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Background: Bacterial vaginosis alters normal vaginal flora and leads to gynecologic complications. Early diagnosis of bacterial vaginosis is so important, because of being asymptomatic of about fifty percent of patients. This study was conducted to study the diagnostic value of the Papanicolaou smear in the screening of bacterial vaginosis compared with vaginal Gram stain as a standard method.
 Materials and methods: This analytic cross- sectional study was conducted on 150 consecutive patients referred to a gynecologic clinic. Each patient had a standard Papanicolaou smear and Gram stain of vaginal discharge. Detection of clue cell in Pap smear, and fulfill of Nugent criteria in Gram stain of vaginal discharge was diagnosed as bacterial vaginosis. Sensitivity, specificity, positive predictive value, and negative predictive value of the Papanicolaou smear were calculated compared with the results of Gram stain as the standard method for diagnosis of bacterial vaginosis.
 Results: In our study, Pap smear had sensitivity of 69.23%, specificity of 99.24%, positive predictive value of 94.73% and negative predictive value of 94.28% in the diagnosis of bacterial vaginosis.
Conclusion: This study showed that vaginal Pap smear is a valid and reliable method in detecting bacterial vaginosis.

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Background: Epilepsy is one of the most prevalent diseases in all countries. A family having a patient with epilepsy subjects itself to self regulation in order to organize their roles and rules, and attempt to develop consistent patterns of interaction. This is necessary for epileptic patients and their families in promoting mental health and using effective interactive skills.
Materials and methods: In this descriptive- correlation study, 150 families of epileptics referring to the Iranian association of epilepsy selected using a Systematic Sampling. For obtaining further information, a questionnaire was used. The first part indicated the demographic specifications of the patient’s family, the second part showed the general health questionnaire (GHQ) and the third part indicated stress coping strategies Carver-Sheier-Weinrub questionnaires.
 Results: The majority of the epileptic patients’ families (56.7%) were not in an appropriate mental health condition. The majority of epileptic patients’ families (92%) were employing stress coping strategies on a medium level, majority of epileptic patients’ families who had medium mental health (93.8%) were using stress coping strategies in a medium level (S=0.3, P<0.0001).
Conclusion: The result may help promoting more mental health in the family of the epileptic patient and using of stress coping strategies in a more suitable level.

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Background: Occupational diseases are certain sorts of diseases that have been caused by special jobs and subject to special circumstances. There are several factors that can intensify these diseases. Studies of various countries have indicated that they have played an effective role in decreasing exposures and its economic costs and attracting optimal resources through establishment of a comprehensive information system for occupational diseases. In this study the occupational disease Information system in selected countries are compared.
Materials and Methods: This is a descriptive study which was conducted in 2008, during which information systems in USA, Finland, France and Iran have been studied based on their objectives, structure, most important data base characteristics and active organizations. Main instrument of this research were articles, books, magazines and valid internet sites in English language.
Results: All the three selected countries had an electronic information system and database in the field of occupational disease. In Finland, occupational diseases data as well as their damages are kept in separate databases while USA lacks a comprehensive system. In France, supervision on laboratories is a priority. In Iran, there is no certain comprehensive system for registering diseases.
Conclusion: Occupational diseases information system in Finland is more comprehensive. Iran lacks such a comprehensive system. So, it is recommended to use experiences of other countries and establish electronic comprehensive disease system.

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Background: Avian influenza, a viral disease in poultry, is an important infectious disease among human beings, because of easy spreading, no immunity and antigenic shift of virus. It has been occurred outbreak of avian influenza in some neighbor countries of Iran. The aim of this study was to determine the knowledge of medical students toward avian influenza.
Materials and methods: In this cross– sectional study, the knowledge of 403 medical students was gathered using a questionnaire in 2008. A pilot study verified the validity and reliability of questionnaire. The students completed the questionnaire, and then data were analyzed by SPSS software.
Results: The mean age of the participants was 23.68±2.8 years. Male to female ratio was 208 to 194. Mean score of students knowledge was 39.33±7.4. There was significant relationship between educational level and knowledge score (p=0.001). However, no significant relationship was found between knowledge score and other variables (NS).
Conclusion: This study suggests that educational programs can positively influence the knowledge about infectious diseases, especially avian influenza.

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Background: Sustainable development necessitates scientific research in a wide area of subjects. As the results of research productions are usually reported in a wide range of publications, scientometric analysis has been considered as the main approach for measurement of scientific productivity. This research was conducted to assess the status of Iran’s medical subject areas by scientometric data derived from Web of Science (WOS).
Materials and methods: In this descriptive-applied studythe bibliographic data were collected from the Science Citation Index Expanded (SCIE) database. The advanced search was performed with the country tag for Iran for six 5-year time periods. The current research includes all the articles of medical subject areas indexed in SCIE database during 1978-2007. The data analyses were performed with HistCite, SPSS and Excel software.
Results: Most articles from Iran universities were related to 2003-2007 time period. Most articles were observed in pharmacology field and lowest of them in geriatrics. The Tehran University of Medical Sciences identified as superior University in the 20 subject area. Scientific collaboration (22.5 percent) was mostly with USA scientific centers.
Conclusion: Fields of pharmacology, microbiology and biochemistry have a more increasingly growing than other fields. Continuance of this increasingly trend depends on factors such as, giving research facilities and budgets for other universities and considering Tehran University of medical science as a national successful model.

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Background: Cholera is a diarrheal disease caused by different serotypes of Vibrio cholerae. More than 200 O-antigen serotypes have been identified. Interestingly, only the O1 and O139 serotypes are known to cause epidemic disease. Different cases of Ogawa and Inaba serogroups have been found during last years in Iran. In this study, seroepidemiology of cholera in Iran between 2004 and 2008 was studied. Materials and methods: In this descriptive study, fecal specimens (stool or rectal swabs) were cultured in a selective plating media like TCBS. Overnight growth of V. cholerae colony on TCBS was cultured on BHI. Colonies grown on BHI, used for biochemical and biotyping and serotyping tests.
Results: Among 93 clinical strains isolated during 5 consecutive years (2004-2008), different serogroups of V. cholerae O1 (Ogawa, Inaba and Hikojima) biotype El Tor were identified.
Conclusion: This study showed significantly decreasing number of Ogawa strains compared with Inaba strains in recent years in Iran. However, some rare cases of Hikojima strains have been detected in Iran in 2007 and 2008.

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Background: Anemia is a common problem among patients with cancer, particularly among those undergoing chemotherapy. The purpose of this study was to determine the association between hemoglobin levels and severity of fatigue and quality of life in cancer patients undergoing chemotherapy.
Materials and methods: This is a descriptive– correlative study that utilized a purposeful sampling. One hundred twenty one outpatients with cancer participated in this study. Data collected by interview. The instruments used included the sample selection and demographic data form, Fatigue Severity Scale, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Hemoglobin level was reviewed from medical records. Grading of anemia based on hemoglobin level according to the National Cancer Institute classification.
 Results: Prevalence of anemia in cancer patients undergoing chemotherapy was 63.6 percent 57 percent had mild anemia and 6.4 percent had moderate to severe anemia. There were significant differences between mean score of severity of fatigue (p<0.001) and quality of life (p=0.003) in relation to hemoglobin level. There found negative significant correlation between hemoglobin levels and quality of life or severity of fatigue (p<0.001).
Conclusion: Anemia is prevalent among cancer patients undergoing chemotherapy. During chemotherapy, decreased hemoglobin levels are associated with increased fatigue and reduced quality of life. Nurses can help by appropriate intervention and patient's education about self care intervention to reduce anemia and fatigue and also improve quality of life.

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Background: Cataract is opacity of the lens that distorts the image projected onto the retina and that can progress to blindness. Behind rheumatoid arthritis and coronary artery diseases, cataract is one of the prevalent factors causing disability in the aged people. It could be mentioned that cataract causes 50% of people's blindness all over the world. The aim this study is evaluation of age related cataract among the patients referring to ophthalmology centers.
Materials and methods: This is a descriptive, mono variable and mono group study. The samples included in this study were 322 patients who were suffering from age related Cataract. Sampling method is based on the availability and the purpose of the study. Data (individually predisposing, environmental, systematic and other factors in patients’ profile) were collected through filling questionnaire and interviewing samples.
Results: The majorities of the samples were 65-75 years of age, housewives, BMI 25-30 kg/m2, illiterate and had insufficient monthly income. Chi square test indicated a significant relationship between the age of the patients, and their siblings who were suffering from cataract, wearing sun hat, Hypertension, taking Aspirin and Atenolol, high blood urea and creatinine, foods (animal fat, red meat with low fat, cereals) (p<0/050). Moreover, there was significant relation between gender and BMI, cigarette smoking, space of work place, wearing sun hat, Radiation Hypertension, Hyperlipedemia, Rheumatoid Arthritis, using supplementary, Atenolol, Statines and blood creatinine ( p<0/050 ). Conclusion: The results of this study were same as previous studies. The study indicated significant relation between age related cataract and individual, environmental, systematic factors, some of drugs (medicines) and increase of blood urea and creatinine.

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Background: Sleep sufficiency and quality affects medical students’ academic learning and understanding. So, this study was conducted to assess sleep quality and its associated factors among medical students.
Materials and Methods: In this descriptive cross- sectional study, 407 medical students (269 interns and 138 externs) were chosen by a multi-stage random sampling method from five hospitals in Tehran, Iran and questioned using Sleep and Day- Time Habits Questionnaire (S&DHQ). Data were analyzed using descriptive statistic methods and Spearman correlation coefficient test.
Results: 407 medical students with mean (± SD) age of 25±1.67 were studied. 257 (63.1%) and 150 (36.9) were female and male, respectively. 9.1% of students reported their sleep quality as excellent, 36.1% good, 39.3% satisfactory, 13.5% unsatisfactory and 2% poor. There was statistically significant relationship between students’ sleep quality and awakening due to environmental noises, day time napping duration, uncommon bed entry time, early morning awakenings, and day time fatigue and drowsiness in class rooms (P<0.001).
Conclusion: This study showed that sleep disorders are prevalent among medical students, intern and extern.

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Background: There is few studies in Iran investigated the viewpoint of nursing students and their trainers regarding preventing and facilitating factors of effective clinical teaching in Islamic Azad University. The aim of the present study was to compare the viewpoint of nursing students and their trainers regarding preventing and facilitating factors of effective clinical teaching.

 Materials and methods: In a descriptive-comparative study, all nursing students (n= 121) and clinical trainers (n= 21) of Islamic Azad University, Maragheh Branch were participated. Data were gathered by a questionnaire. Validity and reliability of questionnaire was determined by content validity and internal consistency (Cronbach’s alpha), respectively. Questionnaires were completed with self-report method. Data analysis was conducted with SPSS,13 software by Mann- Whitney U test.

Results: 21 trainer and 121 students considered facilitating and preventing factors as important factors for effective clinical teaching. There were statistical differences between nursing students and nursing trainers viewpoints regarding facilitating factors of effective clinical teaching (p= 0.003). In other hand, there were no statistical differences between nursing students and nursing trainers viewpoints regarding preventing factors of effective clinical teaching (p= 0.08).

Conclusion: These findings demonstrate the importance of facilitating and preventing factors of effective clinical teaching from the viewpoints of nursing students and trainers of Islamic Azad University. Attention to this factors have important role in improvement of clinical education of nursing students.

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Background: This study was conducted to assess the association of CagA (Cytotoxin associated gene A) positive Helicobacter pylori (H. pylori) with bacterial colonization and immune response in gastric epithelial cells.
Materials and methods: Gastric biopsy specimens of angulus, antrum, and lesser and greater curvatures were obtained from 138 patients with dyspeptic symptoms referred for endoscopy to Shariati Hospital, Isfahan. Specimens were evaluated for H. pylori and in positive ones, serum samples were investigated for anti-CagA IgG antibody. Immune response to Helicobacter pylori was classified according to Sydney system.
Results: Of138 patients, 97 (70.3%) were infected with H. pylori from which CagA antibody was positive in 83.5%. No association was found between CagA positive antibody and age or gender (P>0.05). Also, no association was found between CagA status and bacterial colonization or epithelial immune response (P>0/05).
Conclusion: The presence of CagA positive H. pylori is not related to bacterial colonization or gastric epithelial immune response in dyspeptic patients. However, according to evidence on the association of CagA positive H. pylori with increased of gastric cancers, strict follow-up of patients with this type of H. pylori is recommended even in the absence of severe epithelial immune response.
 Keywords: Helicobacter pylori, CagA antibody, Colonization, Immune response.

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Background: There is high prevalence of pencicllinase producing Neisseria gonorrhoeae and antibiotic resistance in numerous areas of the world. The aim of this study was to investigate drug resistance of gonococci.

Material and methods: In this cross-sectional descriptive study, vaginal discharge of 126 patients visited for vaginal discharge or suprapubic pain or admitted for periodic examination in Azad University hospitals were studied. Direct smear and gram stain of vaginal discharge was prepared and it was cultured into Tyer-Marthin media. Sensitivity to antibiotics was evaluated in positive cultures.

Results: Direct smear and gram staining of cervical discharge revealed 48 (38.1%) gram negative kidney shaped diplococci, but in selective media, only 12 (9.5%) Nesseria gonorrhoeae was detected. From 12 strains of Neisseria gonorrhoeae, 8 (66.6%) were resistant to penicillin, 8 (66.6%) to spectinomycin and 8 (66.6%) to co-trimoxazol, but neither of specimens were resistant to ceftriaxone.

Conclusion: Direct smear of vaginal discharge isn't enough for proper diagnosis of Neisseria gonorrhoeae and it should be confirmed by culture. Ceftriaxone is the best choice for treatment of gonococcal infections, but there is resistance to spectinomycin, co-trimoxazol and penicillin.

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Background: Crimean Congo hemorrhagic fever (CCHF) is a viral zoonosis disease was reported from different part of world since 1944. This research was conducted to study the epidemiology of CCHF and also confirm the epidemic of disease in the province of Khorasan Razavi in spring and summer 2009.

 Materials and methods: In this cross-sectional study, all suspected and probable CCHF cases reported to surveillance system in the Spring & Summer of 2009 were studied.

Results: In the first 6 months of 2009, 13 people were infected to this virus in the Khorasan razavi province. Compared with previous years, it confirms an outbreak. Four patients (31%) were medical staff of Ghaem hospital, four patients (31%) were butchers and the rest (38%) were farmer or poultry staff.

 Conclusion: According to our findings, medical staffs, butchers and ranchers are seriously at risk more than others. For prevention of epidemic, case finding, early diagnosis and training of high risk groups are essential in surveillance system

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  Background : Carpets are commonly used in our lives and are in contact with microorganisms. Antimicrobial agents should be used for the prevention of unwanted effects of microorganisms and control of their transmission. In this study, antimicrobial suspension of nano- silver was used for covering of nylon carpets.

  Materials and methods : Different concentrations of nano- silver suspension were used by spraying method for covering of nylon carpets. In different examinations, small pieces of carpets (0.5 ´ 1 cm²) were treated with bacterial suspensions of Staphylococcus aureus and Escherichia coli. Before and after examination, the numbers of bacteria were counted and decreasing rate of them was determined.

  Results : In nylon carpet with 25 ppm nano silver, decreasing rate of bacteria was 73.3%, while in carpets with 50 ppm and more, decreasing rate was 99.9%. Silver stability was assessed after 1 to 10 times of standard washing in 60 ºC with household bleach for 20 min. Silvers of carpet surface were established and saved their antibacterial effects after washing.

  Conclusion : Spraying nano- silver solution on commodities and factory products can prevent transmission of many microorganisms and infection diseases.

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  Background: Mastery in critical thinking skills is the ultimate goal of learning in medical education. This study was conducted to determine and compare critical thinking skills of first- and last-term baccalaureate students of nursing, midwifery and occupational therapy among medical Universities of Tehran city in 2006.

  Materials and Methods: This descriptive- comparative study was performed on 426 freshman and senior students of three medical Universities of Tehran city, including Shaheed Beheshti, Tehran and Iran. The students were completed a demographic form and California Critical Thinking Skills Test (Form B) .

  Results : There was a significant difference between total critical thinking scores of the first- and last-term students of nursing and midwifery in Shaheed Beheshti and Iran Universities ((p<0.04 and P<0/03, respectively), while there was no significant difference in other groups. In addition, no significant difference was found in total critical thinking scores of students at different disciplines and Universities.

Conclusion: This study showed no significant increase in critical thinking skills of senior students. This may be due to lack of pay attention to education of critical thinking skills in Universities.

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Background: Prenatal care reduces the incidence of prenatal illness and death by health promotion, danger signs recognizing, and where to seek care for pregnancy complications. The purpose of this study was to determine the barriers of prenatal care and the relationship between the barriers of prenatal care and pregnancy outcome among women visited Tabriz hospitals.
Materials and methods: In this cross-sectional study, 140 mothers were selected by purposed sampling among women visited Tabriz hospitals. Data were gathered by questionnaires, mothers file and newborns identification card. Chi-square, T-test, Spearman correlation, Kolmogrov Smirnov and Kruskal Wallis were used to analyze data.
Results: There was a significant correlation between early married mothers (2%), low education of mothers (73%), low income for the family (73%), rented houses (46%), multi pregnancy (33%), many children in the family (25%), unwanted pregnancy (30%), usual complications in the pregnancy (67%), the lack of prenatal care in the previous pregnancies (27%), going to the centers at the time of problems (16%), the lack of encouraging factors (52%), inappropriate situation of clinics (30%), doctors office (17%), preterm labour (3%), fewer than 7 points of Apgar score (12%) in the first minute of birth, IUGR (3%), LBW (5%) and the adequacy of prenatal care (p<0.001).
Conclusion: The significance of prenatal contacts not only does the provision of quality and client-centered counseling and encourages pregnant women to obtain adequate prenatal care it also suggests safe motherhood programs should emphasize the education and communication content of prenatal care.

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Background: Bacterial vaginosis (BV) is the most common type of vaginitis during reproductive period. Preterm labor, tubal infertility and pelvic inflammatory disease are more prevalent among women with vaginosis. Regarding high amount of refers and lack of data about their risk factors, this study was conducted.
Materials and methods: In this descriptive- analytic study, 1000 women referred to Tabriz health centers were randomly selected. Data were collected by a questionnaire containing demographic and fertility characteristics, previous history of treatment of symptoms as well as individual and sexual hygiene, researcher’s observations and results laboratory tests. Three samples were obtained from vaginal and cervical secretion and were used for microscopic observation and culture. Amsel’s diagnostic criteria were used for bacterial vaginosis. Data were analyzed by chi-square, t-test, exact Fisher test and logistic regression.
 Results: Gardnerella Vaginalis was found in 9.2% of vaginal discharges. Risk factors of BV included number of delivery, vaginal delivery, abortion, IUD utilization, individual and sexual hygiene and duration of antibiotic use. Number of vaginal delivery and abortion, vaginal pH, sexual hygiene, women’s education and husband’s occupation were predictive factors of BV.
 Conclusion: This study showed that diagnosis and treatment of BV based on symptoms could not be appropriate. It is recommended that laboratory testing should be added to clinical observation and examination to detect BV, especially before IUD insertion.

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Background: Anxiety, as a cognitive process, is the most prevalent mental disorder among any age group of human. In response to anxiety, subjects experience different psychological reaction, such as worry about physical situation and hypochondriasis. The aim of this study was to evaluate the frequency and association of anxiety and hypochondriasis student of Islamic Azad University.
 Materials and methods: This is a correlation- descriptive study. Among students of Islamic Azad University, Lahijan medical branch, 300 subjects were selected by random- stratified sampling. Data were gathered by demographic, Spielberger anxiety and hypochondriasis questionnaires. SPSS was used to analyze data.
Results: 28.3 and 34.4 percent of college students had severe anxiety and severe hypochondriasis, respectively. There was significant association between anxiety and hypochondriasis, and also between them and age, sex, marital status, residency, economic status, diseases at infancy and parents diseases (p<0.05).
Conclusion: Anxiety can decrease the capability and personal or social functionality. As hypochondriasis is a reaction to psychological or affective problems such as anxiety, these researches can improve people mental health.

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Background: Learning is considered as the basis of the education system, and the other issues in this field depend on this important factor. The students’ presence and their participation in the classroom are considered as the foundation for learning and education. This study was conducted to assess the causes of absenteeism and lack of attention to the instructions among medical students of Islamic Azad University, Tehran Medical Branch.
Materials and methods: The participants of this causal- comparative study consisted of 375 students from basic medical science group. The instrument used for the present study was a 3- section form designed by the researcher himself.
 Results: Among the 4 factors affecting students’ presence in the classroom, the instructors’ performance was the major cause of their absenteeism and the next parameter was educational programming. Self and family problems and medical science situation in society were the other effective factors, respectively.
Conclusion: According to our findings, the accurate and continuous assessment of the quality of instruction, holding methodology, expression skills, and successful interrelation skill workshops for the instructors especially the inexperienced, and modifying the educational programs will increase the students’ interest to participate more in the classroom.

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Background: High Resolution Melting (HRM) is a method that analyzes genetic variations such as Single Nucleotide Polymorphisms (SNPs) in PCR amplicons. The STK11 gene encodes a member of the serine/threonine kinase and regulates cell polarity and function as a tumor suppressor gene. The germ-line mutations in this gene are associated with Peutz-Jeghers syndrome. The patients with this syndrome are prone to some types of neoplasm.
Materials and methods: In this experimental study, genomic DNA was extracted from the whole blood samples of 56 patients with various gastrointestinal cancers. The nucleotide changes in the entire STK11 gene were analyzed by Real-time PCR and H RM technique.
Results: The nucleotide screening by HRM technique showed two types of SNPs in introns 6 and 7 of STK11 gene in 10 patients. Four patients had C / T substitution [cluster id/dsSNP/rs9282860] with homozygous genotype in intron 6, and six patients showed a C/G substitution [cluster id/dsSNP/rs2075607] with heterozygous genotype in intron 7. The direct sequencing of the fragments confirmed that the results obtained by HRM were 100% reliable.
Conclusion: In this study we found no SNP in exons of STK11 gene. However, two SNPs were found in the introns of this gene. Our results show that the primary screening of the STK11gene by the HRM technique is easily applicable to detect the unknown germ line and somatic mutations in patients with neoplasia at a relatively low cost.