Search

Background: Chamomile and flaxseed are traditionally used medicinal plants to treat painful menstruation. Therefore, this study aimed to investigate the effects of chamomile and flaxseed on pelvic pain, dyspareunia, and dysmenorrhea in endometriosis patients. Materials and Methods: A controlled randomized clinical trial was conducted on 102 endometriosis patients referred to Reyhane Infertility Center of Qom University of Medical Sciences, Iran, from July 2021 to March 2022. Patients were divided into three groups: chamomile, flaxseed, and placebo, using the block randomization method. Patients used 1000 mg capsules (three times a day) for 8 weeks. A Visual Analog Scale (VAS) was used to measure the severity of pain. Pelvic pain, dyspareunia, and dysmenorrhea were assessed on three occasions Data were analyzed using the Chi-square, repeated measures ANCOVA, and ANOVA. All statistical analysis was performed using SPSS version 20. Results: Before the intervention, there was no significant difference between the three groups regarding dysmenorrhea, pelvic pain, or dyspareunia (p > 0.05). The mean score of pelvic pain (on one and two-month follow-ups) in the chamomile and flaxseed groups (F = 383.07, p < 0.001) was lower than that in the placebo group. The mean score of dyspareunia (on one and two-month follow-ups) in the chamomile and flaxseed groups was significantly lower than that in the placebo group (F2 = 479.34, p < 0.001). The mean score of dysmenorrhea on one and two-month follow-ups (F2 = 385.67, p < 0.001) in the chamomile and flaxseed groups was lower than that in the placebo group. Conclusions: Chamomile and flaxseed may reduce pelvic pain, dyspareunia, and dysmenorrhea associated with endometriosis.

Abstract Background and objectives Mineral Trioxide Aggregate (MTA) is one of the main retrograde filling materials that is used today as a root end filling material and perforation repair material. This study was conducted with the aim of investigating the antibacterial and antifungal properties of four types of bio-ceramic materials, AGM MTA, Ortho MTA, Pro root MTA and Cem cement for oral and dental health. Methods In this study, the antibacterial activity of four types of bio-ceramic materials against two bacterial strains of Enterococcus faecalis (ATTC 29212), Escherichia coli (ATTC 35318) and antifungal activity against Candida albicans (ATTC 10231) were investigated using the well diffusion method. Results In the context of the relationship between the type of microorganism and the diameter of the growth inhibitory zone for each type of bio-ceramic material, there was no significant difference for Enterococcus faecalis, and a significant difference was observed for Escherichia coli and Candida albicans (p

Background and purpose: Lasers are of great importance in dentistry and have shown positive results in surface conditioning of ceramic brackets. The aim of this study was to compare the effect of two surface conditioning method, Nd:YAG laser and sandblasting on shear bind strength (SBS) and (adhesive remnant index (ARI). Materials and methods: This experimental study was conducted in six groups of zirconia blocks to get prepared by laser (LG1-LG2-LG3) or sandblast (SG4-SG5-SG6). Two debonding methods, including conventional (LG3-SG3) and Nd:YAG laser (LG2-SG2) methods were used for zirconia blocks. SBS and ARI indices were compared between the two methods using ANOVA and post-hoc test. Results: The mean SBS did not show significant difference between LG1 and SG4 groups (8.2±2.04 and 7.1±1.5, respectively, P=0.228). ARI did not show significant difference between LG2 (3.1±0.8) and SG5 (3.5±0.7) groups (P=0.129) and between LG3 and SG6 (2.3±0.7 and 2.7±0.5, respectively, P=0.219). ARI was found to be significantly different between LG2 and LG3 (30.1±0.8 and 2.3±0.7, respectively, P =0.011) and between SG5 (3.5±0.7) and SG6 (2.7± 0.5) (P=0.024). Conclusion: Nd:YAG laser can be considered a suitable alternative for zirconia surface conditioning and debonding ceramic brackets from zirconia crowns.

Background: Studies show that leaving the hospital with personal consent is increasing. This phenomenon has unpleasant and sometimes irreversible consequences. This study aims to investigate the causes and consequences of leaving the hospital with the personal consent of patients referred to the emergency department of hospitals affiliated with Qom University of Medical Sciences in 2021. Materials and Methods: In this descriptive-analytical study, 345 patients were selected who, with personal consent, left the emergency department of selected hospitals affiliated with Qom University of Medical Sciences in 2021. The study data were collected via a questionnaire and a checklist. The questionnaire comprised demographic variables, patient-related factors, personnel-related factors, and hospital-related factors. The checklist of the consequences included questions about leaving the hospital with personal consent. The data were analyzed using descriptive and inferential statistics in SPSS software, version 20. Results: Of 345 patients included in the study, 55.9% were male and the mean age of patients was 47.1 years. The most important reasons for leaving the hospital with personal consent were as follows: personal reasons (22.9%), fear of continuing treatment (11.9%), preference to continue the treatment in other medical centers (9.3%), the suggestion of other hospital staff (35.1%), not having the desired doctor (27%), nurses’ suggestion (19.4%), lack of care (20.4%), and inadequate hospital space and facilities (14.0%). The consequences of leaving the hospital with personal consent in this study included re-admission and hospitalization (10.3%), mortality (3.4%), heart disease (0.87%), and mental disorders (0.57%). Conclusion: After identifying the reasons for leaving the hospital with personal consent and highlighting the irreparable human and financial consequences, these causes should be eliminated to prevent irreparable and unfortunate consequences. Such causes include personal reasons, fear of continuing the treatment, and lack of care. Fixing the causes requires proper planning and effective actions.

Background and Objectives: Empathy is one of the most important concepts in patient care. This study aims to design and implement an early patient contact program and investigate its effect on the empathy of medical students in Qom, Iran. Methods: This is a case-control interventional study. Sixty-four students from Qom University of Medical Sciences were recruited by a convenience sampling method and were randomly divided into intervention and control groups. The instrument was the Jefferson Scale of Empathy. First, empathy training was provided to the both groups. Then, the intervention group participated at three sessions of attending hospital. The collected data were entered into SPSS software, verion 22 and analyzed by chi-square test and paired t-test. Results: There was no significant difference between the two groups before the intervention. After the intervention, the empathy score was 74.04±10.32 in the intervention group and 68.31±8.14 in the control group; the difference between the groups was statistically significant. Conclusion: Early patient contact before the start of the internship period increases the empathy of medical students.

Abstract Introduction SARS-CoV-2 causes more severe symptoms in most chronic diseases, and rheumatic disease is no exception. This study aims to investigate whether there is an association between the use of immunomodulatory medications, including conventional disease-modifying agents (csDMARDs), glucocorticoids, and biologic DMARDs, and outcomes such as hospitalization and lung involvement in patients with rheumatic disease with COVID-19. Methods We performed a cross-sectional study on 177 COVID-19 cases with rheumatologic diseases using immunomodulatory drugs as their regular treatment. All patients were evaluated regarding their initial chest computed tomography (CT) scan, COVID-19 symptoms, and comorbidities. We ran predictive models to find variables associated with chest CT-scan involvement and hospitalization status. Results CT findings showed lung involvement in 87 patients with chest CT-scan severity score (C-ss) of less than 8 in 59 (33%) and more than 8 in 28 (16%) of our patients. Of all patients, 76 (43%) were hospitalized. Hospitalized patients were significantly older and had more comorbidities (P = 0.02). On multivariate analysis, older age [odds ratio (OR) 1.90, 95% confidence interval (CI) 1.31–3.08] and comorbidity (OR 2.75, 95% CI 1.06–3.66) were significantly associated with higher odds of hospitalization (P = 0.03). On multivariate analysis, older age (OR 1.15, 95% CI 0.94–2.01), pulmonary diseases (OR 2.05, 95% CI 1.18–3.32), and treatment with csDMARDs (OR 1.88, 95% CI 0.37–1.93) were associated with higher C-ss (P = 0.039). Conclusions This study found that advanced age and comorbidities, similar to the general population, are risk factors for hospitalization in patients with COVID-19 with rheumatic disorders. Administration of csDMARDs, older age, and pulmonary disorders were linked to increased risk of COVID-19 pneumonia in these individuals.

Background: Idiopathic thrombocytopenic purpura (autoimmune), the most common cause of acute onset of thrombocytopenia in children who are otherwise healthy. This study was conducted with the aim of investigating the factors affecting the response to treatment in hospitalized children. Methods: This retrospective study was conducted by examining the files of patients hospitalized due to ITP in Hazrat Masoumeh (S) Hospital from April 2009 to March 2019. The criteria for inclusion in the study included confirming the diagnosis of ITP and the age of 1 month to 14 years, and the exclusion criteria included cases of discharge with personal consent and not completing the patient's treatment course, the presence of pancytopenia or bicytopenia, the presence of moderate or severe splenomegaly or severe in clinical examinations, BMA based on the presence of a diagnosis other than ITP, not receiving any of the ITP treatment protocols, and patients whose first visit with the diagnosis of ITP was in another center or city. The information about age, sex, clinical symptoms on arrival, initial platelets and the platelets of days 3, 5, 14 and 180 were extracted from the patients' files. The type of treatment protocol, the need to repeat the treatment, the recurrence of the disease and the major complications of the treatment were extracted from the patients' files and finally the data were analyzed with SPSS software. Results: The response to the treatment on different days was unrelated to the age, gender, and initial platelets (except for one exception) (P>0.05). In relation to clinical symptoms, the response to treatment on days three and five was related to the clinical symptoms at the time of presentation and on days 14 and 180 it was unrelated. Response to treatment on days 3 and 5 in different treatment protocols had a significant relationship (P

Introduction: Schizophrenia is a complex mental disorder, and one of the variables that are important in people with schizophrenia is emotional self-regulation. On the other hand, another study has shown that there is a relationship between emotion regulation disorder and ambiguity intolerance. Aim: The purpose of this study was to investigate the relationship between emotion regulation and meta-concern in the tolerance of ambiguity in patients with schizophrenia. Method: The present study was a correlational study and a cross-sectional study was conducted. The research population was schizophrenic patients referred to the Forghani-Nekoui Psychiatric Center in Qom in 2020. The sample of the study was 141 hospitalized patients or referred to a psychiatric center, which were selected using the convenience sampling method. In order to collect information, Questionnaires on Difficulty in Emotion Regulation Scale, Wells' Metacognitions Questionnaire and Ambiguity Tolerance Questionnaire were used. Research data were analyzed using pathway analysis with PLS software. Results: The average score of the difficulty in performing purposeful behaviors in times of helplessness was 54.1±21.63 and the average score of the difficulty in controlling impulsive behaviors in times of helplessness was 67.27±19.27. The average score of the ambiguity tolerance questions was 25.12±4.32. No significant relationship was found in the relationship between the variables, difficulty of emotion regulation and transcendence, difficulty of emotion regulation and tolerance of ambiguity. The only significant relationship was shown between the effect of meta-worry on the ambiguity tolerance (P=0.049). Conclusion: Therefore, it can be concluded that these patients, as mentioned, have less capacity to tolerate ambiguity and meta-worry. It is suggested to pay more attention to these aspects in the treatment of schizophrenia patients.

Abstract Background Rheumatoid arthritis (RA) is one of the most common chronic non-organ-specific autoimmune diseases; meanwhile, autoimmune thyroid disease (AITD) is the most common organ-specific autoimmune disease that can lead to hypo or hyperthyroidism. Although the etiology of both diseases is complex with a combination of genetic and environmental factors, there are overlaps in genes contributing to the pathogenesis of both diseases. Numerous studies found a correlation between thyroid abnormality and RA in different populations, yet some didn’t. This study is aimed to evaluate the prevalence of thyroid dysfunction, AITD, and anti-thyroid peroxidase (anti-TPO) positively in Iranian patients with RA. Methods A total of 250 RA patients and 248 patients with non-inflammatory rheumatologic disease were included in this case–control study. All participants underwent complete clinical and laboratory assessments. Participants were also assessed for thyroid function testing, including anti-TPO antibodies. Results Thyroid dysfunction was twice as common in RA patients as in controls (OR = 2.16; P-value > 0.001). Overt hypothyroidism was the most common thyroid dysfunction among RA patients (58 out of 84). Anti-TPO positivity was also significantly more common in RA compared with controls (OR = 2.65; P-value > 0.001). The proportion of controls and RA patients with AITD were 9 and 21.5%, respectively. AITD was found 2.8 times more common in RA group than controls (OR = 2.77; P-value > 0.001). Conclusion It was demonstrated that RA was an independent factor associated with thyroid dysfunction and AITD.

Abstract Background Compared to the healthy population, the psychological impact of rheumatoid arthritis(RA) on patients' lives could dramatically lower their oral health-related quality of life (OHRQoL). Our goal is to analyze OHRQoL in RA patients and look into the role of disease activity, dental health index, and Temporomandibular disorders score in maintaining their oral health. Methods In a cross-sectional comparative study, we compared a sample of 40 RA patients with 40 age- and gender-matched healthy controls in terms of oral health and OHRQoL. Temporomandibular disorders (TMD), number of decayed, filled, or missing teeth (DMFT), and Oral Health Impact Profile (OHIP) were among the oral health factors studied (OHIP-14). This study also looked at the link between the RA disease activity score (DAS28) and oral health factors. Results RA patients had a significantly higher mean (poorer OHRQol) than healthy controls in total oral function, total psychosocial impact, OHIP-14 sum score, OHIP-14 extent score, TMD score and the number of missed teeth (Mann–Whitney U test, P-value

Abstract Background Helicobacter pylori infection is one of the most common infectious diseases in humans. Dental plaque is considered as a reservoir of this bacterium, which could play an important role in the development of gastrointestinal problems. Our aim was to investigate the prevalence of H. pylori and its virulence factors in dental plaques in children with and without dental caries. Methods Among children aged 6 to 12 years, a total of 72 children were enrolled in the study, including 36 cases with total DMFT/dmft > 3 (case group) and 36 participants with total DMFT/dmft

Background and Objectives: Undoubtedly, breaking bad news is one of the most difficult duties of a doctor. Not having this skill and not paying attention to its details can result in poor patient satisfaction, psychological morbidity, and weak clinical decisions. The present study was conducted to investigate the medical students’ perspectives about delivering bad news to patients. Methods: A cross-sectional study was conducted using a questionnaire for all medical students of Qom University of Medical Sciences, Iran. A total of 269 out of 310 students responded to this survey (86.8% response rate). The questionnaire was designed and validated by ten medical ethics experts. Results: In this study, 54.4% of students believed that delivering bad news to patients depends on the patient’s compliance and condition and 55.8% of the participants believed that patients’ families should be the first recipient of the bad news. In addition, 54.3% believed that physicians should deliver the bad news. A total of 78.8% of the participants believed that breaking bad news should be accompanied by empathy and hope Also, 47.6% of students said that they did not receive training about breaking bad news. Conclusion: Breaking bad news is a balancing act that requires doctors to constantly adapt to different factors. Although most medical students were keen to help their patients, they lacked the essential knowledge and skills for breaking bad news. Development of strategies and guidelines is needed to improve societal views, and train physicians about breaking bad news.

Background and Objectives: Multiple sclerosis is an autoimmune disease characterized by inflammation and demyelination of the central nervous system. About half of patients with MS complaint of sleep disorder which could be an indicator of the quality of life. The present study was conducted to evaluate the prevalence of sleep disturbances in patients with multiple sclerosis in Qom province. Methods: We included 120 patients from the MS community list and assessed the participants based on the demographic, Pittsburgh sleep quality index (PSQI) and Global Sleep Assessment (GSA) questionnaire. Data were analyzed using SPSS v. 23 software. Results: We showed that the majority of our patients (74.2) were women with a Mean±SD age of 33.95±8.01 years old. 90(75%) of our patients suffered from at least one sleep disturbance in which difficulty initiating or maintaining sleep were the main complaints. Age was estimated to be the main independent factor significantly associated with sleep disturbance. Except the gender, other studied variables had a considerable impact on certain types of sleep-related disorders. Conclusion: As sleep disorders is frequent and mainly undiagnosed in patients with MS, it is necessary to routine evaluate the patients for sleep disorders.

Background and Objectives: According to hazardous infection possibility in patients with a weakened immune system, old adults, and children, microbial contamination in the waterlines of dental units has become a recent concern. The aim of the present study was to evaluate the microbial contamination in dental unit waterlines in the School of Dentistry, Qom University of Medical Sciences, Qom, Iran. Methods: This descriptive-analytical study investigated 94 water samples collected from three parts of each unit, including air/water syringe, turbine headpiece, and cup filler, in the School of Dentistry in 2019. The water samples were taken on Saturday and Wednesday before and 60 sec after flushing on the same unit. The samples were transported in closed sterile containers to the Microbiology Laboratory. All the samples were incubated on nutrient agar plates using the Spread plate technique. Subsequently, bacterial contaminations were counted and reported based on CFU/ml for every plate. The data were analyzed using the Kruskal-Wallis test and Wilcoxon signed-rank test by SPSS software version 25. Results: The total mean of the bacterial counts was reported as 16,457 CFU/ml. The pre-clinic and periodontics were reported with the highest and lowest bacterial counts, respectively. The mean of bacterial counts after flushing was significantly lower than that reported before flushing on the same unit (P

Background and Objectives: Thyroid dysfunction and rheumatoid arthritis (RA) are autoimmune diseases that can cause many problems and complications in patients. Accordingly, this study aimed to investigate thyroid disorders in patients with rheumatoid arthritis. Methods: Thyroid hormones, including TSH, T4, and T3, were measured by radioimmunoassay. Following that, thyroid antibodies, including Anti TG Ab and Anti TPO Ab, were measured by ELISA. The data were analyzed in SPSS software through the Chi-square test, Fisher test, and t-test. Results: The results of statistical analysis show that there is a significant difference between the two groups in terms of the prevalence of hypothyroidism. Also, the results of this study show that there is a statistically significant difference between the two groups in terms of Anti TG, Anti TPO, RF, Anti CCP and also in terms of Free T3. On the other hand, the results of statistical analysis for TSH and Free T4 showed that there was no significant difference between the case and control groups. Conclusion: Overall, the results of this study indicate that there is a higher prevalence of thyroid dysfunction in RA patients, especially hypothyroidism. It is recommended that thyroid tests and examinations be included in the evaluation of rheumatoid arthritis patients. Further studies are also suggested to clarify the underlying mechanisms of the relationship between rheumatoid arthritis and thyroid dysfunction.

Background and Objectives: Nutrition is the first and most important factor facilitating mother-child interaction. Maternal nutritional knowledge, attitude, and practice are effective in many stages of child growth and development. Therefore, the present study was aimed to investigate the knowledge, attitude, and practice of the mothers of 12 to 36-month-old infants regarding child nutrition and its related factors using self-report method, in Qom, Iran. Methods: This cross-sectional descriptive-analytical study was conducted on 120 mothers with 12 to 36-month-old infants. For sampling, out of 28 health care centers located in Qom, 3 centers from the lower-, middle-, and upper-class areas were selected by the simple random sampling method. Subsequently, a total of 120 mothers were selected from these centers. The data related to the maternal knowledge, attitude, and practice regarding child nutrition were collected using a self-report questionnaire. Data analysis was performed in SPSS statistical software using t-test, ANOVA, and Pearson correlation. Results: With respect to the infantile gender, 55% of the infants were female. Based on the results, 68.3%, 58.3%, and 40% of the mothers had good knowledge, attitude, and practice with regard to nutrition. Furthermore, maternal nutritional knowledge (P=0.018) and practice (P=0.015) showed a significant relationship with their education level. However, there was no significant relationship between maternal nutritional knowledge, attitude, and practice and their occupation, infantile gender, history of previous referral of the infant, number of children in the family, and infant's birth order (P>0.05). Conclusion: Based on the findings, maternal nutritional knowledge, attitude, and practice were not at a good level. Therefore, it is required to improve maternal nutritional knowledge, practice, and attitude.

Introduction: Professional ethics in the medical sciences is an intellectual field of study that requires educating the medical team about the thoughts, ideas, and behaviors of ethical principles and values that are carefully evaluated until these principles and skills are institutionalized. In so doing, this study endeavored to develop a professional ethics curriculum template for medical students. Methods: This study was conducted using a combination method in the academic year 2020 in two phases like this qualitative (model design) and quantitative (model accreditation). Qualitative data analysis was performed by interviewing 17 members of experts in the field of education, research, treatment, and ethics in medical sciences and accreditation by 10 members of curriculum specialists and Medical ethics of different universities by using Delphi method who were selected by purposive sampling method through Brown and Clark analytical method using Atlas TI. Results: After summarizing the concepts and categories in the form of curriculum components (i.e., objectives, educational content, implementation or educational strategies and evaluation), a total of 150 conceptual propositions, one major category with four subcategories along with a sub-category, final analysis, and report a model of professionalism curriculum was presented for medical sciences students. Finally, the validation of the developed model was done by curriculum and medical ethics experts using Delphi method. Conclusion: The results revealed that the development of uniform and codified professional ethics training programs from upstream sources seems to be essential. It is also necessary to explain the educational content of practical and applicable professional ethics, training and continuous evaluation of the principles of professional ethics in all courses and disciplines to institutionalize the principles of professional ethics in three areas of education, research, and treatment.

Background and Objectives: Increasing complexity and changes in environmental conditions, policies, attitudes, systems, and structures, are factors influencing the goals of strategic planning, which can change programs. Programs without strategic thinking are not able to cope with such changes, thus they fail. Understanding of the factors affecting strategic planning, is crucial for the goals to be achieved. Therefore, the present study aimed to determine the barriers to the implementation of the strategic plan from the viewpoints of hospitals managers in Qom province. Methods: The current study was performed as a cross-sectional study in the hospitals of Qom province in 2019. Samples included 50 senior executive and operational managers, quality improvement officers, and administrative-financial managers of hospitals. Barriers to the strategic plan implementation, were collected by a pre-designed questionnaire. Data analysis was performed using independent t- and ANOVA tests. Results: The present study showed that structural barriers (1.82), human-motivation barriers (1.81), and process barriers (1.8), were the most important barriers to the implementation of the strategic plan. Senior and executive managers, financial managers cited the structural barriers, quality improvement officers mentioned the process barriers and managers of administrative units cited human-motivation factors as the most important barriers to the implementation of the strategic plan. Conclusion: The results of the present research explained the points of view of Qom hospital managers in terms of the barriers to the implementation of strategic plan. It seems that when designing and implementing a strategic plan, the participation of human resource that is the most important elements, should be considered in complex organizations, such as hospitals.

The Need to Update Respiratory Disease Surveillance System and Indigenization of the Pneumonia of Unknown Cause Surveillance System in Iran according to the COVID-19 Pandemic Seyed Hasan Adeli1, Mohammad Aghaali2 1 Associate Professor, Department of Internal Medicine, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran 2 Assistant Professor, Department of Epidemiology, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran dr.aghaali@yahoo.com E-mail: letter to Editor .

Background and Objectives: Given the consequences and serious dangers, which threatens neonates born with meconium-stained amniotic fluid, and also due to the high prevalence of cesarean section, the present research was carried out with the aim of comparing the outcomes of neonates with meconium - stained amniotic fluid in vaginal delivery and cesarean section. Methods: The present study was an analytical cross-sectional study conducted on the records of all deliveries with meconium - stained amniotic fluid performed at Izadi Qom Hospital in 2017. The data, including type of delivery, birth weight, gestational age, meconium intensity, and outcomes (such as Apgar score, umblical blood pH, need for admission, and death), were extracted from the records using a checklist. Data analysis was performed using t-, Chi-square, or Fisher tests at a significant level of less than 5%. Results: In this study, 284 deliveries with meconium-stained amniotic fluid, were investigated. Only 28.9% (82 cases) of these cases had been born by vaginal delivery. Percentage of vaginal delivery was 42.7% in diluted meconiosis and 22.6% in concentrated meconiosis. In concentrated meconiosis, the mean Apgar score and cord blood pH in the vaginal delivery group, was significantly lower. Conclusion: The results of this study revealed that in cases of high concentration of meconium, short-term neonatal outcomes is lower in the cesarean delivery. Regarding the choice of the type of delivery in these pregnancies, decision should be made comprehensively and with consideration of all maternal and neonatal aspects.

Background: With the increase in the number of premature neonates, there are concerns about the complications of this group. One of the common complications of preterm neonates is fungal sepsis. Therefore, this study was conducted to evaluate the efficacy of intravenous fluconazole on fungal sepsis and other complications related to premature newborns under 1200 g in a neonatal intensive care unit. Methods: The study was conducted by field trial. The intervention included intravenous injection of fluconazole (3 mg/kg, twice per week for 6 weeks) in neonates weighing less than 1200 gr in the Izadi Hospital in Qom, Iran. The intervention was conducted on September 2016 in entire population of the study. The control group was retrospective and from neonates admitted to Izadi Hospital, which were hospitalized before intervention. The outcomes (such as the need for amphotericin injection, death, fungal sepsis, time taken to reach enteral feeding and length of stay) were compared between the two groups. Results: There was no significant difference between the two groups regarding their sex ratio (P=0.139), gestational age (P=0.834), type of delivery (P=0.841) and birth weight (P=0.458). After the intervention, fungal sepsis (from 65% to 48.3%) and the need for amphotericin injection (from 27.1% to 5%) were significantly reduced, and the mortality rate decreased from 40% to 28.3%, but this decline was not statistically significant (P=0.178). After the intervention, the length of stay in hospital (P=0.142) and neonatal intensive care unit (P=0.422), time to reach the weight of 1500 gr (P=0.717), and time taken to reach enteral feeding (P=0.289) did not change significantly. Proportion of pneumothorax, apnea, necrotizing enterocolitis, retinopathy of prematurity and need for respiratory support did not change significantly. Conclusion: The present study showed that administration of venous fluconazole could reduce fungal sepsis in neonates weighing less than 1200 grams in the intensive care unit. However, this study failed to demonstrate the effect of fluconazole on death, pneumothorax, apnea and need for respiratory support.

Background and Objectives: The most common type of cancer in children is leukemia, and most common type of which in children under the age of 19 years is acute lymphoblastic leukemia. The survival of the affected children varies from region to region. The aim of this study was to determine the five-year survival of children with acute lymphatic leukemia and its related factors in Qom Children Hospital. Methods: This historical cohort study was carried out using data obtained from children’s records that were diagnosed with acute lymphoblastic leukemia from 2007 to 2017. The extracted data included age, gender, family history of leukemia, history of radiation therapy and radiation, history of contact with chemicals, parental occupation, living area, blood type and type of leukemia, tests, and initial examinations of the patient. Data were analyzed using Kaplan Meier charts and Cox survival analysis. The level of significance was considered less than 0.05. Results: In this study, a total of 97 patients were studied. The mean age of the patients was 5.12±3.99 years, and 55.67% (54 subjects) were male. The five-year survival rate of children was 65.10%. Among the studied factors, only the age of diagnosis and history of recurrence was significantly associated with the survival of patients, so that the survival was lower in the patients who had less than one year of age or had a history of recurrence. Conclusion: The findings of the present study showed that the survival of children with acute lymphoblastic leukemia in Qom province is lower than that in other studies. Moreover, the survival of children was associated with age of developing the disease and history of recurrence variables.

Background: Coronary artery disease is the most common cause of death worldwide as well as in Iran. The present study was designed to predict short and long-term survival rates after the first episode of myocardial infarction (MI). Methods: The current research is a retrospective cohort study. The data were collected from the Myocardial Infarction Registry of Iran in a 12-month period leading to March 20, 2014. The variables analyzed included smoking status, past medical history of chronic heart disease, hypertension, diabetes, hyperlipidemia, signs and symptoms during an attack, post-MI complications during hospitalization, the occurrence of arrhythmias, the location of MI, and the place of residence. Survival rates and predictive factors were estimated by the Kaplan–Meier method, the log-rank test, and the Cox model. Results: Totally, 21 181 patients with the first MI were studied. There were 15 328 men (72.4%), and the mean age of the study population was 62.10±13.42 years. During a 1-year period following MI, 2479 patients (11.7%) died. Overall, the survival rates at 28 days, 6 months, and 1 year were estimated to be 0.95 (95% CI: 0.95 to 0.96), 0.90 (95% CI: 0.90 to 0.91), and 0.88 (95% CI: 0.88 to 0.89). After the confounding factors were controlled, history of chronic heart disease (p

پنج قدم برای عقب راندن کرونا ویروس سازمان جهانی بهداشت و فیفا برای تجهیز جامعه فوتبال برای مقابله با COVID-19 اقدام مشترکی را آغاز کردند ژنو، 23 مارس 2020 فیفا، هیئت مدیره بین المللی فوتبال و سازمان بهداشت جهانی (WHO) با راه اندازی یک برنامه آگاهی بخش جدید به رهبری فوتبالیست های مشهور جهان، برای مبارزه با COVID-19 از همه مردم در سراسر جهان خواسته است تا پنج مرحله مهم را برای جلوگیری از شیوع بیماری را دنبال کنند. کمپین "ارسال پیام برای عقب راندن کروناویروس" پنج گام مهم را برای افرادی که به دنبال حفظ سلامتی خود در راستای توصیه های سازمان جهانی بهداشت ( شستن دستها، آداب سرفه، عدم لمس صورت، رعایت فاصله جسمی و ماندن در خانه ) هستند را ارتقاء و بهبود می بخشد.

There are significant misconceptions and many obstacles in the way of illuminating the epidemiological and clinical aspects of COVID-19 as a new emerging epidemic. In addition, usefulness of some evidence published in the context of the recent epidemic for decision making in clinic as well as public health is questionable. However, misinterpreting or ignoring strong evidence in clinical practice and public health probably results in less effective and somehow more harmful decisions for individuals as well as subgroups in general populations of countries in the initial stages of this epidemic. Accordingly, our narrative review appraised epidemiological and clinical aspects of the disease including genetic diversity of coronavirus genus, mode of transmission, incubation period, infectivity, pathogenicity, virulence, immunogenicity, diagnosis, surveillance, clinical case management and also successful measures for preventing its spread in some communities.

Background and Objectives: Evaluation of the status and improvement of professional behavior among dental students is a vital objective of the dentistry faculty. The principles and methods of professional behavior, which affect the doctor-patient relationship, are of paramount importance in all medical services. Regarding this, the present study aimed to assess the professional behavior of dental students studying at two universities, namely Shahid Sadoughi University of Medical Sciences, Yazd, Iran, and Qom University of Medical Sciences, Qom, Iran. Methods: This study was conducted on 72 and 82 dental students of Qom University of Medical Sciences and Shahid Sadoughi University of Medical Sciences, respectively, who entered the clinical course, in 2017. The study population was selected from students with various college admission years using stratified random sampling technique. Data collection tool was a 35-item professional behavior assessment questionnaire, the validity and reliability of which were confirmed. Data analysis was performed using the statistical tests of ANOVA, Pearson’s correlation coefficient, and t-test. P-value less than 0.05 was considered statistically significant. Results: According to the results, the mean scores of the professional behavior of dental students in Yazd and Qom universities were 102.70±15.76 and 106.41±13.66 out of 135, respectively. The results of Pearson test revealed a direct correlation between professional behavior and interest in dentistry (r=0.246, P

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children. With increasing prevalence of childhood obesity, NAFLD is increasingly seen in children. The prevalence varies according to the population studied (race and ethnicity) and the definition of NAFLD used in the study. In Iran, the prevalence of NAFLD in obese children ranges from 50% to 55% and in the general population of children is about 17%. Most patients with NAFLD are asymptomatic. However, abdominal pain may be present in the right and upper extremity, and hepatomegaly or non-specific symptoms such as abdominal discomfort, weakness, fatigue or attention disorder may also be seen. Diagnostic methods of NAFLD include laboratory tests, biomarkers, biopsy, and imaging studies such as ultrasound, CT, MRI. There is no definitive treatment for non-alcoholic liver disease. Modification of some risk factors such as obesity, diabetes, and hyperlipidemia are often recommended, but weight loss is more beneficial. Early diagnosis of NAFLD in children and its management can reduce further complications. Therefore, in this study, we reviewed the articles published on NAFLD in children (until 2017) using electronic databases, including PubMed, ProQuest, Scopus, and Google Scholar. We reviewed the signs of NAFLD, its epidemiology, etiology, complications, laboratory findings, different diagnostic methods, treatments, and follow up procedures.

Background and Objectives: Health system reform plan is a plan for improvement of health systems in Iran, which started on May 15, 2014 in hospitals of Ministry of Health of Iran. In this study, changes in neonatal outcomes following the implementation of the health system reform plan, were investigated. Methods: This cross-sectional study (before and after exposure) was conducted in a public educational hospital. The study population was all deliveries (normal and cesarean section) performed at Izadi educational treatment hospital (2011-2016), which were selected using Stratified random sampling. Information was collected using a checklist based on hospital records. The data were analyzed by t-test and Chi square test. Results: According to the results of this study, after implementation of health system reform plan, the ratio of normal delivery significantly increased (p

Background & Aim: One of the important issues that affects the quality of hemodialysis is recirculation. Some researchers have suggested that the direction and distance of needle cannulation can affect the amount of recirculation. Therefore, this study aimed to investigate the effect of direction and distance of needle cannulation on recirculating of arteriovenous fistula in hemodialysis patients. Methods & Materials: This clinical trial was performed on patients referred to the dialysis ward of Kamkar-Arabnia hospital affiliated to Qom University of Medical Sciences in 2016. The amount of recirculation was measured in 22 patients by urea based method, in four consecutive sessions. In each session, the distance and direction of the needles were three centimeters in opposite direction, three centimeters in same direction, six centimeters in opposite direction, and six centimeters in same direction. Data were analyzed using Stata and GEE test. Results: The average age of participants was 53(16±0.75) years. In 41 dialysis cases (out of 88), the amount of recirculation was higher than 10%. The odds ratio for more than 10% recirculation for a distance of three centimeters compared to six centimeters was 2.05 (1.07-3.93) and for same direction compared to opposite direction was 1.98 (1.03-3.78). Conclusion: The results of this study showed that the insertion of needles at a distance of six centimeters in opposite position had the lowest chance of recirculation. Therefore, the attention to proper insertion of needles can be effective in reducing recirculation and increasing the quality of dialysis. Clinical trial registry: IRCT2016082929581N1

BACKGROUND: Delay in seeking medical help in patients with acute myocardial infarction (AMI) challenges the patients in terms of diagnosis and treatment. This study aimed to evaluate the outcomes of delay referral (≥12 h) in patients with AMI. MATERIALS AND METHODS: In this retrospective cohort study, the medical records of 252 patients with AMI (2017–2019) admitted to Shahid Beheshti Hospital, Qom, Iran, was reviewed. Data collection tool was a researcher-made data sheet that included demographic characteristics, times, hospitalization costs, risk factors, history of heart disease, results of paraclinical tests, clinical information at the time of admission, and outcomes of delayed referral. Data were analyzed using t-test, Chi-square, Kaplan–Meier estimator, log-rank test, Cox regression by STATA, and SPSS (version 25). RESULTS: The levels of troponin, creatine phosphokinase, lactate dehydrogenase were significantly higher in the delayed referral group (P < 0.05). After treatment, the cardiac ejection fraction was significantly different in the nondelayed referral (41.56 ± 9.16) and the delayed referral group (38.39 ± 11.01) (P < 0.001). There was no significant difference in the percentage of hospital deaths in the groups (P = 0.078). CONCLUSION: Delayed referral of patients with AMI is associated with decreased physiological cardiac function, which complicates recovery for these patients.

Background: Blood pressure decreases during sleep and is markedly increased in the morning in healthy individuals. Lack of nocturnal blood pressure fall (non-dipping) has been associated with cardiovascular morbidity, mortality and other organ damage. However, their importance in chronic renal failure is unclear. This study aimed to investigate relationship between circadian rhythm of blood pressure and renal failure severity in patients with chronic kidney disease. Methods: This cross-section study was done in April 2016. The study population was 95 patients, more than 30 year old with hypertension and chronic renal failure. Patients were selected from clinics of two private and university hospitals affiliated to Qom University of Medical Sciences Shahid Beheshti Hospital and Vali-e-Asr Hospital, Iran. Checklist containing data such as age, sex, duration of renal failure and cause of renal failure were filled. Serum creatinine and serum urea levels were measured and entered in the checklist. The circadian rhythm of blood pressure in all patients was assessed by Holter monitoring. patients who had less than 10% decrease in blood pressure overnight were considered non-dipper and those who had 10% or more decrease in blood pressure overnight were considered dipper. Results: Average (SD) 24-hour ambulatory systolic and diastolic of blood pressure was 136.56 (16.66) and 84.84 (10.86) mmHg, respectively. 70 patients (73.7%) had non-dipper blood pressure pattern and 25 patients (26.3%) had dipper blood pressure pattern. There was no significant difference between two groups (dipper and non-dipper) based on distribution of gender (P=0.744), age (P=0.407), serum creatinine (P=0.569), serum urea (P=0.689) and renal failure duration (P=0.812). Mean of glomerular filtration rate in dipper group was 68.64±4.13 and in non-dipper group was 65.09±16.27 (P=0.337). Conclusion: The results of this study did not show a significant relationship between circadian rhythm of blood pressure and renal failure severity. In addition, patients with chronic renal failure showed higher rates of non-dipping pattern of blood pressure.

Background and Objectives: Escherichia coli is among the most important causes of bacterial diarrhea, especially in children. The aim of this study was to investigate the frequency of E. coli pathotypes in children with acute diarrhea referred to Teaching and Treatment Center. Methods: This study was performed as a cross-sectional study on febrile children with acute diarrhea aged 1 month to 5 years, who referred to Teaching and Treatment Center in 2014. Before starting antibiotics, stool samples of all patients, were sent to the hospital laboratory for culture. In case of positive culture, patients entered the study, then pathogenic types of E. coli were identified using multiplex PCR method. Patient information, such as age, gender, season, and stool test results of the obtained pathotypes, were analyzed by statistical tests of Chi-square, variance, Mann-Whitney, and t-test. Results: A total of 51 children with E. coli-induced acute diarrhea, were studied. Eighteen children (35.3%) were male and 33 (64.7%) were female. There were no significant differences among different pathotypes of E. coli in terms of age and gender distribution. The frequency of RBC and WBC in stool was not significantly different among diarrhea induced by different pathotypes of E. coli. Conclusion: The result of the current study showed that the most common pathotype in E. coli-induced diarrheas in children is EHEC. There was no significant difference among different strains of E. coli in terms of age, gender, season of hospitalization, and stool test result.

Background and Objectives: Parasitic diseases are one of the major hygienic and economic problems in most of the developing countries and dealing with them is one of the most important parts of the national development programs in these countries. In the current study, the prevalence of intestinal parasitic infection, determination of its affecting factors in primary and secondary school students in Qom city, and providing necessary solutions to prevent it, were investigated. Methods: This cross-sectional study was performed on 2410 students (age, 7-14 years) in primary and secondary girls and boys schools in Qom City. Data gathering tool included School Health Assessment Questionnaire and a questionnaire containing demographic data of the students and their parents' education level and occupation. Data were analyzed using Fisher and chi-square tests. The level of significance was set at p

Background and Objectives: Nosocomial infections are associated with complications, mortality, and imposing high costs. Staphylococcus aureus is the most common strain causing nosocomial infections. Colonization of this microorganism in the nose is also a source of spread of nosocomial infection. In this study, the prevalence of nasal carriers of this bacterium, was investigated among the staff of Hazrate Masoumeh Hospital. Methods: This analytical cross-sectional study was performed on all the staff of Hazrate Masoumeh Hospital, who were in contact with patients. A nasal sample was obtained using a sterile swap. The samples were cultured in a culture medium appropriate for staphylococcus aureus, and antibiogram was performed for positive culture sample. Data were analyzed using chi-square, independent t- and ANOVA tests. The significance level was considered to be p

Background: Predicting the survival of preterm neonates admitted to Neonatal Intensive Care Unit (NICU) care is important for counseling parents, informing care, and planning services. This study was conducted to establish a predictive model for evaluating the survival of NICU admitted preterm neonates by the cure model. Materials and methods: 1,200 preterm neonates admitted to the NICU of a tertiary referral hospital in Qom, Iran, were enrolled to build a model and to train relevant parameters for prediction. The time to discharge from hospital and potential predictive factors were collected for analysis. A mixture cure model with the Stata version 14.2 was applied to predict the cure rate. Established factors and significant variables in the simple models were included in the multiple model. Results: The cure rate of all patients by birth weight were: > 2,500 g, 87.31%; 1,500-2,500 g, 84.68%; 1,000-1,499 g, 75.31%; and < 1,000 g, 46.39%. The significant predictors in the final model include congenital abnormality, resuscitation, Apgar score, invasive procedure, pneumothorax, ventilation and birth weight. The result of the area under the curves for the final model on the validation data was 0.89 (95% CI, 0.823-0.951). It showed that predictive validity was satisfactory. Conclusion: By using the cure model survival analysis, we identified significant predictors of the cure rate of NICU admitted preterm neonates. The model showed a satisfactory predictive validity, which prompted one to make an individual prediction.

Background and Objectives: Lack of a constructive and appropriate communication between medical universities authorities and students’parents can lead to problems for students and universities. In this study, attitudes and challenges of communication between parents and medical universities were investigated from the point of view of medical and nursing students. Methods: The study was persormed as a cross-sectional study on nursing and medical students of Qom University of Medical Sciences in 2014. Data collection tool was a researcher-made questionnaire containing 18 questions about attitude and challenges of students about communication between parents and medical University. Data were analyzed using t- and Pearson correlation tests. Results: A total of 102 students responded to the questionnaire (85%). The general attitude of students towards the communication between parents and university was positive, and there was no significant relationship between students' attitude score and sex, course of study, and marital status. Thirty percent of the students mentioned that University Counseling Center plays the greatest role in this communication. Conclusion: The results of this study showed that the attitude of the students towards the relationship between their parents and university is positive, thus creating communication centers could be effective in improving the quality of students’ education and areas of cooperation between their parents and the university.

Background and Objectives: Most physicians believe that telling lies and withholding the truth is not permissible. However, it appears that holding the phenomenon telling the truth to be absolute or unconditional is not acceptable either. This study was conducted to examine Qom City physicians’ attitudes with regard to revealing the influential news to patients. Methods: This was a descriptive-analytical investigation whose statistical population encompassed 150 physicians working in Qom City, including physicians engaged in hospitals, clinics, and medical offices. A tailor-made questionnaire was utilized to examine physicians’ attitudes to telling the truth to patients. SPSS Ver.16 was used to analyze data obtained in the study, employing the statistical tests of Independent T-Test, ANOVA, and chi-square. Results: 41 (27.3%) male and 109 (72.7%) female physicians took part in this study. The mean work experience of the participants was 16.21±9.19. Overall, the attitudes of 36 physicians (24%) were low, 85 (56.7%) average, and 29 (19.3%) were weak. Pearson correlation coefficient indicated a positively significant relationship between work experience and attitude. Conclusion: The results demonstrated that most physicians believed that telling lies is not absolutely prohibited for health professionals, who, in some certain cases, are permitted to do it. Moreover, it is concluded that patients’ level of knowledge, awareness, age, and other items should be taken into vigilant account upon disclosure of bad news to them, who are entitled to know about their health status.

Background and Objectives: Clinical education evaluation in the fields of medical sciences is of particularly high sensitivity due to its important role in the training of professional staff, and different methods are mostly used in this field to assess performance and clinical competence of students. This study was carried out to compare the satisfaction of operating room students of two methods of electronics portfolio and conventional evaluation. Methods: In this quasi-experimental study, clinical evaluation was performed on 21 operating room students in the sixth semester by a conventional method and in the seventh semester by electronic portfolio. After similar clinical training, satisfaction of the two evaluation methods was assessed using a questionnaire. Data were analyzed using paired t-test. The significance level was considered less than 0.05. Results: The total satisfaction of electronic portfolio evaluation (11.5±6) was more than the conventional evaluation (6.6±4.1), and this difference was statistically significant (t=2.64, p=0.01). The level of satisfaction in terms of fairness of the evaluation, similarities of the existing subjects to clinical experiences, creating interest and motivation towards learning, dominance of coach in the implementation of evaluation method, getting feedback from coach, creating motivation for the use of books and other literature, paying attention to different aspects of evaluation, and helping to find defects and compensate them during training evaluation method, was reported more in the electronic portfolio than in the conventional method, and this difference was statistically significant (p

مقدمه: سپسیس و مننژیت نوزادی، به دلیل تظاهرات بالینی غیر اختصاصی، مشکلات تشخیصی و عوارض و مرگ و میر زیاد از اهمیت ویژه‌ای برخوردار است. هدف اصلی این طرح، بررسی روند تغییرات ابتلا به سپسیس و مننژیت در نوزادان بستری در بخش مراقبت‌های ویژه (NICU یا Neonatal intensive care unit) بود. روش‌ها: در این مطالعه، پرونده‌ی همه‌ی نوزادان بستری در بخش مراقبت‌های ویژه‌ بیمارستان ایزدی از فروردین 1389 تا اسفند 1392 از نظر مدت زمان بستری، سن بارداری، وزن تولد، جنس، نوع زایمان و سابقه‌ی پارگی زودرس پرده‌ی آمنیوتیک مورد بررسی قرار گرفت. نتایج کشت خون، کشت و آنالیز مایع مغزی- نخاعی، تعداد گلبول‌های سفید و پروتئین فاز حاد نیز از آزمایشات انجام شده، استخراج و از نظر آماری تحلیل گردید. یافته‌ها: در مجموع، 1010 نوزاد مورد بررسی قرار گرفتند. نسبت پسر به دختر، 564 به 446 بود. درصد نوزادان کم وزن، سزارین، سابقه‌ی پارگی پرده‌ی آمنیوتیک، تأخیر رشد داخل رحمی، نارسی و طول زمان بستری بر اساس سال‌های بستری، اختلاف معنی‌داری نداشت. در مجموع، 79 مورد سپسیس و 3 مورد مننژیت در این 4 سال تشخیص داده شده بود. در سال 1389، میزان ابتلا به سپسیس 3/12 درصد بود که و در سال 1392 به 8/7 درصد رسید. نتیجه‌گیری: این مطالعه نشان داد که میزان ابتلا به سپسیس و مننژیت در بیمارستان ایزدی قم روند نزولی داشته است. به نظر می‌رسد، این یافته به علت بهبود رعایت بهداشت، درمان مناسب و کاهش سوش‌های عامل مننژیت باشد.

Background and Objectives: Students are the main stakeholders of educational system in universities, who evaluate the quality of educational services according to their expectations and perceptions. Therefore, nowadays the viewpoint of students about the quality of educational services is considered as an essential factor in monitoring the quality of education in all scientific centers all over the world. This study was conducted to determine the gap between expectations and perceptions of students on educational services of Qom University of Medical Sciences. Methods: This study was carried out as a descriptive cross-sectional study on the students of Qom University of Medical Sciences, studying in 5 faculties (Medicine, Paramedical Sciences, Health, and Nursing and Midwifery) in the first semester of 2013 academic year. A total of 307 students were selected for the study using systematic random sampling. Data collection tool was a standard ServQual questionnaire. Data analysis was performed by one-way ANOVA and post hoc Duncan tests. Results: There was a quality gap in all dimensions of educational services quality and related measurement phrases. The highest average of quality gap was observed in the responsiveness dimension (-1.6), followed by tangibles (-1.5), assurance (-1.4), and empathy (-1.2), and the lowest average belonged to reliability dimension (-1.1). Conclusion: According to the findings of this study, in general, there were negative gaps in different dimensions of educational services quality between expectations and conceptions of the students in Qom University of Medical Sciences. Therefore, to reduce this gap, it is necessary to revise education method and education management.

Background and Objectives: Studies have shown that fasting can have an impact on the course and severity of chronic diseases. There are a few studies on the association of fasting and asthma. Therefore, this study has been conducted with the purpose of examining the effects of fasting on asthma severity and pulmonary functioning tests. Methods: 30 patients with asthma who attended a pulmonology clinic in Qom were enrolled in this study. The severity of patients’ asthma has been studied by questionnaire and spirometry of pulmonary functioning in the month of Shaban, Ramadan and Shawwal. The results of Asthma Control Questionnaire and the pulmonary functioning tests in three months have been compared. Results: The average age of patients was 43.42 years and 43.3% of patients were males. The Average score for asthma severity questionnaire in three months were 20.4, 21 and 20.17 respectively. Statistically, there haven’t been any significant differences between the results of pulmonary functioning test and asthma severity before Ramadan (Shaban), during Ramadan and after that (Shawwal). Conclusion: The findings of this study showed that fasting in patients with asthma has no effect on pulmonary function and asthma severity.

Background and Objectives: Early diagnosis of secondary cardiac involvement due to iron overload is very important in thalassemia patients. The aim of this study was to evaluate cardiac systolic and diastolic function by Tei Index in patients with β-thalassemia. Methods: This descriptive cross-sectional study was conducted on 64 transfusion dependent major and intermediate β-thalassemia patients referring to HazrateMasoumeh Hospital from 2012-2013. The relevant parameters measured were as follows: Myocardial performance index (Tei Index), ejection fraction, current ferritin, mean ferritin of past three years, hemoglobin, and the age of starting blood transfusion and chelation therapy. Data were analyzed using Chi-square, Mann-whitney, and Spearman correlation. p

Background and Objectives: Congenital heart diseases are one of the most common anomalies in infancy. This study was performed aimed to determine the accuracy, sensitivity and specificity of the left ventricular Tei index (TX) and the systolic to diastolic duration ratio (S/D) to detect ventricular dysfunction in pediatric pediatrics with congenital heart defect accompanied by mitral regurgitation. Methods: In this study, systolic and diastolic function of left ventricle was evaluated by TX and S/D ratio parameters in 66 children with mitral regurgitation (34 children with normal ventricular function and 32 patients with ventricular dysfunction) and the results were compared to the findings of echocardiography. Tei index>0.5 was defined as abnormal. Results: The accuracy, sensitivity, specificity, positive and negative predictive values of S/D ratio were obtained 89.3%, 87.5%, 91%, 90% and 88.5%, respectively and for TX, 87.8%, 87.5%, 88.2%, 87.5% and 88.2%, respectively. Conclusion: The results of this study showed that in general, accuracy, sensitivity, specificity, predictive values, and likelihood ratios of TX are less than those of S/D ratio in patients with congenital heart defect accompanied by mitral regurgitation.

Background: Diabetes is one of the most common causes of peripheral neuropathy. There are no known cures for diabetic neuropathy. Pentoxifylline could theoretically be a beneficial treatment for diabetic sensory neuropathy, but there is not enough evidence to prove its effect. The aim of this study was to investigate the effect of pentoxifylline on distal diabetic neuropathy. Materials and Methods: In this randomized double-blinded placebo-controlled trial, 60 patients with diabetic peripheral neuropathy were randomized into two groups. The intervention group received Vitamin B1 (100 mg twice daily) and pentoxifylline (400 mg twice daily) and control group received Vitamin B1 (100 mg twice daily) and placebo (twice daily) for 2 months. Before and after the intervention, the symptoms of distal polyneuropathy were recorded by the Michigan Neuropathy Screening Instrument. ANCOVA, Paired t-test, unpaired t-test, Chi-square, and Fisher's exact test were used to compare changes in symptoms and sign of distal polyneuropathy. Results: The mean age of patients was 57.1 ± 8.02 years. There was no significant difference between the two groups in regard to the baseline variables. Blood pressure, body mass index, and blood glucose did not change significantly during the study. In the pentoxifylline group, the symptoms of peripheral neuropathy were significantly improved, in comparison with placebo group (P = 0.042). Conclusion: This study showed pentoxifylline could be effective in reducing the symptoms of distal diabetic neuropathy.

Background. Brucellosis is one of the most common diseases of humans and animals and its clinical manifestations differ from asymptomatic infection to chronic illness associated with recurrence of symptoms. This study aimed to evaluate the prevalence of brucellosis in asymptomatic children 7 to 12 years old in Kahak, Iran. Methods. In this study, 186 children 7 to 12 years old were evaluated. Demographic data and exposure to the brucellosis agent were recorded and blood samples for the Wright, Coombs, and 2ME tests were collected. All the study subjects were followed up for one year about the appearance of symptoms. Results. The mean age was 10 ± 1.72 years and 51% were boys. Family history was positive for brucellosis in 15% of children. A total of 8 children were brucellosis seropositive and, in subsequent follow-up, 6 of them showed the disease symptoms. Conclusion. This study showed that approximately 4.3% of children in endemic areas can have asymptomatic brucellosis and many of these children may be symptomatic in short term.

Introduction. Naegleria fowleri, a free living amoeba, can cause devastating and deadly diseases in humans. This is the first report of primary amoebic meningoencephalitis from Iran. Case report. A five-month-old male infant presented with the history of fever and eye gaze for three days, after beginning of bacterial meningitis, a plain and contrast CT revealed communicated hydrocephalus. In the repeat of CSF analysis on microscopic examination of wet preparation of CSF, Naegleria Fowleri was seen. Then, Amphotericin B and Rifampin were started. On followup, two months later, the patient was totally asymptomatic. Conclusion. Though occurrence of PAM is rare, this unusual disease has grave prognosis, so infection with free living amoebas must be considered in differential diagnosis of pediatric patients of purulent meningitis without evidence of bacteria on Gram’s stain and imaging findings, nonspecific brain edema on CT or hydrocephalus even without history of contact.