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The role of Technology in health care of aging people with Cognitive disorder: a narrative review Hamideh Azimi lolaty  

Cognitive function plays an important role in everyone’s life and the prevalence of cognitive impairment increases with age. According to the statistics, this disease is so common in Iran and the worldwide. Nowadays, technology has helped people with cognitive impairment and their careers in different aspects. This study aimed to review the role of technology in health care status of aging people with cognitive disorder.
We searched Google scholar, Medline, Science Direct, Scopus, ProQues, Ovid, Iranmedex, SID and Magiran. We searched for terms such as "elderly", "aging", "technology", "cognitive impairment", "care giver", "virtual", "Alzheimer", " Dementia", "Telecare", "sensor", "information and communication", "memory training"," assistive device ","smart phone", "Web Base Education" and "Web Based Learning". 1977 related articles from the period of 2005- 2015were found, We checked the reference lists of all papers of included studies for further potentially eligible studies. eventually 17 relevant papers were studied.
Reviewing the obtained articles, showed the positive role of technology in assessing cognitive impairment in early-stages, helping caregivers, improving the quality of health care and memory enhancement in people with Alzheimer's disease. It is suggested to provide Support Services for the elderly with improving infrastructures, such as a careful program planning for responsible organizations, setting the necessary funds, development of interdisciplinary communication, appropriate culture building practices and providing appropriate training in the community and developing communication systems in the country.

Brucellosis seroprevalence in the normal and high-risk individuals in Iran : A systematic review and meta-analysis Maryam Ghajar  

Objective: Brucellosis is an zeonotic disease and it is a health and economic problem in many parts of the world, including Iran. The disease is endemic in Iran and the reported cases increased, however, disease outbreaks are not clear. This review aimed to determine the prevalence of brucellosis in normal and high-risk population in Iran.
Methods: This systematic review and meta-analysis was performed in article about Brucellosis in Iran. Systematic search was conducted in the databases, include: Pubmed, Scopus, SID (as a local database) until August 2015. Finally we have 454 article after deleting duplicating material by Endnote software. Data extraction form contains author, publication year, sample size, laboratory test, study population in normal person and high risk person and seroprevalence. Finally, Data were analyzed by STATA 11.1 and random effect.
Results: Finally, we enrolled 11 studies and 7688 person in high risk group and 13858 person in normal group were studied. The seroprevalence of brucellosis in normal population was 0.12 (CI95%: 0.08 - 0.17). The seroprevalence of brucellosis in High-risk population was 13.07(CI95%: 12.3 - 13.7).
Conclusion: The prevalence of brucellosis in high-risk occupations was high in comparison with normal population and it seems that control of livestock diseases should be considered more.

Brain Metastases in Melanomas: Historical Highlights Wilson I. B. Onuigbo  

There is a recent study of the history of the pigmentary tumors. However, it does not mention brain metastases. Accordingly, extensive search of the Transactions of the Pathological Society of London, which I have in my mini-Library, was undertaken. Consequently, the findings are analysed here. They range not only from observing the brain in its “natural” state but also to abstracting useful data. In this context, some eponymous giants were exemplified in terms of anatomical exactitude. Even the concept of “emboli” appeared.

Brucellosis seropositivity among adults in al rass city, qassim province, saudi arabia Reham Alhoshani  

Introduction: Brucellosis constitutes a major health and economic problem in many parts of the world, including countries Middle East and the Arabian Gulf. Epidemiological investigations conducted in the Middle East, demonstrated a wide spread distribution of brucellosis in the region, with Saudi Arabia having the highest prevalence of brucellosis.Thus the aim of the study was to evaluate the prevalence of brucellosis in Al-Rass city, Qassim region of Saudi Arabia and to determine its associated factors.
Materials and Methods: A cross-sectional survey was carried out in March 2013 with a random consecutive sample of 40 subjects visiting Aljreef dispensary, in Al-Rass city, Qassim region, K.S.A. The blood samples obtained from the study subjects were analyzed in two steps namely: (1) Slide agglutination test; and (2) Standard tube agglutination test.
Results: The prevalence of brucellosis in this study sample was 15% predominantly in the age group of 34 to 46 years. The two predisposing factors associated with brucellosis prevalence were consumption of raw milk and daily direct contact with animals.
Conclusion: It can be concluded that there is a high prevalence of Brucellosis in Al-Rass city, Qassim region. The prevalence of Brucellosis is significantly associated with drinking raw milk and direct contact with animals. An improved healthcare system with outreach programs to educate farmers on Brucellosis preventive measures is needed to minimize the prevalence.

Comparison of training and leanings environment in educational hospitals with Ministry of Health and Medical Education standards Hojjat Derakhshanfar  

Backgrounds: teaching and learning environments are subject of different investigations and many researchers in medical education are working on it. Therefore in this study we examined the clinical skills labs equipment with Ministry of Health and Medical Education standards in different educational hospitals of Shahid Beheshti University of Medical Sciences.
Material and methods: The study population involved 15 attending physicians and 40 emergency medicine residents in the three hospitals, Imam Hussein, Lughman Hakim and shohadaye Tajrish of the Department of Emergency Medicine of Shahid Beheshti University of Medical Sciences in the academic year 2015 to 2016. Self-made questionnaire was used to compare the Ministry of Health and medical education standards with the clinical skills labs in these centers.
Results: Clinical Skills Centers with the facilities of examination skills, communication skills and procedures, Evaluation the performance of students in each training session under the supervision of clinical faculty members had the highest scores.
Conclusion: we concluded that that learning environment is very important in the quality of learning and most of the participants proved it. Educational centers must provide the well-equipped environment to achieve in high quality in teaching and learning.

Relationship between Religious Attitude and General Health of Medical Science Students in Different Regions in Iran Reza Alipoor  

Background: Religion and religiosity have important effect on physical and mental aspects of human, and thus religious study is nowadays a new and attractive field of study. The role of religion in general health of students stimulated the conduction of this study.
Materials and Methods: In this descriptive-analytical study, 1,900 students of Lorestan, Fasa, Shiraz, Golestan, Kerman, and Shahrekord Universities of Medical Sciences were selected for evaluation, using stratified random sampling. The demographic questionnaire, Khodayarifard's religious attitude questionnaire, and general health inventory were distributed among students. Data was analyzed with descriptive tests, chi-square test, and Pearson correlation coefficient, using SPSS.
Results: The mean and standard deviation of age, general health score, and religious attitude score of students, on a scale of 100, were 22.18±3.24 years, 23.17±8.14, and 82.4±10.35, respectively. Among the students, 13% had medium religious attitude and 87% (1,653) had strong religious attitude. A positive relationship was observed between religious attitude and mental health. A significant direct correlation was also observed between religious attitude and general health (p<0.05). Conclusion: Results indicated that the majority of medical science students had strong religious attitude. A positive significant correlation was observed between religious attitude and general health. Since more than half of the students demanded the holding of religious question and answer sessions and marriage workshops, the necessity of holding such courses was further sensed.

The Pre Analytical Phase: Precautions in Specimen Collection and Patient Preparation for Trace and Ultra Trace Elements Analysis Mehri Aliasgharpour  

Pre analytical factors are probably the most important causes of erroneous trace element reference data in biological matrices today and the development of sensitive , specific, and accurate analytical technology at an acceptable cost has moved determination of trace and ultra trace elements from research facilities into a wide range of clinical laboratories. Besides, expanding knowledge of trace element nutrition and toxicity has increased clinical demand for these assays. However, with increased sensitivity and lower limits of detection the problem of specimen contamination with the element of interest has been magnified. It is vital that the accurately determined trace element concentration to reflect the condition of the patient and not contamination introduced during collection and handling. In the following paper, the concept of pre analytical factors that can contribute to trace and ultra trace elements concentration are discussed. In addition, specific percussions for collecting different sample types and special considerations in patient preparations and sample types for specific Trace and Ultra Trace Elements analysis are addressed.

Foniculum vulgare: review of pharmaceutical features Hossein Zarei Amand  

Human kind has used the herbal plants to treat lots of diseases since a long time ago and there was always a very close connection between people and plants due to the development of all the societies and they were used to treat different diseases in eastern Asia ,India , China and Iran since a thousand years ago .This plant height is one to two meters and has some leaves with separated and narrow laminas .This plant has some estrogenic ,anti inflammatory and antioxidant effects and traditionally is used to treat infertile women .Its specific combinations are Anethole, limonene and fenchone .it’s properties are :pharmaceutical effect on the treatment of the initial dysmenorrhea ,testis growth , excretion channel and Prostate glands , mammary gland weight gain, fallopian tubes, ovaries, endometrium, myometrium protective effect on the liver by reducing Liver enzymes and bilirubin, have estrogenic effects in increasing the milk secretion, early periods, ease at birth and increased libido and anti hyper tension effects through the diuretic and natriuretic effects .

PENGENDALIAN KUALITAS TEMPE DENGAN METODE SEVEN TOOLS Iswandi Idris Ruri Aditya Sari

Kualitas merupakan faktor yang dapat meningkatkan daya saing suatu produk. Dengan peningkatan kualitas maka biaya produksi akan semakin kecil sehingga mengurangi pemborosan. Kegagalan suatu produk terjadi akibat beberapa faktor pada proses produksi, bahan baku, mesin, peralatan, manusia dan lingkungan. Untuk menjaga kualitas produk yang dihasilkan dan sesuai dengan kebutuhan pasar, maka perlu dilakukan pengendalian kualitas (Quality Control) atas aktivitas proses yang dijalani. Pengendalian kualitas dengan menggunakan peta control (control chart) dapat digunakan untuk mencapai suatu keadaan terkendali atau berada dalam batas-batas pengendalian sehingga menunjukkan bahwa proses tersebut konsisten. Selain itu, pengendalian kualitas dengan menggunakan peta kontrol dapat digunakan sebagai alat perbaikan kualitas, sehingga dapat meningkatkan kualitas produk yang dihasilkan dan memberikan keuntungan karena produk yang dihasilkan mempunyai kualitas yang baik. Penelitian ini bertujuan untuk mengetahui pengendalian kualitas dari produk tempe dengan menggunakan metode seven tools. Untuk mendapatkan data yang sesuai dengan penelitian, maka perlu dilakukan pengamatan dari suatu produk yang tidak sesuai spesifikasi (rusak), selanjutnya dilakukan perhitungan dengan menggunakan metode check sheet, flow charts, histogram, pareto chart, control chart, scatter Diagram, dan fishbone diagram untuk hasil produk. Dari analisa hasil terhadap perhitungan dengan peta control yang dilakukan, maka dapat disimpulkan bahwa selama 20 kali pengamatan, nilai garis tengah (central line) adalah 3, nilai batas kontrol atas (UCL) adalah 5.6, dan nilai batas kontrol bawah (LCL) adalah 0.32. Dari hasil perhitungan tersebut maka dapat diketahui tidak adanya variasi proses yang berada diluar batas pengendalian (Out of Control) atau proses masih berada dalam batas pengendalian (In Control). Keadaan lingkungan juga menentukan jumlah produk cacat pada produksi tempe.

PERANCANGAN SISTEM INFORMASI KAMPUS TERINTEGRASI DI LINGKUNGAN POLITEKNIK LP3I MEDAN Iswandi Idris Humala Napitupulu

This study was conducted to obtain Integrated Information System(IIS)in Politeknik LP3I Medan (PLM), Analysis of the cost of an integrated information system design and integrate information systems in the campus environment. The subjects of the study a total of 336 samples. Cronbach Alpha reliability test values obtained 0.753 or reliable (reliability) is high. Correlation Test Double (R) of 0.247 or lower of a relationship between the independent variable on the independent variable. Test R2 (R Square) of 0.61 or (61%). F calculated > F Table (2,663> 1.9667), then H1 is accepted, it means There is significant effect between 8 independent variables together to SIT (dependent). T test showed 2 independen variabels rejected H0 means academic documentation process speed and sophistication of communication tools, collaboration and coordination between units in PLM partly no significant effect on the integrated information system. Using cost-benefit ratio analysis (Benefit Cost Ratio, BCR) then the total benefit greater than the total cost of 1 is 4.66 to SIT investment can be applied, and further integration of the SI strategy is applied. Scheme design of information systems will be easier to implement with a top-down and bottom-up, carried out in stages, starting from planning, analysis, design, preparation of DFD, design arsitekktur SIT.

ANALISIS PERANCANGAN SISTEM INFORMASI TERINTEGRASI DI LINGKUNGAN PERGURUAN TINGGI SWASTA DI MEDAN Iswandi Idris Yuana Delvika

Penelitian ini dilakukan untuk memperoleh Sistem Informasi Terpadu (SIT) di Perguruan Tinggi Swasta. Analisis biaya desain Sistem Informasi yang terintegrasi dan mengintegrasikan sistem
informasi di lingkungan kampus. Subyek penelitian sebanyak 108 PTS di Medan. Dari hasil analisis diperoleh Cronbach Alpha nilai uji reliabilitas sebesar 0,825 atau dapat diandalkan (reliability) sangat tinggi. Uji Korelasi Ganda (R) dari 0,303 atau lebih rendah dari hubungan antara variabel independen terhadap variabel independen. Uji R2 sebesar 0,92 atau (92%). Sedangkan nilai F hitung

PENENTUAN WAKTU STANDAR BAGIAN PRODUKSI PADA CV. SANGGAR PUTRA KALINGGA MEDAN Iswandi Idris Syafwani N Pohan

CV. Sanggar Putra Kalingga adalah perusahaan yang bergerak dibidang Furniture yang bahan utamanya adalah Kayu Jati. Perusahaan ini akan melakukan produksi jika mendapat
pesanan/orderan dari pelanggan. Hal utama yang diprioritaskan oleh setiap perusahaan manufactur adalah waktu yang tepat untuk memenuhi permintaan pelanggan. Waktu Standar adalah waktu
yang dibutuhkan untuk menyelesaikan suatu siklus pekerjaan yang dilakukan menurut metode kerja dan kecepatan normal dengan pertimbangan faktor penyesuaian ditambah kelonggaran waktu untuk keperluan pribadi dan lain-lainya yang tidak terduga. Penelitian ini menggunakan metode analisis data deskriptif kuantitatif. Dari hasil penelitian yang dilakukan diperoleh hasil waktu standar pada proses pemotongan kayu sebesar 49,28 menit. Pada proses penghalusan kayu didapat waktu standar sebesar 50,51 menit. Pada proses perakitan didapat waktu standar sebesar 317 menit. Pada proses pewarnaan/finishing didapat standar sebesar 155 menit.

IBM PENINGKATAN PRODUKTIVITAS KELOMPOK USAHA ROTI “NENOT-NENOT” KELURAHAN SUKA RAMAI MEDAN Iswandi Idris Helviana Hasibuan

Persaingan industri roti sekarang ini semakin meningkat dalam memenuhi permintaan pasar. Para usaha kecil menengah mereka berlomba untuk memenuhi permintaan pasar tersebut. Dari segi proses pembuatannya, Mitra IbM (Iptek bagi Masyarakat) tidak menggunakan bahan tambahan agar harga jual roti dapat menjadi murah dan terjangkau. Ditemukan beberapa permasalahan dalam peningkatan produktivitas pada mitra antara lain: kelemahan dalam penyusunan anggaran biaya operasional sehingga sulit menentukan perencanaan anggaran dan laporan keuangan secara cepat. Permasalah persediaan bahan baku yang tidak tepat karena mengandalkan make to order sering stock bahan baku habis atau terbatas sehingga permintaan konsumen dan pelanggan jadi terganggu, permasalahan selanjutnya adalah rancangan fasilitas kerja pada stasiun kerja pembentukan (terdiri dari pengerjaan pengadukan, penipisan adonan, pengisian, pembentukan) yang tidak ergonomis, dengan metode kerja yang tidak efektif yang mengakibatkan para pekerja sering kelelahan dalam memproduksi roti sehingga produktivitas menurun. Permasalahan lainnya yang ditemui adalah rancangan alat bantu untuk mengurangi musculoskeletal dibagian pemanggangan akibat aktivitas angkat angkut yang dilakukan secara manual, permasalahan selanjutnya yang ditemui adalah lemahnya motivasi kerja para pekerja, lemahnya strategi bauran promosi dibandingkan kompetitor kecil dan besar lainnya. Berdasarkan uraian diatas untuk menyelesaikan permasalahan yang dihadapi kelompok usaha roti ’nenot-nenot’ perlunya usaha peningkatan produktivitas dari berbagai lini produksi sampai bauran promosi Mitra. Untuk itu melalui program IbM maka dirancang dan dibuat teknologi tepat guna serta pelatihan untuk membantu kelompok usaha roti agar adanya peningkatan aspek produksi dan manajemen usaha yang baik. Hasil pelaksanaan IbM menunjukkan Pemilik usaha roti dan pekerja Mengetahui peran ergonomi dan teknik tata cara kerja dalam mengevaluasi dan merancang suatu sistem kerja yang terdiri dari manusia dan mesin. Pemilik usaha roti dapat mempertahankan stabilitas atau kelancaran kegiatan operasi bakery, sehingga bakery masih dapat memenuhi permintaan pasar serta mampu melakukan perbaikan terhadap postur kerja operator yang salah atau kurang ergonomis dan keberhasilan juga terlihat dengan Meningkatnya produktivitas dan penampilan kerja.

Association of coronary artery disease with psoriasis in a group of patients in queen alia heart institute (qahi) in jordan Ramzi a .hiary  

Abstract
Objective: The aim of our study is to demonstrate the association between psoriasis and CAD in a group of patients at QUEEN ALIA HEART INSTITUTE (QAHI)..
Methods: This retrospective study was conducted at QUEEN ALIA HEART INSTITUTE from April 2012 to August 2016. 167 psoriatic patients (with moderate to severe psoriasis) and 197 non-psoriatic patients (control group) were matched by sex, age and risk factors of CAD. All patients underwent coronary angiography, and the incidence of coronary artery disease was compared between the two groups.
Results: After analysis, the p-value of CAD risk factors in both groups (psoriasis and controls) were: age (41.3 year, 35.4 ,0.04) , male (67% , 64% ,0.06), smoking (60.5% , 56% , 0.4) , HTN (40.5 % , 43% , 0.29 ) ,DM (37.5% ,36.3% ,0.3), hyperlipidemia (20.3% , 17.8% , 0.41), family history (36.1% ,34..4 ,0.05). After matching for all these risk factors, the rate of CAD in psoriasis patients was (8.2%) and (2.1%) in non-psoriatic patients with p-value less than 0.001.
Conclusion: Psoriasis (moderate and severe) is an independent risk factor for increasing the risk of coronary artery disease in (sex, age, and other risk factor for CAD) matched patients.

Comparing between varicocele surgery and embolization , our experience in King Hussein medical center Mohannad Al-Naser  

ObjectiveOur objective was to compare between endovascular varicocele embolization Vs varicocele surgery , for the treatment of varicocele . varicocele is considered the most common surgical cause of male infertility .
Methods : Retrospective review of the prince Hussein Medical Center varicocele database . We reviewed a total of 265 patients , All of the patients in the database had clinical varicoceles confirmed by scrotal ultrasonography , a total 45 patients underwent unilateral varicocele embolization, and a total 220 patients underwent bilateral and unilateral varicocele surgery in Prince Hussein Center of Urology and Organ transplantation , between January 2015 and March 2017 . Patients have been followed up at the urology outpatient clinic , and by their semen fluid analysis to assess the results .
Results : In patients who underwent varicocele embolization , the failure rate was 3 % , and the recurrence rate were 3 % , sperm motility improved in all patients , with no complications related to the procedure . In the other hand , in patients who underwent varicocele surgery , the recurrence rate was 7 % , sperm motility improved in all patients too , and there are no documented complications in all patients .
Conclusion : Both methods , have similar result regarding semen fluid analysis improvement , and recurrence rate ( in the international studies . recurrence rate between 5 and 10 % ) . but the surgical option is is less than embolization

Performance of Nitrogen Phosphorus compound fertilizer in Boro rice Mosud Iqbal  

Objective: Evaluation of new nutrient sources plays an important role in crop production. A field experiment was conducted at BRRI, Gazipur and at BRRI regional station, Sonagazi, Feni during Boro season of 2014-15. A new fertilizer, NP compound (NPC) was evaluated and compared the performances with di-ammonium phosphate (DAP). Test crop was BRRI dhan29. At Gazipur site, phosphorus (P) control plot produced only 1.97 t ha-1 grain yield that increased with added P along with two N rates. At lower N doses, application of P either from DAP or NPC produced similar grain yield. It was observed that 30% less N produced statistically similar grain yield to 100% N, irrespective of P sources. It can be inferred that 30% N could be saved without significant reduction of rice yield. At Sonagazi site, application of P either from DAP or NPC could not increase rice grain yields compared to P control plot. From the results of both sites it can be concluded that NPC and DAP performed equally either with 100% N or 30% less N rates.

The Occurrence of Calcaneal Spurs In Plantar Fasciitis Patients Raad Jaradat  

Objective: The aim of this study is to find out the occurrence of calcaneal spurs in plantar fasciitis patients.
Methods: Patients with planter fasciitis were diagnosed in the rheumatology clinic at Prince Rashed Hospital and Prince Hashem Hospital. Only 140 eligible patients were exposed to careful examination and hind foot lateral radiographs. All patients were observed in regards to their age, weight and calcaneous bone X-Ray. For calcaneal spurs occurrence, the patients were divided into two groups; (present, absent). Data analysis was done based on simple statistical methods and Chi-squares tests.
Results: Planter fasciitis occurrence increase with the increase in age and weight (80%, 76% respectively) (Ps < 0.05). 98 patients out of 140 of patients with planter fasciitis were diagnosed with calcaneal spurs (70%) (Ps < 0.05). Conclusion: This study shows that there is a positive relation between calcaneal spurs and planter fasciitis.

Aggressive Ulcerating Squamous Cell Carcinoma Arising In Old Burn Scar: A Case Report Masoud Shayesteh Azar  

Carcinoma arising in posttraumatic ulcers and chronic wounds was first described by Jean- Nicholas Marjolin in 1828. Marjolin’s ulcers are malignant neoplasms that originate from chronic irritation such as burn wounds, venous stasis ulcers, traumatic wounds, osteomyelitis, fistulas, and lacerations, Burn wounds are the most frequent underlying etiology of Marjolin’s ulcers. We reported Marjolin’s ulcer that arising from very old burn scar in foot.

A Case Series of Portal Vein Thrombosis Following Laparoscopic Sleeve Gastrectomy Omar Al-Shawabkeh  

Background: laparoscopic sleeve gastrectomy is presently the most common bariatric surgery at our center (King Hussein Medical Center). Portal vein thrombosis is a rare surgical complication with an insidious presentation and a high risk of bowel compromise. The aim of this study is to present a series of patients who developed portal vein thrombosis post sleeve gastrectomy, and to describe the overall incidence, associated risk factors, clinical presentation and management.
Case Reports: Four patients developed portal vein thrombosis post laparoscopic sleeve gastrectomy at King Hussein Medical Center during the period (Jan 2006 to Feb 2017). All patients presented with abdominal pain, nausea, and vomiting and decrease oral intake. The abdominal Computed tomography (CT) scan confirmed the diagnosis of portal vein thrombosis in all of them. One patient required medical treatment along with operative intervention and bowel resection. The other three patients were treated conservatively with anticoagulation and fluid resuscitation.
Conclusion: Portal vein thrombosis is a rare but severe complication after laparoscopic bariatric surgery. Familiarity with this high-risk entity is critical. Early diagnosis and management, initiated by a high index of suspicion, is crucial.

Meningitis retention syndrome: a case report Farhang Babamahmoodi  

Urinary retention is a urologic emergency that is defined by an inability to voluntarily void urine, which can be acute or chronic. Benign inflammatory nervous diseases also cause acute urinary retention, in which patients lack apparent urethral outlet obstruction, but exhibit minor neurological and cerebrospinal fluid (CSF) abnormalities. The development of urinary retention in the context of meningitis and CSF pleocytosis without any lumbosacral radiculomyelitis is known as Meningitis Retention Syndrome (MRS). We report a 24-year-old male with complaints of urine dribbling, fever and also complete urinary retention a few hours later and nausea/vomiting, headache and flank pain. The general and genitalia examinations, routine laboratory tests, diagnostic ultrasound, and brain MRI were normal. But HSV Ab (IgG) and PCR HSV were positive in CSF analysis. Finally, Urologist performed the Urodynamic study and flaccid neurologic bladder was reported due the patient was treated with intravenous acyclovir 500 mg, every eight hours, with the diagnosis of MRS. MRS is a rarely described clinical entity with features of meningitis and acute urinary retention. The most common cause of urinary retention is benign prostatic hyperplasia. Other common causes include prostatitis, cystitis, urethritis, stones, and vulvovaginitis; receiving medications in the anticholinergic and alpha-adrenergic agonist classes; and cortical, spinal, or peripheral nerve lesions. Since MRS has a benign and self-remitting course, the effectiveness of immune treatments (steroid pulse therapy) remains unclear, although such treatments may shorten the duration of the disease. Management of the acute urinary retention is necessary to avoid renal injury due to hydronephrosis.

Comparison of PCR and culture methods for detecting of Listeria monocytogenes in vaginal samples Mohtaram Nasrollahi  

Listeria monocytogenes is an opportunistic intracellular pathogen that has become an important cause of human food borne infections worldwide. The aim of this study is the determinate sensitivity of diagnostic methods of this organism and achieving a test that can detect Listeria monocytogenes in all circumstances in clinical samples. Materials and Methods: In this study 88 vaginal swabs were collected from women with age of (15-45) referred to gynecologic clinics in the hospital (Sari, Iran). Vaginal swabs were examined by culture on specific PALKAM agar medium and PCR technique by specific primers. Results: Out of 88 studied vaginal swabs, 8 cases with culture method and 27 cases were positive with PCR technique. The sensitivity of PCR and culture is reported %100, %29 respectively. Conclusion: The results show that PCR is a more sensitive, easier, and faster method in comparison to in clinical samples.

Determining the Moral Sensitivity of Intensive Care Nurses Bilsev Araç  

Introduction: Intensive care units are defined as clinics that aim to support and cure critically ill patients, have a priority with their allocation in terms of patient care, are equipped with advanced technology devices, follow patients‟ vital signs for 24 hours and provide a multidisciplinary service. This study was conducted for examining the moral sensitivity of intensive care nurses in moral decision-making.
Method: The sample of this descriptive and cross-sectional study consisted of 84 nurses who worked in intensive care units of university and public hospitals in the province of Malatya between February - March 2015 and accepted to participate in the study. The data were collected using Socio-Demographic Data Form and Moral Sensitivity Questionnaire. Statistical analyses of the data were evaluated using computer-aided SPSS program, descriptive statistics (frequency, mean, minimum and maximum values, standard deviation), Anova variance analysis and Student t test.
Findings: 70,2% intensive care nurses who were included in the study were in the age group of 18-34, 54,8% were married, 91,7% had bachelor's degree and 53,6% had studied ethics. While the total moral sensitivity score of intensive care nurses ranged from minimum 51 to maximum 131; the average score was 87,30±17,03. Average scores obtained by intensive care nurses from the lower dimensions of moral sensitivity were as; 18.32±5,84 (autonomy), 11.41±4.40 (benefit), 10,67±2,97 (integrative approach), 13,46±4,78 (conflict), 11,05±3,08 (application) and 8,47±3,33 (orientation). It was determined that there was no difference between the total scores obtained by nurses from moral sensitivity and their educational background, duration of working in intensive care units, the unit where they worked and the state of studying ethics before and after graduation (respectively p:0,265, p:0,555, p:0,299 and p:0,439), however, there was a significant difference between the scores of some lower dimensions of moral sensitivity according to their age and marital status (respectively p:0,036, p:0,037).
Conclusion: It was determined that intensive care nurses had a moderate level of moral sensitivity. Thus, it is recommended to plan and conduct continuous curriculums containing information and personal development aimed at increasing the moral sensitivity of intensive care nurses. Besides, it is considered important to conduct studies in larger groups for the moral sensitivity of intensive care nurses.

Arthroscopic Reconstruction of Anterior Cruciate Ligament by Hamstring Graft; Endobutton vs Rigidfix Salman Ghaffari  

Introduction: Anterior cruciate ligament (ACL) tear is a common sport injury. In recent years hamstring ligaments have become the most widely used graft for ACL reconstruction. One important issue is type of femoral side graft fixation. We compared the clinical outcomes of two femoral side fixation methods, endobutton and Rigidfix.
Methods: From March 2014 to March 2016, 147 patients with ACL tear were treated by arthroscopic ACL reconstruction using autogenous quadruple hamstring graft. Femoral side fixation was performed with endobutton or Rigidfix. Demographic and perioperative data were collected from hospital documents. Patients were evaluated using objective and subjective International Knee Documentation Committee (IKDC) and Lysholm Knee Scores.
Findings: 87 (59%)cases (48 endobutton and 39 Rigidfix) were accessible for final evaluation. Mean duration of follow up was 18(range 17-22) months. There was no significant difference between two groups regarding age, gender, body mass index (BMI), damage mechanism, activity level and postoperative pain, limp, subjective IKDC and Lysholm scores. Pivot shift test was normal in all cases of both groups. Anterior translation of more than three millimeter in comparison with intact knee in 30o and 90o of flexion was seen in 3(6.25%) and 3(7.69%) of endobutton and Rigidfix cases,respectively.
Conclusion: There was no significant difference between endobutton and Rigifix using subjective scores. Rotary and anteroposterior stability was similar. Both fixation methods result in a stable knee.

The Effect of Delivery Type on the Indices of Term Newborn Infants’ Umbilical Vein Blood Gas Daryoush Zohouri  

Introduction: Caesarean section (also known as C-section or caesarean delivery) has undergone an enormous increase over the recent decades, particularly in Iran where the rate of C-section is five times larger than that of the global standards. Moreover, according to several studies, there is the possibility that caesarean delivery can affect umbilical vein blood gas. Accordingly, the present study was conducted aiming to examine the impact of delivery type on the indices of term newborn infants’ umbilical vein blood gas.
Methods: The present cross-sectional study explored a total of 222 newborn infants born in Shahid Motahari Hospital, Marvdasht, Iran in 2015 based on three delivery-type groups, namely, natural delivery, general anesthesia-used caesarean and spinal anesthesia-used caesarean. Of all the infants, an amount of 0.5cc umbilical vein blood was taken and then examined in terms of blood gases. The two groups were compared with each other with regard to 1st and 5th minutes’ Apgar score, anesthesia duration as well as its influence on blood gases. The data was then analyzed using SPSS software.
Findings: Mean and standard deviation values for Apgar score in natural delivery at the beginning of birth equaled 8.8 ± 0.59, suggesting a significant difference between natural delivery and other caesarean groups (P= 0.01). It should be noted that no significant difference was reported in infants’ umbilical vein blood in the two groups in terms of pH (P=0.08), PO2 (P=0.79) and PCO2 (P= 0.85). Likewise, there was a significant difference in umbilical base excess of natural delivery and caesarean groups (P=0.03).
Conclusion: Based on the research results, compared to infants in caesarean groups, those born naturally enjoy higher Apgar score and base excess.

Primary Hydatid Cyst of the Thigh , an unusual localization: a case report Feras Almbaidin  

Introduction: Subcutaneous musculoskeletal hydatid cysts are rare ,representing around 1-5%.It mimics a soft tissue tumor ,so preoperative radiological diagnosis is important to choose the treatment.
Case Presentation: This case was presented to clinic in Prince Ali Hospital in Karak . A 78 years old female patient was presented complaining of right medial thigh swelling which appeared a few weeks ago.The swelling caused discomfort and pain .On exam ,a lump was located in the medial aspect of the right thigh,round,soft,non mobile. Her US revealed multiple well defined cystic lesions in the posterior aspect of the thigh, with internal septae mostly representing a hydatid cyst. A MRI was ordered and showed a large,multi-lobular, thin walled and non-calcified fluid containing cyst. The appearance was consistent with a hydatid cyst.Next,the patient underwent abrain,chest and abdominal CT to check if there was aprimary source,the results were negative.An Echinococcus Granulosa titer test was ordered, the result was negative. Treatment options were discussed.we preferred to start with the conservative approach.So,a high dose of Albendazole was started,with regular follow up in the clinic,but conservative treatment failed so we decided to continue with surgical treatment by complete excision.
Conclusion: Echinococcal disease should be considered in any patient who presents with a cystic mass despite body location. Especially in endemic areas.

Comparing The Pipelle With Dilatation And Curettage (D&C) In Diagnostic Power Of Sampling For Evaluating The Patients With Abnormal Uterine Bleeding Tahereh Gelini Moghaddam,  

Introduction: Abnormal uterine bleeding is a common and serious problem in the women of late reproductive age, and an indication for biopsy.
Common diagnostic methods in Iran including the endometrial biopsy with dilatation and curettage (D&C) are the gold standard for diagnosis. The aim of this study is to compare the diagnostic power, complications, and duration of endometrial biopsy caused by two diagnostic methods of endometrial sampling of pipelle with dilatation and curettage (D&C) in patients with AUB.
Methods: This single blinded- parallel randomized clinical trial was performed at the Iranian Center for Clinical Trials (IRCT). The research population is the patients referring to the specialized clinic of Mostafavian and Baghban 1 in Sari with complaints of AUB from October 2016 to September 2018. The patient selection was available for study. The patients were divided in simple random method into two groups of D&C and pipelle alternatively. The samples were sent to pathology after sampling, and when sampling is done, the patient was examined for complications such as uterine bleeding or vasovagal shock symptoms for the cervical stimulation, then, the results were compared with D&C, and also it was compared with the sample histopathologically.
Findings: A number of 70 patients were included, while many of which were excluded, and finally 50 patients were completed the study. First, the biopsy with pipelle and then biopsy with D&C were performed on all the patients. The mean age of subjects was 47.5 years old. The highest number of patients (28%) was in the 40-45 group. The mean thickness of the endometrium in patients was 11.5 mm. In the pipelle group, 34% of the cases of insufficient samples were obtained, while using the biopsy, only 4% of the insufficient samples are obtained. A total of 23 samples from 50 patients undergoing pathologic diagnosis were obtained from two similar sampling methods. In the pipelle group, the insufficient sample with 34% proliferative, and then the secretion and proliferative samples were the second and third (prophylactic and secretion pathology are considered as normal tissues that was calculated 56% in this study) in the diagnosis, and accommodation of the pipelle and D&C samples in proliferative has allocated the highest percentage of 9%, and the lowest accommodation was in the in atrophy and polyps and hyperplasia. The average duration of the procedure in the pipelle group was significantly lower than D&C. The pain was significantly higher in pipelle group than D&C (P <0.05). Conclusion: Pipelle is a cheap, fast, outpatient method with low side effects without the use of anesthesia and operating room facilities for diagnosis of hyperplasia and cancer with lower susceptibility to D&C. In the D&C with acceptable susceptibility and specificity, the pain was lower, number of insufficient samples was lower, and diagnosis of polyps was higher.

Evaluation Of Ct Scan Results In Patients With Minor Head Trauma Based Its Indications And Final Clinical Results In Patients Referred To Emergency Department Of Namazi Hospital In 2016 Kazem Jamali  

Introduction: There is much controversy over whether or not to use CT scan in patients with minor traumatic brain injury. The present study was conducted aiming to examine the results of CT scan in minor traumatic brain injury on the basis of the required indications and final clinical results.
Methods: A cross sectional study, the present study was conducted in the emergency section of Namazi Hospital, Shiraz, Iran. Patients with traumatic brain injury and Glasgow Coma Scale scores 13 to 15 were included. The clinical and CT scan results of patients were collected, compared and analyzed using SPSS software. P-values less than 0.05 were regarded as significant.
Findings: Out of 263 patients, 182 (62.6%) and 81 (30.8%) were male and female, respectively. Also, the mean age of participants was 21.36±21.79. The most prevalent indication in patients was vomiting (56.3%) and the most prevalent unnatural indication was linear skull fracture. The present study reported that there is a significant association between unnatural CT scan results and indications of loss of consciousness level (P<0.01), headache (P=0.01) and post trauma seizure (P=0.04). Conclusion: The present study came to the conclusion that the four indications, namely, consciousness level, headache, post trauma seizure and vomiting can well predict the necessity for using CT scan in patients with minor traumatic brain injury.

Diagnostic value of clinical examinations in confirming fracture of elbow bones Farzad Bozorgi  

The purpose of this study was to evaluate the value of diagnosis of extension, supination, ecchymosis, hematoma and local tenderness in elbow injury in patients referred to Imam Khomeini Hospital in Sari..
Methods: This study is a prognosis test that evaluates the clinical findings of physical examination and imaging results in predicting elbow bone fractures in patients aged between 18 and 60 who suffer from blunt trauma referring to the emergency department of Imam Hospital. Initially, the first examinations of the patient's joint wound were assessed by assessing the range of motion including extension, supination, and pronation, as well as the presence of localized tenderness in radial head, ulna and epicondyle hemorrhoids, and examining the presence of ecchymosis and hematoma in the articular region by the expert Emergency medicine is done, the results of the examinations are recorded in the questionnaire form. Then, the standard geometry of the elbow joint is requested and the results are analyzed separately by the two radiologists. After collecting and entering the data, SPSS

Comparison of primary maladaptive Schema in patients under methadone maintenance treatment and healthy people in MMT clinics Mohammad Khademloo  

Introduction: The aim of this study was to Comparison of primary maladaptive Schema in patients under methadone maintenance treatment and healthy people in MMT clinics.
Methods: The study population consisted of all addicts and non-addicts under methadone maintenance treatment in MMT clinics in Sari formed of 200 people (100 people addicted and 10 normal men) were selected with available sampling procedure. Young schema questionnaire was used to collect data in 5 areas (areas of cuts and rejection, Impaired Autonomy and Performance domain, direction and other fields, hyper vigilance and impaired inhibition and field constraints) with 75 questions.
Findings: Face and content validity according to the standard tools of the sighting several professors and its reliability using Cronbach's alpha coefficient α; 0.968 is obtained. To analyze the data, independent t-test was used. The results showed that, in the domains of basic incompatibilities between addicts and healthy subjects undergoing methadone maintenance treatment MMT clinic there is a significant difference.
Conclusion: in are

Study of DMFT index in First grade children in Sari in 2016 Negin Meschi  

Introduction: DMFT is an index in which the number of decayed and lost teeth due to caries is calculated. Caries and lost teeth cause functional and aesthetic problems and also lower level of personal and social health. By obtaining a true measure of this index and factors enhancing it, a careful planning for reducing caries as well as improving the level of community health is possible.
Methods: This is a descriptive study and is conducted using a cross-sectional method. The population of the study consisted of male students of first grade of elementary school who referred to the examination center in summer. A total of 767 students were examined. Examinations were performed on an ordinary chair in natural light using mirrors and disposable catheter by senior dental students and data was recorded in special forms. The index is calculated using descriptive statistics and algebraic summation of Total of decayed, extracted and filled teeth and then mean and standard deviation are obtained for groups.
Findings: The amount of DMFT of all students was obtained as 93/2 ± 08/4 in in which

Evaluation of the effects of anticoagulant drugs on the rate of bleeding of oral surgeries and warfarin alternatives Amirhosein Pakravan Tahmine Bamdadian

Introduction: Today, with advances in the treatment of cardiovascular patients such as intravascular stents, cardiac valves and intracavitary pacemakers and cardiac transplantation, many cardiovascular patients should use anticoagulants such as warfarin, aspirin, Plavix and Sosix, Ticlopidine and other drugs. The aim of this study was to investigate the effects of coagulation drugs on the rate of bleeding of oral surgeries and warfarin alternative.
Methods: For access to studies on anticoagulant drugs and their effect on the bleeding of oral surgery in heart patients, the PUBMED, MEDLINE, MAGIRAN, SID, ELMNET and GOOGLE databases have been used since 1998 to 2015. Keywords include oral surgery, anticoagulants, warfarin, dentistry and bleeding.
Findings: In the investigations done on the studied articles, it seems that patients with anticoagulant drugs that are supposed to undergo minor dental surgeries do not require discontinuation, dose reduction, or even control of coagulation factors and bleeding can only be controlled by local dental procedures such as suturing, mouthwash, gel

THE PROGRESS OF EU AND TURKEY RELATIONSHIP Majda SIYAD  

Relations between Turkey and the EU, which express a difficult process, are important in every period of history. Relations that started with the Ankara Agreement passed through different phases over time, resulting in changes in mutual expectations of the parties. Turkey has not been able to give up on entering the EU. Similarly, the EU was able to see Turkey completely out of the union. Turkey has not been among the candidates for full membership with the 1997 Luxembourg Summit, and Turkey has tried to follow the policy of cutting the relations by reacting to the EU. After this unfortunate situation, the EU announced that it would prepare an accession partnership document by accepting the candidacy of Turkey with the 1999 Helsinki Summit. This has led to a shift in relational obligation and expectations.

Management Related Challenges that Inhibit the Integration of ICT into Secondary Schools Financial Accounting Systems in Kenya. Dr. Kapkiai Moses Kogei  

Information communication technology (ICT) is a major drive in global economies. It has been used in most sectors of the world economies. In most developed countries it is yet to be optimally incorporated in the education sectors as a tool for Education management. The purpose of this qualitative study was geared towards establishing management related challenges that inhibit the integration of ICT into secondary schools financial accounting systems in Kenya, taking North rift region of rift valley as case. The study sampled 60 from the targeted 1200 schools and by extension, the respondent using purposive sampling technique. Generic qualitative design and interpretive research methodology were adopted. Data was collected using interviews, observations, documentary analysis and structured questionnaires. Data collected was analyzed using descriptive statistics and presented using frequency tables, percentages and bar graphs. The findings showed that the major managerial challenges included among others; secondary schools’ leadership ignorance of ICT policy in education, absence of IC

An Exploration of Innovation Strategies Adopted By Telecommunication Services Providers for Competitive Advantage in Kenya.A study of Airtel Kenya Dr. Bichang’a Evans  

Innovation strategy provides a clear direction and focuses the effort of the entire organization on a common innovation goal. This study seeks to investigate the innovation strategies adopted by telecommunication service providers for competitive advantage in Kenya with special focus on Airtel Kenya. This research problem is studied through the use of descriptive research design. The target population for this study is the 68 employees of Airtel Kenya at the head office in Nairobi and 100 customer of Airtel Kenya. Stratified random sampling and purposive random sampling techniques were used to select the sample size of 158 respondents since the population of interest is not homogeneous and could be divided into three strata namely; top, middle and low level management.

Analysis of Socio-Economic, Factors Influencing Adoption of Biogas Technology among Farm Households in North Rift Region, Kenya. DR. Charles Obunde Ongiyo  

Biomass is one of the main sources of energy in Kenya accounting for over 68% of the total primary energy consumption. The continued dependency on biomass energy has resulted to land degradation, deforestation, drought and famine. The adoption and continued use of biogas energy technologies within the developed and developing countries is of great social, economic and environmental benefit. Although the positive benefits of using biogas is clear, in Africa and Kenya the households’ biogas adoption level is low. The main purpose of this study was to analyze social, economic factors that influence adoption of biogas energy among farm households in Nandi, Uasin-Gishu and Trans-Nzoia counties in North Rift region of Kenya. The target population was all the farm households in the three counties. The study employed farm household multistage research design mainly cluster, and simple random sampling techniques to get a sample size of 295 respondents for the study. Farm households were used as units for analysis. Data was collected using questionnaires and analyzed using descriptive and infe

Developing Information for Disasterand Risk Management in Public Universities of Kenya:An Emerging Role of Information Profession. Henry Lucheli Lusala  

Disasters entails factors that are coupled with naturally occurring hazards such as droughts floods, fire, war, terrorism, HIV/AIDS, landslides and epidemic outbreak among others which are risks to human life. Disaster management is the organization and management of resources and responsibilities for dealing with all humanitarian aspects of emergencies, in particular preparedness, response, and recovery in order to lessen the impact of disasters. It usually refers to the management of natural catastrophes such as fire, flooding, or earthquakes. Related techniques for disasters management include crisis management, contingency management, and risk management. Developing an Information for disaster and risk management in universities of Kenya is framed within an environment where senior managers in the university need to integrate with low level staff as they face the pressure to professionalize; explore the world of risk, trust, and the distribution of power to allow confrontation and flow of information as they gather daily intelligence on acts of disasters. Unfortunately this objec

Characteristics and Performance of C02 Heat Pump at 50% Overcharged Conditions. Paul Maina  

A CO2 water to water heat pump system was used to investigate the effects of throttle valve opening and water flow rates at higher charge capacity (149% of the full charge). It was observed that the throttle opening affects the gas cooler pressure (and inlet temperature) where the less the opening the higher the pressure. Although the increase in gas cooler pressure was improving the gas cooler heat output and therefore the system efficiencies, there is an optimum pressure which when exceeded, the system performance deteriorates. This optimum pressure also is related to a certain throttle opening which is approximately at 20% in this
study. Similarly, as the throttle valve is reduced, the overall system becomes more ideal as indicated by Lorentz efficiency. On the other hand, the higher the flow rates the higher the performance although it’s better to keep the chilling water (evaporator) flow rate low and cooling water (gas cooler) flow rates high than vice versa for the best heat pump performance. However, if the main intention is to idealize the system, then it’s better to keep th

Effect of Mentorship Programs on Early Pregnancy Prevention among Secondary Schools Girls in Homa Bay Sub-County. ISABELLAH W. WAINAINA  

Unintended pregnancy among adolescents represents an important public health challenge in developed and developing countries. Numerous prevention strategies have been employed by countries across the world, in an effort to address this problem. However, many girls still cannot complete school due to early pregnancies. The purpose of the study was to examine the effect of mentorship and role modeling programs on pregnancy prevention among secondary school girls in Homa Bay Sub-County. The study adopted a descriptive survey research design and guided by the feminist theory. The study was carried in girls’ schools and mixed schools only because students in boys’ schools only are not directly affected by the phenomenon under study. Questionnaires and interview schedules were used for the purpose of collecting data. Two sets of questionnaires were administered for the heads of guidance and counseling department and the class teachers. Interview schedules were administered to the principals and the sub-county director of education. Data was analyzed using descriptive statistics of frequenc

Meeting Health Needs of the Marginalized Health Implications of Children Living in the Streets in Eldoret,Kenya. Carren Morangi Onwong’a  

Globally, millions of street children live in the streets where they are deprived of social, economic, education and health opportunities for their survival. Street children grow up in an environment where equanimity and psychosocial stability is frequently threatened. To the worst, their health is compromised by shoddier and everyday deteriorating environmental conditions. This is compounded by inadequate research on health issues of street children hence, lack of enough data in planning effective interventions for them. This paper is an extract of a larger study that was conducted in Eldoret town and partly looks into the health implications of children living on the streets in Eldoret town, Uasin Gishu County, Kenya. A cross sectional descriptive type of study was conducted among 45 street children between the ages 8 to 16 years who were available at different bases of Eldoret town. Study findings show that street children in Eldoret face myriad health challenges which included poor access to health facilities where they were discriminated against and were also required to buy med

Cyberbullying:Effect on Work Place Production MR. JAMES NAMBUSI MAKHULO  

Cyber bullying affects many adolescents and teens on a daily basis; it is a form of violence that can do lasting harm to people at different ages and social status in a society. Cyber bullying is real experience that has been in existence for a quite a long time; Bullying statistics show that cyber bullying is a serious problem among teens and gaining roots among adults. By being more aware of cyber bullying, teens and adults can help to fight it. Cyber bullying involves using technology, like cell phones and the Internet, to bully or harass another person. The introduction of social media and other communication systems has seen several people being bullied online by those who are already proficient on the platforms. The reasons behind cyber bullying might or might not be mala-fide but its existence isn’t in the best interest. It has been looked at mainly from the teens’ effect both in physical and psychological perception not realizing that adults are also equally affected. The impact on adults comes in different forms and has serious impact on the families and work places. The imp

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