Journal of

Backgrounds and Aim: Self-care behaviors are an important aspect of Heart Failure (HF), management, Educating self-care behaviors to HF patients have to be a part of routine management of HF in hospitals and health care Centers. The aim of this study was to determine the impact of an educational intervention on self-care behaviors and its perceived benefits and barriers in patients with HF in Tehran.

Materials and Methods: This is was an interventional study. A Simple sampling was conducted on 180 outpatients (90 intervention group and 90 control group) with HF referring to Shaheed Rajaee Heart Hospital in Tehran to participate in this study. Before and 2 months after implementing the educational program through group discussion, face to face interview, educational movies and pamphlets, a self-prepared questionnaire was completed by the participants. Validity and reliability of the scales were approved. SPSS software was used for the purpose of data entry, manipulation, and analysis.

Results: After implementing the educational program, patients' self-care (74.5%) and perceived benefits (19.35%) were significantly increased (P<0.0001) and their perceived barriers (27.76%) were significantly decreased (P<0.0001). After intervention there was no significant difference in these variables in control group.

Discussion and Conclusion: In order to design effective educational programs, healthcare professionals and nurses should better understand self-care behaviors in HF patients and their determinants and develop educational interventions. Promoting perceived benefits and barriers of these behaviors are priorities of the program. Healthcare professionals and nurses applying such educational programs can have a more effective role in promoting self-care behaviors and consequently quality of life of HF patients.

Backgrounds and Aim: Physical activity is one of lifestyle components. 2010 report of health people indicates that physical activity in young people is a high priority of health. A youth attends to maintenance self physical activity till adulthood, since lifestyle is forming mainly in this period. Insufficient physical activity and inactivity with unhealthy nutrition causes chronic diseases such as heart disease, diabetes, ostheoporoses , etc.

Materials and Methods: This study was an interventional educational upon female school students in Tonkabon in 2008 in two groups, intervention and control (each group 300). Data gathering tools included demographic, knowledge/attitude and practice assessment questionnaires. First knowledge ,attitude and practice of whole students was assessed.Then the interventional educational programe: 8 hours education (weekly sessions, every session one hour), lecture, question and answer ,pamphelet, and movies about advantages and disadvantages of physical activity and the nessecity of continuing till the future was done. After two month of intervention ,two groups were compared in knowledge,attitude and practice.The data were analized with SPSS and STATA.

Results: After the intervention, there was a significant increase in mean of knowledge, attitude and practice, in intervention group compared to control group (p<0.05). Educational intervention caused 15 score on knowledge ,5 score on attitude and 1.6 score on practice improvement. Among effective factors variable Such as :mothers literacy and fathers job affected knowledge ,and level of literacy affected attitude , and mothers education affected practice of student.

Discussion and Conclusion: Physical activity is one of the lifestyle components and in young people is a high priority of health. This study shows that Educational intervention caused improvement on knowledge attitude, and practice.

Background and Aim: Thalassemia is a genetic disease whit relative or complete lack of alpha or beta globin chain. Patients with moderate and severe form need to have multitransfusion in early life. Occurrence of all immunization against blood group antigens in patients with thalassemia is relatively high and may have difficulties in treatment and transfusion. Antibody production against this blood groups cause lots of problems like preparation of compatible blood for transfusion. Correct diagnosis of blood group phenotype due to existence of dual population of donor and patient RBC would be difficult.

Materials and Methods: In this study, randomly from 40 thalassemic patients, before blood transfusion, 4cc of peripheral blood collected in tubes containing EDTA. Also, 10 healthy individuals who had no history of blood transfusion were in the study as control for serological (agglutination) and molecular results . Phenotyping of patients and control group was done by tube agglutination method by commercial antibody. For molecular test, Allele Specific Primer Amplification (ASPA) PCR was performed for each antigens in separate micro tubes.

Results: In this study' we could set up a method that can amlify any of Rh C c E and E gene separately by a pair of specific primer in a same thermal conditions.Comparison of results of two methods showed that in the control group with no transfusion history. Similar results in phenotyping and genotyping was observed. But in patients, results of two methods had lots of differences.

Discussion and Conclusion: The advantage of this method over PCR-RFLP method is that' all four genes can be amplified the in a same concentration and temperature conditions, and ability to determine the individual's antigen, immediately by electrophoresis. Therefore, Since the above method is simple and inexpensive for medical and research centers it is recommended.

Background and Aim: Occupational diseases are certain types of diseases that have been caused by special jobs and subject to special circumstances. There are several factors that can intensify these diseases. 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 with a appropriate structure. Health improvement is considered as the first aim of the health system which requires a comprehensive, complete and integrated information system on occupational disease.

Materials and Methods: This is a descriptive Comparative study which was conducted in 2008 during which information systems in countries such as US, Finland, France and Iran have been studied based on their objectives and structures. Main instrument of this research was articles, books, magazines, valid internet sites in English language. Then, the gathered data were classified and analyzed.

Results: All the three selected countries had an electronic information system and database in the field of occupational disease. In Finland, data of occupational diseases as well as their damages are kept in separate databases while US lacks a comprehensive system. There are countless systems in these countries in this field. In France, supervision on laboratories is a priority. In Iran, there is no certain comprehensive system for registering diseases.

Discussion and Conclusion: All of these countries have the same objectives. Structure of occupational diseases information system, in Finland, is more comprehensive. Iran lacks such a system, so it is recommended to make use of the experiences of other countries and establish electronic comprehensive disease system in this country.

Background and Aim: Citation could be considered as basis of scientific researches. Each researcher will use citation to prove his scientific findings either to be in correspondence with truth or to familiarize readers with more references. Maintenance and continuation of informational link by citation is essential. Theses are not exceptional for this subject. This study was done to review the accuracy of cited articles of specialized theses (Tehran University of Medical Sciences in 1386) and the rate of correspondence with Vancouver style.

Materials and Methods: Citation analysis is used as study approach. By systematic sampling and Morgan table 357 cited articles were selected to review for accuracy of citation and their correspondence with Vancouver style. Six studied factors are as following: Name of author(s), title of article, title of journal, year of Publishing, volume number, number of pages. Citation errors are divided in to two main groups: 1-Minor errors 2-Major errors. Method of sampling is direct observation. Data was entered in a check list, based on Taylor division. SPSS(11.0) software was used to analysis.

Results: Out of all 357 reviewed cited articles, totally 111.4% citation errors were observed and only 136 (38.09%) of citations had no error and 221(62%) citations had errors. 9.8% of citations fully corresponded with Vancouver style.

Discussion and Conclusions: Main reasons of dissatisfying results of citation errors and rate of correspondence with Vancouver style are as follows: Student's unawareness of importance of scientific researches consistence Laxity of students about citification produce, inaccessibility to original references and copy of other sources. Teacher's less emphasis on accuracy of citation, carelessness of educational universities about accuracy of citation in thesis, not use of experts and specialized librarians for consultation, being not familiar with reference management software.

Background and Aim: Development and evaluation of rehabilitation services as a section of health system, which plays an important role in the improvement of the quality of life, needs a mechanism for information management as well as other healthcare levels. The effectiveness of information management has been assured through standardization & ongoing evaluation of rehabilitation centers. There is no standardization on rehabilitation information management processes in Iran, Therefore we surveyed the standards of information management at Commission on Accreditation for Rehabilitation Facilities and compared them to same English & Australian rehabilitation services evaluation & standardization organizations. At the end, we present a framework for necessary standards for this field.

Materials and Methods: In this literature review article CARF standards in axis of information management infrastructural standards, data gathering, content of records, documentation principles, information reveal for confidentiality policies of standard classification has been investigated. We used reliable electronic references in this article.

Discussion and Conclusion: The CARF information management standards are included a standardized outcome-oriented program evaluation & management systems as a fundamental & infrastructural requirement, data gathering standards, internal content of patient records, the framework for complete documentation and maintenance of information confidentiality. Therefore CARF standards in term of information management are the most complete model and have enough details in compare to the others. The results indicate that CARF standards can be a proper model for standardization activities and evaluation rehabilitation centers.

Background and Aim: Peptic Ulcer Disease (PUD), which is a prevalent disease, can have a considerable impact on patients' quality of life (QOL). The aim of this study was to explore the factors related to QOL based on PRECEDE Model in patients with PUD in Sanandaj, Iran.

Materials and Methods: A non-probability sample of 120 outpatients with PUD, referring to Beasat Hospital, in the city of Sanandaj participated in the study. The study took place between March and June of 2009. A descriptive, cross-sectional design was employed and the data were collected using a survey questionnaire based on PRECEDE model, consisting of QOL, Health Status, predisposing, reinforcing and enabling factors and self-management behaviors constructs. The data collected by interview and analyzed by SPSS v. 11.5. The statistical analysis of the data included Pearson correlation, t- test, one-way ANOVA and linear regression.

Results: Health status (p<0.01), reinforcing (p<0.01) and enabling (p<0.05) factors and knowledge (p<0.05) as a predisposing factor were related to quality of life of peptic ulcer patients. Moreover, health status (p<0.05) and social support as a reinforcing factor (p<0.01) had significant relationships with self-management behaviors. Finally, all of PRECEDE variables accounted for 68.9% of the variation of quality of life in PUD patients.

Discussion and Conclusion: With respect to the results of this study, preparing an educational program to promote self-management behaviors and quality of life in peptic ulcer patients is proposed. It was concluded that the PRECEDE Model may be used in developing countries, like Iran, as a framework for planning intervention programs in an attempt to improve the quality of life of patients with PUD.

Background and Aim: Tuberculosis is an infectious disease with worldwide distribution. Based on WHO report one third of people are affected with mycobacterium tuberculosis. Today, the traditional bacteriological methods are only available using diagnostic methods for detection of tuberculosis. Innovation of a simple and efficient method for the diagnosis of tuberculosis is one of the most important aims of the world program against tuberculosis. The methods which are based on indicating of specific antibody response against mycobacterial antigens are potentially valuable for substituting traditional methods. These methods have attracted the researchers' attention for some reasons. Firstly the strong antibody response against mycobacterial antigens is detected only during active tuberculosis. Secondly the serologic methods are simple rapid, cheap and noninvasive. Thirdly, these methods in contrast to cutaneous PPD test are able to differentiate between an asymptomatic contamination with mycobacterium and active disease. In this study, a secretary glycoprotein antigen of mycobacteriurn tuberculosis, named 38 kD antigen, was used for a screening test for diagnosis of tuberculosis by immunodot method, since in previous researches, this antigen was considered as a special specific one in serological tests and showed much specificity.

Materials and Methods: In this study the results of immunodot tests on serum of 32 patients with pulmonary tuberculosis and positive sputum smear compared with 32 healthy people. Then, the results were compared with similar tests on protein was mixture of culture filtrate.

Results: Assay by using 38 kD antigen, resulted in 29 positive response among 32 patients, whereas by using protein mixture of culture filtrate, the test resulted in positive response in all patients (sensitivities are 90.6%, and 100% respectively). On the other hand, using 38 kD antigen resulted no positive response in assay with serum from healthy ones, but by using protein mixture from culture filtrate resulted in 8 positive response in healthy people (specificities 100% and 75% respectively).

Discussion and Conclusion: Results of this study showed the efficacy of using 38 kD antigen in rapid diagnosis of tuberculosis by immunodot method, because this method has more specificity and does not require sophisticated and expensive equipments. Thus this test may be used in field studies as a simple, precise and efficient test.

Background and Aim: Today, cardiovascular diseases are the most important public health challenges in the world. Prevention and management of cardiovascular diseases necessitate the existence of a comprehensive system for recording data. Patient medical document is one of the most important data which should be classified so to facilitate and expedite the treatment process. A comparison of cardiovascular disease classification systems could assist health care policy makers to battle cardiovascular diseases.

Materials and Methods: This descriptive-comparative study conducted during years 2007-2008. The cardiovascular diseases classification systems in USA, Australia, England and Canada were reviewed. Data collecting was done through literature review, Internet and e-mail.

Results : The cardiovascular disease classification systems of all the developed countries are national. The developed countries, with the exception of England, utilize a multiracial classification model, especially designed to reflect the individual requirements of every single one of them. This model employs health care standards, e-learning, annual educational programs, and consultation with experts. Iran lacks such a national classification system for cardiovascular diseases.

Discussion and Conclusion : In order to improve the management and prevention of cardiovascular diseases in Iran, it is essential that the cardiovascular disease classification system in the country be national.

Background and Aim: Today, psychological diseases like so many diseases, have an old history. Clinical Information System of psychological diseases resulting from war is a part of the information management system of mental illnesses, due to the management of mental patients from the war. This study is aimed to compare information management of psychological diseases in American, Australia and England with Iran.

Methods and Materials: This research is a study. At first, the existing situation was studied in three Psychiatric Centers in Ahvaz and Tehran with the use of a cheek list. Then information system of psychological disease has been studied in elected countries and based on the need of our own country, proposing practical solutions for Iran.

Results: The results of this study showed that there was no a information system of psychological disease in Iran. Also, four factors of this system including (goals, content structure, informational elements, information registration criteria) are reviewed in four selective countries.

Discussion and Conclusion: The design and implementation of this system in psychiatric centers is recommended to set two main goals including quality control and cost control in Iran.

Background and Aim: Today provision of an adequate and appropriate health services depend on many factors. Human resources are one of the most important factors. Nursing managers with more exact understanding of nursing activity could prevent of human resource wastage. In other way goal achievement in an efficient remedial system depends upon favorite delivery services and one of the appropriate ways for quality of care evaluation is patient satisfaction measurement about care delivery. This study was conducted and implemented to measure the nursing care time and its relationship with patient satisfaction.

Materials and Methods: This descriptive and analytical study was done in internal ward in Gorgan 5th Azar educative and therapeutic center for one month. nursing activity checklist was used for measuring the time that spend for Nursing staff activity and patient satisfaction scale. Data were analyzed with SPSS for Windows package.

Results: In this research findings showed, 46.46% of nursing activity time was spent for direct care, 15.8% of total time was used for documentation activities and 22.5% of time spent for nurses' individual activity, whereas only 7.43 percent of total time was spend for patient assessments. 60.3% of patients were satisfied about care delivery and 24.8% of them had moderate satisfaction. A significant correlation was seen between patient satisfaction and nursing direct care (r =0.272, P= 0.001).By increasing The spent time for direct care, patients' satisfaction was also increased.

Discussion and Conclusion: Nursing managers' awareness from scientific methods of management, rules modification, use of new equipment and technology and also delegating of some nursing activity to nursing assistants could promote quality of care with increasing of nursing direct care.

Background and Aim: Evaluation is a principle function of management which measure organizational goal attainment and eliminate the problems and modify the policies and procedures. Teachers are the most important educational system inputs and are evaluated with more complexity. There are several evaluation procedures for teachers' evaluation. For example, evaluation of teaching process by students. This research is aimed to conduct faculty members and teachers' opinion about teachers evaluation questionnaires form completed by the students in school of Allied Health Sciences, Tehran University of Medical sciences by the Students.

Materials and Methods: All the teachers and faculty members were selected to collect their opinions about teaching evaluation form. The data were analyzed by Excel and descriptive statistical method.

Result: The research findings showed that most of the faculty members and teachers believed that teachers evaluation questionnaire form is truly designed and conducted.

Discussion and Conclusion: Several universities faculty members and teachers don't believe in teachers evaluation by students, however we think that compound evaluation technical is most appropriate for teachers evaluation.

Background and Aim: Teeth-mouth diseases include a cost between 10-5% of the total of cost of health care and have the damaging effects on childhood and in adult. Transtheoretical Model shows change of behavior dynamically. The purpose of this study was to determine Stages of change of inter-dental cleaning behavior based on Transtheoretical Model in male and female students in Yazd, Iran.

Results: In this study 54.8% female and 45.2% males participated with mean age of 17.35 ±.55 years. %49.6(59student) of students were in pre contemplation stage. Other participants were 5.3 % (19) in contemplation, 24.1 % (87) in preparation, 6.8% (31) in action and 12.5% (5) in maintenance stage. There was a positive significant relationship among stages of change with self-efficacy (r=0.33) and perceived benefits (r=0.19). Also a negative significant relation between stages of change and perceived barriers (r= -0.19) was oberved. Constructs of the model were statically significant predictors of stages of change and accounted for 0.15% of the variation that self efficacy was most important predictors (β=0.212).

Materials and Methods: This cross-sectional study was performed on pre-university 361 students in 8 schools cluster sampling. The instrument for collecting the information were questionnaires consisting of demographic characteristics, self-efficacy questions, decisional balance (perceived advantages and perceived obstacles) and stages of change of interdental cheaning behavior. Reliability and validity of questionnaires was confirmed. The data collected by interview and analyzed by SPSS.

Discussion and Conclusion : In this study, most of students were in pre contemplation stage. They will be probably exposed to dental caries. Not only Trans-theoretical Model can be a model to determine strategies to each stage of change of teeth-mouth self - care Behavior but can also be used in educational interventions.

Background and Aim: The JAK2 is an acquired mutation that is observed in majority of patients with classical Philadelphia-negative Myeloproliferative neoplasms that include polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF). This acquired mutation is characterized by a G to T transversion at nucleotide 1849 in exon 12 of the JAK2 gene, leading to a substitution of valine to phenylalanine at amino acid position 617(V617F) of the JAK2 protein, and result in constitutive JAK2 activation that promotes hypersensitivity to growth factors and cytokines.

Materials and Methods: In this study we evaluated RNA from 58 patients with MPNs and statistical analysis was done with mann whitney test. The mutation detected by AS-PCR. In addition, 3 samples were sequenced in Mille gen company.

Results: 46 patients:86.6%(26/30) of those with polycythemia vera, 53.3% (8/15) of those with essential thrombocythemia,61.5% (8/13) of those with idiopathic myelofibrosis polycythemia vera patient carrying the mutation displayed higher levels of WBC (p=0.03). on the other hand,16 out of 26 JAK2V617F positive patients were female there is a demonstrate correlation between the presence of a mutant allele and female gender. The difference in other groups were not significant.

Discussion and Conclusion: The JAK2V617F mutation has been detected in the vast majority of patients with polycythmia vera (65-95%) and in a lower frequency in patients with essential thrombocythemia (23-57%), idiopathic myelofibrosis (23-57%) and chronic myeloid leukemia 19% (3/16 CML Ph-). Detection of the mutation is helpful in differential diagnosis, prognosis, and prediction of therapeutic response.

Background and Aim: Cardiovascular disease is the first and for most factor for mortality in adults and hypercholesterolemia (HC) is a susceptible agent for them. The main objective of this study is to determine the of prevalence of HC and some risk factors related to it in adults in Golestan province  in 2006.

Materials and Methods: This is a Crossectional-Descriptive study based on population and 1995 cases (997 men and 998 woman) between 25- 65 years old, were chosen by cluster and stratify sampling in Golestan adult population. We interviewed all the cases and determined anthropometric and biochemical indexes. Data was analyzed by SPSS.14 software. HC was defined as serum cholesterol levels over 200 mg/dl.

Results: Mean age was 39.2 year and mean ±SD of serum cholesterol in men and women was 196.7±39.11 and 209.4± 42.9 respectively. Prevalence of HC showed significant deference between men (44.7%) and women (57%) (P<0.05). There is a  significant difference between age groups, region, physical activity and BMI in the mean value of serum cholesterol (P<0.01) but regarding economic status it is not significant. Prevalence of HC in abdominal obese and healthy group is 63.2% and 41% respectively and statistical difference is significant (P<0.05). The people of Golestan province consume fruits , vegetables and fish 4.84, 3.65 and 2 days in a week  respectively and  vegetable and fish are consumed more in HC group than in non- HC group. The consumption of hydrogenated oil, liquid oil and other type of oils is 85.4% ,14% and 0.7% respectively, and in HC people the intake of liquid oil is slightly higher than others, but statistical differences is not significant.  

Conclusions: HC is one of the most health problems in Golestan province and women suffer from it more then men. Life style and food behavior are two risk factors for it. Thereby correction of food and social behavior can decline incidence of cardiovascular disease.

Background and Aim: Enteroinvasive Escherichia coli (EIEC) strains include a group of diarrheagenic Escherichia coli (DEC) and are known to cause shigellosis-like symptoms in both adults and children. They belong to a limited number of serotypes and their somatic (O) antigens are identical with, or related to, certain Shigella antigens. EIEC strains are confirmed by demonstration of invasiveness by polymerase chain reaction (PCR) for detection of the ipaH (invasive plasmid antigen H)  gene that is specific for these strains among DEC.Since in our country,Iran study for detection of  these strains. hasnot been carried out therefore the aim of this study was detection of EIEC in diarrheal under 5 year old children in Tehran.

Materials and Methods: During the descriptive study,300stool samples were collected from children with diarrhea in Ali Asghar Hospital and children medicinal center of Tehran during 4 months (April-Jul 2008). E.coli species were isolated by standard bacteriological and biochemical tests. Presence of invasive plasmid antigen H (ipaH) gene in confirmed colonies was investigated by PCR technique.

Results: Among 300 stool specimens studied using culture method and biochemical tests,39(13%) E.coli species were isolated. Among these 39 strains,7(2.3%) strains containing ipaH gene (EIEC) were detected by PCR technique.

Conclusions: Enteroinvasive Escherichia coli (EIEC) in our country, Iran, may be as bacterial pathogen causing childhood diarrhea. Therefore we should apply new techniques for investigation of these strains.

Background and Aim: Because of preventing of radiation damages, special safety issues are considered in radiology departments: But, the other safety aspect issues are not observed regularly. As an important part of safety plan, radiology departments should be assessed from physical, building design aspects and cope with fire.

Materials and Methods: This descriptive study was directed as a cross sectional research. Tehran University of Medical Sciences hospitals radiology department were assessed for standards of physical spaces, radiation preventing, and cope with fire, patient's and staff safety.A Check-list was used as data collection instrument.Each safety issue estimated as safe (>80%), not safe (<50%) and relatively safe (between 50 and 80 %).

Results: Overall, safety standards were observed in Tehran university of Medical Sciences Hospitals Departments,with relatively safe standards regarding patient's safety and cope with fire.

Conclusions: Fire protocols must be regarded in radiology wards in hospitals. Appropriate designing and programming which considers patient's safety from the time of  entering to radiology ward until leaving is offered.

Background and Aim: The main goal of each hospital - like all health care sectors - is protecting and increasing the health level in orsig country. The important role of human resources in hospitals is appropriate strategic decisions making for fast environmental changes and shows the need of staff participation. Nurses as a one of the biggest parts of hospital staff need to participate much more in strategic decision making in hospitals. This article is aimed to measure the level of nurses' participation in strategic decisions making.  

Materials and Methods: This research is descriptive - analytic. Total nurses of Shariati hospital were 577 nurses of which 175 nurses were selected and studied.The gathering information instrument was questionnaire adapted from Dustdar thesis. This questionnaire contained 35,5 - choice questions set by Likert basis. Project's data was analyzed with SPSS software in % 95 confidence levels and statistical specifications like mean, standard error,correlation and non parametric tests were used.

Results: According to the results obtained, there are meaningful relation between staff participation in strategic decision making and: marriage situation (PV=0.01), Decision Directing (PV=0.0), culture of participation (PV=0.00), organization maturity (PV=0.00) and risk tolerance (PV=0.01)  

Conclusions: It has been observed that nurse participation in strategic decision making in Shariati hospital is in "low" position (participation mean score: 28.52 from 100). So an administrator effort for spreading culture of participation to owner's process is something that should be paid attention more than before.

Background and Aim: Evaluation for STIs requires speculum examination. It is sometimes uncomfortable and rejected by many patients. Speculum examination often is impractical or not available in remote areas. Recently, it is possible to omit the speculum examination and noninvasively diagnose for Chlamydia and gonorrheal infections from urine sample. This comparison study was conducted by collected vaginal specimens directly without performing a speculum examination for the diagnosis of trichomonas infections.The aim of this study was comparison of two methods of vaginal discharge collection with and without speculum examination for diagnosis of the trichomonas infection.

Materials and Methods: We examined 100 patients with vaginal discharge to the gynecology clinic of the Taleghani hospital. Two vaginal swab were collected from vaginal discharge of patients before and during speculum examination for diagnosis of trichomoniasis. Both of vaginal specimens were tested with blinded microscopic. Compared collection methods sensitivities, specificity, positive predictive value, negative predictive value and accuracy of both methods was compared.

Results: Sensitivities, specificity, positive predictive value, negative predictive value and accuracy of speculum collection methods were 69%, 99%, 92% ,94% and 93% for trichomoniasis respectively. Sensitivities, specificity, positive predictive value, negative predictive value and accuracy of nonspeculum collection methods were 62.5%, 99%, 91%, 93% and 92% for trichomoniasis respectively. The differences between methods was not statistically significant (P= NS). There was a very good agreement between both methods for diagnosis of trichomoniasis (KAPPA= o.85).

Conclusions: We have demonstrated the benefit of  nonspeculum vaginal specimens for the diagnosis of trichomoniasis. This technique has applicability for studies involving the epidemiology of vaginal infection as well as for home diagnostic testing ,elder and pregnant women respectively.

Background and Aim: Electronic learning system is a new educational process which designed upon basis of computerized technology, multimedia and processors. It has several potentials and contexts.
To do comparative study and utilizing of successful electronic learning in developed countries could help us to develop this new process in Iran's Universities of  Medical Sciences.

Materials and Methods: This research is developed descriptive comparative study in 2007 - 2008 by using of developed countries universities websites information and 62 references and keywords such as Electronic Educations,Medical Sciences Courses,Commutation Technology, Comparative Study and University in the field of electronic medical sciences. Then, the findings will compare with each developed countries universities and Iran's Universities of Medical Sciences.

Results: The results showed that Manchester and Dekin University have much experience in developing of electronic learning. The Students should be assessed by attendance, online and blended in developed universities.
Degree based courses are only present in South - Africa University, meanwhile single courses and training are present in other universities. Electronic health sciences courses and training are developed much more in compressive with others.

Discussion and Conclusion: The studied universities are different in history of construction, student assessment type, homework presence type, registration procedures, electronic medical education type with each other.
Iran's Universities of Medical Sciences, electronic education have several deficiencies in comparison with developed countries universities. We suggest appropriate technological and cultural infrastructure and use's skill improvement to develop this process in our country's universities of Medical sciences.