Obesity is a chronic disease with the global epidemic spread. The worldwide prevalence of obesity is a considerable source of concern given its potential impact on morbidity, mortality, and cost of health care. The World Health Organization (WHO) has recognized obesity as a predisposing factor to measure chronic diseases ranging from cardiovascular diseases to cancer. Once considered a problem only in wealthy countries, the WHO estimates show that overweight and obesity are now dramatically on the rise in low- and middle-income countries. The disturbing sequelae of this increased trajectory of overweight populations are the parallel increases in chronic diseases that are comorbidities of obesity. Primary health-care providers, including dental professionals, are well positioned to address this public health problem at the patient level. Dental professionals must be aware of the increasing numbers of the obese patients and of the significance of obesity as a multiple risk factor syndrome for oral and overall health. Thus, it seems that dental health is becoming a global health concern and further, multinational and cultural studies are needed. Although the relationship between obesity and periodontitis needs further investigation, dentist should counsel obese individuals regarding the possible oral complications to diminish morbidity for such individuals.

Obesity is a chronic disease with global epidemic spread. The worldwide prevalence of obesity is a considerable source of concern given its potential impact on morbidity, mortality, and cost of health care. The World Health Organization (WHO) has recognized obesity as a predisposing factor to measure chronic diseases ranging from cardiovascular diseases to cancer. Once considered a problem only in wealthiest countries, the WHO estimates show that overweight and obesity are now dramatically on the rise in low- and middle-income countries. Primary health-care providers, including dental professionals, are well positioned to address this public health problem at the patient level. Both obesity and dental caries have common determinants and require a comprehensive, integrated management approach by multidisciplinary medical teams. Dental professionals should promote healthy diets not only to prevent dental caries but also to reduce the risk of childhood obesity. Obesity and dental caries share common lifestyle factors among adolescents, regardless of the nationality and different health-care systems. Thus, it seems that dental health is becoming a global health concern and further multinational and cultural studies are needed. Improvement of dental health and general well-being of adolescents requires active collaboration between dental and general health-care providers and the implementation of health promotion strategies targeting management of both obesity and dental caries for young people using a holistic approach.

Introduction: A successful surveillance system must consist of business intelligence (BI) modules that refer to applications and technologies used to gather, access, and analyze data. The objective of the current study was to develop a general checklist using a structured method for gathering BI requirements for an antimicrobial resistance surveillance system (AMRSS). Methods: First, a review was conducted to extract BI specific requirements. Final checklist was completed by ten context experts, using a decision Delphi method for two rounds. Items with <50% agreement were excluded in the first round, and those with more than 75% agreement were included in the first round. Those within the range of 50%–75% were surveyed in the next round. Results: The total number of items was 133. After applying the Delphi method in two rounds, the number of items was reduced to 94. The 94 items were divided into 10 classes of items as follows: goals and vision, data inquiries, data manipulation, data analysis, reporting, graphics, data security, documents, automation, and portability and accessibility. Conclusion: Although our specific problem was the design of an AMRSS, the outcome of this study was a general tool that can be used to capture and gather BI requirements in other fields.

Snoring and obstructive sleep apnea syndrome (OSA) can affect both esthetics and health. This review article, describe the role of the dentist in evaluation and treatment of snoring and OSA in adults, with an emphasis on oral appliances as a means to treatment.

Background: Cytomegalovirus (CMV) is one of the Human Herpes Viruses that is one of the main causes of mortality in transplant patients, acquired immunodeficiency syndrome (AIDS) patients, and neonates. It is one of the important congenital infections. CMV infections during pregnancy are important as they not only threaten maternal health, but also can cause fetal demise and congenital malformations with consequent costs and difficulties. Objective: The current study was done with the objective of determining the CMV seroepidemiology among pregnant women in Kermanshah, Iran. Material and Methods: In this descriptive cross-sectional study that lasted from March 2014 to March 2015, 300 pregnant women who presented to the Central Laboratory of Kermanshah, Iran, were included. Demographic data, clinical findings, and laboratory findings including IgM and IgG antibodies to CMV were documented. The findings were analyzed using the SPSS software (ver. 22.0). Results: There were 95 patients (31.67%) with positive CMV IgM antibody and had primary infection. Of 300 patients, 296 had positive CMV IgG antibody (98.7%) and 4 did not have CMV IgG (1.3%). There was a significant relationship between abortion and CMV infection (P < 0.05), but no such relationship was found between other factors and CMV infection. Conclusion: The CMV infection rate was 31.67% among pregnant women that is compatible with earlier studies and indicates the high prevalence of this infection among pregnant women. The observed primary infection was higher than similar studies. It is essential to implement health precautions to prevent CMV transfer to fetuses and performing screening tests in this population.

Background: End-stage renal disease (ESRD) is a chronic clinical condition that starts with an initial damage and ultimately develops into a complete loss of kidney function with an unknown mechanism. MMP-9C1562T (rs243866) and MMP-2G1575A (rs3918242) polymorphisms in the promoter region are associated with the incidence of many diseases including cardiovascular, hypertension, chronic kidney disease (CKD), and diabetes mellitus which result in ESRD. Objective: This study was conducted to investigate the possible effect of MMP-9C1562T and MMP-2G1575A polymorphisms on the incidence of ESRD in Kermanshah population as well as their correlation with the serum level of malondialdehyde (MDA). Materials and Methods: The present study was conducted through a case-control method. A total of 136 unrelated ESRD patients and 137 unrelated healthy individuals as the control group matched with patients based on the age and sex. MMP-9C1562T and MMP-2G1575Apolymorphisms were determined using the PCR-RFLP method and serum levels of MDA by High performance liquid chromatography. Results: We found that the frequency of MMP-9C1562T and MMP-2G1575A functional promoter genotypes and alleles in ESRD patients was significantly different compared to the control group. MMP-9C1562T and MMP-2G1575A alleles act synergistically to increase the risk of ESRD by 1.41 times (P = 0.008). In addition, results of this study demonstrated that there is a significant increase in the serum level of MDA in the presence of a dominant model of MMP-9 genotypes (T/T+ C/T vs C/C) and MMP-2 genotypes (A/A+G/A vs G/G) in ESRD patients compared to controls also increased the risk of ESRD 1.36 and 1.4 folds, respectively. Conclusion: We found in this study that MMP-9C1562T and MMP-2G1575A alleles synergistically increase the risk of ESRD but also raise the serum level of MDA in ESRD patients. This information may be important in the evaluation of ESRD progression and in the elucidation of the mechanisms of the disease pathogenesis. Further studies with larger sample sizes and different ethnicities are necessary to confirm these findings.

Objective: The objective of this study was to compare the pattern of lipid profile among subjects with or without anemia. Methods: All proven cases of anemia (hemoglobin <13 g% in men and <12 g% in women), irrespective of the causes, were included as cases. The controls were age- and sex-matched population without anemia. Patients with underlying diseases/medication that could affect either lipid profile or anemia were excluded from the study. The data collected include demographics and laboratory investigations such as complete hemogram, random blood sugar, serum creatinine, liver function tests, serum ferritin, serum iron, and fasting lipid profile. Results: A total of 200 participants were included in the study, which includes 100 cases and 100 controls. The mean cholesterol in patients with anemia is 122.47 ± 29.32 mg/dl, whereas in controls is 160.43 ± 38.91 mg/dl. The mean serum triglyceride level in patients with anemia was 89.41 ± 33.1532 mg/dl and in control group was 111.45 ± 40.6632 mg/dl. Mean high-density lipoprotein levels were 36.13 ± 12.8132 mg/dl in anemic patients and 45 ± 13.032 mg/dl in control group, whereas low-density lipoprotein (LDL) cholesterol level was 70.12 ± 21.64 mg/dl in the anemic group and 100.45 ± 30.8032 mg/dl in control group. Very LDL levels were higher in control group (21.96 ± 8.132 mg/dl) compared to the anemic group (18.34 ± 7.6432 mg/dl). The differences between two groups with regard to all lipoprotein levels were statistically significant; all the values being lower in anemic patients. Conclusion: Lipoproteins levels were significantly lower in anemic patients compared to nonanemic patients, and the reduction was proportionate to the severity of anemia. Type of anemia did not have any effect on lipid profile.

Introduction: Due to growing competition among health-care institutions and increasing expectations of caregivers, hospitals need to strengthen their competitive advantages. This study aimed to determine the Dimensions of patients' loyalty in military hospitals of Tehran, Iran in 2016. Materials and Methods: A cross-sectional, analytical study was conducted among patients receiving health-care services in military hospitals affiliated by Baqiyatallah University of Medical Sciences in 2016. The survey instrument was a self-administered questionnaire included 28 questions categorized into seven sections of service quality, satisfaction, commitment to relationship, respect to patients' rights, brand trust, loyalty, and value. Collected data were analyzed using LISREL 8.8 software through structural equation modeling. Results: Analysis findings reported all fitness indices related to factor analysis of study variables in an acceptable level and affirmed the theoretical model of the research. Results revealed positive relationships between some of the constructs. The path coefficient between service quality and loyalty was (0.76) showing a positive relationship between two variables. The coefficient related to the association between brand trust and loyalty (0.5) also affirmed a positive relationship between variables (t > 1.96). Discussion: To satisfy customers and develop a competitive advantage for health-care institutions, it is suggested to improve the quality of healthcare services, focus on promoting professional skills and experience among health-care providers, compliance with ethical issues and patients' rights and generally try to develop their competitiveness by effective utilization of existing resources.

Background and Purpose: There are various methods for assessment of pain in children, but the priority of use of tools in different circumstances is still unknown to many of the researchers. The aim of this study is to review the methods of pain assessment in children. Materials and Methods: All internal studies conducted in Iran in the past 10 years using the keywords such as pain assessment tools to evaluate pain, utilities pain in children, and ways to measure pain in children of databases including Magiran, MEDLIB, SID, Iranmedex, and databases Latin CINHAL, PubMed, Scopus, and Google Scholar search and data were analyzed using meta-analysis (random effect model). Results: Of the 485 original articles, 33 review articles in the field of pain assessment tools in Iranian children were selected based on inclusion criteria. Various pain assessment tools were used, the most important of which were the most commonly used pain evaluation tools included eight FLACC, CHEOPS, PPPRS, TPPPS, self-report tools including the Wang-Baker FACES and Numerical Rating Scale, physiological criteria, and storytelling, and the report includes Wong-Baker FACES tools and Numerical Rating Scale (NRS). Conclusion: The criteria Wong-Baker FACES and NRS were used, although emerging standards such as the FLACC are now widely used in the world.

Introduction: Pain in trauma patients with injuries due to rib fractures and chest trauma is one of the primary goals of management. Through various methods including oral medications, intravenous and intramuscular and different techniques of regional analgesia such as block intercostal, par vertebral block, and epidural block are performed. This study aimed to compare the efficacy of epidural block and block intercostal among patients with rib fractures. Methods: This study was a randomized, double-blind clinical trial involving 82 patients with fractures of the ribs 4-3 visit to Valiasr Hospital, and no pneumothorax as well as hemothorax was carried out. They were randomly divided into two groups of 41 people intercostal block and epidural blocks. In the first group in the thoracic epidural block, using the Marcaine 0.25% 0.3 cc/kg was given. In the second group, posterior dose 0.2 cc/kg Marcaine 0.25% block was given through intercostal. Results: The mean pain score (vascular-space-occupancy, the pain before surgery) was not significantly different between the two groups with respect to P ≥ 0.05. However, compared to the pain in 15 min, 1 h, 2 h, 12 h, and 24 h after block was significantly different between the two groups, according to P ≤ 0.01 and the pain was lower in the epidural block. In terms of age, sex, and chest X-ray changes, there was no significant difference between the two groups (P ≥ 0.05). Conclusion: The results of our study showed the effectiveness of thoracic epidural block in patients with 3–4 intercostals rib fracture which results in blunt trauma.

Background and Objectives: Plyometric exercises are done by adults to improve muscle strength, neuromuscular coordination, and vertical jumping. Unfortunately, there is limited information about effects of this kind of exercises on respiratory system. This study evaluated the effects of plyometric and aerobic exercises on chest wall expansion and respiratory volumes in high school students. Methods: This randomized clinical trial was performed in Zahedan. Sixty girls and boys, ranging 14–18 years old, were recruited through simple nonprobability sampling. The students were randomly assigned to two groups: cycling (n = 30) and jump roping (n = 30). Each group performed the exercises 3 times a week for 12 sessions. Before and after exercises, we assessed chest wall expansion (at axillary and xiphoid levels), vital capacity (VC), expiratory reserved volume, forced VC, and forced expiratory volume in 1 s. Data were analyzed using independent and paired t-tests. Results: Chest wall expansion at axillary level increased from 76 ± 10 to 77.4 ± 10 in cycling group and from 77.7 ± 8.1 to 78.5 ± 8.7 in jump roping group (P = 0.0001) and at xyphoid level from 68.7 ± 8.9 to 70 ± 8 in cycling group and from 71.3 ± 6.4 to 72.3 ± 6.4 in jump roping group (P = 0.0001). In addition, the increase in respiratory volumes was statistically significant (P < 0.05). Conclusion: Findings showed that chest wall expansion and respiratory volume increased following plyometric exercises such as jump roping.

Background and Aim: The main challenge of world health change to outlive with better quality in 21^st century. Positive self-evaluation in aging process associated with increasing in the quality of life and longevity. The concept of life satisfaction is the subjective image of human's welfare. Aging perceptions and life satisfaction are different among various cultures. The aim of this study is to investigate the correlation of aging perceptions and life satisfaction in Iranian older adults in 2016. Methods: In this descriptive, correlational study, a convenience sampling was used. A total of 320 older adults aged 60 and over in Tehran city were selected in 2016. Information was collected using demographic questionnaire, Barker et al.'s Aging Perceptions Questionnaires and Diener's Satisfaction with Life Scale. Data were analyzed using inferential and descriptive statistics by SPSS software version 19. Results: The results demonstrated that the mean score of various dimensions of aging perceptions was at medium level, and the mean score of life satisfaction was 22/39 ± 6/19 that was in low satisfied level and all dimensions of aging perceptions except identity dimension had correlated with life satisfaction (P < 0.05). Conclusion: Based on the findings several dimensions of aging perceptions have correlation with life satisfaction and various dimensions score of aging perceptions was at medium level, and life satisfaction score was in low satisfied level, it is essential to focus on educations that reinforce and encourage positive perceptions and controls in elderly people and also with social support might improve the negative concepts of aging in society. In this way, we can help to protection health and more life satisfaction in older adults.

Background and Purpose: Burnout has an impact on the quality of care and can cause damages to the quality of care. It seems that there is a relationship between “compassion fatigue” and “burnout.” If we can help reducing compassion fatigue and burnout among nurses, then we can take a step toward improving the quality of services in the field of nursing. Materials and Methods: This study is a descriptive correlative one which its purpose is to investigate the relation between “compassion fatigue” and “burnout” among nurses of selective educational health centers of Tabriz in 2016. One hundred and ninety-one nurses have been selected from these centers based on two-stage clustering sampling method. The tools used in this study consist of three parts: (1) exploring the demographic information including age, gender, education, marital status, years of service, type of employment, and the type of service sector, (2) the questionnaire of compassion fatigue (Figley), and (3) the questionnaire of burnout (Maslach). SPSS20 software has been used for analyzing the data. The descriptive-analytical statistics (including frequency distribution tables and mean indicators and standard deviation) and Pearson correlation coefficient also have been used for studying the relationship between aforementioned variables. Results: Pearson correlation coefficient among the “compassion fatigue” and “burnout” in the sample has been calculated as r = 0.087 and P = 0.233, and there is no significant relationship among these variables (P > 0.05). In exploring the relation of “compassion fatigue” and “burnout” with demographic variables such as type of service sector and location of work, there can be seen a significant relationship, and it is reported that nurses working in emergency sectors show greater risk for reduced compassion fatigue and burnout compared to nurses working in Intensive Care Units and surgery rooms. Conclusion: The result shows that compassion fatigue and burnout are two separate issues, so we need educated nurses regarding these issue to overcome the problem. This papers reveals the extent of nursing burnout in intermediate and long term care sector as well as identifies factors associated with burnout.

Background: Postpartum depression including psychiatric disorders during pregnancy and the time after that can cause the problems in the relations between mother, child, and family and that in the absence of proper attention and treatment in the family caused damage. Due to the sensitive nature of the postpartum period and frequency of this disorder is variable, this research seeks to investigate the relationship between type of delivery and postpartum depression has been done. Materials and Methods: This cross-sectional study on all pregnant women referred to health centers in Kermanshah in 2013 who were selected by random cluster sampling conducted. Beck depression inventory data-gathering tool included a demographic questionnaire-obstetric data analysis, descriptive, and inferential statistical methods to data using software and by SPSS 19 Chi-square test was examined. Results: The results showed that the mother's age, type of delivery, number of delivery, acceptance, sex, education, and maternal depression after propose relationship are statistically significant (P < 0.5) as well as the prevalence of postpartum depression is 33.4%, respectively, of which 13.8% related to emergency cesarean, 7.2% of vaginal deliveries, and 8% of elective cesarean section (CS). Conclusion: In this study, given that postpartum depression after CS is more than vaginal delivery which is recommended that appropriate advice for choosing the type of delivery and the correct way, according to the mother and baby and avoid perform CSs, and can play an important role in reducing postpartum depression and avoid spending a lot on the ground.

Background and Objective: Pregnancy and the period afterward are accompanied by major psychological and physiological changes. Stress in pregnancy can be associated with poor prenatal results and adverse repercussions for the health of the mother. Hence, the present study aimed to investigate the effects of physiological parturition training on stress and mental health of pregnant women. Methodology: As a two-group, randomized clinical trial, the present study was conducted on 50 pregnant women visiting Kermanshah-based health-care centers and Motazedi Hospital in 2015. The samples were randomly divided into the experimental and control groups. The experimental group was provided with eight 90-min training sessions, from which the control group was excluded from the study. For data collection, a researcher-made demographic questionnaire, the depression anxiety stress scale-21, and the general health questionnaire-28 were utilized. Moreover, the three questionnaires were distributed to both groups in the pretest and posttest. To analyze data, the Levene's test, analysis of covariance, and Kolmogorov–Smirnov test were employed in the which were filled out by the participants in a pretest-posttest design. Data analysis was performed in SPSS, version 20, using analysis of covariance. Results: Given the findings of the present study as well as the difference between the mean scores before and after receiving the physiological parturition training (measuring 13 and 7.4, respectively), it was concluded that the said training was efficacious in the alleviation of stress in pregnancy (P < 0.01). Furthermore, due to the mean scores before and after receiving the physiological parturition training (measuring 23.6 and 20.55, respectively), it was concluded that this training was effective in improving the general health of pregnant women (P < 0.01). it could be concluded that reduction scores after the training sessions was indicative of improved mental health and stress of the participants. Conclusion: According to the results of the present study, exploitation of physiological parturition training both promotes the mental health of pregnant women and lessens the accompanying stress and consequences. Accordingly, this training is thoroughly recommended for all eligible pregnant women.

The purpose of this study was to evaluate the performance of hospitals in Iran using Pabon Lasso model. In this descriptive study, both Persian and English papers about performance, function and Pabon Lasso model were searched in Iranian databases: Scientific Information Database Information Bank Country (Magiran), Banks Articles of Medical Sciences (Iranmedex), Science Direct, ISCCSI, PubMed, ProQuest, and Google Scholar. The study population was comprised 386 hospitals and 24 articles that 18 articles were valid and used in research. A total of 386 hospitals, of which 98 hospitals (25.4%) had a poor performance in the first zone, 79 hospitals (20.4%) had moderate performance in the second zone, 123 hospitals (32.1%) had a great performance in the third zone, and 86 hospitals (22.1%) were relatively modest performance in the fourth zone. Given that the most of the hospitals have above average performance, it is necessary to perform detailed plans for the optimal use of human and material resources in hospitals.

Introduction: Nurses as professional care providers, have adequate health literacy to understand and use it to provide health promotion and community members. The aim of this study was to determine the relationship between health literacy and health promotion in nurses of Medical Sciences University of West Country has been done. Methods: The present study is applied and correlation and cross-sectional that was performed in 2016. The population consisted of the nurses of University of Medical Sciences in West Country (Ilam-Kermanshah-Kurdistan-Hamadan) formed and 346 centers through two-stage cluster sampling were selected. A questionnaire for data collection was used with 57 items. The validity of the study was content validity, and its reliability (Cronbach's vary from 850) was confirmed. The data using SPSS version 22, using descriptive statistics (mean and standard deviation), and inferential statistics (binomial test, Pearson correlation, Kruskal–Wallis, and Mann–Whitney) analysis were reported. Results: The results showed that 97% of nurses and 80% of nurses in health literacy and good health promotion was acceptable. Variable between health literacy and health promotion with a correlation coefficient (0.556) was positive and significant relationship, as well as differences in health promotion nurse-square statistic (56.52) and differences in health literacy nurse-square statistic (31.80) was significant in various hospitals (P < 0.05). Conclusion: The present study demonstrates the relationship between health literacy and promoting health nurses, and this suggests that the managers and officials plan to improve health literacy and health promotion for this stratum of society done.

Background: Osteoporosis is a systemic skeletal disorder characterized by the reduction of bone mass, deterioration of bone structure, increasing bone fragility, and increasing fracture risk. Most important modifiable factors of osteoporosis are receiving inadequate calcium intake and physical activity. The purpose of this study was application of health belief model (HBM) to survey determinants of osteoporosis-related preventive behaviors among Ahwaz city students 2016. Materials and Methods: The current research is descriptive-analytical study. Four hundred and twenty high school students in Ahvaz city participated in this study. Samples selected by multistage sampling overall of 8 schools. Data collected using a standard questionnaire based on HBM and food frequency questionnaire and physical activity questionnaires. Statistical analysis was performed by SPSS 21 developed by IMD corporation, London, UK. Results: Findings present study showed there were not significant differences between no one of structures HBM and preventive behaviors of osteoporosis (calcium intake and physical activity) in students using Pearson correlations. Conclusion: In present study, HBM structures were not unable to predict preventive behaviors of osteoporosis in students.

Backgrounds and Purpose: Since childbirth is a natural phenomenon and is as old as the history of humanity, man has always been involved with the problem of pregnancy and childbirth. Childbirth is one of the most important events of women's life and negative events of this event result in adverse psychological consequences for her and her family. Therefore, some solutions have been concerned to experience a pleasant childbirth and reduce pain and shorten the duration of childbirth that it would lead to a reduction in cesarean sections in women. Methods: For this purpose, an experiment was done to examine the effect of massage with jasmine oil, in comparison to aromatherapy with jasmine oil on childbirth process in Abadan city hospitals in 2013. This was a clinical experimental study. In this study, statistical population consisted of pregnant women with singleton, 18–35 year old, a low-risk pregnancy-cephalic-entering the active phase childbirth. This was a clinical experimental study. Research units consisted of mothers who were referred for delivery to hospitals of Abadan. In this study, inclusion criteria were pregnant women with singleton, term 18–35 year old a low-risk pregnancy-cephalic-entering the active phase childbirth. Totally, 120 patients were enrolled and randomly divided into one control group and two groups. Results: About the aromatherapy procedures also results from the study showed positive effects of this method in relation to the purpose of the study. What is clear is allowing the use of very simple and it should this should be done by trained personnel to achieve the best result achieved and prevent the adverse effects. What is important whenever both methods are integrated, their effects in reducing pain and anxiety are more efficiently. According to the study, it can be found that no pharmacological pain management methods that increased the tolerance of pregnant women about the pain on the one hand, on the other hand, reduce sense of loneliness and elevated and strengthened confidence to reduce the level of anxiety and fear of childbirth. At the end of researcher pointed out that the continuation of studies on the use of adjuvant therapies to have beneficial effects to those in the chain of service delivery methods on implementing methods, aware, and be more efficient. In addition the most basic proposal, its preparation as head of a team of technical education and interested, or as a partner in the form of a highly qualified team to provide technical training content “up to date” to families and pregnant women officials at the ministerial level lets by having needed information. Conclusion: During the various sessions in the country, particularly in Abadan and Khorramshahr, rates to reduce maternal mortality and to make informed choices about the health of mothers and babies and help maintain an effective delivery method.

Introduction and Goal: Operating rooms are a great source of hospital infections caused by a variety of microorganisms. The use of different disinfectants is one of the most effective methods to reduce or eliminate the microbial load of the equipment and facilities that are in the hospital. This study aimed to compare two disinfectant solutions deconex 53 plus 2% and glutaraldehyde (Cidex) 2% on reduction of medical equipment contamination in the operating room of urology ward in Shahid Beheshti Hospital of Yasuj to microbes such as Staphylococcus aureus, Citrobacter, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella. Materials and Methods: Experimental study was conducted to investigate the effects of disinfectant solution with microbes including S. aureus, Citrobacter, P. aeruginosa, E. coli, and Klebsiella. Sixty-two metal and nonmetal tools used by qualified research (sterile conditions with disinfectants) were sampled. Collected data using SPSS version 22 and Chi-square and t-tests were analyzed. Results: In this study, contamination intervention with disinfectant solution deconex before the intervention, with E. coli, Pseudomonas and Citrobacter, S. aureus, and Klebsiella was 53%, 28%, 21%, 18% and 12% respectively. Moreover, the contamination of microbes in interventional suites with a solution of glutaraldehyde was 14%. Conclusion: Use of the disinfectant substance deconex 53 plus 2% and glutaraldehyde 2% for disinfection of equipment of urology operating room with respect to conditions and factors affecting disinfections such as concentration, reaction time, and learning the correct disinfection procedures showed that S. aureus, Citrobacter, P. aeruginosa, E. coli, and Klebsiella are completely removed.

Purpose: The aim of this research was to compare the skills of social, behavioral disorders and feelings of loneliness and despair of hearing-impaired children with low vision children of Uremia city in April and May of 2016. Methodology: The research method is causal comparative. The statistical population consists of all hearing-impaired and low vision children of Uremia city, who are studying in schools for exceptional children (32 visually impaired children and 32 children with loss hearing). In this research, the availability sampling is used. Matson Social Skills Questionnaire, Child Behavior Checklist Questionnaire Aachen Bach, the Questionnaire loneliness feelings of Usher Wheeler and the Questionnaires of disappointment in children of Kazdan et al. have been used for data collection. In order to data analyzing in addition to use, descriptive statistics t-test of two independent groups is used. Findings: The findings showed that the average of social skills-impaired children is significantly better than the hearing-impaired students and behavioral disorders and feelings of loneliness and hopelessness in children with low hearing significantly more than low seeing children. Hence, with considering this point that social skills in hearing-impaired children is lower than low vision children, and in addition, improving social skills reduces behavioral disorders, loneliness feelings, disappointments in children. Conclusion: Therefore, the use of effective strategies for improving social skills, especially in hearing-impaired children is important.

Pneumocystis pneumonia (PCP) is a challenging disease faced in immunodeficiency diseases. PCP became important when human immunodeficiency virus (HIV) epidemic in the world. Due to the increasing prevalence of the disease, especially people with acquired immunodeficiency disease (AIDs), here, we report a patient with AIDs and PCP. A 42-year-old woman living in a care center has been presented with a 2-month history of fever, chills, rough cough, and 6 kg weight loss. She was admitted to our hospital due to nonresponse to the outpatient treatments. The result of smear and staining was positive for PCP and patient was treated with trimethoprim-sulfamethoxazole. After 1 week, respiratory symptoms and fever has been getting better. No specific cause was determined for pancytopenia and for the second time viral markers was tested, and HIV mix reactive by Eliza was positive this time. Hence, she has been introduced to the health center to get treatment. Negative HIV test does not rule out the disease. In patients with long-term respiratory infections with leukopenia and failure to respond to common antibiotics, checking PCP is needed.

Midwifery is a high-stressed job, and midwiferies are prone to many stresses threatening their health over long working hours; further, it also influences their ability and the quality of patient care. Midwifery is characterized with sleep disorder influenced by stress and working shifts. This research is conducted to study the effect of Ginkgo biloba on midwiferies sleep quality in hospitals. In this random controlled clinical trial, thirty midwiferies working in hospitals were assigned into two groups of receiving treatment and placebo. The participants suffering from sleep disorder received the packs containing G. biloba and/or placebo and a pill every 12 h was prescribed over 30 days. Demographic and Pittsburgh Sleep Quality Index questionnaire were distributed prior and after Ginkgo. Following a 1-week cleaning, Ginkgo group received placebo; while, the placebo received Ginkgo over 30 days. Pittsburgh Sleep Quality Index questionnaire was also completed at the beginning and end of this period. Data were collected and descriptive, and inferential statistics was analyzed by t-test, Anova test through SPSS-20. At significant level P = 0.457, it may be expressed that there is no significant difference seen in the total sleep quality following treatment in experimental and control group. Research results demonstrate that Ginkgo has no effect on sleep quality of working midwiferies. Therefore, it is necessary to conduct longer studies with larger sample volumes.

Background and Purpose: Infertility in most societies across the world is considered as a stain and shame which leads to the infertile couples suffering. It also affects all aspects of their quality of life (QOL). Most previous studies have concentrated on the effect of infertility on one of the spouses especially women while infertility affects QOL of both spouses. Thus, this study tries to analyze QOL and its aspects and the factors that may affect them. Methodology: This analytical-descriptive study examined 324 infertile couples (162 men and 162 women) who were referred to Kerman's Afzalipoor Infertility Treatment Center. The data were collected using demographic profile questionnaire, World Health Organization-QOL-BREF and Beck's Depression Inventory and results were analyzed using SPSS version 21. Descriptive statistical, paired t-test and multiple linear regression were used to analyze the data. Results: The results of this study showed that in general in infertile couples men enjoys a higher QOL which is significant statistically (P < 0.05). Regarding various aspects of the QOL, men gained higher scores in the two physical and mental aspects rather women, which is significant statistically (P < 0.05). However, there was no difference between men and women in terms of social relations and environmental health. In infertile men, there was a significant relationship between age and infertility period, and the general QOL score was P < 0.05. For women, there was a significant relationship between the level of education and treatment period and QOL (P < 0.05). Assessing intensity of depression scale indicated that women in contrast to men suffer from a higher level of depression as the average scores of depression in men and women were 10.24 and 15.1 respectively which was significant statistically (P < 0.001). Conclusions: This study made it clear that although infertility may affect women's general QOL rather men's when we pay attention to details, it will be clear that in some aspects men QOL is influenced by infertility as much as women's QOL. Hence, infertility would affect QOL of men and women equally. Although women are usually subject to the infertility treatments, treatment duration will affect QOL of both spouses.

Introduction: Error is an integral part of human life because most of the errors are derived from natural psychological process (cognitive) and behavioral adaptations which are created by correct skill behaviors. The objective of this study was evolution of medication errors using self-reporting method and its relation with gender and work experience in nurses of one of the educational medical Centers of Kermanshah University of Medical Sciences in the second half of 2014. Research Methods: This is a descriptive-analytical single group and single-stage study. The study population included 540 nurses working in Imam Reza Hospital at the time of the study, and sample was calculated to be n = 225 using Cochran formula based on pilot study considering the average incidence of errors observed. Researcher-made questionnaire was the data gathering tool. Questionnaire was initially distributed in all sections and was then completed by nurses. Content validity and reliability were tested based on the evaluation of opinions of 7 experts and using retest method, respectively, in such a way that questionnaire was given to 20 nurses in 2 steps with an interval of 2 weeks. Reliability was calculated to be averagely 0.69 for these questions using kappa coefficient. Data were analyzed by SPSS 20 software. Results: There was no significant relation between 18 cases of medication errors evaluated using self-reporting method and work experience. From all evaluated errors, there was a significant relation between the error of lack of compliance with the time of prescription of medicine as well as giving a medicine more or less than the prescribed dose and gender. Discussion and Conclusion: Based on the obtained results, we suggest that parallelism and extensive studies be carried out in all hospitals in the province for identified of the highest cases of errors and providing suggestions for reducing those. On the other hand, the possible causes fear or negligence of nurses about reporting of errors is essential, and use of training, control, and close monitoring is necessary in the field of medication errors.

Background and Purpose: The research aimed to investigate the effect of kabaddi local game reducing the percentage and severity of stuttering among girls 7–11 years old in the city of Saravan. Material and Method: The population consisted of 23 students from Saravan city primary schools in the 1395–2015 school years, of which twenty as the sample size using nonrandom sampling method selected purposefully. The method used in this study is a quasi-experimental and pre- and post-test control group so that the effect 8-week kabaddi game in both group intensity and frequency of symptoms of stutter were measured. Results: To measure the frequency and severity of symptoms of childhood stuttering, stuttering tests and tests to measure the severity of stuttering were used. First, Kolmogorov–Smirnov test to determine the normality of data distribution and equal variances was used to examine Levine. Then, to test hypotheses, parametric t-paired test to determine intergroup differences between pre- and post-test groups and parametric t-independent test to determine differences between groups in pre- and post-test were used. After running 8 weeks in three sessions per week kabaddi game for half an hour each time, the frequency and severity of symptoms stutter were measured again. The results showed that children with stuttering in two training groups and controlling for age, severity, and the percentage of stuttered were homogeneous and uniform because the comparison mentioned in the pre-test variables was not significant. Conclusion: The difference between mean changes severity and the percentage of children stutter that exercise in control groups was not statistically significant.

Introduction: The quality of life (QOL) is a multidimensional concept that encompasses dimensions such as mental health, physical health, financial conditions, personal beliefs, and interaction with the environment. One of the most stressful emergency medicine specialties is the high sensitivity job, as well as studies on the comparison of QOL for residents and professionals from different fields in Iran, is very limited. This study was designed to investigate the QOL for the basic cortex information for interventions to promote the life quality of the people is necessary. Materials and Methods: To assess the QOL standard and validated questionnaire was used immunosuppressant-related QOL anonymous survey among residents and specialists in different fields of clinical and nonclinical medical school and teaching hospital in Tehran distributed and maintained the integrity of the responses of the participants in the scheme. Finally, responses obtained and analyzed using SPSS software were analyzed. Results: A total of 531 clinical assistants, 65 Ph.D. students (Ph.D.) with 460 clinicians and 55 nonclinical specialists filled out questionnaires delivered. In the area of health and environment, the other three groups were lower clinical assistants, and in the areas of mental health and social relationships, clinical assistants and Ph.D. students score significantly lower clinical and nonclinical professionals. Conclusion: Emergency medicine residents in the areas of physical and mental health and environmental health disadvantage compared to other disciplines, respectively. As well as emergency medicine, specializes in the field of mental health and social relationships had lower scores than other professionals. It can be due to the particular circumstances of the emergency department, stressful situations and out of order emergency department, a permanent night shelters in experts in this field, the daily bickering this group with other groups and specialists because of overlapping tasks.

Background and Purpose: Cardiovascular disease, especially coronary artery disease, is the most common cause of death in the world. Cardiac rehabilitation (CR) is provided to improve the effectiveness and decrease the side effects of coronary artery bypass grafting (CABG). This study was performed in 2014 in the CR center of Ekbatan hospital, Hamadan, Iran, to compare the double product (DP) index before and after CR in patients undergoing CABG. Materials and Methods: In this study, 100 patients visiting the center, who underwent CABG 2 months earlier, were studied. The exercise tolerance tests (ETTs) were conducted before and after the rehabilitation sessions for everyone, and the maximum heart rate and systolic blood pressure of them during the ETT were collected at their peak level. Results: In general, the mean of the DP index showed a significant increase after rehabilitation compared to before it (P = 0.05). Furthermore, the mean comparison of this index based on the independent study variables showed that the increase of the mean of the DP index after rehabilitation in men in both the age groups of below and above 60-year-old, in nondiabetic patients, in people with high blood lipids, people with normal blood lipids, patients with moderate degree of left ventricular dysfunction (EF = 30–44), people with relatively normal left ventricular function, smokers and nonsmokers, as well as individuals with no history of high blood pressure, was significantly different. Conclusion: The results of this study showed that the mean of the DP index which is a quantitative criterion for the assessment of cardiac function, significantly increased after 12 rehabilitation sessions in patients who underwent CABG.

Introduction: The accreditation process is conducted to enhance the organizational quality and outcomes based on the localized standards. The objective of the study was to compare quality indices in hospitals of Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran with different accreditation degrees. Materials and Methods: Ten indices, representing the quality measures of inpatient cares, were selected among accredited hospitals based on importance and patient influences. In this applied descriptive study, data of 11 teaching hospitals of SBUMS were studied and analyzed by SPSS 21 using descriptive statistics and ANOVA in 2015. Data were collected from hospital records. Results: The most favorable indices - patients' satisfaction with emergency and hospitalization services, mean duration of triage (levels 2, 3, 4, and 5), and unsuccessful cardiopulmonary resuscitation (CPR) - were in the lowest ranking hospitals. Six of 10 indices, including cesarean, the death level, the discharge rate of admitted patients in the emergency department and hospital wards by personal consent, the patients' satisfaction with the hospitalization and emergency services, mean duration of triage (levels 2, 3, 4, and 5), and unsuccessful CPR were the most unfavorable in hospitals with the highest ranking, i.e., the first excellent degree. Conclusion: There was no significant difference in the indices of hospital care processes with different accreditation degrees. There were also reverse correlations between the direction of outcome changes and the accreditation level in some domains, which might require reassessment of the conduction of the program.

Introduction: Public health in modern societies increases motivation and development of people at work, and also, in most cases, most people are dealing with daily life in addition to experience problems with different intensities and are experiencing stress. Some of the problems are transient and some have more permanent role; undoubtedly, peace is the first condition for a healthy psyche and in its shadow it can be reached as a counterbalance to everything else in life and progress. Of course, the purpose of the serenity, calm, and lack of concern is multiple and sometimes crippling. This study aimed to assess the general health of hospital staff in Gilan Province. Methodology: In this cross-sectional study, 57 individuals from different wards were selected in Gilan Province and responded to the questionnaire (General Health Questionnaire [GHQ]). In terms of depression GHQ-28 questionnaire and criteria provided by Noor bala et al. was used as the standard, then their responses were analyzed using SPSS software.^[23] Results: The mean age of those surveyed was 31.5 years, 81% of those surveyed also married, and the rest were single. Based on these criteria, it was found that, 43 (75.4%) of employees, suffered from some degree of depression, and, only 14 (24.6%) did not suffer from depression. Conclusion: The study showed that a high percentage of staffs suffered from depression which indicated the importance of health facilities.

Objectives: Epidemiological studies are available in developed countries with temperate conditions that assessed residential dampness in relation to health using various methods, but studies are very limited in tropical settings, especially in developing countries though favorable conditions prevail. As the reasons for building dampness in tropics are not similar to Western countries, there is always a need for baseline information on its prevalence and selection of method for assessment. Methods: We here discuss on limitations and advantages of each of the various methods to assess dampness. In addition, based on a household level survey on the possible sources of dampness and condition prevailing, we have developed a study instrument for obtaining self-reported information related to residential dampness that is suitable for epidemiological studies in a tropical developing country. Conclusion: Based on the suitability of the methods discussed, it is concluded that a single method would not be valid enough to provide accurate results in regions where previous studies are unavailable. A combination of objective measurement and self-reported information would be appropriate to assess dampness in health-related epidemiological studies conducted in tropical developing countries that lack sufficient previous research. This study may act as a prelude for further large level-field investigations on dampness in tropical developing countries.

Background: Occupational diseases such as musculoskeletal disorders changed to be one of the most important issues in different workplaces. They could be obvious on various parts of the body. Although researchers can find different sorts of techniques to assess Work Related MusculoSkeletal Disorders (WRDSDs) they look forward to find newer ones that are more strength. Objective: This in this cross-sectional and descriptive-analytical study was objected to evaluate posture of workers in a publishing industry by Loading on the Upper Body Assessment (LUBA) as a new method and also Nordic Musculoskeletal Questionnaire (NMQ), to analyze risk factors of WRMSDs in a central province of Iran. Materials and Methods: All workers were included. Gathering data about musculoskeletal disorders was done using NMQ. LUBA considers postures of four body parts including neck, shoulder, elbow, and wrist. Finally, data were tested through SPSS Version 20 and by applying Mann–Whitney, Kruskal–Wallis and Kappa agreement tests. Results: NMQ depicted that the most problems were in lumbar with the prevalence of 35.1%. One more thing, it was found that postures in the second action level and needed to more studies were in majority results showed the position of posture can predict disorders in this part of the body (P < 0.05). Conclusion: Altogether, upper limbs were not in desirable conditions and need more attention in the form of correction in workstations and manners of doing the tasks. However, it is recommended to develop more studies.

Background: Shift working has the potential of negatively influencing the quality of work life among nurses. Objective: The aim of this study was to investigate the outbreak of shiftwork-related disorders and the relationship between shift work, occupational stress, and job satisfaction among in a hospital in Iran, to help identify potential strategies for improving the quality of life among shift-working nurses. Materials and Methods: In this cross-sectional study, 100 shift-working nurses from three hospitals in Iran were randomly selected. Survey of Shift worker questionnaire was used as the main study tool. The nurses' demographic and work condition data were collected using a research-made questionnaire. Furthermore, Cooper's job stress questionnaire was used for collecting stress-related information. Chi-square and One-way ANOVA tests were used for the inferential analysis of data. Results: The most prevalent shiftwork-related problem was found to be psychological disorder (96.4%), followed by social life (84.5%) and digestive problems (81%). Nurses who had chosen shift work voluntarily showed significantly higher job satisfaction as compared to those who were forced to work on shifts (P < 0.05). Moreover, the 1^st year of work was reported as the most stressful year of their works in terms of conflict with colleagues and lack of enough experience for doing the given tasks. Conclusions: To reduce the associated disorders and increase job satisfaction among nurses, our study recommends that shift work be assigned preliminarily to the nurses who voluntarily choose to work on shifts. Furthermore, to reduce the nurse's occupational stress, the least conflict with colleagues is recommended.

Background: Nurses constitute the largest professional group in the health-care sector, and they are subjected to high level of occupational stress. Work-related stress is likely to have a profound psychosomatic effect and led to health problem. Objective: The study investigates job stress and its side effects in clinical nurses in a hospital in Iran. Materials and Methods: This study is a cross-sectional with descriptive analytical. The participants included 350 nurses from a hospital of Iran. A job stress questionnaire was used for the purposes of the study. Accident-related documents were also used to collect accident data. The study is a cross-sectional study taking advantage of dossiers and personal memories. SPSS version 22 and Chi-square were used to analyze collected data. Results: Twenty-six percent of the participants stated a very low job satisfaction and only 6% of them were completely satisfied with their job. 71.4% of the nurses, again because of job problems and difficulties, had medium to high levels of stress. The most important stress-causing factors are work load, ambiguity of duty, responsibility, social level, level of managers, and physical environment. Conclusion: The findings of the study indicate that stress causes adverse effects in nurses. The study also shows that physical environment, workload, and ambiguity of duties are the main factors that cause medium- to high-level stress. Furthermore, findings show that stress is severe in nurses with sleep disorder and digestive problem and sued effect of stress is mental.

Background: Nowadays, 24-h performance is an inevitable part in many industries and public services. Night work is a necessity for employees of a main part of labor force. Shift work is considered as working out of usual working hours (about 7–18). Objective: The aim of this study is drowsiness trend in night workers and adaptation to night shift in hospital staff. Materials and Methods: We used panel method. The studied society belongs to one of the hospitals in Iran. Ninety staffs were selected as samples. To collect sleepiness, data from Stanford Sleepiness Scale demographic information and questionnaire were utilized. The data were analyzed by SPSS software version 22. Results: Results show two identical groups of samples have largest degrees over four nights at 5:00 then at 3:00 AM and 1:00 AM. The degree of correspondence of second night was more than the first night. Conclusion: These landings can have important applications in increasing the safety and productivity of the workplace and the workers.

Background: Lifestyle and food pattern play a key role in the creation and control of metabolic syndrome (MS). Objective: The present study was conducted to determine the role of nutritional and anthropometric factors as the predictors of MS in food production and distribution business owners. Materials and Methods: The present cross-sectional study was conducted on 112 food retailers selected in a random fashion. The study questionnaires included the demographic information questionnaire and food frequency questionnaire. The body composition was measured using the body analyzer. To examine lipid profiles and blood sugar, 5 ml fasting blood samples were taken from the participants. The data were analyzed using the logistic regression test. Results: The present study found high waist–hip ratio and body fat mass to be the strongest anthropometric predictors of MS. High lean body mass and total body water were negatively correlated with and played a protective role in MS. Consumption of dairy products as a food group was negatively correlated with MS, i.e., the higher the consumption, the lower the emergence rate of MS. The prevalence of MS was found to be 30.4% in the over 40 age group, 51.4% in 40–49 years old and 61.3% in those aged 50 and above, suggesting a positive correlation between the prevalence of MS and increasing age (P = 0.02). Conclusion: The present study found increased waist circumference and reduced dairy consumption to increase the risk of MS. Furthermore, weight reduction changes in lifestyle by increasing physical activities and observing proper diets were found to significantly decrease the risk of MS.

Background: Nutrient labeling raises consumers' awareness of nutritional values of foods. However, uncertainties with regard to amluracy of nutrition facts' labels have recently increased. Objective: The objective of this study is to determine the compliance between information presented in food labeling of widely consumed foods and their true values. Materials and Methods: This study investigated 24 types of foods including dairy, meat, and protein rich foods, snacks, dressings and tomato paste, and pasta. In total, 1764 experiments were conducted. The levels of fat, carbohydrate, and protein were measured using Folch method, Fehling's solution, and Kjeldahl device, respectively. The data were then analyzed using Spearman correlation coefficient and Wilcoxon test. Results: The amount of fat, carbohydrate, and protein content in 67.8%, 48.4%, and 38.5% of analyzed foods was different from their nutrition fact labels. The fat content on nutrition facts label of dressings was lower than their analyzed values (10.15 ± 15.87 vs. 11.40 ± 21.44 g, P = 0.001). In total, the fat content on food labels was significantly different from analyzed values (15.54 ± 13.02 vs. 12.60 ± 10.77 g, P = 0.001). The carbohydrate content on food labels of meat and protein foods was less than their analyzed values (5.49 ± 3.24 vs. 6.88 ± 4.47 g, P = 0.001). Conclusion: The study showed a significant difference between laboratory analyzed values and food labels nutrition facts which may have misleading effects on foods choice of customers. In general, lack of amluracy in labeling nutritional value of foods and providing inamlurate information might lead to public unhealthy eating.

Background: Lifestyle, as one's behavior patterns, greatly affects one's health and society. In addition, happiness is seen as one of the major mental needs of human beings. When happiness is addressed in relation to university students, as the vibrant strata of societies, its significance becomes twofold. Objective: The present study aimed to investigate the relationship between the lifestyle and happiness of students at Kermanshah University of Medical Sciences between 2015 and 2016. Materials and Methods: In this descriptive and correlational study, the statistical population comprised all students at Kermanshah University of Medical Sciences in the 2015–2016 academic year, of which 600 students (210 males and 224 females) were selected through the stratified random sampling. Further, for data collection, the lifestyle questionnaire and Argyle's revised Oxford happiness questionnaire were utilized. Then, data were analyzed through the descriptive and inferential statistics in the SPSS Statistics Software version 21.0 (P < 0.05). Results: In the present study, the mean scores of lifestyle and happiness measured 13.0 ± 50.2 and 0.25 ± 39.3, respectively. Furthermore, the results of the Pearson product-moment correlation coefficient revealed that there was a significant positive relationship between the university students' lifestyle and happiness (r = 0.631, 0.38). Conclusions: The bilateral relationship between lifestyle and happiness and their effects on the overall health is a topic that should be discussed in issues pertaining to health. Given the relationship between the variables of the present study, to boost the students' lifestyles toward improving their happiness, it is recommended that careful plans should be laid by the cultural departments in collaboration with the counseling centers in universities through providing various packages in the form of classes and workshops.

Background: Spiritual health is regarded as one of the major dimensions of human health and an important approach in public health. On the other hand, happiness plays a vital role in mental and physical health and efficient social participation. Objective: The present study aimed to investigate the relationship between the components of spiritual well-being and happiness of students at Kermanshah University of Medical Sciences in 2016. Materials and Methods: In this cross-sectional and correlational study, the statistical population consisted of all students at the Midwifery, Paramedics, Health, and Nursing Schools at Kermanshah University of Medical Sciences in 2016. The sample size was determined through the Cochran's sample size formula, and 277 students were selected through the simple random sampling. Further, for data collection, the spiritual health scale by Paloutzian and Ellison and the Argyle's revised Oxford happiness questionnaire were utilized. Then, data were analyzed through the descriptive (percentage, mean, and standard deviation) and inferential statistics (Pearson's correlation coefficient) in the SPSS Statistics Software version 21.0. Results: In the present study, the mean scores and standard deviations of students' spiritual health and happiness measured 3.95 ± 0.47 and 3.38 ± 0.24, respectively. Furthermore, the results demonstrated that there was a significant and positive relationship between the students' spiritual health and happiness. Further, the results of the Pearson product-moment correlation coefficient revealed that the correlation coefficient between the students' spiritual health and happiness measured 0.51. Conclusions: The results revealed that the students' spiritual health and happiness at Kermanshah University of Medical Sciences were average, and they significantly and positively correlated. Hence, it is recommended that the contents of spirituality, spiritual health, and their significance be incorporated in the core curriculums in universities.

Background: Pollution of aquatic system with heavy metals is one of the important environmental problems that can make toxic marine organisms and aquatic food chain, so it is a risk factor for human health over time. Objective: The present study aimed to the evaluation of cadmium (Cd) and lead (Pb) Levels in fillet marine fish (Otolithes ruber and Lutjanus johni) from Persian Gulf. Materials and Methods: At the first, 50 fish samples (O. ruber and L. johni) were collected during winter and spring of 2012 at three different sites from Persian Gulf. The Cd and Pb concentrations were determined with an atomic absorption spectrophotometer. The results expressed in micrograms of metal per dry weight gram of fish (μg/g). Results: The results were validated according to the International Standards Organization 17025 accreditation. Statistical analyses were performed using SPSS software at the significant level of 95%. Maximum Cd and Pb concentration were seen in O. ruber (0.47 μg/g and L. johni (3.12 μg/g), respectively. No significance difference between the fish size and the metal levels for Cd was recorded in fish (P > 0.05). The relationship between the fish size and Pb level in the muscles was positive in two fish species (P < 0.05). Pb concentration was increased with increase of the length of fish, simultaneously. Conclusion: In all samples, Cd level was minimum. Pb concentrations in two fish specimens of this study exceeded FAO/WHO, IAEA-407, TFC, EC, and Chine but had not exceeded the guidelines limits except for the range of international standards. The metal accumulation in the aquatic organism may be species and size-dependent.

Background: Hemodialysis (HD) patients have poorly functioning kidneys in terms of blood detoxification; therefore, they need regular and continued HD to be able to continue their lives. Objectives: This study was aimed to survey changes in the concentrations of lead, cadmium, chromium, and zinc by seven dialysis instruments at hospitals of Kermanshah Province. Materials and Methods: One hundred and twenty-six samples were collected from three different dialysis cycles and tested using inductively coupled plasma system. Results: Results showed that the mean concentrations of lead, cadmium, chromium, and zinc were 18.53 ± 8.25, 0.706 ± 0.42, 86.06 ± 5.56, and 112.67 ± 63.56 pbb in the feed water of the reverse osmosis (RO) system (tap water), 18.81 ± 5.32, 0.719 ± 0.53, 84.25 ± 2.46, and 43.39 ± 19.4 in the permeated water of the RO, and 12.56 ± 6.32, 1.39 ± 0.87, 66.15 ± 13.54, and 60.38 ± 22.39 in permeated water of the dialysis instrument, respectively. Efficiency of RO in the dialysis instrument was 61.5 and 2.1% for zinc and chromium removal, respectively while this system was not effective in terms of removing lead and cadmium metals. Increases in lead and cadmium levels in the permeated water of the RO system compared to the feed water indicated that the performance of RO was decreased. Conclusions: It can be concluded that lead and cadmium reduction in the permeated water of the dialysis instrument showed that these two dangerous metals were increased in the blood of HD patients, which might be due to the malfunction of RO membrane.

Background: Food hygiene is one of the fundamental and essential issues in environmental health that should be followed to prevent food-borne illnesses. Objective: This cross-sectional study aimed at determining the role of educational intervention in changing knowledge and attitudes of rural homemakers in the city of Bisotun toward food hygiene. Materials and Methods: The first step to conduct the study was designing a survey questionnaire. We selected rural homemakers of the villages of Bisotun as target population for the study and a used random sampling for selecting a hundred of them. All achieved data were analyzed by SPSS and evaluated using independent t-test and ANOVA at a significance level of α = 0.05. Results: There was a significant difference (P < 0.05) in knowledge of the studied rural homemakers depending on their marital status, use of media, education, and age. The results showed that the educational intervention elevated their knowledge. Besides, there was also a significant difference (P < 0.05) based on different demographic variables in attitudes of the studied rural homemakers toward food hygiene. Conclusion: From the results, it can be concluded that the regional health workers failed to follow guidelines for improving the situation because of the multiplicity and diversity of their duties. It seems, therefore, that there is a need to use periodical educations (every 6 months) intending to teach important subjects such as food hygiene to rural homemakers and even health workers by experienced and highly educated food hygiene professionals, considering parameters including gender, age, and education of the individuals.

Background: Rodents are the main reservoir hosts of zoonotic cutaneous leishmaniases (ZCLs) in different parts of Iran. Nonetheless, no evidence of natural infestation of Leishmania parasite has been reported from spiny mice Acomys dimidiatus (Rodentia: Muridae). Materials and Methods: Between March 2011 and March 2012, 62 wild rodents were captured and checked for leishmanial infestation of their livers and spleens using polymerase chain reaction in fourteen regions of Darab district in Fars province, southern Iran. Results: Overall, 62 rodents consisting of 42 Tatera indica, 6 Meriones libycus, 5 Meriones persicus, 5 Mus musculus, and 4 A. dimidiatus were identified. Infestation to Leishmania major was confirmed in all the captured species of rodents: T. indica (23.8%), M. libycus (50%), A. dimidiatus (50%), M. persicus (20%), and M. musculus (20%). Conclusions:T. indica was the reservoir host of L. major in this focus of ZCL. Moreover, M. libycus and M. persicus had a remarkable role in the maintenance of the parasite. A. dimidiatus was also introduced as a new probable reservoir host of L. major for the first time. Yet, the role of this species in the maintenance, transmission, and epidemiological cycle of ZCL needs more specific researches.

Background: Malaria accounts for 90% of the 1.5–3 million deaths occurring annually in Africa. Insecticide-treated nets (ITNs) have proven to be highly effective in preventing malaria. It can reduce malaria transmission by up to 90% and avert up to 44% of all-cause malaria in children <5 years. Aim: The aim of the study determined to explore the reasons why the available insecticide-treated nets were not put to use. Methods: This was a cross-sectional study of 389 caregivers of under-five children in the three local government areas of Enugu, Southeast Nigeria. Study participants were recruited through a multistage stratified sampling process. Results: The results showed that net ownership rate was 85.6%. Mean possession rate of ITN was 4.8 nets per household. About 93.8% had heard about ITN, while 91.8% of the participants knew that it was used to prevent mosquito bites. Only 53.9% used their ITN. Educational status of the caregiver was the most consistent factor affecting ITN use (P = 0.001).

Background: The use of modern contraceptive (MC) is a cost-effective public health measure for reducing maternal deaths due to unintended and high-risk pregnancies. In Nigeria, efforts have been made by government and nongovernmental organizations toward improving access to family planning services. The impact of this effort among rural women in Rivers State, Nigeria, however, is insufficiently documented hence the need for this study. Subjects and Methods: A total of 380 rural women of childbearing age in Rivers State, Nigeria, were recruited by a multistage random sampling method using a cross-sectional descriptive design. Respondents provided information on their socioeconomic background, sources of information and knowledge of MCs, contraceptive use, and the reasons for use or nonuse of contraceptives. Data were analyzed with SPSS version 15 and the level of statistical significance was set at P = 0.05. Results: Almost all (n = 378; 99.5%), the rural women had awareness of MCs, but only 238 (63.0%) had good knowledge of it. The most common known methods were the male condom (n = 255; 67.1%) and injectables (n = 190; 50.0%). Those in current use of any MC method were 140 (36.8%) while only 86 (22.6%) used it consistently. Male condom was the commonly used method. Conclusion: Although the awareness of MCs among rural women in Rivers State Nigeria is high, their uses are unacceptably low. Family planning education should be provided for community-based health-care givers; mass media efforts need to be intensified in local languages.

The central hypoventilation syndrome is a rare disease which is mainly characterized by respiratory failure in response to hypercapnia and hypoxia. Patients need some levels of ventilation support during sleep or even during the day. This study introduces a young Turkmen male patient with central hypoventilation suffering from the loss of consciousness and severe drowsiness.

Background: Fever with rash is a diagnostic challenge for treating physician. Careful illustration of history, clinical examination and judicious investigations are essential for managing such case. Case Report: A 35years old soldier, presented with intermittent high grade fever associated with dry cough, difficulty in swallowing, vomitings, watery loose stools and high coloured urine of seven days duration. Examination revealed temperature of 1030 F, tachycardia, pharyngeal suffusion, conjuctival congestion, petechial rash, distended mildly tender abdomen and decreased air entry in both the lung fields. The laboratory investigations revealed leucopenia, thrombocytopenia, mild shift to left with toxic granules, deranged LFT, Chest X-ray showing pulmonary oedema and IgM Ab for measles was positive. He was promptly managed with supportive therapy. Conclusion: Measles with pulmonary oedema, features of SIRS, thrombocytopenia is very.

Salmonella typhi infection presents most commonly as typhoid fever and infrequently as extraintestinal localized infections of bone, joints, soft tissues, spleen, endocardium, pulmonary, hepatobiliary, genital and urinary systems. Urinary tract infection ( UTI) is rare and clinical presentation is indistinguishable from UTIs due to other etiological agents or may even be asymptomatic. We report two cases of patients with chronic kidney disease with UTI due to S. typhi. Renal cyst, nephrolithiasis, and urethral strictures were the concomitant findings in one case and renal tubular acidosis with nephrocalcinosis in the other. In patients with relapses and a chronic course with coexisting functional or structural abnormalities of the urinary tract system, the suspicion of Salmonella as one of the probable causative agents should be kept in mind so as to ensure appropriate and adequate therapy. Furthermore, in the presence of long-standing hypokalemia, one should investigate for renal abnormalities and vice versa.