[Comparative effects of massage therapy and bandage on shoulder pain, edema and dysfunction after the modified radical mastectomy]

Mastectomic patients experience complications such as edema of the operated hand, shoulder pain and dysfunction. This study was conducted to compare the effects of manual lymph drainage and low pressure bandage on shoulder pain and dysfunction after modified radical mastectomy. In this clinical trial study, 90 women with radical mastectomy referred to the oncology ward of Imam Khomeini hospital [Tehran] were randomly assigned to three groups: the massage, massage+bandage and control groups. Groups were trained how to use manual lymph drainage massage and low pressure bandage. Shoulder pain intensity and dysfunction were measured at 7 and 30 days post-surgery. Edema was measured at 24 hours post-surgery and also 30 days post-intervention. Data were analyzed using descriptive and inferential statistics [one-way ANOVA and Kruskal-Wallis]. There was no statistically significant difference among three groups in the means of three measured variables [the arm circumference, shoulder pain intensity and dysfunction] before the intervention. Moreover, the results showed a significant reduction in the means of shoulder pain intensity and dysfunction among the three groups on the 30th intervention day [P=0.001], but the difference was not significant in the mean of arm circumference. Lymphatic drainage massage and low pressure bandage are effective in reducing post-mastectomy complications

[Comparison of reading skills between cochlear implantation and normal hearing children in second and third grade elementary in Tehran]

Reading skill is necessary for academic achievement, that deaf children have problems in this skill due to hearing impairment. Use of cochlear implant can improve auditory inputs. The aim of this study was to investigate the reading skills of children with cochlear implants and comparing that with normal ones. This descriptive - analytic study was done on 24 children with cochlear implant and 24 normal ones that was selected from second and third grades students of Tehran primary schools. Children's reading performance was assessed by Nama reading test and the data were analyzed using T-test, linear regression and Pearson correlations. The results showed that the means of reading scores of normal children were significantly greater than the cochlear implanted ones [P<0.01]. Also, there was a significant relationship between reading skills and period of cochlear implant [P<0.01]. Cochlear implanted children showed weaker performance in reading skills than normal ones due to less access to auditory and Phonological information. It seems that early surgery and cochlear implant before the age of language learning can be partially compensated reading defects of deaf children

Trend analysis of gastric cancer and colorectal cancer mortality in Iran, 1995-2003

Cancer is the third most common cause of death in Iran. Gastric cancer [GC] and colorectal cancer [CRC] are two important causes of mortality due to cancer. With regards to cancer mortality, data are important to monitor the effects of screening program, earlier diagnosis, demographic data and other prognostic factors. The aim of this study was to evaluate the mortality rates and trends from GC and CRC in Iranian population during a period of almost a decade, i.e. from 1995 to 2003. National death Statistic Reported by the Ministry of Health and Medical Education [MOH and ME] from 1995 to 2003, stratified by age group, sex, and cause of death are included in this study. CRC and GC were expressed as the annual mortality rates/100,000, general and/or per gender, and age group. The general mortality rate of CRC slightly increased during the years under study from 0.44 to 2.54 and CRC mortality was higher for older age and male. The general mortality rates of GC showed a sharp increasing from 1.68 to 9.67. In addition to this, GC mortality rate was higher for male than female. Our study indicated remarkable increasing trends in GC and CRC mortality. So developing for a gastric cancer for both primary prevention and early detection programs and manage the delays of diagnosis is recommended to decrease the trend of GC mortality. For CRC, since the rate of CRC screening is very low in Iran, it is recommended that in Iran screening be started as a public program in order to control the mortality and burden of CRC in the future

[Comparative efficacy of tibolone and classic HRT on the urinary complications in menopausal women]

Urinary complications are a common disorder which affects the quality of life of women. The objective of this study was to compare the therapeutic effects of Tibolone and classic hormone replacement therapy [HRT] on the urinary complications of menopausal women. This randomized controlled trial study was conducted at Tarbiat Modarres University in 2007-2008 on 100 menopausal women which were divided into two therapeutic groups. Women in the first group used 2.5 mg tibolone plus one tablet of Ca+D daily. Women in the second group used HRT classic [0.625 mg conjugated equine estrogen and 2.5 mg medroxyprogesterone acetate] plus one tablet of Ca+D daily, for six months. Before and after each treatment, frequency, urgency, nocturia, stress and urge urine incontinence was recorded. The collected data was analyzed by the SPSS software using independent sample t-test, Mann-Whitney test, Wilcoxon test, and Fisher test. The data showed that the two groups were matched in age, menarche and menopausal age, gravid, education level, occupation and socio-economic level [P>0.05]. After six months, all of the urinary complications reduced after treatment in each group, but Wilcoxon test showed that only the reduction of nocturia was significant [P=0.007, P=0.03]. Mann-Whitney test showed that all of these complications in the HRT group reduced more in the tibolone group, but this reduction statistically wasn't significant [P>0.05]. Treatment by classic hormone replacement therapy reduces the urinary complications of menopausal women in comparison with Tibolone. Therefore care should be taken for considering of an appropriate medical approach in these cases

Smoking among male medical sciences students in Semnan, Islamic Republic of Iran

We determined the prevalence of smoking among 320 male medical sciences students [174 studying for a medical degree, 95 a bachelor degree and 51 a associate degree] in Semnan, Islamic Republic of Iran. A self-administrated, anonymous questionnaire was used. The prevalence of smoking was 14.4%; 45.6% of the smokers started smoking between the ages of 18 and 20 years, 43.5% starting at university. There was no significant difference in the prevalence between students undertaking different college degrees and also those having different types of accommodation. However the smoking behaviour of friends and family was significantly correlated with smoking in the students. Smoking amongst medical sciences students, who will become the health professionals of the future, needs to be addressed

[Effect of acupressure at SP6 point on labor pain intensity]

Despite conventional views that pain is unavoidable during delivery and should be suffered; today pain relief is introduced as new idea. Our aim was to evaluate acupressure effect at SP6 point on labor pain intensity and women delivery type. A single blind, clinical trial was undertaken to evaluation acupressure effect at point of SP6 on pain intensity, labor duration and women delivery type. The subjects were 131 pregnant women in their term pregnancy and labor condition that were randomly divided to experimental group of pressure on SP6 point [41 women], and control groups of SP6 touch [41women] and common care [49 women]. Data then were analysed by means of SPSS and using descriptive statistics, ANOVA and non-parametric Test. Average modified difference of labor pain intensity had statistically significant decrease within 2 minutes after intervention among the three studied groups [P<0.001] but there was no statistically significant difference in stages 30 minutes after intervention and 30 minutes after the end of intervention. There was also no difference between the three groups in delivery type. Findings show that applying pressure on SP6 is effective 2 minutes after intervention. It could be an effective supplementary method to decrease pain intensity

[Comparative evaluation of fasting plasma glucose and one hour 50-G glucose challenge test in screening gestational diabetes mellitus]

Gestational diabetes is one of the most common metabolic disorders during pregnancy. In order to find out a simple and cost effective method with acceptable sensitivity and specificity, fasting plasma glucose [FPG] and one hour 50-g glucose challenge test [OGCT] were compared in patients with gestational diabetes mellitus [GDM]. In this prospective cohort study, 1804 pregnant women without preexisting diabetes underwent FPG and OGCT tests between 24 and 28 weeks of gestation. If the OGCT threshold values exceeded >/= 130 mg/dl, the 100g oral glucose tolerance test [OGTT] was performed using Carpenter and Coustan criteria. Receiver operating characteristic [ROC] analysis was used to evaluate the performance of the two tests. GDM was diagnosed in 7.3% and impaired glucose tolerance in 3.2%. The best cut-off points for GCT and FPG were 134mg/dl [sensitivity: 99.24%, specificity: 76.57%] and 87mg/dl [sensitivity: 80.15%, specificity: 85.62%]. By using GCT, an optimal cut-off values of GCT<135mg/dl [sensitivity: 96.95%] to rule out GDM; and values >/= 165mg/dl [specifity: 96.10%] to rule in GDM, would eliminate the need for the OGTT in 80.1% women [misclassification rate: 3.83%]. By using FPG, an optimal cut-off values of <76mg/dl [sensitivity: 95.42%] to rule out GDM; and values >/= 91mg/dl [specifity: 95.56%] to rule in GDM, would eliminate the need for the OGTT in 51% women [misclassification rate: 4.43%]. The results showed that the best test for predicting macrosomia, preterm delivery and caesarian section is OGCT; and for preeclampsia and respiratory distress is FPG. As OGCT can decrease the necessity of OGTT performance with lower misclassification rate comparing to FPG, OGCT would be the best screening test for GDM in Iran

[ effect of acupressure at the 3[rd] point of liver channel on quality of life of female students with primary dysmenorrhea in Tehran teacher training center in 2008: a randomize clinical trial]

Dysmenorrhea affects women's quality of life; moreover it results in physical, mental, social and economical problems. The aim of this study was to evaluate the effect of acupressure at the third point of liver channel [liv3] on quality of life in female students of Tehran Teaching Training [Tarbiat Moallem] Center with primary dysmenorrhea. This single-blind randomized clinical trial was conducted on 194 female students of Nasibeh Tarbiat Moallem center in Tehran who had had inclusion criteria. In the first cycle, the severity and duration of pain and quality of life were determined. Therefore, the participants were randomly assigned to either experimental or control group. In the second, third and fourth cycles, acupressure at liv3 and placebo point during 3-7 days before menstruation for 20 minute were carried out. In the fourth cycle, participants completed SF-36 questionnaire after menstruation again. Data-gathering Instruments used in this study included wrong-Baker faces pain scale, Beck-21 questionarre, SF-36 questionnaire, clock, Acuhealth tens pro 900 set, force guage. Data were analyzed with SPSS 16 and x[2] test, Man Whitney U, independent and paired test. P values were set as 0.05 [p<0.05]. There was no significant difference in mean quality of life dimension between two groups in the first cycle [p>0.05] but there was a significant difference in mean quality of life dimension between two groups in the fourth cycle [p<0.05]. The comparison between the first and the fourth cycle in two group showed a significant difference in all dimension [p<0.05] but there was not any significant difference between two cycles in Role Emotional functioning dimension in experimental group [p>0.05]. Moreover, there was no significant difference between two cycles in Role Emotional functioning and social functioning dimensions in experimental group [p>0.05]. with regard to the results of this study, acupressure at liv3 point is suggested as useful, effective, cheap and available treatment for primary dysmenorrheal

[Effect of barley [Hordeum vulgare l.] seed extract on fasting serum glucose level in streptozotocin induced diabetic rats]

diabetes mellitus and its related disorders are associated with significant burden on individuals and health care system. In Traditional Iranian Medicine [TIM] the consumption of barley products has been recommended for treatment of diabetes mellitus. The aim of this study is to examine the effect of oral barley seed aqueous extract on fasting serum glucose level and body weight of normal [non-diabetic] and Streptozotocin-induced diabetic rats. Forty male wistar rats were randomly divided in to diabetic and non-diabetic group. Diabetes was induced by single intraperitoneal injection of 45 mg/kg Streptozotocin. After one week the diabetic group [fasting blood glucose more than 200 mg/dL] and non-diabetic group were randomly divided in to control group and barley seed extract group. Body weight and fasting serum glucose level were measured and compared among groups at 1[st], 3[rd] and 4[th] weeks of study. Significant reduction [p<0.05] of fasting serum glucose level was seen at 4[th] week of treatment with aqueous extract of barley seed in diabetic rats in comparison with diabetic control group. In non-diabetic group, significant reduction [p<0.05] of fasting serum glucose level was seen after one week treatment comparing to non-diabetic control group. No significant effect was detected on the body weight of diabetic and non-diabetic groups. The aqueous extract of barley seed significantly reduced serum glucose level after 4 weeks in diabetic and after 1 week in non-diabetic group. In non-diabetic rats this reduction was not continued after first week

[Effects of adjacent teeth on caries status of a deciduous tooth in 3-5 years-old children]

Based on the carried out studies, the prevalence of dental caries in preschool children is high and ranges from 31.64 to 83.7 percents in Iran. The dmft criterion is not able to compute the impact of neighboring teeth on caries status of a tooth in deciduous teeth. The purpose of this study was to investigate the above issue in a sample of 3-5 years old children in Tehran during 2008-2009. In this cross-sectional study, a group of 400, 3-5 years old children who lived in Tehran and referred to Pediatric Dentistry Department of the Dentistry Faculty of Tehran University of Medical Sciences, Iran, for treatment of their deciduous teeth were investigated The demographic variables and mouth health cares data were collected by a questionnaire and the caries status of deciduous teeth were diagnosed by standard methods. The caries statuses were considered as spatially correlated binary data. The auto logistic regression model was implemented for inspecting the association of a tooth and its neighboring teeth which consists of two adjacent teeth and the opponent tooth. The effects of factors were tested using z-score. The fitted model and the computed criteria showed that there was a strong dependency between caries statuses of a tooth and its three neighbors [including the two adjacent and the vertically opponent teeth] [p=0.0001]. Also the effect of spatial auto covariate which is equivalent to the sum of statuses of nearest neighbors of a tooth is highly significant. Furthermore, the effects of local variables such as jaw and posterior-anterior positions were also highly significant [p=0.0001]. In deciduous teeth, the three nearest neighbors have a high effect on a tooth. As a result, the teeth in maxilla and posterior locations are decayed sooner than the other ones. These findings may be considered in preventive programs of health of mouth and tooth in children

[Effect of cardiac rehabilitation program's first phase on anxiety in patients with coronary arteries bypass surgery]

It is important to measure the anxiety level in patients who undergo heart surgery and find out ways to relief it. This study aimed to determine the effect of cardiac rehabilitation program's first phase on the level of anxiety among patients hospitalized for coronary arteries bypass surgery. In this randomized clinical trial, sixty patients were selected using block sampling and randomly allocated into experimental and control groups. Data were gathered using a questionnaire including the spiel burger's standardized questionnaire. The level of anxiety was measured in both groups. Then, the first phase of cardiac rehabilitation program [including physical exercise, and daily living activities] was carried out in the experimental group. Finally, patients in the experimental group discussed their experiences of surgery. Control group Patients received usual care. The level of anxiety was measured in both groups the day before surgery and at the time of discharge. Data were analyzed using t-test, chi-square, and Friedman tests in SPSS. Findings showed that the level of anxiety had no significant differences between two groups at the time of admission. After implementing the rehabilitation program, the level of anxiety decreased significantly [P < 0.001] in the experimental group. Significant differences were observed in the level of anxiety between two groups after intervention [P=0.015] and at the time of discharge [P=0.038]. This procedure should be used in surgery patients

Assessment of Marhame-mafasel pomade effect on knee osteoarthritis with non-compliance

Osteoarthritis is the most prevalent chronic non-infective joint arthritis. In this present study, the effect of new herbal pomade [Marhame-Mafasel] on knee osteoarthritis was investigated in randomized trial. The objective of this study was to assess efficacy of Marahme-Mafasel pomade, which was consisted of several medic herbs like Arnebia euchroma and Martricaria chamomilla in primary osteoarthritis of the knee with non-compliance. The 2x2 crossover trial enrolled 42 osteoarthritis patients [Marhame-Mafasel versus placebo] in 2006. The instrument of data collection was Western Ontario and Mc Master Universities [WOMAC] LK3.1 standard questionnaires. We used conditional estimation to adjust non-compliance effect. The participants in each group were 21 patients. About 30 [71.4%] were female. The participants were between 40-76 years old. Positive analgesic effect of herbal pomade "Marhame-Mafasel" on knee osteoarthritis severity was considerable [P<0.01]. After adjusting results to compliance level, the estimators were sharper than crude results. Herbal joint pomade "Marhame-Mafasel" has significant positive analgesic effect on primary knee osteoarthritis

[ female sexual function index [FSFI]: validation of the Iranian version]

To validate Persian version of the FSFI and to determine its diagnostic cut off score. This was a descriptive analytic study. To fill in the Persian version of the FSFI. In addition clinical interviews were carried out by a psychiatrist on DSM-4 criteria. Women divided in two age and educational matched groups: the control group [n=28] who have not sexual dysfunction and the case group [n=53] who have sexual dysfunction. Data were analyzed by Cronbach's alpha and validity was assessed by comparing mean scores of two groups. Optimal cut off score determined by Receiver Operating Characteristic [ROC] curve. The findings showed satisfactory results for full scale and each subscale with Cronbach's alpha ranging from 0.66 or above for sexually dysfunctional sample and 0.70 or above for sexually active sample. Discriminant validity confirmed the ability of both total and domain scores to differentiate between active and inactive women. On the basis of sensitivity and specificity analyses we found that the optimal cut off score was found to be 28 for differentiating women with and without sexual dysfunction. The findings showed that the Iranian version of Female Sexual Function Index [FSFI] is a reliable and valid instrument for measuring sexual function in women

effect of organized auditory stimulations on the consciousness level of comatose patients

High frequency of traumatic and non-traumatic brain injuries in one hand and improvement of the health care condition to restore patient's life in the other hand has increased the frequency of comatose patients in ICU. These patients often experience physical, cognitive, behavior or sensory defects, and the sensory input reduction in intensive care units expose them to cognition disorders. It seems that using sensory stimulation programs may be effective in preventing from sensory deprivation and facilitating recovery process. In this quasi-experimental study, 30 comatose patients who were hospitalized in ICU in Shariati and Sina hospitals were sought to be studied. The subjects were selected randomly using matching that was placed in case and control group. In the intervention group, patients received an auditory stimulation for 2 weeks, 6 days of a week, 2 times a day. The auditory stimulator was a recorded tape [5-10 minutes] of a familiar voice for 30 minutes. The Glasgow Coma Scale [GCS] was used for measuring the level of consciousness [LOC]. LOC was measured before and after each intervention 4 times a day. The control group LOC was measured in a similar manner to the case group. At the same time, homodynamic symptoms [blood pressure, pulse rate, and mean arterial pressure] were measured. Non-parametric test was used for analyzing data. The data was analyzed through SPSS V.11.5 computer software. The findings indicated that there was a significant difference in LOC of the intervention group at the first day and after fourteen days of the intervention [P<0.001], but not in the control group [P=0.769]. Although 2 groups were similar in LOC of the first day [P=0.605] but there were a significant difference between their LOC at the fourteenth day [P=0.001]. The results showed that the auditory stimulations with familiar voice were effective in increasing LOC in the comatose patients. It is suggested that nurses expose comatose patients with auditory stimulations using a recorded tape of familiar voice in ICU

effect of counseling on post traumatic stress disorder after a traumatic childbirth

Adverse childbirth experiences as a trauma can evoke fear and post-traumatic stress disorder in some women. This study was conducted to investigate the effect of counseling on post traumatic stress disorder after a traumatic childbirth. This research was a clinical trial which was conducted at Kamaly hospital in Karaj. Samples [300 women] who had experienced a traumatic childbirth were selected by a convenient sampling method and were randomized into an intervention [n=150] and a control [n=150] group. The intervention group received face-to-face counseling within 72 hours of birth for forty to sixty minutes in a session. The control group just received usual care after childbirth. The data collection tool was questionnaire, which was completed via interview. The measuring variables were demographic characteristic, reproductive history, maternity social support, and post-traumatic stress disorder. Data were analyzed using descriptive statistics and inferential tests [Chi-square, Fisher's exact test, and generalized Fisher's exact test] by SPSS v.13 software. After 4-6 weeks of follow-up there was no significant difference regarding post-traumatic stress disorder between two groups [P=0.295]. At 3-month of follow-up, the intervention group reported less post-traumatic stress disorder comparing with the control group [P=0.001]. A midwife-led counseling plan is effective in reducing post-traumatic stress disorder during a long term

Effect of nurse-led telephone follow ups [Tele-Nursing] on diet adherence among type 2 diabetic patients

Diabetes education does not assure adherence to diabetic regimen. The aim of this study was to investigate the effect of nurse-led telephone follow ups [Tele-Nursing] program on adherence to diabetic diet among type 2 diabetic patients. This was a quasi experimental study. Sixty patients who were registered at Iranian Diabetes Society were selected using convenience sampling method. Data gathering instruments included a data sheet to record glycosylated hemoglobin and a questionnaire. Data were gathered at baseline and 12 weeks after the intervention. First, all participants attended in a three-day self-care education and dietary consultation program at Iranian Diabetes Society. Then, they were randomly assigned to the experiment and control groups. Telephone follow ups were applied in experiment group for 3 months, twice a week for the first month and then weekly for the second and third months. Data were analyzed using SPSS version 13. Results showed that there were significant statistical differences between control and experiment groups in adherence to diabetic diet [P=0.035]. There were significant differences in glycosylated hemoglobin between control and experiment groups after the intervention [P<0.000]. According to the results of the study, it is concluded that the nurse-led telephone follow ups can improve HbA[1c] and diet adherence in type 2 diabetic patients

effect of childbirth preparation classes on childbirth fear and normal delivery among primiparous women

There has been an increase in the number of women willing to have a caesarean birth because of their fear of childbirth. It seems the childbirth preparation educational class is a good way to remove or alleviate fears associated with pregnancy and childbirth.This research designed to identify the effect of childbirth preparation classes on childbirth fear on the primiparous women. The present study is a clinical trial which was carried out in 2007 at Milad Hospital, with 100 nulliparous pregnant women. Childbirth fear was measured by childbirth attitudes questionnaire. Normal pregnant women in the second trimester with childbirth fear score was 28 or more were randomly selected and dirided into experimental and control group with 50 subject in each qroup. The experimental group attended nine childbirth preparation class sessions and control group received routine antennal care. The mean scored fear of childbirth in case and control group were 39.35 +/- 6.96 and 40.71 +/- 6.23 respectively. There was not significant difference between two groups. After the sessions, comparing childbirth fear score between two groups in third trimester showed the mean score of childbirth fear among experimental group was lower than control group [29.82 +/- 7.18 compare to 38.03 +/- 9.27], and the differences statistically was significant [p < 0.001]. Mode of delivery was significantly different between the two groups. Primiparous women attended childbirth preparation classes acquired lower score of childbirth fear in compare to women received routine prenatal care. The results of this research showed relaxation training decreased childbirth fear and increased normal vaginal delivery

Effect of pomegranate fruit juice and seed oil on serum lipid levels and atherosclerosis development in hypercholesterolemic rabbits

Pomegranate [Punica granatum L.] is a drought tolerant fruit-bearing deciduous shrub native to Iran. It is widely cultivated in dry areas of Iran. Pomegranate fruit juice contains a wide range of polyphenolic metabolites, especially punicalagins with powerful antioxidative properties. Pomegranate seed oil is a unique natural product and a rich source of conjugated fatty acids. The aim of this study was to investigate the pharmacological effects of fruit juice and seed oil of pomegranate on serum lipid levels of hypercholesterolemic rabbits and development of atherosclerosis on their aortas. Fourthly two males and six months aged white New Zealand rabbits [1.7 -2 kg] were randomly assigned to six equal groups and caged in the same environmental condition. One group was fed on regular animal house rabbit chew. Five other groups fed with high cholesterol diet [1% cholesterol]. One group kept as control and other 4 groups fed on same diet supplemented with 1% and 2% doses of pomegranate fruit juice or seed oil. The whole experiment lasted 2 months. At the end of the study [after 2 months] the biochemical analysis of serum lipids and pathological evaluation of atherosclerotic plaque of aortas were performed. Results of biochemical analyses showed that administration of fruit juice and seed oil at both doses did not significantly affect the level of serum lipids profile of hypercholesterolemic rabbits. Pathological data analysis showed that treatments of rabbits with fruit juice and seed oil at both doses significantly reduced aortic atherosclerotic plaque formation. Pomegranate fruit juice and seed oil administration inhibited atherosclerosis development in hypercholesterolemic rabbit's aortas without any significant effects on lipid profile

effect of external load and trunk posture on lumbar lordosis inclination under static condition

Epidemiological studies have shown that low back pain after load-carrying is an important and costly disorder in muscolo-skeletal system. Lumbar curvature is an important factor in posture and body movement that may assist us to evaluate how low back pain problems may develop. Differences in lumbar inclination affect the vertebral stresses. The object of this study was evaluation of the affects of external load and trunk posture on lumbar curvature under static condition. Ten healthy female subjects with no history of low back pain were participated in this study. Two inclinometers were used to evaluate the lumbar inclination. Six static tasks while holding three levels of load [0, 6, 12 Kg] and two levels of trunk position [neutral and 30 degree of flexion] were simulated for subjects. Trunk position [30 degree of flexion] and external load [6, 12 Kg] both had significant effects on lumbar inclination and reduce lumbar lordosis [p < 0.05]. Lumbar lordosis reduced while holding load, so muscles activity and may reduce tissue injuries reduced. Increased lumbar kyphosis shown resulted in trunk flexion is a lumbar supportive factor for compressive stresses

[Management by objective approach in nursing performance appraisal and its impact on quality of nursing care]

Performance appraisal is one of the most important duties for nursing managers. This will improve the quality of nursing care, and it needs suitable approaches and effective strategies in nursing services. The aim of this study is to determine the impact of performance appraisal using management by objective approach on nursing care quality. This was a quasi-experimental and single-blind study that was carried out in two surgical units of an affiliated hospital of Tehran University of Medical Sciences. 80 patients were selected using a randomized sampling. The quality of nursing care were controlled in both experiment and control units before and after the performance appraisal procedure. The procedure was programmed on the basis of management by objective approach for six months in the experiment unit. In the intervention unit, nursing performance appraisal was done three times and in every time head nurse and supervisors participated in giving feedbacks and recommendations for the nurses. At the end of the intervention, quality of nursing care was assessed in both groups blindly. The results were compared and statistically analyzed. Significant difference was found between quality of nursing care in the experiment and control units [P<0.001]. Quality of nursing care was significantly different before and after intervention in the experiment unit [P=0.009]. Performance appraisal using management by objective approach could increase the quality of nursing care. As a result, using nursing performance appraisal plans according to the basis of MBO could be an effective evaluation way to access the quality of nursing care