). Data analyzed by SPSS software both descriptively and inferentially. Established input index and process index of organizational health in IUMS was significantly lower, and the established output index was significantly more than average. According to systematic model it was observed that there are not necessary grounds for organizational health index establishing in IUMS. A warning of organizational health status makes shortcomings managerial weak, necessary reflective abilities become clear, and causes organizational affairs to be performed scientifically and expertly, and unwise matters are avoided. Applying competent individuals, attracting and employing them, relation communication and using information, supporting inventions and productivity, establishing training courses, popularizing organizational culture and individual participation could be effective for organizational health promotion.

Due to the complications associated with fixation by Titanium screws and plates in Bilateral Sagittal Split Ramus Osteotomy (BSSRO) surgery, the use of resorbable polymers has been increasingly recommended. Since there are not enough studies on this issue, this study aimed to assess the most appropriate stress distribution in fixation with resorbable screws after BSSRO surgery by Fnite Element Analysis (FEA). This experimental study was performed on simulated human mandible using Ansys and Catia softwares. The osteotomy line was applied to the simulated model and experimental loads of 75, 135 and 600 N were respectively exerted according to the natural direction of occlusal force. The distribution pattern of stress was assessed and compared for fixation with one resorbable screw, two resorbable screws in vertical pattern, two resorbable screws in horizontal pattern, three resorbable screws in L pattern and three resorbable screws in inverted backward L pattern using Ansys software. Among the four simulated fixations, L pattern showed the highest primary stability. Two screws in vertical pattern were also associated with sufficient primary stability and less trauma and cost for patients. One screw did not provide enough stability under 600 N. Polymer-based resorbable screws (polyglycolic acid and D, L polylactide acid) provided satisfactory primary stability in BSSRO surgery.

Teams as the fundamental units of organizations and lever keys are considered for improving the function of organization. For promoting the productivity and acquiring the satisfactory staffs and clients, organizations use working teams. Some organizations are highly dependent teams. Hospital is also one of these organizations, in which establishing cooperation between the members of team can play a role to accelerate patient's life saving operation and his/her improvement. This article aimed to determine and evaluate the effects of effective factors on efficacy of surgical work team's efficacy from employee's point of views in training hospitals. This study is a descriptive- survey research. Research population was surgical teams of Isfahan teaching hospitals. These teams were made of 6 groups of nurse, aides, and experts in surgery theaters, experts in anesthesia, nurses, anesthesists and surgeons. So, used sampling approach was classified sampling approach. 189 persons of members of surgical teams were selected randomly. Data collecting tools was a researcher made questionnaire, with Lycert scoring. External and content validation was confirmed by of guide and advisor professors, and its constancy was provided by primary study using Cronbach's alpha 0.94 coefficients. Our finding showed that team size, team task fitness, existence of definite goals in team, team, and norms in the efficacy of surgical work teams meaningfully affected more than average: and team cohesiveness, team composition, evaluation of function and the effect of remuneration in team and organizational support of team on the effectiveness, were less than average. By considering that surgical teams were complicated and incongruous one, team composition and team cohesiveness did not affect the efficacy of surgery teams. With multivariable regression analysis, team norms with 74. 5% had the highest amount effect on the efficacy of surgery teams. With promoting team norms, organizational support, and existence of clear goals in teams, the efficacy of surgical teams increase. Also perspectives of members of hospital surgery teams in terms of education, service background, position, hospital, age, and team size and sex, were similar about the effects of mentioned factors.

Spider bites are common in most parts of the world. In some areas, where snake or scorpion bites are common, spider bites may not be considered a significant problem by the general public and those who have been bitten by spiders may not go to a hospital. However, significant problems are observed in the victims of certain species of spiders including: widow spider (of the genus Latrodectus), including the black widow and brown spiders (of the genus Loxosceles), such as the brown recluse. Case: We report a six-year-old boy, admitted to the hospital two weeks after suffering a spider bite. The patient presented with a severe nose bleed, ecchymosis and purpura, as well as anemia, indicating a clotting disorder. Laboratory results revealed abnormal values for prothrombin time (PT) >50 sec, partial thromboplastin time (PTT) >120 min and fibrinogen = 0 mg/dl, whereas factor VIII was normal according to a mixing study, with a normal platelet count of 350,000/µl. The patient was managed with fresh frozen plasma every 12 h, and was discharged one week after hospital admission. At present, the patient is well with more normal laboratory results one month after treatment: PT=13.4 sec, PTT= 34 sec, fibrinogen=105 mg/dl. Although spider bites are uncommon in Iran, severe systemic reactions may occur in the pediatric population requiring admission to the pediatric intensive care unit. These systemic reactions may include hemolytic anemia coagulopathy and renal failure.

We have investigated MRD in bone marrow samples by three color flowcytometry approach in 63 pediatric B-precursor ALL patients treated according to BFM ALL 95 protocol. Bone marrow samples were collected from children at three different times including: Day 28th, At the beginning of intensified therapy and at the end of therapy. Cells with leukemia associated Immunophenotype were investigated by DNA analysis for evaluation of DNA content. Among 63 children with diagnosis of B-lineage ALL and quantified for post induction residual disease study. We observed that the mean number of blast cells have significant differences among these groups. The mean number of Leukemic blasts counted on day 28 was 2.7± 0.4, at the beginning of intensified therapy 1.7±0.4, and at the end of treatment 0.5±.2. These patients were in complete re mission in light microscopy examination. Relapse of ALL was demonstrated in six of 63 children (9.5%) whose MRD were more than one blast in 10-2 cells. Comparing this to light microscopic exami nation dill of these patients had 4-5% blasts vs. 1% for those who did not relapse. MRD analysis does have a useful role in the risk directed treatment of child hood ALL and the investigation of levels and the dynamics of MRD by sensitive and quantitative flowcytometry and PCR methods reduce false negative results. However a good morphology is also valuable.

Human mesenchymal stem cell (MSC) can be isolated from bone marrow (BM) and differentiated into multiple lineages. These properties make them promising tools in cell and gene therapy. Up to now, no definite therapeutic intervention for late stages of multiple sclerosis (MS) has been found. We decided to inject MS patients with autologous expanded MSC.Five patients participated in this ongoing study. Patients were injected intrathecally with the culture expanded BM MSCs. Patients were followed monthly for their clinical status and every 3 months re garding their magnetic resonance imaging.During 7 months follow up, one patient improved 1.5 EDSS, two patients improved by 1 and 2 scores, and two others remained unchanged till now. The first MRI findings of patients showed no change. We can claim that the injection of expanded MSC is a safe procedure. Three patients showed some de gree of improvement and the other two had no progression. Patients should be followed for at least one year and a larger sample is required in order to draw a definite conclusion.

Gastric cancer is the second most common cancer worldwide and a major cause of death from cancers. Unfortunately, there are few studies regarding the profile of gastric cancer in Iran, thus, the present study evaluate related indicators of gastric cancer in Tehran and other 7 provinces in Iran during a two-year period, 1999-2000. In this descriptive study, we gathered 943 pathological samples of gastric cancer patients from all the pathology clinics in these centers. This was achieved by means of an expert team comprising a physician and a nurse. Our results indicated that gastric cancer was reported more frequently in Tehran (58.5%) but less commonly in Systan-Balouchestan (1.3%). 688 patients were men (%73) and 255 (%27) were women. Of diagnosed cases, 83.9% had diffuse carcinoma. These findings revealed that gastric cancer is more common in men (Male/Female: 2.7) than women that is in agreement with other published studies. Tumors are more commonly located in mid third of stomach. Meanwhile, most of the affected patients had diffuse carcinoma.