fatemeh rafiei

Migraine is a complex neurological disorder. The precise etiology of migraine is not clear. Many studies have been conducted on the association of the immune system with migraine pathophysiology. Neurogenic inflammation, the main pathomechanism of migraine, is well described. This study evaluated the pattern of changes in interleukin (IL)-1β, IL-17A, total antioxidant capacity (TAC), and malondialdehyde (MDA) in migraine patients. In this case-control study, serum samples were taken from 31 migraine patients referred to the neurology clinics of medical centers associated with Arak University of Medical Sciences. The severity of the headache was assessed with standard questionnaires. Serum samples were also obtained from 30 normal individuals. The IL-1β and IL-17A levels were measured by a sensitive ELISA method. TAC was measured by the FRAP technique, and lipid peroxidation levels were evaluated by an MDA assay. Data were analyzed descriptively and analytically using SPSS 21 software. The results showed that the mean level of IL-1β in the case group was significantly higher than the control group (P = 0.01). The mean level of IL-17A was not significantly different in the two groups. The mean serum MDA level in the study group was significantly higher than in the controls (P = 0.005). No statistical difference was observed in the mean serum level of TAC between the two groups. According to our results, the pathogenesis of migraine can be associated with immune system function, and inhibition of pro-inflammatory cytokine production may be effective in treating migraine patients.

The aim of the present study was to evaluate the effectiveness of solution-oriented and systemic structural-oriented couples therapy on marital relationship, sexual performance and marital satisfaction in couples of Kermanshah city. The method of this study was a semi-experimental pre-test-post-test type with repeated measurements. The statistical population was all the couples who referred to counseling centers in Kermanshah in 2022, after screening with Reed et al.'s (2006) marital relationship questionnaires, Rosen et al.'s sexual performance of women (2000), Rosen's men's sexual performance. and colleagues (1997) and marital satisfaction of Enrich and colleagues, 40 couples were selected purposefully and 20 couples were randomly replaced in the experimental group and 20 couples in the control group. The experimental group received eight sessions of combined solution-oriented and structural-oriented couple therapy interventions as a group, and the control group was placed on the waiting list. The results showed that solution-oriented and structural-oriented couple therapy is significant in the post-test scores of marital relationship, sexual performance, and marital satisfaction. The findings of this research potentially have important practical effects for therapists to pay attention to the combined effectiveness of solution-oriented and structural-oriented couple therapy on marital interaction, sexual performance, and marital satisfaction in couples.

During the last two decades, the rate of diagnosing coeliac disease has increased significantly in Iran. The present study aims to describe the life experiences with coeliac disease among the patients referred to the Iranian Coeliac Society in 2017.

In the present descriptive phenomenology, 19 patients with coeliac disease referred to the Iranian Coeliac Society, were selected as participants by purposeful sampling method. The data were collected through in-depth interviews with an average of 45 minutes for each session at the coeliac center. The sampling process continued until the data saturation was achieved. The nine-step Colaizzi method was used to analyze the data.

Based on the results, eight issues such as psychological distress, fighting with disease, disease ambiguity, challenging diets, disease non-acceptance, social isolation, the tendency towards spirituality, disease acceptance efforts, and four other categories such as fear, anxiety, despair, stress and mental instability, and 11 subcategories were identified as life experiences with Coeliac disease. About living with coeliac disease, 8 themes were extracted from the patients’ experiences.

Since the findings help nurses understand the life experiences of coeliac patients, they can provide appropriate nursing care based on the patient’s needs through the research result. Keywords: Coeliac Disease, Life Experiences, Phenomenology

Energy subsidies have significant economic implications. On the one hand, they have protected consumers, but on the other hand, they have increased the budget deficit and public spending recently. Moreover, they have reduced private investment, especially in the energy sector, another dangerous consequence of energy subsidies. It is one of the key and controversial debates in the energy sector of the Iranian economy. The present paper is aimed at promoting thinking and research on how to eliminate energy subsidies. One idea is that energy subsidies should be reduced all at once, while others suggest a gradual elimination of energy subsidies. This paper simulates the elimination of energy subsidies in the base metals industry as one of the most energy-intensive industries in Iran. A dynamic recursive computable general equilibrium model is estimated to evaluate the economic impacts of removing gas subsidies in basic metal manufacture in Iran. according to the results, gas consumption will decrease, and electricity and petroleum products will increase in both scenarios (gradual increase in gas prices after 5 years as Scenario 1 and an increase in gas prices at once as Scenario 2). However, during the period, Scenario 2 reduces the supply of basic metals more than Scenario 1.

An efficient diabetes control delays the emergence of the side effects of the disease. The present study aimed to assess factors associated with blood sugar indices in type 2 diabetic patients.

This cross-sectional study was conducted among 201 diabetic individuals who were referred to Imam Reza Clinic in Arak, Iran, in 2019. To this end, all type 2 diabetes mellitus patients subjected to fasting blood sugar (FBS), 2-hour postprandial (2hpp), and hemoglobin A1c (HbA1c) tests during the recent one month were selected using a convenience sampling method. Additionally, a demographic checklist and the Health Literacy for Iranian Adults questionnaire were filled out through face-to-face interviews.

Based on the results, blood sugar levels, especially HbA1c were related to residence (P=0.012) and access to health clinics (P=0.028) so that those with easier access had lower blood sugar indices. Further, an inverse correlation was observed between the HbAlc value and health literacy (P=0.013). An increase in the education level improved blood sugar amount, although the relationship was not significant. Finally, the mean value of 2hpp was related to the family support level, thus better family support led to a lower amount.

The results suggested a relationship between access to health clinics, residence, family support, health literacy, and occupation with blood sugar levels in diabetic subjects.

One of the important strategies to provide quality care is to motivate healthcare workers.

This study aimed to determine the components of job motivation among operating-room and anesthesia staff.

This cross-sectional study was performed on 152 operating-room and anesthesia staff working in Zanjan hospitals and by the convenience sampling method. Data were collected using demographic and job motivation questionnaire. Data were analyzed using SPSS 16 software and Pearson correlation coefficient and Mann-Whitney test.

The mean (SD) job motivation power was 25.2(11.9) which was relatively desirable. In the operating-room staff, the strongest relationship between the dimensions of motivation and total motivational power was related to the autonomy dimension (r=0.7), and the weakest relationship was associated with the identity dimension (r=0.3). In the anesthesia staff, the strongest relationship was associated with the dimensions of autonomy and feedback (r=0.6), and the weakest relationship was associated with the identity dimension (r=0.001) and total motivational power (P<0.001). Also, the mean (SD) skill variety dimension in operating-room staff was 3 (0.6), which was higher than that in the anesthesia staff was equal to 2.7(0.5) (P=0.015); but the mean score in other dimensions and the total score of motivational power between the two groups had no statistically significant difference (P>0.05).

Given the low score of the job identity dimension, it is better for policy-makers and managers of the health system to take measures to strengthen this dimension of job motivation as one of the priorities of the healthcare system.

About one third of all new HIV infections are estimated to occur among young people globally. In recent years, the increasing age of marriage in Iran has caused increasing risky behaviors in the young population. According to evidence, risk perception toward acquiring HIV is an important factor for risky behaviors.

This study was conducted to detect the concern toward HIV acquisition among Iranian youths.
Evidence Acquisition:In this systematic review, the knowledge, attitudes, threat perception, and practices of youths toward HIV/AIDS were assessed through searching such databases as the Web of Science, PubMed, and Scopus. Quality assessment was done using STROBE and PRISMA-P checklists. A total of 1,036 articles were initially found, of which 28 articles were analyzed.

The youths’ knowledge about HIV/AIDS varied from low to moderate, their attitude was generally negative, perceived risk susceptibility was low, and risk perception ranged from 6.5 to 60%. Premarital sexual relationships were reported by 8 - 50% of the youths, while the rate of both condom use and consistent condom use was less than 50%.

The current situation is worrisome and needs serious practical measurements. Therefore, urgent and multifactorial interventions such as establishment of youths’ sexual reproductive health services and its integration into the current primary health care system across the country are needed.

Medical students make extensive use of virtual social networks, especially in the era of the coronavirus pandemic, so that their health-promoting behaviors may be adversely affected.

 This study aimed to determine the relationship between the use of virtual social networks and a health-promoting lifestyle among postgraduate medical students.

This cross-sectional study was conducted among post-graduate students studying at Tehran University of Medical Sciences in 2020. A total of 240 students were included using quota sampling method. Data were collected via valid and reliable questionnaires consisting of socio-demographic information, health-promoting lifestyle Profile-II, and virtual social networks utilization. The spearman test was employed to evaluate the association between virtual social networks and lifestyle.

The mean age of participants was 32.21±7.45 and 75.4% were female. The mean score of lifestyle was 138.28±21.18, while the mean score of virtual social networks utilization was (64.55±11.40). There was a statistically significant correlation between utilization of virtual social networks and total score of lifestyle (r=-0.189, P=0.003), as well as physical activity (r=-0.232, P=0.001), nutrition (r=-0.179, P=0.005), and self-actualization (r=-0.154 , P=0.017) of health promoting lifestyle. Linear regression model showed that utilization of internet and social networks (B=-0.37, P=0.02), utilization in the time between 12 pm and 8 am (B=-14.3, P=0.011) were independently associated with Health Promoting Lifestyle score.

This study showed that more than half of students had a healthy lifestyle (55%). The average score of virtual social networks used by students was high. Utilization of internet and the time of utilization were independent predictors of Health Promoting Lifestyle score.

Anxiety is considered a common problem in women with breast cancer, and non-pharmacological interventions, such as reflexology, can contribute towards controlling. This study aimed to determine the effect of foot reflexology on anxiety in women with breast cancer. In this randomized-controlled clinical trial, 66 women with breast cancer referred to Ayatullah Khansari Hospital, Arak, Iran, were selected based on the inclusion criteria by convenience sampling method and randomly assigned into intervention and control groups using a randomized block allocation method. In the intervention group, reflexology was then conducted by a trained nurse in the oncology department in a two-point morning and afternoon session for 40 min on the thumb and solar plexus of the feet. However, the control group did not receive any intervention and the Spielberger State-Trait Anxiety Inventory was completed again by the patients. The mean anxiety scores before reflexology were 48.27±4.95 and 49.72±4.18 in the intervention and control groups, respectively (P=0.202). Furthermore, the mean anxiety scores in the intervention and control group after reflexology were obtained at 47.03±4.14 and 49.71±4.28, respectively.Implications for Practice: As reflexology did not affect the anxiety of women with breast cancer, this method can be combined with other non-pharmacological interventions to control anxiety in women with this complication; however, it should not be utilized alone in the clinic to manage anxiety. Further studies are recommended to be conducted with larger sample sizes and extended periods on anxiety and mental health disorders in these women.

Soil microorganisms play an important role in the biological control of pathogenic fungi. The aim of this investigation was to isolate soil-borne Bacillus subtilis with the ability to produce antifngal lipopeptides  that are suitable  for suppressing Fusarium graminearum, which contaminates wheat, corn, potato and a wide range of plants.Materials &

B. subtilis was isolated from the rhizospher of healthy plants of park slocated in the five areas north, south, east, west and center of Tehran and was identified based on morphological characteristics, biochemical tests and sequencing of 16S rRNA. The antagonistic activity of isolated strains against F. graminearum was investigated by Well method. The strains that inhibited the growth of fungi and showed the greatest inhibition zone, were selected. Surfactin of selected bacteria was purified by methanol method and bacterial metabolites and pure surfactin (Sigma Company) were compared with, high performance liquid chromatography (HPLC).

Among 60 isolated strains, 27 strains had antifungal activity. Six strains with the highest fungal inhibition zone (8-16 mm) were selected and their yellow color and transparency was a confirmation to HPLC. Two bacteria with the highest amount of surfactin production by  molecular method showed high similarity with B. subtilis.

The results show that Bacillus subtilis isolated from soil are good candidates for biological control of plant pathogenic fungi and therefore can a suitable alternative to chemical fungicides.

The prevalence of coronavirus disease 2019 (COVID-19) resulted in health anxiety among general population and unreasonable referring to health centers. This study aimed to assess health anxiety related to COVID-19 in individuals referring to healthcare centers of Arak, Iran in 2020.  

Using convenient sampling method, the participants of this cross-sectional study were selected from 16 urban health centers of Arak. Salkovskis 18-item Health Anxiety Inventory (HAI-18) was completed by 392 participants. The collected data entered in SPSS software version 24 and was analyzed by Mann-Whitney U and Kruskal-Wallis tests.  

Mean ± SD of total score of health anxiety was 28.96 ± 7.62. Most participants (74.7%) had medium anxiety and 19.1% had high anxiety. The mean of total score of health anxiety was higher in the 30-59 age range, higher education, single people and students. Participants with chronic diseases and symptoms of cold and people who referred to health centers due to COVID-19 screening had a higher anxiety level.  

Most people referring to health centers of arak had moderate anxiety. COVID-19-related health anxiety was higher in middle age range, higher education, students, people with chronic diseases, and people with symptoms of common cold.

Among energy carriers, electricity has been focused on more closely than the other energy carriers because of its ease of conversion, ease of use, low risk, as well as environmental considerations. In 2017, 11% of the final energy consumption belonged to electricity. Electricity is also an indicator of social welfare; however, electricity consumption has grown in recent years for such reasons as population growth, urban development, increasing living standards and welfare, realizing tariffs, climate change and industrial and commercial development. Even in some years when Iran has had low or even negative economic growth, the upward trend in electricity consumption has not stopped, and the implementation of the subsidy reform plan has not been able to stop this trend. Therefore, in the absence of structural reforms, widespread socio-economic costs will be imposed on the Iranian economy. This is because the high speed of energy consumption in Iran raises serious concerns about the country's ability to export energy in the coming decades.  Electricity reduction policies can be divided into two categories: price and non-price policies. Pricing policies in Iran have brought the price of electricity closer to the cost of production and reduced subsidies. Non-pricing policies to reduce electricity consumption can also be referred to as efficiency improvement policies. Increase of efficiency depends on the increase of the useful output of each process per unit of energy received. It is commonly thought that improving energy efficiency reduces energy consumption, but there is widespread debate in both economics and energy policymaking about the real impact of such improvements on energy efficiency.

In order to study the relationship between the increase of efficiency and the reduction of electricity subsidies, this paper creates a CGE model based on the latest Social Accounting Matrix published in 2011. The final SAM is aggregated into 11 economic sectors, namely agriculture, electricity, fossil fuels, textile production, production of chemical materials, other non-metallic mineral products, production of basic metals, production of motor vehicles and trailers, other industries, transportation and other services, two factors of production, labor and capital, two groups of urban and rural households, enterprises, government, saving-investment and the rest of the world. To calculate the effect of price increase on the efficiency, the structure of the production layers is formed in such a way that the energy-producing parts are separated from other non-energy parts. Results and

By implementing the policy of increasing electricity efficiency, electricity consumption has increased by 4.17, and there are rebound effects above 100% as well as backfire for electricity and total energy in the economy. The policy of increasing electricity prices by 10% will reduce electricity consumption by 0.02%. With the increasing electricity efficiency, the amount of energy consumption will increase by 1.20%. Taking into account the price drop for electricity due to increased efficiency, the cost of fossil fuel production will decrease and, therefore, fossil fuel consumption will increase. Consumption of energy commodities increases too. The main reason for the increase in energy consumption is that the application of the energy efficiency policy makes the level of activity rise in all sectors and, therefore, energy consumption is needed to increase production. Due to the reaction of various economic entities, including households and production sectors, energy consumption increases and may offset a part or all of the reduction in primary energy consumption. With the reduction of implicit energy prices, the energy consumer faces a situation similar to the reduction of prices, so the consumer is driven to increase energy consumption. Also, as stated in the microeconomic literature, with implicit price reduction, real energy consumption (whether in households or in the production sector) will increase and, as a result, the consumer will face a wider range of goods and services. An increase in real income will increase energy consumption. As a result, part of the reduction in the initial consumption due to increased energy efficiency is offset. Contrary to the engineering approach, a 10% increase in electrical efficiency results in a reduction of less than 10% of energy. This difference is called the rebound effect. Therefore, the increase in energy efficiency is in line with the ultimate goal of protecting the environment as well as boosting the economic growth. In contrast, the policy of increasing electricity prices reduces electricity consumption by 0.02%. Rising electricity prices will also reduce the consumption of energy-efficient commodities. A rise in fossil fuel prices will raise the electricity price. Therefore, the relative price of energy increases and is replaced by other inputs based on the effect of energy substitution. Also, price increase has caused a decrease of 0.54% in the production of the total economic activities. If the goal is to reduce energy consumption and emissions, the policy of increasing electricity prices is better than the policy of increasing efficiency.

The results show that the policy of increasing electricity prices by 10% reduces energy consumption by 4.91%, but the policy of increasing electricity efficiency by 10% does not reduce energy consumption due to rebound effects; it just increases energy consumption by 1.2%. Therefore, as realized by Khoshkalam and Mahdavi (1397), it is recommended that policy makers avoid overestimating the power savings resulting from the efficiency increase policy and not expect consumption to decrease as efficiency increases. It is important to note that the policy of efficiency compared to increasing energy prices raises the production of economic sectors, but increasing the price of production reduces it. Therefore, if the increase of the price of electricity is implemented, it is better to apply complementary policies to prevent the reduction of production.

The main goal of policies to increase the energy efficiency is reducing energy consumption, but this goal is limited by the rebound effect. In the literature of energy economics, there are two types of non-price and market tools to reduce rebound effects. Among the market tools, energy taxation is a favored approach. In the Iranian economy, where the prices of energy carriers, including electricity, are lower than their actual prices, and the government is paying consumers a hidden subsidy, trying to reduce energy subsidies is like taxing. In this paper, it is attempted to estimate recurrent effects by applying Social Accounting Matrix of 2011 and Computable General Equilibrium Model of Return Effects in two scenarios of 10% increase in electricity efficiency and simultaneous increase of 10% efficiency and 10% electricity price. The model results show that the energy rebound effects are 112% if efficiency is increased that means energy consumption growth by 1.2 percent but rebound effect may decreases to 99% if price and efficiency increase simultaneously. The high rebound effects observed are due to the relative price reduction of energy and thus to increased consumption. Also, the efficiency-enhancing policy also encourages 0.04% of the level of economic activity in manufacturing sectors, which is another factor in the increase in energy consumption as well as exports in this scenario 0.3% Growth. In contrast, in the policy of simultaneously increasing energy efficiency and price, the level of consumption will decrease by 0.1 percent, the level of activity of manufacturing sectors will be 0.08 percent and exports will be 0.5 percent.

The outbreak of COVID-19 in China in late 2019 was an unprecedented catastrophe that also involvedmany other countries, including Iran. Concerning the danger of disease contagion, it is necessary to detect asymptomatic or mild cases, especially in hospital staff who are highly exposed to the disease.

In this serosurvey study, we aimed to estimate IgG seroprevalence among hospital staff in two public hospitals to determine local transmission and infection risk factors, as well as protective immunity among high-risk populations.

Screening was offered to the hospital staff of two public hospitals in Shiraz, Iran. Screening involved the measurement of IgG antibodies against SARS-CoV-2. Besides, a checklist that consisted of questions about sociodemographic, occupational, and epidemiological characteristics was completed by the participants.

Among 494 participants in this study, 29 (5.8%) had anti-SARS-CoV-2 IgG in their blood. Besides, 320 (64.8%) had at least one of the clinical symptoms within sixmonths before this survey. Among participants with positive PCR, nine (21.4%) had anti-SARS-CoV2 IgG, while this figure was seven (33.3%) for individuals with positive CT scans. Non-proper disposal of used protective equipment or infectious wastes (OR = 26.5), rotational daily work shifts (OR = 7.5), being anxious about getting COVID-19 (OR = 3.8), and age (OR = 1.06) were the significant determinants of having anti-SARS-CoV-2 IgG in the hospital staff.

It is essential to continue training and giving technical consultations about COVID-19, especially the proper disposal of used protective equipment or infectious wastes in rotational daily shift workers

Musculoskeletal disorders are mainly prevalent among college students who experience direct contact with patients. This study aimed to determine the prevalence of musculoskeletal pains among Rehabilitation, Dentistry, and Nursing students at Arak University of Medical Sciences in 2017-2018.

Methods & Materials: 

In this cross-sectional descriptive study, 538 students of Arak University of Medical Sciences were recruited using the convenience sampling approach. Variables included age, sex, body mass index, study field, hours of using smartphone per day, and nine symptom sites being neck, shoulders, upper back, elbows, low back, wrist/hands, hips/thighs, knees, and ankles/feet. The researchers assessed the musculoskeletal pain by using the Nordic questionnaire and demographic questionnaire. Statistical analysis was performed using SPSS V. 18.

Ethical Considerations: 

The Research Ethics Committee of Arak University of Medical Sciences approved this study (Code: IR.ARAKMU.REC.1397.253).

  In this study, 538 students (205 males and 333 females) were studied with Mean±SD age of 22.04±2.53 years old. The results showed that the prevalence of musculoskeletal pain in the spine (neck 29.4%, upper 24.3%, and lower back 37.2%) was higher than in upper and lower extremities. Musculoskeletal pain in the shoulder, upper, lower back, and thigh were significantly different based on sex. Also, musculoskeletal pain in the neck and ankle, and foot were significantly different based on age (P<0.05). There was a significant difference between musculoskeletal pain of back and ankle based on smartphone use hours per day.

 This study suggested that rehabilitation, nursing, and dentistry students are at risk for musculoskeletal pain, especially in the lumbar, cervical, and upper back.

Job satisfaction is a significant factor in increasing the efficiency of staff, enhancing the quality of medical services, and achieving organizational goals.

The aim of this study was to determine and compare the level of job satisfaction among anesthesia and operating room staff.

This descriptive-comparative study was carried out on 152 anesthesia (71 individuals) and operating room staff (81 individuals) in Zanjan hospitals. Sampling was accomplished by census method. Job satisfaction was assessed using the JSS (Job Satisfaction Survey) in nine areas (Pay, Promotions, Supervision, Coworkers, Fringe Benefits, Contingent Rewards, Nature of Work, Operational Procedures and Communications). Data analysis was performed using SPSS 16 software. Descriptive and analytical statistics, including Fisherchr('39')s exact test and Mann-Whitney test, were analyzed as well.

Most of the participants were female (69.1%), under 30 years old (48.7%), and with a bachelorchr('39')s degree (75%). In general, job satisfaction of the majority of staff was moderate (75%). The mean job satisfaction in the areas of operational procedures (P=0.005), communication (P=0.027), and total score (P=0.042) in operating room staff was significantly higher than anesthesia staff; however, there was no statistically significant difference in other areas (P> 0.05).

Job satisfaction of anesthesia staff was lower in terms of operational procedures, communication, and total score; therefore, it is suggested that managers and authorities take this issue into account and take appropriate measures to improve the job satisfaction of staff in the mentioned areas.

Comparing time use patterns and self-efficacy in two groups of mothers, including mothers of children with Cerebral Palsy (CP) and mothers of children with typical development, is the main objective of this study.

This study was carried out in 2017 in Arak, Iran, on 200 mothers. Multiple sources of the evaluation, including Mothers’ Time Use Questionnaire and Sherer General Self-efficacy Questionnaire, were used. SPSS v. 22 software was used to analyze the data.

The Mean±SD age of children was 4.64±1.46 years in the group of children with CP and 4.64±1.47 in the group of children with typical development. Significant differences were found between groups in the amount of time spent in various occupations, including self-care, childcare and household, leisure, rest/sleep, and work. Mothers of children with CP significantly spent a bigger proportion of time on “rest/sleep” and “childcare and household” areas (P<0.001). However, mothers of children with typical development spent significantly more time in “Self-care” (P=0.01), “Leisure” (P<0.001), and “Work” (P<0.001) areas. Also, significant differences were found between groups in the level of satisfaction.

Lower total score of the time use questionnaire in the group of mothers of children with CP might be because of the nature of limitations and the negative burden of this type of disease in terms of socio-cultural and fewer health system services.

Acanthamoeba is a resistant protozoan that causes severe diseases, such as GAE and CAK. Because many medications are ineffective on the parasite, the quest to find alternative drugs is in progress.

This research was aim13 ed to assess the performance of the black and green tea extracts on Acanthamoeba.

The clinical isolate of Acanthamoeba was cultured on non-nutrient agar plates. The black and green tea extracts were prepared via maceration, dried by rotary evaporation, and stored at 4 °C. The main component of the extracts (caffeine) was recognized using GC-MS analysis. The effects of three concentrations of black and green tea extracts were evaluated on the parasite and compared with the control and current drug.

Black and green tea extracts have lethal effects on Acanthamoeba cysts and the performance was more than that shown by the control and the current anti-keratitis drug. Moreover, the effectiveness of the tea extracts was tim 25 e- and dose-dependent (P < 0.0001). There was no significant differences between the performance of black and green tea (P > 0.05).

Black 13 and green tea extracts demonstrated the potential to inhibit the Acanthamoeba parasite, but the use of tea extract in clinical applications requires further study.

Hysterectomy is one of the most common surgeries in women, which causes many physical and psychological complications including anxiety. The aim of this study was to compare the effect of diaphragmatic breathing and pursed lip breathing on anxiety in women undergoing hysterectomy.

In this double-blind randomized controlled clinical trial, 126 patients referred to Taleghani hospital of Arak during 2017-2019 were selected by convenience sampling, and then assigned into three groups of diaphragmatic breathing, pursed lip breathing and control using the random number table. Anxiety was measured the evening before the operation (before the intervention), one hour before entering the operating room (after the intervention) and two hours after the operation, using the Spielberger Anxiety Questionnaire. Data were analyzed using descriptive and analytic statistics using the SPSS software version 16.

The mean and standard deviation of anxiety scores for the diaphragmatic breathing, pursed lip breathing, and control groups were 55.33±10.49, 55.4±9.84, and 55.07±11.31 respectively, and there was no significant difference between the groups (P=0.983). One hour before going to the operating room (after the intervention), the mean and standard deviation of the anxiety score was 41.98±8.5, 42.43±7.88, and 52.86±11.5, respectively, and after the operation, the scores decreased to 37.79±8.13, 38.07±8.33 and 50.62±11.35 respectively. There was a significant difference between the three groups (P<0.0001). There was no statistically significant difference in the anxiety scores between the diaphragmatic breathing group and the pursed-lip breathing group after the intervention (P=0.999).

The results of this study showed the diaphragmatic breathing and pursed-lip breathing techniques are effective in reducing hysterectomy anxiety in women. Therefore, using this non-pharmacological approach is recommended to reduce anxiety before and after hysterectomy surgery.
Clinical trial registry: IRCT20180103038211N4

Impaired immune system provides favorable conditions for colonization by Acanthamoeba in the human body. In this case control study, we compared the molecular and culture methods in identifying Acanthamoeba in the nasal and oral secretions of HIV+/HIV human.

In a current case control study, nasal and oral discharge of 53, HIV+ patients and 53, HIV people were evaluated. The nasal and oral secretions of each patient were prepared by sterile swabs and transferred to the laboratory. All samples were cultured but only the positive samples used for molecular analysis.

By cultivation method, of the 53, HIV+ patients, a total of 11 samples, including 5 nasal and 6 oral samples, were contaminated with Acanthamoeba. Of the 53, HIV people, 3 samples of nasal discharge were contaminated with this parasite. The molecular method approved the contamination of 10 samples, including 5 oral and 5 nasal samples from HIV+ patients with this parasite. Statistical analysis showed the rate of infection in HIV+ patients was significantly different compared to HIV people

The results of the current study showed that the rate of Acanthamoeba infection in HIV+ patients was higher than that of HIV- individuals. Also, considering that in the control group (HIV- individuals) only the nasal discharge were infected with the parasite, it seems that in the case group (HIV + patients) the infection of the oral discharge with the parasites is due to the  entry of its cysts into the nose and transmission to the mouth

Iran is one of the countries with high energy consumption per capita in the world. One solution to reduce energy consumption while increasing economic growth is to improve energy efficiency in various economic activities because increasing in energy savings is one of the eligible effects of the policy of efficiency increase. Improving energy efficiency in the economic activity is a way to reduce energy consumption and enhance economic growth, but the desired effects of the policy are limited due to rebound effects. One of the challenges is decomposition direct and indirect rebound effect and economy-wide rebound effect. The purpose of this article is to provide a theoretical model for the analysis of rebound effects and its calculation in various activities using a general equilibrium model. Based on the results of the modeling, which uses the data of the Social Accounting Matrix of 1390 in Islamic Parliament Research Center , the total direct and indirect rebound effect of increasing one percent of efficiency of electricity and fossil fuels are 90.1% and 72.8%, respectively. The economy-wide rebound effect are also not significantly different from the direct and indirect rebound effects, as households do not respond very well because of the low contribution of energy costs from household expenditures, and so economy-wide rebound effect are 89.9 and 72.5. The high rebound effects observed in the Iranian economy will limit the effectiveness of the efficiency-enhancing policy on reducing energy consumption, so pricing policies along with the efficiency-enhancing policy are recommended.

Positioning of premature newborns significantly affects their health status. However, the most suitable position remains controversial. The current study aimed to compare the effect of supine and prone positions on oxygen saturation and vital signs in premature newborns.
In this crossover clinical trial, a total of 22 newborns admitted to the Neonatal Intensive Care Unit (NICU) of Amir Kabir Hospital in Arak, Iran, were selected through purposive sampling technique, and then randomly assigned into groups 1 and 2. Newborns in group 1 were first placed in a prone position (i.e., the first period for 3 h), and then in a supine position (i.e., the second period for an additional 3 h). The reverse procedure was applied to the intervention group 2. Heart rate, respiratory rate, and oxygen saturation were measured and recorded every 15 min.
The mean oxygen saturation in the prone position (96.164±0.148) was higher than in the supine position (90.479±0.513; P=0.0001). The mean heart rate in the prone position (138.24±1.87 beats/min) was lower than that in the supine position (147.48±1.597 beats/min; P=0.0001). The mean respiratory rate in the prone position (40.430±0.504 breaths/min) was lower than that in the supine position (46.773±0.685 breaths/min; P=0.0001).
The current study demonstrated that the prone position put the newborn admitted to NICU in a more stable condition. However, the selection of the best position must be made based on the newborn’s health status and situation.

Objective Family is the center and core of the patient’s care, so the most effective therapeutic programs are those that emphasize the role of the family in treatment. The purpose of this study was to evaluate the delivery of family-centered services by service providers for families and children in Iran based on the Persian version of the Measure of Processes of Care for Service Providers (MPOC-SP) Questionnaire. Materials & Methods In this study, 150 service providers participated including doctors, nurses, midwives, rehabilitation therapists, as well as graduates in public health. The Persian version of the MPOC-SP questionnaire was used to collect the study information. The collected data were then analyzed in SPSS 22. Results The results showed no significant difference between men and women providing the service regarding the components of the questionnaire for measuring the process of care. The mean of components in "providing general information" in the medical group was statistically significant and higher compared to the basic science group. The average score of "showing interpersonal sensitivity", "providing general information", and mean score of total services in different service centers were statistically significant. The average score of the "showing interpersonal sensitivity", "providing of general information" as well as the mean score of the whole questionnaire of the process of care in the private centers was statistically significant and higher than the governmental centers. The average components of "showing interpersonal sensitivity", "treating people respectfully", "providing of general information", as well as the average score of the total questionnaire of the process of care in different age groups of service recipients were statistically significant. The average of the same components in different service providers also had a statistically significant difference. Conclusion providers' responses showed that health and rehabilitation centers provided good services in terms of respectful behavior, but providing general information and showing interpersonal sensitivity were relatively weak areas. The average scores of these components as well as the average total score of the questionnaire were the highest in rehabilitation fields and then ranked by medical and other therapy personnel respectively.

  The PAEI model of Adizes is a new pattern in the decision maker's direction. The aim of this study was to investigate the adherence of decision making methods of educational and research managers in Shahrekord University of Medical Sciences using Adis model. This research was a descriptive study and population of the study was faculty members of Shahrekord University of Medical Sciences in year 2013 that were 176 people (57 women and 119 men) and 116 people (38 females and 78 males) with stratified random sampling have been considered. The instruments that used in this research were two questionnaires including decision-making questionnaires of educational and research managers. For analyzing of the data, descriptive and inferential statistics (ANOVA and Tukey test) were used using SPSS. The rate of adherence of educational and research managers from the Adizes model including administrative model, the pattern of implementation, organization and leadership, creativity, and entrepreneurship was significant (P>0.01). According to the degree of respondents, there was a significant difference between the leadership style of the educational managers and the administrative staffs of the research directors (P>0.01). Also, based on the work experience, there was a significant difference between the follow-up of the executive and administrative model of educational managers and also the adherence of executive model, administrative, creativity and leadership of research directors(P<0.01) According to usage rate of educational and research managers of Shahrekord University of Medical Sciences from the pattern of administration, executive model, organization and leadership, creativity and entrepreneurship of Adizes model, it is proposed the rules and guidelines are revised, the fields of creativity in the organization are predicted and for implement decisions, the appropriate individuals are determined

Nephrotic syndrome (NS) as a glomerular basal membrane disease has different outcomes. The current study aimed at evaluating epidemiologic status in NS and its correlation with the outcome in children. The current hospital based study evaluated the patients of pediatric clinic at Amir-Kabir hospital. Demographic information was obtained by interviewing both the physicians and patients. Also, to determine the sesitivityto steroid drugs, children were given prednisolone (2 mg/kg/day with maximum dose of 60 mg/day) for four weeks and syndromes were determined based on children responses to the drug. Patients were divided into four groups of 25. At the end, data were transfered to SPSS program and the correlations between epidemiological information and different types of NS were investigated Results of the current study showed that steroid responded children with frequent relapse as well as steroid dependent children had better epidemiological and socioeconomic status compared with the steroid resistance ones (P < 0.05). Prognosis of NS or medication responses was related to epidemiological status of children.