naser valaie

Considering the structural and physiological difference between an aged patient and young people in the mouth and teeth areas and the growing increase of the aged population in our country and acceleration of the reference of these patients to the dentistry clinics, having sufficient information to make a proper handling and present a suitable treatment for these patients is necessary.This study has conducted to take attention about this information gap.
This research was conducted in cross sectional method on 400 samples of the dentists who participated in the 53rd International Congress of Iranian Dental Association(IDA). The method of sampling was in form of constant proceeding . In order to collect data, the method of completion of questionnaire in the presence of project administrator was used. The questionnaire included three sections: Questions related to the individual characteristics 10 questions, dentists’ knowledge 10 questions, dentists’attitudes 11 sentences which were in multiple choice form .Then the rate of knowledge and attitude in the samples were determined,The maximum score of knowledge was 10 and the minimum was 0. The score scale of each attitude question was determined between 0-3. The maximum score of attitude was 33 and the minimum score was 0 and the role of individual factors in connection with the rate of knowledge and attitude was studied and analyzed by using the Regression tests.
Of the numbers 400 dentists participating, 48/7 % were women and 51/3% were men ,and their age was (32/ 6±2/4)year. Based on the average of knowledge the score obtained from the research is (2/71±1/8), 88/5% had a weak knowledge, 11/5% had an average knowledge and therefore, unfortunately, they did not have a good knowledge. Based on the average score of attitude obtained from the research is (22/3±3/4),39/7% had a positive attitude, 58% had a relatively positive attitude ,the whole positive number was 97/8%,and 2/2% had a negative attitude. According to the results, there was no significant relationship between the related factors and the rate of dentist`s knowledge and attitudes.
As the dentists’ knowledge of geriatrics dentistry is weak ,it is an important hints. On the other hand, the dentists’ attitude of geriatrics dentistry is relatively positive, so the design and inclusion of course unit credits and implementing constant and suitable educational courses in student period and also holding retraining and conferences on geriatrics dentistry after graduation are all very effective in promoting the scientific level of dentists towards geriatrics dentistry.

Objective (s): To evaluate accuracy of writing of published papers in biomedical scientific journals in Tehran، Iran. In this cross sectional study، all original articles published in two scientific journals in 2010 were evaluated. Different topics of articles، including abstract، introduction، methods and materials، results، discussion and references were assessed. Totally، 52 items were evaluated and classified as 3 categories of “correct”، “relatively correct” and “incorrect”. Seventy-seven original articles were evaluated in two journals. Accuracy of writing were as follows: 47% correct، 50. 5% relatively correct، and 2. 5% incorrect. Inaccuracy among incorrect writing articles were: abstract 31. 65%t، introduction 35. 5%، methods and materials 44%، results 21%، discussion 68. 6%، and references 41. 35%. The findings suggest that there is considerable inaccuracy in published articles of scientific research journals. Implementation of measures to prevent such scientific mistakes seems necessary.

Many different indices are used to evaluate the scientific production of universities, research centers and researchers. H-index represents the quality of published researches. In the present study we determined the H-index of faculty members in the dentistry department of Shahid Beheshti University of Medical Sciences.

The H-index of academic staff in the department of dentistry in Shahid Beheshti University of Medical Sciences was extracted from the Scopus database until the beginning of 2012. Relation between the H-index and related factors was studied by Chi square test.

Out of 107 of academic staffs in the department of dentistry of Shahid Beheshti University of Medical Sciences, relevant information of 98 individuals was extracted, (91 percent), H-index of 46 faculty members was equal to or more than one (43 percent). Statistical analysis revealed that the number of articles and academic grading of faculties had significant relationship with the H-index of faculty members (p<0.05).

Overall, the number of faculty members with H-index of 1 or higher is low. Programs to improve the quality of research papers are urgently needed. 

Hydroxyapatite (Ca10(PO4)6(OH)2) is the major inorganic component of hard tissues, the best bio-active materials, which is compatible with the bone tissue. In addition, hydroxyapatite nanoparticles (Nano-HA) have received enormous national attention in medical and dental applications recently; but the ultimate fate of the Nano-HA within the body is still unknown. Degradation products of nanomaterials are potentially cytotoxic. Thus, it is essential to assess biocompatibility before their usage in clinical applications.

Purpose of this research is to evaluate toxicity of hydroxyapatite nano particles on the human peripheral blood mononuclear cells.

In this experimental study, nano sized, rod-like hydroxyapatite particles sterilizalied then HPBMCs were cultured on 96-well plate. Cells were exposed to Nano-HA at the following concentrations: 15.5, 32, 65, 125, 250, 500, 1000, 2000, 4000, 8000 ppm. Later, For measuring the cell vitality, MTT method was utilized. Measuring the photo absorption was done by ELISA READER system at 570 nm, which evaluated the vitality of cell by the value of MTT absorption cells. The statistical ANOVA test was used in this study

All of drug concentration were effective in Loweriy eellular biologic ectivity but none of them were statis fically significant.

Therefore as a conclusion we can adjudicate that "Nano-HA" biomaterial is the material which is compatibility with the human blood mononuclear cells.

Given the different prevalence of accessory spleen in previous studies and no information about its rate of detection and also its known side effects, this study was designed to determine the prevalence and associated factors of accessory spleen among patients referred to a CT scan center in Tehran between 2008 and 2010. In this cross- sectional study, all patients with different indications of abdominal CT scan with the CT multidetector were studied. Frequency of accessory spleen in abdominal CT scan was evaluated and its prevalence with 95% confidence interval in the population was estimated. Characteristics of the accessory spleen, including size, density, shape and location, were evaluated. prevalence accessory spleen in 851 eligible patients was 10.6%. Mean (± SD) age was 55.5± 13.3 years and 55.6 percent were women. One hundred eleven spleens were detected in 90 patients. In 90.1% of cases, size of accessory spleen was more than 10 millimeter. Majority of cases which includes 60% of them were located next to hilum. Also, 90.1% of cases were isodense. It seems that prevalence of accessory spleen in Iran is less than other countries. Although uncomplicated accessory spleens are asymptomatic and incidentally discovered, radiologists should be aware of accessory spleens and their characteristics and should consider them in the differential diagnosis of unclear perisplenic masses.

Hydroxyapatite (Ca10(PO4)6(OH)2) is an important biomaterial in medical and dental applications. Due to low solubility of its particles, it has had little application in bone reformation. For this reason, nanohydroxyapatite (Nano-HA) with a higher surface area and higher solubility has attracted the attention of researchers as an effective strategy for bone grafting purposes. There have been controversies regarding biocompatibility of the latter particles. The purpose of this research was to evaluate the biocompatibility of nano-HA on L929 fibroblast cells.

In this experimental study, nano-sized, rod- like hydroxyapatite particles sterilized, then L929 fibroblast cells were cultured on 96-well plate. Cells were exposed to nano-HA at the following concentrations: 15.75, 32, 65, 125, 250, 500, 1000, 2000, 4000, and 8000 ppm. Later, for measuring the cell toxicity of the material, MTT method was utilized to measure the absorption, which evaluated the viability of the cells for each concentration and time point. The statistical ANOVA test was used in this study.

Results of this study showed that although cell viability decreased by increasing concentration and time but ANOVA analyze indicated that there was no significant difference between the groups (p>0.05).

The results indicate that “Nano-HA" biomaterial has acceptable compatibility with L929 fibroblast cells.

We prepared this study to determine the effect of cryoanalgesia on post-thoracotomy pain. In this double-blinded randomized clinical trial, 60 patients who underwent thoracotomy were divided into two groups (control and cryoanalgesia). Visual Analogue Scale (VAS, 0-10) was used for the measurement of severity of post-thoracotomy pain. It was classified into three categories: 0-1 (mild), 2-3 (moderate), and 4-10 (severe). Pethidine (0.5-1 mg/kg) was administered in case of need for both groups. Patients were visited at the hospital a week later, and were contacted by phone at the first, second, and third months post-operatively. Intensity of pain in the control group was higher than the cryoanalgesia group in all visits the follow-up period. On the second day, the frequencies of severe pain (4-10) were 33.3% and 0 in the control and cryoanalgesia groups, respectively. The mild pain on the seventh day was 13.3% and 83.3% in the control and cryoanalgesia groups, respectively (P < 0.01). Pethidine consumption was 151.6 ± 27 mg in the control group and 87.5 ±48 mg in the cryoanalgesia group on the first day post-operation (P < 0.001). Cryoanalgesia is a useful technique with not serious side effects in order to alleviate post-thoracotomy pain and reduce the need for opiate consumption.

As most researchers are unaware of the quality of articles published in scientific journals of nursing-midwifery, findings from these studies are not used in clinical practice. This study was conducted to evaluate the accuracy of articles published in nursing-midwifery journals in Tehran in 2008 as regards design and methodology of writing a scientific paper. In this cross sectional study, all original articles published in scientific journals of nursing-midwifery in Tehran in 2008 were evaluated. Research methodology in different sections of articles including, abstract, introduction, methods and materials, results, discussion and references were assessed. Totally, 52 criteria were taken into consideration, articles were evaluated on the basis of these criteria and classified into 3 categories of “correct”, “relatively correct” and “incorrect”. Data analysis was done by chi-square. Eighty three original articles published in 3 selected journals were evaluated. On the whole, format of the papers was correct in 45% of articles, in 8% it was relatively correct and in 47% the presenting format was incorrect. Inaccuracies found in the incorrectly written articles were found in the following sections: abstracts 53%; introduction 69.7%, methods and materials 32.2%; results 45.4%; discussion 48% and references 25.3%. Articles published in nursing-midwifery journals have major flaws. Implementations for reducing mistakes in article writing would result in increasing application of the study results.

Endometrial cancer is the most frequent cancer in the female genital system. Nowadays outpatient diagnostic procedures like pipelle and uterobrush have facilitated the diagnosis and treatment of endometrial cancer in early stages in high-risk patients. This study has been done to compare the accuracy and tissue sufficiency of biopsy by pipelle and uterobrush.

Between 2005 and 2007, 70 candidates admitted for hysterectomy in Imam Hossein Hospital entered a clinical trial study. Under local or general anesthesia, biopsies were taken by pipelle and then uterobrush or vice versa. The order of using pipelle and uterobrush was selected randomly. The samples were sent to the pathology department and examined by an expert pathologist. The results of endometrial biopsies by pipelle and uterobrush were analyzed. After that the cases were grouped (each group consisted of 35 patients) according to the order of using the pipelle and uterobrush.

The endometrial samples sufficiency from uterobrush and pipelle were 68.1% and 87.1%, respectively. The positive predictive value of pipelle was 100% and negative predictive value was 84%. These values for uterobrush were 100% and 90% respectively.

It seems that pipelle is better for obtaining sufficient size samples. However in sufficient samples, uterobrush has higher sensitivity and accuracy. Order of using pipelle and uterobrush caused no significant difference in the results.

Abstract Backgraound: Regarding to increasingly prevalence of total hip arthroplasty and no information about its results in Akhtar hospital, this study was conducted in patients referred to Akhtar hospital between 1985 and 2005. This study was performed on existing data. Patients records, including age, sex, indication of surgery, applying cement, 10-year survival according to radiologic and clinical evaluation, and Haris Hip Score (HHS), were studied. Patients with at least one-year follow up were evaluated. 10-year survival was calculated and effects of associated factors were analyzed using chi-square or exact Fisher tests. 235 hips from 210 patients with mean age of 55.5±16.8 years were operated. 49 percent were male and 51 percent were female. According to applying or not applying cement, and also type of evaluation (clinical and radiographic), 10-year survival was measured between 60 and 85 percent (p<0.2). HHS was calculated as 78.8±15.7. Surgeon, type of surgery and body mass index (BMI) didn’t affect on therapeutic outcome. Survival rate of total hip arthroplasty was lower in Akhtar hospital compared with other centers and further studies were recommended to find causes of these differences.

The prototypical injury of the median nerve at the wrist is either an acute or chronic compressive lesion referred to as carpal tunnel syndrome (CTS). The present study was conducted to determine the individual risk factors for carpal tunnel syndrome (CTS) in subjects referred to Department of Physical Medicine and Rehabilitation of Shoha-Tajrish Hospital.

A cross sectional study was performed on 1000 patients with upper limbs pain, among whom 250 cases (34 men and 216 women) aged 18-69 years were diagnosed to have CTS on basis of clinical history and electrodiagnostic criteria. Following factors were compared between CTS patients and controls: body mass index (BMI), wrist A-P/M-L diameter, occupation, average daily hours of computer use, history of steroid use, family history, diabetes mellitus, thyroid disease, chronic heart failure, renal failure, history of wrist and distal radius fracture, smoking, alcohol drinking, use of OCP, history of hysterectomy, pregnancy, menopause, radiculopathy, associated rheumatologic disease and other soft tissue rheumatism.

The frequency of CTS among the studied subjects was 25%. Mean BMI was higher in patients with CTS in both genders (p<0.000), but increasing of BMI excess 30, didn’t raise the risk of CTS (NS). Wrist (A-P/M-L) dimension was found to be higher in CTS group (p<0.05). Steroid use was 2% in control group and 8% in CTS group (p<0.05). Colleś fracture was only reported among 2.4% of CTS subjects (p<0.05). Diabetes mellitus was 4% in controls versus 11.2% in CTS group (p<0.05). Severe CTS was associated with the following factors: BMI≥25, WD>0.7 and duration>6 month, female gender, and diabetes mellitus and Colleś fracture, in both genders.

The prevalence of syndrome was quite high, therefore, supplementary investigation should be performed. The wrist A-P/M-L dimension was higher in both genders of CTS group, thus we suggest wrist A-P/M-L dimension as a risk factor for CTS, however it could be explained as a consequence of CTS pathology.

Since neutropenic patients with malignancies are at high risk of contracting life-threatening infections, reliable and readily available parameters to diagnosis or rule out infection are of utmost importance. The objective of the present study was to determine the accuracy of procalcitonin (PCT) compared with culture to predict bacterial infection in children with febrile neutropenia. Blood culture and serum procalcitonin level were investigated in all studied febrile neutropenic children. Bacterial infection was defined as children with positive blood cultures or serum procalcitonin level of >0.5ng/ml. The study population included 29 boys and 22 girls with the mean age (±standard deviation) of 6±3.5 years. PCT differed significantly between bacterimic and non-bacterimic episodes for the prediction of bacterimic patients. The associated positive predictive value (PPV) and negative predictive value (NPV) of procalcitonin test (in diagnosis of bacterial infection) were 50% and 97/4%, respectively. A rapid determination of procalcitonin concentration could be useful for early diagnosis of children with febrile neutropenia since the test showed an acceptable NPV.

There are some defects in classification of scorpions. This review is focusing on the diagnostic clue for classification and statement of defects. Classification of scorpions has been varied during 5 years ago, repeatedly. By searching the internet, Journal's data bank and specific references, we reviewed 37 articles to design a diagnostic clue for classification. This diagnostic clue can be used to classify scorpion's species.

Tuberculosis (TB) is a common disease in our society for which acute diagnosis is rather a time-consuming process. Early diagnosis is of utmost importance. Cold agglutinin could serve as a diagnostic modality in patients with TB, thus, the present study was conducted to determine the efficacy of this test in patients with TB and their control group hospitalized in Shaheed Beheshti hospital in Kshan. The study population included 36 cases of TB and 65 non-TB patients. Blood sample (1ml) was obtained and cold agglutinin test was achieved on bed side. Positive agglutinin test was defined as clumping of RBCs in test tube walls and graded as +1 to +4. Absence of RBC agglutinin was considered as negative test result. Finally, sensitivity, specificity, positive and negative predictive values (PPV, NPV) of cold agglutinin was determined in accordance to the definite diagnosis of TB. The TB group included 18 males and 18 females with the mean age of 50.8 years (13-86 years), of whom, 69.5% had pulmonary TB and 30.5% had extra pulmonary TB. If strongly positive cold agglutinin test results are considered, it may have sensitivity of 44.4%, specificity of 98.5%, PPV of 94.1%, NPV of 76.2% and total accuracy of 79.2%. However, if relatively positive results (grade <+3) are considered the sensitivity and specificity may change, improving sensitivity up to 89%. Cold agglutinin test has an acceptable PPV for TB diagnosis. Thus, it could be used as a screening test or as a diagnostic modality in early stage of the disease or even to evaluate the success of treatment.

With respect to the prevalence of traumatic hyphema and its well-known complications, a thorough study should be accomplished to draw appropriate therapeutic approaches. The present study was conducted on patients with traumatic hyphema hospitalized in Farabi hospital during a four-year period (1995-99). For this existing type data study, all medical files of patients with traumatic hyphema hospitalized in our center were reviewed. Initial data including sex, age, visual acuity, severity of hyphema, increased intraocular pressure, and secondary bleeding were recorded. The study population included 195 patients (76.4% males and 23.6% females) with the mean age of 17.3 years. Total hyphema was reported in 61%, increased intraocular pressure (>25mmHg) was found in 44.1% and visible secondary bleeding were reported in 16.9%. Poor vision of less than 1/10 was recorded in 88.2% of the patients. Traumatic hyphema is more common in young males presenting with poor vision. Most of the cases were total hyphema with increased intraocular pressure. Prevention of eye-related trauma should be concerned

Jaundice is of the most important signs of septicemia, meanwhile, it could be one the presenting signs of neonatal urinary tract infection (UTI). Physicians may request blood and urine culture for jaundiced but otherwise healthy neonates, thus the present study was conducted to determine the incidence of septicemia and UTI in newborns with jaundice hospitalized in Mofid hospital. For this descriptive study, 750 jaundiced but otherwise healthy neonates were selected. Urine (by suprapubic approach) and blood samples were obtained for culture. The mean weight, age, and billirubin level of the subjects were 3228±408gr, 4.95±3.87 days, and 20.7±3.6mg/dl, respectively. We have founf no positive blood culture, but 4 positive urine culture. They were discharged following a successful treatment. Blood and urine cultures are not necessary for jaundiced neonates and may lose our time and energy.

Burger disease is a relative common problem. The present study was conducted to determine the clinical features of Burger disease in patients referring to Taleghani hospital between 2000 and 2001. It was a descriptive study. Diagnosis was made according to the clinical manifestations and angiographic studies. Finally, clinical features, and other demographic characteristics were recorded and analyzed using descriptive statistics. There was 42 patients with Burger disease, all of whom were male with the mean (±SD) age of 35.9±2 years. All of the subjects were smokers. 71% were addicted and 54.8% have been smoking for 10-20 years. 77.3% had low educational level and 69% were belonged to low-health status class. Pain on rest (81%), ischemic ulcer, claudication, gangrene, migrating thrombophlebitis, and upper limb pain were the most common symptoms. Our study revealed different clinical profile as compared to western societies. Low socioeconomic status is associated with greater risk of Burger disease. Further studies are highly suggested.

Burger's disease has various presentations. During the present study we have determined the clinical manifestations of Burger's disease in a group of patients referring to Taleghani hospital in 2000-01. It was a descriptive study. Diagnosis was confirmed in accordance with clinical manifestations and angiography. Patients’ clinical signs and symptoms as well as other demographic data were recorded. 42 patients with definite diagnosis of Burger's disease and the mean age of 35.9±2 years were included. All were male and smoker. 71% had addiction and 54.8% had previous history of smoking for more than 10-20 years. Poor health status was reported in 69%. Clinical manifestations were: Resting pain (81%), ischemic ulcer, intermittent claudication, thrombophlebitis and upper limb’s pain. Our patients’ clinical signs and symptoms have differed with reports of western societies. Poor socioeconomic and health status are the major risk factors. Further studies are highly recommended.

History and Considering the high incidence of breast cancer and its known prognosis and the existence of controversies on the role of patient’s age, tumor malignancy and its prognosis, this study was carried out on referrals of Mostafa Khomeini, Shohadayeh Tajrish and Loghman Hakim from 1993 to 1999. The case-control strategy of this study was conducted on 200 patients with breast cancer. In this respect, 100 cases with lymphatic involvement and tumor size greater than 2.5 cm were selected as bed prognosis (Case group) and 100 cases were selected as good prognosis (Control). Then, their age was determined and tumor malignancy was determined using Bloom-Richardson criteria and they were selected as I, II and III groups. For statistical analysis, student’s t-test and X² test were applied and O.R. was determined for patients and population. This study was conducted on 200 patients in control (n=100) and case (n=100) groups. The age of control and case groups was 42.5±8.8 and 53.4±12.2 years respectively with a difference of 11 years between them (P<0.001). In addition, it was found out that breast cancer at ages greater than 50 years increases the risk of malignancy 17-fold. Meanwhile, malignancy type III relative to type I is more effective for the development of malignancy (5.6-fold) (P<0.0005). Conclusion and Recommendations: It is concluded that age and malignancy play an essential role in the development of tumors with bad prognosis. It is recommended to apply preventive measures for known malignancies.

History and Considering the role of episiotomy in normal parturition and the existence of different views on its sterilization, this study was carried out on episiotomy wound healing referrals of Ziaian hospital in 1998. The clinical trial strategy of this study was conducted on 100 cases. They were randomly divided into betadine (n=50) and water (n=50) groups and were similar regarding age, weight to height ratio, health status, head periphery, labor duration, number of sutures and type of method. The efficacy was determined according to wound healing, redness, infection and suture absorption at first, fifth and tenth days post-operation. Patients were similar regarding personal, sociological and disorder status. Swelling less than 1cm at first and 5th days was 56% and 60% in betadine group and 46% and 62% in water group. Swelling less than 1cm at 10th day was 68% in betadine group and 40% in water group. Redness less than 3mm was 60%, 46% and 68% respectively, but it was 60%, 38% and 66% in water group. Absorption of skin stitches at 10th day was 46% in betadine group and 52% in water group. There were no signs of wound opening and infection in both groups. There were no significant differences between the above-mentioned criteria. Conclusion and Recommendations: Betadine has no effect on wound healing after episiotomy and there is no indication for its usage.

History and Considering the incidence of ulcer infection within incision area and its complications and a similar condition in perforated and gangrenous appendicitis and the efficacy of local application of antibiotics in reduction of infection, this study was carried out to evaluate the effect of ampicillin washing in incision area. The clinical trial strategy of this study was performed on two groups for patients incised with McBorni method. All of the patients received intravenous injection of metronidazole and gentamicin one day before operation and for 7 consecutive days therefore received ciprofloxacin and were followed up for a period of 1 month. For healing, control group was washed with normal saline and experimental group washed with saline solution and ampicillin. A total of 74 patients in two groups (n=37) were studied and they were alike regarding age and gender. The incidence rate in control and experimental group was 13.5% and 10.8% respectively that was non-significant statistically. In addition, age, gender and type of complication played no role in infection. Meanwhile, a thickness greater than 2cm for subcutaneous tissue can increase the incidence rate. It is concluded that ampicillin washing in comparison to saline itself can not affect the incidence of infection. It is recommended to perform more studies on ulcers with a subcutaneous thickness greater than 2cm.

History and Considering the incremental trend for the incidence of trauma and the existence of little information and much controversies in this field, the present study was carried out on referrals of Farabi hospital in 1999. The descriptive and sequential sampling strategy was carried out on hospitalized patients with definitive diagnosis of trauma. For this purpose the personal characteristics and condition were evaluated regarding the cause of trauma, its kind, the ensuing lesion and post-traumatic vision. A total of 150 patients were studied and the incidence rate for post-traumatic hospitalization was 3.2%, that is in the ages 16.3 respectively 14.5 from a minimum 3 months to a maximum 70 years and with a ratio of 2.7/1 for males to females. The most common causes of trauma were stone (14%), wood (13.3%) and knife (8.7%) and the most prevalent lesion was corneal rupture (77.3%), scleral rupture (30%), traumatic cataract (25.3%) and iris prolapse (25.3%). Since the patient’s characteristics, the causative agent and condition of trauma is different from other countries or in comparison with references, therefore it is recommended to perform more intense research in this field by other universities and their affiliated hospitals and to find the most appropriate method to involve in a general training program.

History and Considering the concern for ways of application of WHO guidelines and the problems as a result of not executing these items and for determination of tendency of pediatricians for applying the suggested protocols for acute gastroenteritis, this study was carried out on pediatricians who participated in a yearly congress in 1999. The descriptive and cross-sectional strategy of this study was randomly performed on 95 pediatricians who had graduated more than 10 years. In this regard, a 19-item questionnaire was prepared containing questions on personal characteristics, knowledge, information on gastroenteritis, use of ORS and feeding pattern for acute gastroenteritis and their answers were analyzed according to WHO guidelines. Out of 95 selected cases, 87 ones answered all of the questions and their age was 44±17 years and a working record of 17±6. In addition, 73% of them had enough information, but only 60% of them applied WHO guidelines. Meanwhile, 69% of them had enough information regarding use of ORS and 83% had an appropriate tendency for using ORS. Theoretically, 31% of these specialists and practically, 37% of them showed controversial views regarding the continuous use of foodstuffs during the period of acute diarrhea as recommended by WHO. Application of WHO guidelines have not been executed for continuation of feeding during the acute phase of gastroenteritis. Therefore, it is recommended to explore the causative factors and to perform the necessary procedures for quality upgrading.

Considering the significance of continuous medical education and its role in the quality of the presented health and treatment services, and the holding of more than 3000 of such programs, this study was carried out to determine the effect of continuous medical educational program regarding renal stones during the years 1997-1998. In this study, the educational trial strategy was carried out on 100 physicians having their offices in Tehran. In this respect, the effect of training was evaluated on the knowledge, perspective, and way of management of physicians before and after stone ejection, renal colic pain, and its diagnosis. For this purpose, the trained medical students as false patients ( one week before and two months after the program) referred to the offices. The level of knowledge was measured using a 29-item and four-choice questionnaire. For perspective, a 10-item questionnaire was used according to Likert score. The influence of programs was assessed by McNemars, Sign, and Chi-square tests. Out of I 00 studied patients, the data was complete only for 80 ones. In this respect, 19 (24%) were female and 61 (76%) were male at an age range of 43.2 ± 12.5 years and a period of 14.5 ± 11.9 years has passed from their graduation. It was shown that the training program was successful in improvement of knowledge and perspective, even for the total period of the study (P<0.001). In addition, only the way of management showed a significant and successful improvement. In this regard, the serum administration had been reduced significantly (P<0.01) in patients with colic pain. It is concluded that the contents of training programs in proportion to the requirements can upgrade the knowledge and perspective and in this way can affect the efficiency of physicians and other methods should be applied for alteration of behavior.