Journal of

Background and Aim: Aspergillosis are the most prevalent cause of the respiratory infections. These fungi show invasive aspergillosis(IA) in immunocompromised patients. The number of immunocompromised patients are increasing due to immunodisorder illnesses, grafts and immunosuppressor drugs, so, rapid identification methods are very important. The aim of this study was to detect the Aspergillus spp. In fluid samples by nested PCR, and compare with culture and direct smear.

Materials and Methods: Conventional detection methods such as culture and direct smear are unsensitive and time consuming. Some methods such as immunodetecting methods have high false positive and are unreliable. Nowadays, molecular methos and PCR are very helpful. These methods are both sensitive and reliable and very rapid. In this study, we used Nested PCR, culture and direct smear to detect Aspergillus spp in BAL fluid samples.

Results: This research is a descriptive-comparative study and has been done for rapid identification of fungi related to Aspergillosis such as culture, direct smear and nested- PCR. Findings of this study show that positive results by nested-PCR were more effective and sensitive than culture and direct smear.
Conclusions: We found that positive results by PCR were more effective and sensitive than two other methods.

Background and Aim: High blood pressure in children, especially in developing countries is growing. Birth weight, age and anthropometric parameters such as current height and weight as factors in childhood hypertension and adolescents have been considered. The objective of this study was to evaluate the prevalence of hypertension in children school and it's correlation with birth weight and current height and weight.

Materials and Methods: In a cross-sectional study, between 2006-2008 among 1195924 students in Tehran's schools, 2040 individuals were selected by multistage random sampling method. Inclusion criteria were age 6 to 19 years, physical health and having health card. The twins, students with hypertensive and smoker mothers were excluded. Statistical analysis was conducted by SPSS software version 16. The multiple regression analysis equation was used to determine the predictors of blood pressure levels.

Results: 69 students(3.4%), including 4.84% of girls and 3.5% of boys had high blood pressure(p=0.14). Significant direct correlation between age, current weight, current height, and body mass index, systolic and diastolic blood pressure was found. However, birth weight has a weak reverse linear correlation with systolic and diastolic blood pressure(respectively=-0.152 and r=-0.111, p<0.001).

Conclusion: Attention to Current size, especially Current weight with consideration to birth weight can be helpful to predict blood pressure in adulthood. This is important in monitoring the weight and blood pressure in children, especially child with an abnormal birth weight and overweight children.

Background and Aim: Since managers' efficiency depends on their communication skills suitable for their employees, this study was conducted to determine such skills among Shiraz University of Medical Sciences (SUMS) managers.

Materials and Methods: In this cross-sectional study, 298 SUMS employees working at different departments were selected through simple random sampling technique. The data-collection device was a 21-item questionnaire having 3 parts: verbal skill, effective listening, and feedback communication skills. The data were analyzed using SPSS software. Statistical tests employed included Pearson correlation, T-Test and ANOVA, and the level of significance was determined at 0.05.

Results: The respondents' mean age was 32.7 years. Most of them were female, had a bachelor's degree, and worked in logistics department. According to their judgment, their managers had good verbal and effective listening skills, but were average in their feedback. The highest score for communication skills was reported for the students' department and the lowest score for the research department. Older and more experienced employees evaluated their manager's feedback skill (p= 0.001) at a lower level. The statistical test indicated a significant relationship between feedback and level of education (p= 0.001).

Conclusion: It seems that the intermediate level of effective listening and feedback skills are due to the managers' lack of sufficient scientific and practical attention to the issue of communication. Therefore, it is recommended that educational workshops be held for managers to make them familiar with the importance of effective communication skills.

Background and Aim: Low weight at birth is one of the main health indexes in evaluating pregnancy period care, and recognizing its related factors is very important. The aim of this study was a comparison of pregnancy age, height, the distance between two pregnancies, gaining weight during pregnancy, economical condition, nutrition, general health of the mothers with low and normal birth weight.

Materials and Methods: The research method was casual-comparative conducted as field-work. From all newborns born since (Jan 2008 to Nov 2009) 168 low birth weight babies with their mother and 157 newborns with normal weight from 20 maternity center at Guilan province were randomly selected. Mothers filled general health questionnaire with the reliability of 0.82. The data were analyzed using SPSS Software.

Results: There was a significant difference among mothers (case and control ) in terms of pregnancy age, height ,distance between two pregnancies, increasing weight during pregnancy, economical condition, nutrition condition and general health (mental), (p0.01).

Conclusion: Various factors affected newborns' weight at birth. Therefore, decreasing the rate of low weight will be one of the main social health indexes requiring cooperation of counter- groups and different organizations such as the Ministry of Health and treatment, psychotherapy, counseling centers and radio/television.

Background and Aim: Patents are used as indicators to assess the growth of science and technology in a given country or area. They are examined to determine the research potentials of research centers, universities, and inventors. This study aims to map the past and current trends in patenting activities with a view to understanding better and tracking the changing nature of science and technology in Iran.

Materials and Methods: The patenting activity in Iran was investigated based on USPTO, WIPO, and Esp@cenet for the period 1976-2011. The researchers analyzed the affiliation of inventors, and collected patents having at least one Iranian inventor. The collected data were analyzed using Microsoft Excel.

Results: results showed that between 1976 and 2011, 212 patents were registered by Iranian inventors in the above-mentioned three databases. The average number of Iranian patents registered per year increased significantly from 25 in 1976-1980 to 119 in 2006-2011. It should be noted that the highest number of registered patents (27%) were in" chemistry, metallurgy" area of International Patent Classification, followed by "human necessities"(18%), and "performing operations transporting"(15%).

Conclusion: Overall, the proportion of Iranian inventors' patents registered in databases is small. However, the figure shows a growth for the years under study. Iran's patents registered in databases have considerable subject concentration. Scientific areas are growing together, and there is more potential of research work and innovation in areas of "chemistry, metallurgy", "Electricity" and "human needs".

Background and Aim: Changes in political, economic, social, scientific and technological circumstances have a major impact on organizational performance. In such circumstances, the success of organizations depends on their ability to cope and adapt to changing environmental factors. This study investigated the relationship between organizational participation(team orientation, capability development and empowerment) and the organizational adaptability (change, customer orientation and organizational learning) in Imam Khomeini Hospital staff.

Materials and Methods: This cross-sectional study was performed on 114 staffs of Imam Khomeini hospital, Tehran University of Medical Sciences who were selected by random sampling. Data were collected by Denison questionnaire (2006 version), which was confirmed validity and reliability. Data were analyzed with spss17 and statistical methods like the mean, standard deviation and correlation coefficients.

Results: The results showed that the rate of the organizational involvement and adaptability of the staffs was 53.44% and 52.37% respectively. The Pearson correlation analysis showed a positive correlation coefficient (p<0.01, r=0.743) between two variables of organizational involvement and adaptability.

Conclusion: With increasing organizational involvement of the staffs increases their organizational adaptability

Background and Aim: Embryonic stem cells are identified with two unique characteristics. First, they can be maintained and expanded as pure populations of undifferentiated cells, a characteristic which is known as self renewal aspect of embryonic stem cells. Second, these cells can give rise to all body cell types. In the current study, we used a feeder-free condition to differentiate mouse embryonic stem cells into lymphoid lineage by IL-7 and FLT-3 ligand.

Materials and Methods: Mouse embryonic stem cells cultured on mouse embryonic fibroblasts were separated from the feeder layer. Then, embryoid bodies were formed from mouse embryonic stem cells. Following that, differentiation was performed by FLT-3 ligand and IL-7. In order to demonstrate the differentiation into lymphoid lineages, the expression of CD25, CD19 and CD3 was assessed by RT-PCR technique on days 7 and 14.

Results: After 14 days of differentiation into lymphoid lineages by defined factors, RT-PCR results showed the expression of CD25 and CD19 markers.

Conclusion: In all previous studies, mouse embryonic stem cells were differentiated into lymphoid lineage by OP9 stromal feeder cells. In this study, a feeder-free condition was used to differentiate mouse embryonic stem cells into lymphoid lineage. It is hoped that the present study can lead to new insights in cell therapy of lymphoid deficiency disorders.

Background and Aim: The aim of this study was to evaluate bacterial contamination of keyboards of computers located in various wards of Vali-e Asr Teaching Hospital, Birjand, Iran.

Materials and Methods: In this study, all computer keyboards in various wards of Vali-e Asr Hospital were sampled (n=24). Then, the samples were sent to Microbiology Research Laboratory at Birjand University of Medical Sciences and were cultured on Blood ager, Manitol Salt ager and Eosin Methylene Blue media. The isolated bacteria were identified based on their colonial morphology and biochemical characteristics.

Results: A total of 26 samples from 24 different computer keyboards of 16 different wards were obtained. Two keyboards of Infectious Diseases and Neurology wards were routinely disinfected at the end of every shift. All samples(100%) showed contamination to different bacteria. The keyboard of the computer located in Internal Medicine ward(women's division) was the most contaminated one. In total, 13 different bacterial spp. were isolated from keyboards of different computers. The species belonging to Enterobacteriaceae family(61.5%) were the most common contaminating bacteria followed by Bacillus spp(30.7%).

Conclusion: Based on the results, all the sampled keyboards were contaminated by at least one bacterial spp. Therefore, it is necessary to pay more attention to the fact that computer keyboards in hospitals should regularly be disinfected.

Background and Aim: Organizations have to establish modern management systems to progress and to obtain maturity. One of the techniques which started in Europe in the last two decades and is considered in management area of country during recent years is the model of organizational promotion (EFQM). The purpose of this study was Performance Evaluation of Rajaei Hospital Based on «EFQM» Organizational Excellence Model.

Materials and Methods: This cross-sectional study was conducted in year 2010 in Qazvin Rajai Hospital. Data collection tool, was EFQM organization Excellence Model questionnaire which was completed by all the managers. Validity and reliability of questionnaire was calculated. Results were analyzed using descriptive statistics.

Results: Results indicated that this hospital has acquired 99.183 scores out of 500 in enablers factor(88.36 percent of optimum score). Also has gained 183.71 scores out of 500 (36/75 percent of optimum score). Overall, this hospital has obtained 366.7 scores out of 1000 as the total score in the model for performance evaluation in year 2010.

Conclusion: Findings indicated that based on Excellence model criteria, this hospital is in a moderate level. Applying this model for Iranian hospitals which often meet serious problems in this area is informative and practical. Strong systematic view, paying attention to organizational process-based management and being result-oriented are advantageous of using this model.

Background and Aim: In recent years demand for a variety of cosmetic surgery, especially rhinoplasty has been increased in our country. Some research has shown that psychological factors influence the request for cosmetic surgery. Therefore, this study was performed to examine the dimensions of perfectionism.

Materials and Methods: The study was a causation - comparative study conducted in the spring and summer of 2010 in yasouj city. Fifty people undergone rhinoplasty surgery were compared with 50 subjects as controls. For the comparison of the dimensions and subscales of perfectionism, Frost multidimensional perfectionism scale was used. Data was analysed using SPSS software and dependent t test.

Results: Women using rhinoplasty were more than men. Most participants were single and between 26-30 years. The majority of the subjects had university education and their income level was between 7010000 to 9000000rials. There was significant difference in the Perfectionism subscale between the two groups in the Individual standards (P=0/001), order (P=0/001), concern about mistakes (P=0/001), parental criticism (P=0/001), doubt about action (P=0/013) and parental expectations (P=0/04). Generally the study showed significant difference in Perfectionism between the two groups(P=0/001).

Conclusion: People who had cosmetic rhinoplasty surgery were more perfectionists and were often negative perfectionists.

Background and Aim: Candida spp can colonize in oral cavity in immunocompromised patients and can lead to candidiasis. Because of immunocompromised condition in patients with Down syndrome, this study aimed at the colonization rate of candida spp in the mouths of such patients.

Materials and Methods: This descriptive cross-sectional study was carried out on 53 patients with Down syndrome (29 males and 24 females) within the age range of 4-31 years (mean age: 11.1 years) and supported by the welfare organization, Tabriz branch.
The samples were taken from the dorsal and buccal parts of tongues using sterile swabs, and were cultured on Sabouraud Dextrose Agar (SDA+ Chloramphenicol) and corm candida agar.
Determination of candida species was based on phenotype characteristics and chlamydoconidia production in Corn Meal Agar containing Tween 80.

Results: Altogether 60 isolates of candida spp were isolated from 46 positive patients [26 males (56.52%) and 20 females (43.48%)]. C.albicans with 35 cases (66.03%) were the most frequent isolate and C.dubliniensis with 9 cases (16.98%), C.krusei with 7 cases (13.20%), C.globrata with 5 cases (9.43%) and C.tropicalis with 4 cases (7.54%) were the following ranks. In 12 patients (22.4%), there were more than one species of candida in their oral cavity.

Conclusion: Due to the immunocompromised condition in patients with Down syndrome caused by a decrease in IgA and the activity of H2O2 (main destructive agent of C.albicans), the necessity of colonization rate of Candida in such patients is recommended.

Background and Aim: Problems such as hypothyroidism and aggressiveness may lead the organizations to reduced and seek to increase further behaviors that have the benefits for organization, such as productivity. One of the factors that produce productivity organization is organizational citizenship behavior. The aim of this study was to determine the relationship between the component of organizational citizenship behavior with human resources productivity among selected hospital's staff in Tehran University of Medical Sciences and Shahid Beheshti University of Medical Sciences.

Materials and Methods: This research was carried out in 6 Hospitals of Tehran University of Medical Sciences and Shahid Beheshti University of Medical Sciences by attitude approach survey and data has been collected via questionnaire that was distributed among 429 staff of these hospitals by 2 stage stochastic sampling method. Research methodology has been descriptive, analytical and cross sectional. For survey to accept or reject the study hypothesis, was performed spearman correlation and regression tests with SPSS software.

Results: The study results showed that, in our population perception, there was a significant relationship between organizational citizenship behavior and productivity in people. This means that, in these hospitals, implementation of organizational citizenship behavior has effect on the amount of peoples productivity.
Conclusion: In this study, the effect of magnanimity and look over component on productivity had different results in the studied hospitals. But results are same as the initiative of individual creativity component. In addition the potential reasons for probable low levels of these components and their related indices have been analyzed and the solutions have been presented for their improvement.

Background and Aim: Work engagement is defined as a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption. Since the quality of care delivery to patients depends on nurse's practices, the objective of this study was to determine work engagement & its effective factors among nurses of general hospitals of Shiraz University of Medical Sciences.

Materials and Methods: This cross sectional study was performed among 273 in-patient nurses of Namazi and Faghihi hospitals using 2 stages of sampling. Our questionnaire was validated by experts opinions and Cronbach's alpha index (86%). Descriptive statistics and correlation tests were used for the analysis of data by SPSS.

Results: According to the results obtained, mean work engagement was 58.95 ± 10.51 and there was a significant correlation between work engagement and organizational - supervisor support, organizational justice, job characteristics, reward & recognition, organizational citizenship behavior, organizational commitment, job satisfaction, turnover( p<0.05). The relationship between work engagement and reward was the strongest(r=0.512).

Conclusion: The results imply the importance of work engagement and its related factors. Nurses are one of the biggest health system groups, and their burnout disadvantages hospitals and community. Thus, work engagement should be noticed in all policy-making related to nurses.

Background and Aim: Pityriasis versicolor is a fungal disease with causative agent Malassezia species which is an opportunistic and lipophilic yeast .With regard to liphophilic nature of the yeast, this study was carried out for evaluation of relationship between pityriasis versicolor and triglyceride and cholesterol levels.

Materials and Methods: This cross - sectional study was performed on 1500 subjects ranging from 10 to 50 years old in Isfahan province. Of total subjects, 105 had pityriasis versicolor. Disease confirmation was based on direct examination, inoculation and culture on Dixon media. Measurement of total cholesterol and triglyceride of patients and control groups in fasting manner was done by Auto analyzer RA 1000. Data of patients including age, education level and job was gathered by questionnaire and analysis of results was done by t student, chi square and Pearson correlation tests.

Results: Prevalence of infection was 7% in the test group. Maximum frequent rates of infection was %3.13 in age group 20- 30 years and minimum in age group 30-40 years(% 0.87). The highest rate of total cholesterol levels was seen in age group 40-50 years (mean 215 mg/dL) and the lowest was in age group 10-20 years(mean 205 mg/dL).

Conclusion: Total cholesterol and triglyceride levels in patients were higher than the control group but the difference was not significant(P<0.05). No correlation was seen between pityriasis versicolor and increase in the total cholesterol and triglyceride levels in patients and control groups.

Background and Aim: Tumor dissemination via blood to distant organs is the main cause of death. Therefore, there is a critical need to set up sensitive methods for the early detection of circulating tumor cells(CTCs) and disseminated tumor cells(DTCs) in peripheral blood (PB) and bone marrow(BM) specimens of breast cancer patients. The aim of this research is to study the detection of micrometastasis using MUC2 in such patients.

Materials and Methods: In this study, PB and BM samples were collected from 50 breast cancer patients after operation and before adjuvant therapy. Mucin 2 (MUC2) was used as a tumor marker and its transcript level in the sample patients was analyzed using gene specific, quantitative real-time PCR reaction with SYBR Green technology. Samples from 20 healthy individuals were used as negative controls. HPRT was used as a reference gene.

Results: MUC2 mRNA was detected in 8 (16%) of PB and BM samples. MUC2 mRNA was not detected in PB samples of healthy individuals. The relapse rate among MUC2-positive patients was higher than MUC2-negative patients and it was statistically significant in BM (P<0.05).

Conclusion: This study shows that MUC2 can be a suitable marker for the detection of micrometastasis in breast cancer patients at early stages of cancer and that it may provide the basis for identifying women at risk of relapse.

Background and Aim: In strategic planning, there are several procedures to perform internal assessment or strength and weakness of organizations. Among other methods created for this purpose, Wiseboard model is the one in which the following six internal dimensions are considered: Organizational Structure, Leadership, Coordination, Reward System and Communication. This study measures three of these variables in hospitals of Tehran University of Medical Sciences (TUMS).

Materials and Methods: This survey is a descriptive, analytical and cross-sectional study conducted during 2010 and 2011. The research population comprised all those working at TUMS hospitals from which a random sample of about 580 people was selected. The questionnaire's reliability was estimated to be 91% and the data were analyzed by the SPSS software.

Results: Of the subjects, 75.4% were below diploma level, 13% above diploma, 7.8% higher diploma, 66.4 bachelor holders, 2.6% master holders, and 5.4% had a doctoral degree or higher. Some 72.6% of the subjects were in Clinical and 19.8% in Nonclinical fields. The mean values of Goal Setting, Organizational Structure, and Leadership came out to be 24.47, 20.37, and 22.06, respectively.

Conclusion: Based on the findings of this research study, TUMS hospitals have weaknesses in some aspects and they need improvement in some areas in the following order: Organizational Structure, Leadership, and Goal Setting.

Background and Aim: Acute leukemia is one of the main causes of cancer in the world. Now a days using natural materials as source of anticancer drugs is more recommended. HESA-A is a drug of herbal-marine origin (patented by Iranian researcher). HESA-A is composed of 50% inorganic substance، 45% organic substance (aminoenthraquinone) and 5% water. In this study effects of HESA-A، on NB4 cell line (Acute promyelocytic leukemia cells) was evaluated.

Materials and Methods: HESA-A was prepared in normal saline as a stock solution (80 mg/ml, PH=7.4), and then was sterilized. After culturing and proliferation of NB4 cell line, the cells were treated by doses of 1, 2, 4 and 8 mg/ml of HESA-A. Respectively after 72h, the percentage of viable and dead cells were counted by using Trypan blue staining in Neubanr hemocytometer. Then by MTTassay, the percentage of cell survival were determined by ELISA reader in 570nm. Finally the effects of HESA-A on apoptosis were evaluated by flocytometery.

Results: This invitro study shows that HESA-A has a cytotoxcic and antiprolifrative effects against NB4 cell line (Dose dependent).IC50 dose was 5mg/ml .HESA-A can result in apoptosis in 50% of the cells.

Conclusion: Although the mechanism of HESA-A cytotoxicity action is not known, yet this study shows that this drug may cause apoptosis of cells by dose dependent method.

Background and Aim: Staff satisfaction is one of the basic and important indicators for assessment of contract management. The aim of this study was to survey relationship between contract management and staff satisfaction in hospitals affiliated to the Tehran University of Medical Sciences in 2011.

Materials and Methods: This research was a cross-sectional and descriptive study. Six hospitals which were deployed a contract management system in recent years were chosen. A questionnaire with Likert scale was designed to measure the satisfaction.
One hundered and twenty three employees filled the questionnaire. The data analysis was performed using descriptive statistics and paired t test.

Results: The average staff satisfaction score before implementing contract management system was 3/04(out of 5) and after implementation was 2/86. The correlation of satisfaction among workers before and after the out sourcing was significant(P<0/005). It was clear that satisfaction was reduced after the transfer.

Conclusion: The average staff satisfaction score before implementing contract management system was 3/04(out of 5) and after implementation was 2/86. The correlation of satisfaction among workers before and after the out sourcing was significant(P<0/005). It was clear that satisfaction was reduced after the transfer.

Background and Aim: Chronic myelogenous leukemia is characterized by Philadelphia (Ph) chromosome, the presence of BCR-ABL fusion gene and constitutive activation of the ABL1 tyrosine kinase. Despite an excellent result of target therapy by imatinib, some patients develop resistance to imatinib. In this study Efficacy of HESA-A on proliferation and apoptosis of K562 cell line was assessed.

Materials and Methods: In this study doubling time of K562 cell line was calculated. The cells were affected by various concentrations of HESA-A(1,2,4 and 8 mg/ml respectively). Cytotoxicity and IC50 dose of HESA-A were detected by MTT and trypan blue exclusion assay. Apoptosis was assessed by flowcytometry after 48 h cell treatment in the presence of IC50 dose.

Results: Doubling time of K562 cells was 24 hours. HESA-A reduced the number of viable K562 cells in a concentration dependent manner.IC50 dose was 3.5 mg/ml. In flowcytometry analysis of apoptosis, 19.22% of the treated cells were located in the position of the necrotic cells.

Conclusion: The results of MTT and trypan blue exclusion assay suggest that HESA-A inhibits the growth of k562 cells in a concentration dependent manner and induces necrosis in K562 cells.

Background and Aim: Human Giardisis infection is caused by the flagellate protozoa. Giardia lamblia, which lives in the small intestine, causing damage and may also cause gastrointestinal symptoms. This parasitic disease has a worldwide distribution and prevalence varies from 5% to 30%. The role of both humeral and cellular immune response in the host defense against parasites has proven. Since an immune response is directly affected by cytokine, study of cytokines changes in patients with giardiosis is of particular importance.

Materials and Methods: In this study the serum levels of IL-2 - 4 - 6 to 17 and 23 in patients and healthy subjects were measured and compared. Fasting blood samples were taken from the volunteers, ELISA was performed to measure cytokines.

Results: In this study, the amount of IL-2 and IL-6 in infected patients was significantly more than the controls, but IL-4 levels were significantly lower in infected individuals (P=0.0001). Also for the first time in people with giardiasis IL-17 and IL-23 was measured and there was a significant aifference in these cytokines between the infected patients healthy controls(respectively P=0.044 and P=0.03)

Conclusion: Host defense response against parasitic infections, is directly and affected by cytokines. Increased interleukin 2, 6, 17 and 23 in patients with Giardiosis was probably caused by immune response and local intestinal inflammation.