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Background: In order to achieve the objectives of MDGs especially reduction of child mortality, the effectiveness of services must be increased. The main objective of the present study is surveying the effectiveness of child health services in Iran Health System.
Materials and methods: This cross sectional study was performed based on existing data. We compared data of 1500 children with their sibling.
 Results: The weight and height of second children were increased as compared to first children. Performance of health care personnel was also improved in growth chart drawing, promoting breast feeding, and on time complementary feeding.
Conclusion: Health network performance showed promotion, however, monitoring and assessing guidelines must be changed.

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Background: There are numerous studies on the effects of caffeine on memory and learning. The activation of α2-adrenoreceptors has been reported to impair memory functions in both rats and humans. In this study, interaction of α2-adrenergic system and caffeine on memory and learning was evaluated.
Materials and methods: In this experimental study, 90 wistar rats assigned into six groups of fifteen. Rats received yohimbine (4, 6, 8, 10 μg), as a α2-adrenergic antagonist, clonidine (2, 4, 6 μg), as a α2-adrenergic agonist, and caffeine (10, 20, 30 μg). The cannula was implanted into the right lateral ventricle of all rats with steriotaxi method. Then, they were trained in shuttlebox. Post-training intracerebroventricular (ICV) injection was carried out in all experiments and optimum doses were identified.
Results: Caffeine and yohimbine fostered memory and learning (p<0.001), while clonidine diminished these abilities compared to saline injection (p<0.05). Co-administration of the optimum doses of clonidine and yohimbine showed statistically significant reduction in the time of step-through latency (p<0.05). Instead, co-administration of clonidine and caffeine revealed no significant increase in the time of step-through latency (NS).
Conclusion: It is concluded that yohimbine and caffeine, unlike clonidine, increase memory.

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Background: Hemorrhoid is a chronic disease that has been known as a problem since 4 thousand years ago. Healthy lifestyle is an important mean of decreasing incidence and complications of chronic diseases. Considering the vast influence of lifestyle on chronic diseases symptoms, the goal of this study was to determine these influences on hemorrhoid.
Materials and methods: The present research is a case-control analytical study. The study population included all patients with hemorrhoid referring to Tehran University of medical sciences hospitals. The study group comprised 101 patients suffering from hemorrhoid, and the control group included 101 healthy individuals. Both groups have been matched in age and sex. The data were collected by using a questionnaire. The questionnaire scientific validity and reliability were determined with content validity and test-retest respectively. We used descriptive and inferential (Chi-square test, Fisher exact test and Mann-Whitney test) statistics for analyzing data.
Results: The majority of patients in study group didn’t have their meals on a fixed schedule (p<0.001), had less than three meals per day (p=0.021), had less daily fluid consumption (p=0.001), always used spicy food (p=0.001), and had less fiber consumption, had sedentary activities (p<0.001), never had walkings (p=0.001), and neither in past nor in present they had exercises, had defecation only one time in 3-5 days (p<0.001) with severe pressure and difficulty, and the duration between 5-10 minutes (p<0.001).
Conclusion: This study showed that there was a significant relationship between lifestyle and hemorrhoid.

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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: Biological personality Gary, as a psychological- neural theory, refers to brain systems of behaviors explaining psychological and social factors. Aim of the present study was to investigate relationship between behavioral inhibition and activation systems with adjustment of students.
Materials and Methods: Among high school students of Tehran province in years of 2011-2012, 332 individuals (166 males, 166 females) were selected using multi-stage cluster sampling. White scale brain systems and behavior (Carver and White, 1994) and scale adjustment of students (Sinha and Syg, 1993) were used. Data were analyzed by Pearson correlation and stepwise regression analyzes and t test.
Results: There was significant correlation between behavioral activation system and white adjustment emotional, academic and inhibition system whit social adjustment deterrent system. There was no significant sex difference between brain behavior system and adjustment.
Conclusion: It seems that important components of biological models of personality can be effective in explaining many psychological and social behaviors.

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Background: Infertility is one of the growing health issues in many countries with numerous emotional, social and economic consequences. The results of some studies in recent years revealed that the actual spread of infertility is changing and increasing due to various factors and the fertility rate has also declined. This study aimed to perform systematic review on Iranian domestic articles between 1999 to 2013, in order to identify the causes of infertility.

Materials and methods: In this systematic review, 58 research papers were retrieved. After auditing them, 38 articles were selected in the past two decades regarding the “etiology of infertility”.

Results: The most frequent causes of male infertility were sperm abnormalities and then varicocele. Tubal disorders and ovarian disorders were the most prevalent causes of female infertility. 

Conclusion: Based on these results and effective factors of infertility, we can consider effective measures in three areas, including preventive measures, educational measures, and support and encouragement measures to improve reduced fertility rate.

Keywords: Infertility patterns, Secondary infertility, Primary infertility, Etiology of infertility, Systematic review.

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Background: The present study was conducted with the aim of comparing cognitive emotion regulation in two male groups, one suffering from cancer and the others cancer free.

Materials and methods: The sample included 100 hospitalized men suffering from cancer, and 100 individuals without cancer who were selected through purposive sampling. The samples filled out Garnefski’s cognitive emotion regulation questionnaire (CERQ-P). Data analyzed by independent t-test.

Results: The results showed that the cognitive emotion regulation index was significantly different between the two groups concerning five factors of blaming oneself, blaming others, acceptance, positive assessment, learning perspective and negative approaches of  cognitive emotion regulation (p˂0.05).

Conclusion: Efforts of patients with cancer for usage of positive approaches of cognitive emotion regulation determines the effect of these approaches on their physical and psychological welfare. In such a manner, a specific method that an individual uses for his/her emotion regulation may make him/her more adaptable to stressful situations, such as cancer, compared with other people.

Keywords: Mind- behavioral systems, Cognitive emotion regulation, Anxiety sensitivity, Cancer patients, Cognitive psychology, Behavioral inhibition and behavioral activation systems.

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Background: Traditional methods for discrimination iron deficiency anemia (IDA) and β-thalassemia trait (BTT), which using CBC indices, are not accurate enough and complementary tests such as Hb electrophoresis are time consuming and expensive. In this study, we introduced the methods with higher accuracy. Materials and methods: In this study, 510 CBC samples were collected from several screening centers in north of Iran. The number of samples associated with IDA, BTT, and normal subjects were 167, 132, and 211, respectively. The collected samples were used to establish the methods, adaptive neuro fuzzy inference system (ANFIS) and multi-layer perceptron (MLP), through the use of 10-Fold cross validation. In each step of cross validation mathematical methods such as MI, E&FI, S&BI, S&LI, G&KI, EI and SI were investigated by the test samples. Results: Several indices, such as sensitivity (SENS), specificity (SPEC), positive predictive value (PPV), negative predictive value (NPV), accuracy (ACC), and Youden’s index (YI), have been obtained for the all mentioned methods in each step of Cross Validation. T test showed that the ANFIS and the MLP had not difference (p<0.05). The mathematical methods had not difference (p<0.05), but there was difference between AI-based and Math-based methods (p<0.05). Conclusion: This study indicates that using artificial intelligence as medical diagnostic tools can help the physicians in discrimination between similar diseases and also it increases accuracy in difficult cases. Keywords: Iron deficiency anemia, Thalassemia trait, Adaptive neuro-fuzzy inference system, Multi-layer perceptron, Complete blood count.

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Health industry is one of the important and growing sections of the global economy. Every year, billions of dollars are spent to improve information systems and provide better care services and greater efficiency in the health sector organizations. Information Systems Strategic Planning (ISSP) in health sector organizations is a tool for informed decision-making to achieve the macro and micro objectives of organizations in the Health Sector and prevent the waste and failure of huge investments in information technology of the organization. This is a non-systematic review study and research data includes required papers and books collected through library and Internet. Several databases such as ProQuest, Web of Science, Scopus, Ovid, Cochrane Library Medline, ISC, Irandoc, Sid, Magiran, Iranmedex Medlib and google Scholar search engine were investigated with keywords including electronic health strategy, medical informatics, electronic health record (EHR), telemedicine and electronic prescribing, E-health strategic planning . This study demonstrated that despite many efforts to implement Electronic Health in Iran, electronic health strategy is in generalities and not fully operational, due to lack of stability and the administrative obstacles. On the other hand, the short comings in the country's IT infrastructures, attitudinal and behavioral constraints, financial constraints, rapid changes of managers and the lack of skilled manpower are of the main obstacles affecting the development of Electronic Health Strategy in Iran. To eliminate these barriers, we need to have a national strategic plan, coordination, the existence of required regulations and standards, related software applications, electronic security systems and promotion of the use of information technology in the health system of the country.
 
Keywords: Strategic planning, Information systems, Medical informatics, Electronic health records, Telemedicine.
 

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Background: Accreditation is a tool for assessing the patients’ safety and quality improvement. The aim of this study was to compare quality management evaluation between Tehran hospitals with Europe hospital with accreditation approach.
Materials and methods: This comparative, cross sectional, multilevel study was conducted among 21 systematic selected hospitals and their quality managers and hospital departments and patients between 2016, June and 2017, June. Anonymous Quality management system index (QMSI) questionnaire was conducted among quality managers.  Quality management compliance index (QMCI) and clinical quality implementation index (CQII) and Clinical review (CR), specialized expertise and responsibility (SER), evidence base organization (EBO), patient safety strategy (PSS) were used during on- site visits by trained external surveyors. Retrospective and case note reviews, and direct observation were used for patient’s level data gathering. The validity and reliabity of constructs were tested. The choice of instruments was based on “Deeping our understanding of quality improvement in Europe” (DuQuE) project. Instruments were translated and back translated and changed base on third generation of Iran hospital accreditation that was developed by ministry of health and medical education (MOHME). We assessed patient- specific process and outcomes for acute myocardial infarction, stroke, hip fracture and deliveries at patient level.
Results: Management specific indexes at hospital level in Tehran hospitals, alike Europe hospitals, were related. In Tehran hospitals, an association was observed between QMSI and departmental levels in EBOP and CR and SER at four clinical conditions. In Europe hospitals, an association was observed between three levels of hospital quality management.
Conclusion: The comparative evaluation for quality management for hospitals in Tehran and European hospitals showed similar results in terms of quality improvement at the management level.

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Background: Skin cancer is the common, but most preventable forms of cancer, in recent decades. The most important key strategies in the prevention of this disease are health education interventions in society. The aim of this systematic review was to review the studies that have used educational interventions to increase skin cancer preventive behaviors, based on methods, application of models, and theories of health education and health promotion.
Materials and methods: Database of Iranian Medical Sciences articles, including Scientific Information Database (SID), and Iran Medex, and also 4 foreign electronic database of articles (Cochrane, Pubmed, Biomed Central and science direct) were studied in a systematic way. The database's search was conducted from February 2016 to May 2016.
Results: Of 12 retrieved articles, 10 studies were conducted based on theories and models of health education, and 2 studies did not use theories and models of health education. Among these theories, the social cognitive theory had most application and performance in improving the studied. Impact of interventions includes the whole range of improvements in structures such as variables and skin cancer preventive behaviors.
Conclusion: According to the results, the interventions based on theories and models of health education and promotion play an important role in promoting skin cancer preventive behaviors.
 
Keywords: Skin cancer, Educational intervention, Prevention, Systematic review.

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Background: Previous studies suggest that dysregulation of the immune system is involved in the pathophysiology of autism spectrum disorders (ASD). The aim of the present study was to investigate some pre-and anti-inflammatory cytokines in the serum of children with autism and healthy children and to determine the correlation between these cytokines and hs-CRP.
Materials and methods: Serum levels of IL-1β, IL-1RA, IL-6, IL-10, TNF-α cytokines and hs-CRP were assessed in twenty boys with autism spectrum disorder, aged 6 to 14 years, and 20 healthy controls. To analyze the data, multivariate analysis of variance analysis was used to compare the variables in the two groups, and Pearson correlation coefficient was utilized to assess the relationship between the levels of the cytokines and hs-CRP at the level of 0,05. SPSS software version 21 was used.
Results: The results showed that the level of all cytokines as well as hs-CRP in the autistic group was significantly higher than normal children (p<0.001), but there was no statistically significant relationship between cytokines and hs-CRP levels in children with autism (p>0.05).
Conclusion: The results suggest that abnormal immune responses such as increased levels of cytokines can be served as one of the biological markers of ASD.

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Background: Nurses need to be lifelong learners to provide care, efficiently, and apply the art of care, in a context of rapid change in knowledge and technology. Life-long learning is an indicator of professionalism for health care professionals. A study of creating a lifelong learning culture for nurses is a necessity. This study aimed to identify the basis of lifelong learning for nursing education in the field of "education system".
Materials and methods: This study was based on grounded theory approach and purposeful sampling method with open-ended semi-structured interviews on 19 nursing scholars and professors who had a PhD in nursing and medical education. According to Strauss and Corbin's method, the data were collected, analyzed and interpreted simultaneously and analyzed by continuous comparative method for validation and the acceptance of data a collaborator check and external observer were used.
Results: By analyzing the viewpoints of participants, the basis of lifelong learning in the field of educational system had three main areas, including "policies, curricula and assessment system, and teaching-learning methods". They became the main category of characteristics in the educational system.
Conclusion: Regarding the necessity of education with the a lifelong learning approach for nursing students, policy makers in the field of health and nursing, planners and administrators of nursing schools can develop effective strategies with the aid of factors identified in this study.

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Background: A group of cells that divide more than normal tissue is called a cancerous tumor.  In most cases, colon cancer which are lumps of flesh originating from the inner lining of the colon staining from intestinal polyps. Elucidating the regulatory relationships between mRNA and lncRNA can contribute to the regulation pattern of gene expression in malignant colorectal cancer.  In this study, the integration of weight gene co-expression network in malignant tumor was investigated by analyzing expression data from samples of normal and cancer patients.
Materials and methods: The data used in this article included lncRNA and mRNA exosomal sequences extracted from Exorbase and GEO database.  The weighted gene co-expression network was used to group genes and find gene groups that have a significant correlation.
Results: In this study, the pathological importance of the groups was classified using the level of expression of the groups.  Between the groups, the green group had the most correlation and significance, and for this reason, it is assumed that they have the top impact on the progression of cancer.
Conclusion: Considering the key genes HSPA1B, PPP2R3B and HSPA1A suggested in this study by comparing healthy and sick people and identifying the difference in gene expression profile, a suitable biomarker can be identified to detect people with colorectal cancer.
 

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Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies against nuclear antigens. Drug-induced lupus erythematosus (DILE) is a type of SLE that occurs as a result of the prolonged use of certain medications, including anti-tumor necrosis factor alpha (anti-TNFα) agents. This study aimed to investigate the clinical and laboratory manifestations of drug-induced lupus in individuals over 20 years of age with inflammatory rheumatologic diseases treated with anti-TNFα at BooAli Hospital in Tehran.
Materials and methods: This cross-sectional, descriptive-analytical study was conducted on 46 patients (13 men and 33 women) with a mean age of 55 years. Patients had rheumatoid arthritis, psoriasis, or spondyloarthropathy and had been suffering from their disease for at least one year. Clinical and laboratory assessments were performed before and six months after the initiation of treatment with etanercept or adalimumab.
Results: After six months of treatment with anti-TNFα, no clinical manifestations related to DILE were observed. The frequency of patients with positive ANA significantly increased from 17.39% to 32.60%. Other laboratory parameters did not show significant changes. A significant decrease in RF and Anti-CCP levels was observed, indicating suppression of the inflammatory process.
Conclusion: Treatment with anti-TNFα in patients with inflammatory rheumatic diseases leads to an increase in positive ANA, but this increase does not lead to the clinical manifestations of DILE. The decrease in RF and Anti-CCP levels indicates the effectiveness of the treatment in controlling disease activity.