[Caregiver burden in caregivers of renal patients under hemodialysis]

Introduction: Family of chronic renal disease patients conducts various supportive interventions for their patients at home and outpatient centers such as dialysis ward in hospitals. Caregivers of these patients often spend a lot of time caring for them and withstand fatigue and burden. Timely recognition of these burdens in the caregivers, have played a decisive role in promoting mental health

Objective: This study aimed to determine the level of caregiver burden and its related factors in caregivers of hemodialysis patients referring to Razi hospital in Rasht city

Methods: In this cross-sectional study, 154 hemodialysis patients referred to the Razi Hospital in Rasht who was chosen by Sequential sampling method. Data were collected through interview by completing two questionnaire of Zarit caregiver burden and socio-demographic of patients and caregivers. Data were analyzed by using descriptive [mean and standard deviation] and inferential tests [binomial test]

Results: Mean and standard deviation deviation of caregiver burden was 50.75 +/- 14 and 74.7 % of the caregivers had severe caregiver burden. In addition, 46.1% of hemodialysis patients had very little vigor to doing things and 42.9% of them required a lot of care as reported

Conclusion: In attention to the need of hemodialysis patients to receive care from family, it is recommended to pay more attention to these caregivers regarding assessment of their burden and taking actions to reduce burden

[Perspective of patients about compliance with standards of professional ethics in nursing practice]

Nursing ethics is an essential part of the nursing profession and compliance with it is expected from the part of health care institutions. This study was aimed at determining perspective of patients about compliance with standards of professional ethics in nursing practice. This is an analytical study using quota sampling. The study conducted after participation of 504 hospitalized patients in medical and surgical wards of Jahrom hospitals in Iran. Data gathering tool was a researcher-made questionnaire with 22 questions. The tool examined compliance of the patients with professional ethics and was designed in three dimensions including: responsibility taking, improving quality care of the patients, and patient respect. Then the data were analyzed using SPSS version 16. Nurses showed good ethical practice in different dimensions including 40% in responsibility dimension, 45% in improving quality care dimension, and 69% in respecting patient. Independent T test showed a significant difference between the type of ward [Medical Surgical ward], and compliance with ethics in responsibility dimension [P=0.03 and R=2.3]. Furthermore, there was a significant difference between compliance with age and professional ethics. Nurses showed good compliance with ethical practice in different dimensions; thus, it is recommended to hold in-service training courses in this theme and remove barriers for a better compliance with professional ethics in the health care system

[Effect of calcium and magnesium ions in the billard salt solution on sperm motility in rainbow trout [Oncorhynchus mykiss, walbaum 1792]]

There are different activating salt solutions for sperm induction of rainbow trout [Oncorhynchus mykiss] under artificial spawning condition, although some uncertainties are associated with the performance. This study was conducted to consider the effects of different concentration of calcium and magnesium ions and change of pH in the Billard salt solution on sperm motility of rainbow trout. Four-year old broodstocks [n=10] of rainbow trout were randomly selected and adapted to the same experimental condition for two weeks. Experimental solutions were also prepared in triplicate by separately adding 1, 2, and 3 mmol calcium and magnesium to the Billard solution. Another three solutions were also prepared with pH adjustment from 9.0 in the Billard solution to 8.0, 8.5, and 9.5. The broodstocks were then transported to the hatchery and artificially spawned. The collected sperm from all broodstocks were mixed for eliminating the effect of genetically differences between the fishes. Finally, the rainbow trout sperm mobility in the experimental treatments was determined in triplicate and compared by the Billard solution as the control treatment. Sperm mobility of rainbow trout in all treatments was significantly more than the control [p<0.01]. The maximum mobility with 105.0 +/- 6.7 s was obtained in the 1 mmol calcium treatment, while the lowest level was found in the Billard treatment [31.33 +/- 4.50 s]. Between the experimental treatments, calcium had the most effect on the sperm mobility of rainbow trout, although no significant differences was observed on the sperm mobility between 3 mmol calcium and 3 mmol magnesium treatments [p<0.01]. A downward trend in sperm mobility was found by increasing the pH of activating solutions with the highest and lowest sperm mobility in the pH of 8 and 9.5 treatments, respectively. The findings of the present study demonstrated that modification of activating salt solutions using each doubly charged ions of calcium and magnesium and the pH adjustment could improve the reproduction efficiency and hatching rate in the hatcheries of rainbow trout

[Comparison of sequential and routine four drugs therapeutic regiments in Helicobacter pylori eradication]

Antibiotical resistance to Helicobacter pylori reduced the eradication rates. This study was done to compare the sequential comparison of sequential and routine four drugs therapeutic regiments in Helicobacter pylori eradication. In this double blind clinical trial study 160 chronic dyspepsia patients randomly divided into 2 groups of sequential and routine four drugs therapeutic regiments. We performed invasive tests for H. pylori in patients who underwent gastroduodenoscopy. 160 patients who were diagnosed as H.pylori-positive by histological evaluation were selected for the trial. A 14-day sequential regimen [Omeprazole, Amoxicillin, each administered twice daily for the first 5 days, followed by Omprazole, Clarithromycin and Urazolidon, each administered twice daily for the remaining 9 days. 14-day 4 drug therapy, Omprazole, Clarithromycin, Amoxicillin and Bismoot each administered twice daily. 5 weeks after treatment urease breath test [UBT] was preformed. The recovery was seen in 50.9% and 49.1% in sequential and routine four drugs therapeutical treatment, respectively. The recovery of patient with severe H. pylori infection was non-significantly higher in sequential regiment [64.7%] than four drugs regiment [41.2%]. In comparison to four drugs, sequential therapy was significantly more effective in patients with sever gastritis [87.5% vs. 25%, p<0.05]. The eradication of H. pylori infection particularly in severe gastritis is preferred by sequential therapeutical regiment

[Correlation of total serum magnesium level with clinical outcomes in stroke patients]

Magnesium [Mg] ion has possible role in protecting neurons and glia from ischemic damage through the cerebral blood flow and neuronal action. This study was done to evaluate the correlation of total serum Mg level with clinical outcomes in stroke patients. This cross sectional study was done on 316 patients whom diagnosed with stroke in Imam Hossein hospital, Tehran, Iran during 2010-11. Mg levels in all patients were measured. Also, recurrent transient ischemic attack [TIA], recurrent myocardial infarction or stroke, unstable angina and death as clinical outcomes were follow-up for period of 3 and 6 months after admission. Data were analyzed using SPSS-18, Chi-Square, Fisher and Pearson correlation tests. The mean age of patients was 65 +/- 15.8 year. Limb weakness [69.9%] and haemoplasia with 63.6% were the most common clinical complaints. Death was the most common finding in 3 month [16.8%] and recurrent stroke was the most common finding in 6 month follow up [2.5%]. There was no significant difference between the total serum Mg and the first and second three-months follow up of clinical outcomes. This study can not show a significant correlation between total serum Mg levels and clinical outcomes after 3 and 6 month follow up in stroke patients

[Screening and identifying of erythrocyte alloantibodies in patients with Thalassemia major referred to Ahvaz Shafa hospital]

Patients with thalassemia major are clinically dependent on red blood cell [RBC] transfusions. Performing multiple transfusions increase the risk of transfusion-related complications including blood-borne infections, iron overload and also RBC alloimmunization. This cross-sectional descriptive study was conducted on 70 thalassemia cases with regular blood transfusions. The serum samples were screened for the detection of the unexpected antibodies and the positive samples were subjected to antibody identification. Among 70 cases, 6 [8.6%] were identified as unexpected alloantibody; three cases as Anti-K, one as Anti-E and another one as Anti-D. Coincidence of Anti D and Anti-E was detected in one case. Eighteen patients [25.7%] were splenectomized. No significant correlation was seen between the presence of alloantibody and age, sex, the time of first transfusion and spleen condition. Considering that the most prevalent unexpected antibodies [8.6%] identified in this study were against the Kell and Rh system antigens, the evaluation of compatibility for antigens found can be recommended before the performing of transfusion. Therefore, this strategy may decrease the possibility of recipient immunization and production of the unexpected antibodies against donor RBCs

[ relationship between caregiver burden with coping strategies in Family caregivers of cancer patients]

Cancer is one of the most common chronic diseases whose caregivers are confronted with related problems to caring and treating the cancer patients. Caregiver burden, which is resulted from the negative impact of living with the cancer patient along with inappropriate use of coping strategies, which could lead to rejection diagnosis, can be accounted as the reasons of why the treatment and health would be impaired. The present study was aimed to determine the relationship between caregiver burden and coping strategies of caregivers of cancer patients. In this cross-sectional study, 133 caregivers of cancer patients who referred to Gorgon's 5[th] Azar Educative and Therapeutic Center were selected via Census sampling method. Data were gathered by three-part questionnaire, including demographics checklist, caregiver burden and coping strategies questionnaire. In order to analyze the collected data, SPSS V. 16 software with descriptive statistics was applied; also, the analysis of variance and logistic regression were conducted. In addition, statistical significance was defined as p< 0.05. Findings showed that mean and standard deviation of caregivers' age was 35.73 +/- 14.31. And, 50.4% of all the participants were male. Based on the results taken from multivariate model of logistic regression, high care demand [OR=0.403,%95 CI: 0.227 - 0.714] and higher rate of emotional coping strategies use [OR=1.09,%95CI: 1.04 - 1.15] have significant correlation with caregiver burden. Based on our findings, the using of emotion-focused coping strategies among caregivers and caring needs of patient, lead to increase care burden, therefore beside of patient empowerment, could be educated efficient coping strategies for caregiver's burden reduction

[Seroepidemiology of VZV in the young adults referring to Rasoul-Akram hospital in Tehran]

Varicella-Zoster virus causes chicken - pox, which is a mild disease in children. However, in adolescents and adults between 20 to 40 years of age, it may be severe with visceral involvement such as pneumonia and hepatitis. In this study the level of anti VZV antibody in young adults was determined. Compatibility of the history of varicella with presence of varicella antibody in this population, considering sensitivity, specificity, predictive positive and predictive negative values, was assessed. This cross-sectional study included 400 healthy young adults. The enzyme immunoassay was used to determine the titer of IgG antibodies against VZV in the sera. Statistical analysis of the data was performed by means of chi2 test. A total of 400 young adults between 20 and 40 years of age were examined and 313 [78. 25%] of them were found to be seropositive. Sero-positivity was more significant in the females [P=0.048]. There was no statistically significant difference in the antibody titer between different age groups [P=0.82]. Correlations of sensitivity and positive predictive value of history of varicella with presence of antibody in the sera were 89% and 95% respectively. The results of this study showed a significant number of young adults are susceptible to infection and extensive screening and sero-prevalence studies are needed to make decision about mass vaccination in children in Iran

Gene diversity of trichomonas vaginalis isolates

Trichomonas vaginalis is protozoan parasite responsible for trichomoniasis and is more common in high-risk behavior group such as prostitute individuals. Interest in trichomoniasis is due to increase one's susceptibility to viruses such as herpes, human papillomavirus and HIV. The aim of this study was to find genotypic differences between the isolates. Forty isolates from prisoners' women in Tehran province were used in this study. The random amplified polymorphic DNA [RAPD] technique was used to determine genetic differences among isolates and was correlated with patient's records. By each primer the banding pattern size of each isolates was scored [bp], genetic differences were studied, and the genealogical tree was constructed by using NTSYS software program and UPGMA method. The least number of bands were seen by using primer OPD 8 and the most by using OPD 3. Results showed no significant difference in isolates from different geographical areas in Iran. By using primer OPD1 specific amplified fragment with length 1300 base pair were found in only 8 isolates. All these isolates were belonged to addicted women; however, six belonged to asymptomatic patients and two to symptomatic ones. There was not much genetic diversity in T vaginalis isolates from three different geographical areas

Report of two brain cancer cases with survey more than 15 years

Brain tumors are considered in regarded to their size, position and aggressive manner. Brain tumors cause several neurologic symptoms. For instance, they increase intracranial pressure due to local damage and displacement of surrounding tissues. In this paper, two glioblastoma multiform cases with more than 15 year- survival have been reported. The first patient was a 52 year- old woman who suffered from seizure. The CT scan demonstrated a focal low density in the left temporoparietal lobe, and Carbamazepine was prescribed. However, after 12 years, the patient started to suffer from seizures with transient awareness repletion and vomiting. Therefore, daily injection of 16 mg of dexamethason in two divided dosages was prescribed. Fourteen years after illness, biopsy with stereotaxy method was used and glioblastoma multiform was diagnosed by a pathologist. Unfortunately, this patient died due to progression of her illness 16 years after beginning of the seizures. The second patient was a 47 year- old man who also suffered from seizure. In the CT scan, a low density lesion was observed in his left parietal lobe. The patient was treated with 400 mg of Carbamazepine per day in two divided dosages. Dosage of drug was increased to 1200 mg per day. After one year, due to drug resistance, Phenytoin and Phenobarbital were also added to Carbamazepine because of repeated seizures. After 15 years, the soberness disorder of the patient increased and CT scan was repeated. However, due to increase in the tumor size, hydrocephaly surgery was performed and the pathologist reported glioblastoma multiform. Following the surgery, radiotherapy and chemotherapy were also used. This patient is in a good condition now and he has no serious problems. Glioblastoma multiform is a high degree astrocytic tumor. In this paper, two patients who were afflicted with glioblastoma multiform in fourth and fifth decades of their life were presented. The life span of these patients is considerable in contrast to several articles which indicated that a- five -year life span is rare in patients with glioblastoma multiform

[Screening for congenital hypothyroidism in East Azerbaijan province, IRAN]

Congenital hypothyroidism [CH] is one of the most common preventable causes of mental retardation throughout the world. The aim of this study was to investigate the prevalence of CH among newborns of East Azerbaijan province in 2009-2010. This descriptive analytic study was performed by using census cross- sectional method on 62459 neonates in East Azerbaijan province from 21[st] March 2009 to 20[th] March 2010. Blood samples were taken within the 3[rd] -5[th] days of life by lancet sticking of neonatal heel and transferred to filter papers for measuring TSH level. In the case of TSH >/= 5mu/l, additional confirmation tests were done and confirmed cases based on serum confirmation test [TSH>10 mu/l or T4<6.5mg/dl] underwent treatment according to the national guidelines. Data were analyzed by SPSS software. The recall rate was 2.5%. Total number of patients was 94, including 55 males [58.5%] and 39 females [41.5%]. Prevalence in males, females and overall was respectively 1:588, 1:769 and 1:666, with no significant difference. Seasonal prevalence was respectively 1:833, 1:943, 1:492 and 1:588 that shows no significant difference among four seasons. The highest prevalence was in Tabriz [27.7%] and the lowest in Azarshahr [0%] and Kaleibar [0%]. Mean maternal age of affected neonates was 26.22 +/- 6.2 years. Mean neonate's weight was 3500 +/- 652 grams. In 76% of neonates time of sampling was in the 3[rd] -5[th] days of life and in 89% of them test result was announced before 13[th] day. Mean treatment onset based on neonate's age was 2.7 +/- 1 day. In 97.5% of screened neonates TSH level was less than 5 mu/l. The prevalence of CH in East Azerbaijan province is significantly higher than national and worldwide levels that requires continuation and reinforcement of neonatal screening programs. On the other hand, comprehensive and complementary studies for recognizing relevant factors are among priorities of health system research in this province

[Comparison of the fluoride content of four tea brands using spectrophotmetry and ionic chromatography methods]

Tea contains high concentrations of fluoride; therefore, tea consumption may contribute significantly to the total fluoride intake. Since different teas contain various amounts of fluoride, this study was conducted to compare the fluoride extraction of four popular domestic and foreign tea brands using spectrophotometric and ionic chromatography methods. In this study, two foreign black tea brands [Lipton and Ceylon] and two domestic tea brands [Golestan and Mozafar] were selected. Three packages of each tea brand with the same production date and different batch types were purchased. To each 4 g of dried tea, 100 ml of boiling deionized water was added and the mixture was left on a water bath for the extraction of fluoride for 20 minutes at 85[degree sign] c and then analyzed with spectrophotometric and ionic chromatography methods. ANOVA, Duncan and paired t tests were used for statistical analysis. All four tea infusions had a considerable fluoride concentration [2.7-4.44ppm, using ionic chromatography and 2.77-4.38ppm using spectophotometry]. There was a significant difference between the fluoride concentration of these four tea brands [p<.05], of which Lipton had the highest floride concentration. Based on this research, there was no significant difference between spectrophotometry and ionic chromatography methods in determining the concentration of fluoride ions. The mean fluoride concentration in Lipton tea was significantly higher than the other brands. There was no significant difference between spectrophotometic and ionic chromatography

Dental erosion and its risk factors in 12-year-old school children in Mashhad

The dental hard tissues might be destroyed by different factors. One is dental erosion defined as the progressive loss of hard dental tissues by a chemical process not involving bacterial action. The purpose of this study was to determine the prevalence of dental erosion and its risk factors in 12-year-old school children. This cross-sectional study was carried out on 483 12-year-old school children in Mashhad, 2007. Dental erosion was recorded for the labial and palatal surfaces of the upper incisors. For measurement purposes, the O'sullivan's index was adopted, and the results were statistically analyzed by T-student and Chi-Square tests. The prevalence of dental erosion was 38.1%, with no significant sex difference. Dental erosion was significantly higher in private school children [P < 0.001] and in underprivileged areas [P = 0.005]. Matt appearance of the enamel was the most prevalent type of dental erosion [21.2% central incisors, 5.2% lateral incisors]. In most of the involved cases, more than half of their surfaces were diagnosed as affected by erosion [24.4% central incisors, 5.2% lateral incisors]. The frequency consumption of carbonated beverages and night drinks illustrated a significant relation with dental erosion [P = 0.01, P = 0.023]. Children who swam professionally in swimming pools had significantly higher dental erosion [P < 0.001]. Based on the findings of this study, individually tailored preventive programs may be recommended to patients and a comprehensive case history should be taken so that all risk factors can be revealed

Comparison of anesthesia success rate and pain perception in children using 27- and 30gauge short needles

The most important aspect of child behavior management is pain control. Since dental injection is usually considered as the most stressful procedure in dentistry, good pain control during injection and dental procedures is a major factor affecting children's cooperation. The purpose of this study was to compare pain perception and efficacy of anesthesia in inferior alveolar nerve block using 27- and 30-gauge short needles. In this clinical trial study which was conducted according to a split mouth design, 27- and 30-gauge needles were used for all patients. Forty patients between 5 and 8 years of age requiring local anesthesia for pulpotomy treatment in both mandibular second primary molar teeth were selected. Immediately after injections, pain ratings were obtained using face and SEM scales. Both nurses and children were blind about the type of used needles. Data were analyzed using Wilcox on Matched-pairs Signed-ranks Test. The 30-gauge resulted in significantly lower pain than 27-guage needles. The success rate of local anesthesia technique was 95% for both types of needles. There was a significant correlation between the two pain measurement methods for both gauges [p < 0.01]. The mean intensity of pain was higher in girls than boys with both gauges. There was no significant difference between age groups regarding pain intensity. Due to the less pain experience and similar efficacy with the use of 30- compared to the 27-gauge short needles, it can be concluded that the use of 30-gauge needle is more appropriate for inferior nerve block anesthesia in children

[Diet analysis and its relation to dental health status of Mashhad preschoolers in 2004]

Humans need food to provide energy, growth and development of body. A standard dietary regimen can be established in childhood with satisfactory general and oral health. The purpose of this study was to analyze the food diet of Mashhad preschool children and its relationship to dental health status in 2005. In this descriptive study, 191 randomly selected children [boys and girls], aging 5 to 6 years old from Mashhad kindergartens were evaluated. A 3-day dietary history was recorded to assess children's diet and food guide pyramid was used for analysis, dmft index was also determined. Friedman, Kruskal Wallis, Mann Whitney and Wilcoxon tests and pearson correlation coefficient were used for statistical analysis. The results of this study showed that 59.2%, 47.1%, 49.2%, 1.6% and 24.6% of children consumed recommended amount of meet and beans, fruits, dairy products, vegetables and grains respectively. The data revealed a sufficient consumption of meat and beans but the amount of vegetable consumption was very poor in study group [P<0.001]. Mean dmft index was 4.5 +/- 4.05 in study group. There was no relationship between each of five main dietary groups and dmft in this study, but there was a reverse correlation ship between the amount of protein and fat consumption with dmft index [P<0.05]. In this cross sectional study, there was a reverse relationship between the amount of fat and protein consumption with dmft index. Nutrition has a great effect on oral and dental health status in long time, so conducting longitudinal studies in this field is recommended

[ prevalence and molecular characterization of vancomycin resistant gram positive cocci isolated from patients in Tehran]

Gram positive bacteria, particularly, Staphylococcus aureus, coagulase negative staphylococci and enterococci are of particular concern in hospitals. But there has been increasing concern about the development of vancomycin resistant enterococci and MRSA strains with reduced susceptibility to vancomycin over the last decade. Therefore, the present study was carried out to confirm the identification of vancomycin resistant gram positive cocci, to determine antibiotic resistance pattern and to study vancomycin resistance genes. The isolates from clinical samples were collected from hospitalized patients and outpatients in Tehran. Gram positive cocci species identification was performed by using conventional tests and PCR using specific primers. VRE isolates were subjected to antibiotic susceptibility testing, MICs of vancomycin were determined by the E-test method. Determination of vancomycin resistance genes, vanA and vanB were performed with PCR. Confirmation of transposons was performed with specific primers for vanS. Out of 1030 gram positive isolates, none of the staphylococci or streptococci isolates were resistant to vancomycin. Most of vancomycin resistant isolates in this study were VRE. faecium [96%] and harbored vanA. All of the isolates were positive for vanS the conserved fragment of transposon and carried the identical digestion pattern like type strain. According to the results of this study, all of the vancomycin resistant isolates were enterococcus spp. Vancomycin resistant enterococci itself is now a major and largely untreatable infection, and can pass the vancomycin resistance genes to the other highly virulent gram positive cocci

Characterization of vancomycin resistant enterococcus faecium

To determine the species distribution, updated drug susceptibility patterns and genes conferring resistance in clinical vancomycin resistant enterococcal [VRE] isolates. Clinical enterococcal isolates collected during 7 months, from September 2005 to April 2006 from hospitalized patients and outpatients were studied. Twenty five VRE were isolated from 450 enterococci samples [5.6%]. VRE isolates were subjected to antibiotic susceptibility tests. Genotype of these isolates was determined by PCR. All of the isolates were E. faecium and carried the vanA gene. Antibiotic susceptibility tests showed that the isolates were resistant to ampicillin 25[100%], ciprofloxacin 25[100%], gentamicin 24[96%], erythromycin 25[100%], tetracyclin 10[40%] and chloramphenicol 2[8%]. VRE strains were resistant to three antibiotics and were susceptible to new antibiotics linezolid and dalfopristin- quinupristin. Switching to treatment with these antibiotics would relieve the problem for a short time

[ causes of short term mortality in status epileptic patients in ICU]

Status epilepticus [SE] is an emergency situation for the neurologist as for the critical care physician, because it is caused by a focal or by a generalized sever brain suffering. The aim of this study is determine of the etiology of SE, the causes of mortality and the efficancy of side- effect on the mortality of SE. In this retrospective and prospective study that was done in ICU department of Tabriz Imam Khomeini hospital [1990-04]. 50 cases of mortality from 176 cases of SE were present. Informations were obtained by finding documented. Acute mortality associated with SE in this study was 35.2%.Mortality rate in patient older than 60 years, in females, in Tonic- Clonic and in >1h SE was highest. Lead was the most important causes of SE and it's mortality [26/4%]. Aspirative pneumonia was the most important complication of SE [48%]. 28% of patients had previous epilepsy and 4% had pervious status epilepticus. The most common complication that effect on short term mortality was long infections. The mortality rate in this study is more than other studies that is in result of delay reference to therapeutic centers or insufficient acquaintance of personnel with correct management of SE. low antiepileptic drug level or give up their usage is the most common causes of mortality that is in result of high prevalence of them in SE's incidence

[Comparison between the effectiveness of physical maneauer and medicinal therapy in the treatment of benign paroxysmal positional vertigo]

Benign paroxysmal positional vertigo [BPPV] is the most common cause of vertigo. Its pathophysiology is described by canalolithiasis theory. A safe and simple treatment has been proposed in recent years [canalith repositioning maneuver]. This study has been performed to compare the effectiveness of physical maneuver and medical therapy in the treatment of BPPV. The study was a clinical trial. Patients with BPPV [Being diagnosed based on positive Dix - Hallpike test and history] were randomized into 2 groups on first visit. They were matched for sex, age and cause of BPPV. 23 patients received Epley maneuver and 22 patients received Betahistine. Patients were evaluated at first week and first month after the beginning of the treatment. After one week, 58.3% of patients in drug group and 94.1% of patients in maneuver group had negative Hallpike test. After 1 week, all patients were asked about the resolution of symptoms. After 1 week, 39.77% of patients in drug group and 81.52% of patients in maneuver group improved. This difference between the 2 groups was statistically significant [2 = -4/338; p< 0/001]. After 1 month, 56. 83% of patients in drug group and 86.98% of patients in maneuver group improved [z =- 3/ 305; p<0/01]. The difference of subjective improvement was statistically significant between 1 week and 1 month follow up in drug group [z = -2/85; p<0.01], this difference however was not statistically significant in maneuver group [z= -1.5; NS]. In short term the Epley maneuver is much more effective than medical therapy to control symptoms of BPPV and is the best treatment for this disease

[Epidemiologic survey of the self-injury in the male students of Tabriz's high schools and it's related factors]

There are currently no reliable estimates of the prevalence of self-injury among adolescent population. The aim of this study is to estimate the prevalence of self-injury among a sample of 10 grade male students in Tabriz city and to evaluate the associated factors such as demographic and risk taking behaviors. Of all grade-10 male students in Tabriz, 1772 were randomly sampled. A self- administered questionnaire was used to collect demographic data, self-injury, substance abuse, general risk taking behavior and friends smoking. The influence of different factors on self-injury was evaluated with a logistic regression model. Among 1772 students 76 [4.3%, CI 95%: 3.4-5.3] had self- injury. Eight [10.5%] of them were carving, 4 [5.3%] burning, 9[11.8%] hitting, 27[35.5%] cutting, 7[9.2%] tattooing, 5[6.6%] skin picking and 17[22.4%] bruising. The results indicate that, ever alcohol use [OR= 1.52], having smoker friend [OR= 2.54] and higher smoking stage [OR= 1.85] were factors associated with student's self-injury. This study has shown low prevalence of self-injury and determined some of its risk factors among students. More studies about adolescent population are necessary to approve the observed results of this study and thus allow for a certain generalization of the observations