Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 79 96 EN Bagher Larijani Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ensieh Nasli Esfahani Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Peyvand Amini Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Behrouz Nikbin Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran. Kamran Alimoghaddam Hematology-Oncology & BMT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Somayeh Amiri Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Reza Malekzadeh Digestive Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran. Nika Mojahed Yazdi Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Maryam Ghodsi Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran. Yahya Dowlati Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ali Sahraian Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ardeshir Ghavamzadeh Hematology-Oncology & BMT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Stem cells are undifferentiated cells with the ability of proliferation, regeneration, conversion to differentiated cells and producing various tissues. Stem cells are divided into two categories of embryonic and adult. In another categorization stem cells are divided to Totipotent, Multipotent and Unipotent cells. So far usage of stem cells in treatment of various blood diseases has been studied (such as lymphoblastic leukemia, myeloid leukemia, thalassemia, multiple myeloma and cycle cell anemia). In this paper the goal is evaluation of cell therapy in treatment of Parkinson's disease, Amyotrophic lateral sclerosis, Alzheimer, Stroke, Spinal Cord Injury, Multiple Sclerosis, Radiation Induced Intestinal Injury, Inflammatory Bowel Disease, Liver Disease, Duchenne Muscular Dystrophy, Diabetes, Heart Disease, Bone Disease, Renal Disease, Chronic Wounds, Graft-Versus-Host Disease, Sepsis and Respiratory diseases. It should be mentioned that some disease that are the target of cell therapy are discussed in this article. https://acta.tums.ac.ir/index.php/acta/article/view/3864 https://acta.tums.ac.ir/index.php/acta/article/download/3864/3839

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 97 100 EN Keivan Basiri Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. AND Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran. Masood Etemadifar Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. AND Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran. Fatemeh Derakhshan Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Fereshteh Ashtari Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. AND Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran. Vahid Shaygannejad Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. AND Department of Neurology, Isfahan University of Medical Sciences, Isfahan, Iran. Zahra Fatehi Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Amir Hadi Maghzi Neuroscience Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Farzad Fatehi Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran 2015 09 28 None of the approved immunomodulatory drugs in adults Multiple Sclerosis (MS) patients have been officially approved for the pediatric patients and are currently used off-label in this population. In this study, we evaluated the effectiveness and tolerability of intramuscular interferon beta1-a (Avonex®) and subcutaneously injected interferon beta1-b (Betaferon®) in children with definite relapsing-remitting MS (RRMS). Thirteen patients aged younger than 16, who were recently diagnosed with definite RRMS according to the McDonald's criteria, were enrolled in this study. Six patients were treated with Avonex® 30 μg, intramuscularly every week, and seven patients were treated with Betaferon® 250 μg, subcutaneously every other day. All patients were treated with adult doses; initially interferon-beta was prescribed with half dose, and it was increased to full adult dose steadily. Eleven girls and two boys, mean (SD) age of 14.7 (1.9) years, were studied. Following nine months of using interferon-beta, nine patients (69.2%) had no relapses and the remaining four, experienced only one relapse. The mean EDSS score was decreased significantly after the study period. The present study provides reasonable data for the use of interferon-beta in Pediatric MS due to lack of short-term complications and safety. Studies with larger sample size and longer follow up duration are required to shed light on the long term impact of the interferon-beta therapy in children. https://acta.tums.ac.ir/index.php/acta/article/view/3865 https://acta.tums.ac.ir/index.php/acta/article/download/3865/3840

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 101 106 EN Mehrangiz Zamani Department of Obstetrics & Gynecology, Hamedan University of Medical Sciences, Hamedan, Iran. Nosrat Neghab Department of Obstetrics & Gynecology, Hamedan University of Medical Sciences, Hamedan, Iran. Saadat Torabian Department of Community Medicine, Hamedan University of Medical Sciences, Hamedan, Iran. 2015 09 28 Medical therapies have been widely used for premenstrual syndrome (PMS), but in all of them side effects are predominant. Herbal remedies rarely have side effects and people have more tendencies toward them than chemical therapies. In this study the therapeutic effect of Vitex agnus castus on women who had the PMS, in comparison with placebo, were investigated. In this randomized, placebo-controlled, doubleblind study, from134 selected patients 128 women suffered from PMS were evaluated (active 62, placebo 66). All patients answered to a self assessment questionnaire about their headache, anger, irritability, depression, breast fullness and bloating and tympani during the premenstrual period before the study. Forty drops of Vitex agnus extract or matching placebo, administrated for 6 days before menses for 6 consecutive cycles. Patients answered the self-assessment questionnaires after 6 menstrual cycles, again. Each item rated using a visual analogue scale (VAS). The mean age was 30.77 (SD=4.37) years in the active group and 30.89 (SD=4.02) years in the placebo group. Rank of variables had significantly difference in active and placebo group before and after the study (P<0.0001) also we noticed significant differences on the use of Vitex agnus in comparison with placebo (P<0.0001). Vitex agnus can be considered as an effective and well tolerated treatment for the relief of symptoms of mild and moderate PMS https://acta.tums.ac.ir/index.php/acta/article/view/3866 https://acta.tums.ac.ir/index.php/acta/article/download/3866/3841

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 107 112 EN Babak Mirzashahi Department of Orthopedic Surgery, Lorestan University of Medical Sciences, Khorramabad, Iran. Mahdieh Ahmadifar Young Researchers Club, Khorramabad Branch, Student Islamic Azad University, Khorramabad, Iran. Mehdi Birjandi Department of Biostatistics, Lorestan University of Medical Sciences, Khorramabad, Iran. Yadollah Pournia Instructor, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran. 2015 09 28 Hallux valgus or the lateral deviation of the great toe is a complex disease. If it is not treated, it will cause the deviation of other toes. Hallux valgus is three times more common in females and may cause uncomfortable deformity of the foot, problems in putting on unsuitable and narrow toe box shoes, and pain on the medial side of the first metatarsophalangeal joint; therefore, patients seek medical services. Untreated hallux valgus may cause the hammer toe deformity of the second toe. In this cohort study, 30 patients referring to the Orthopedic Clinic of Shohada Ashayer Hospital of Khorramabad, Iran, with a complaint of hallux valgus were randomly divided into two groups. The splints designed by the researches (slippers splints) were given to the case group, and the splints on the market including night splints and interdigital pads were given to the control group. The patients were followed every three months for a year and every time the weight bearing anteroposterior radiography of both feet were taken and hallux valgus and intermetatarsal angles were measured. The data was analyzed by the SPSS software using repeated measure tests. In the case group that used the designed splints regularly, hallux valgus angles decreased more dramatically than in the control group (P<0.001). This study showed that, despite controversies over the nonoperative treatment of hallux valgus, if hallux valgus angle in patient is mild to moderate, the splint can be used as a nonoperative treatment. https://acta.tums.ac.ir/index.php/acta/article/view/3867 https://acta.tums.ac.ir/index.php/acta/article/download/3867/3842

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 113 116 EN Babak Malekpour Department of Neurosurgery, Shiraz University of Medical Science, Shiraz, Iran. Ali Mehrafshan Department of Neurosurgery, Shiraz University of Medical Science, Shiraz, Iran. Forough Saki Department of Pediatric Endocrinology, Shiraz University of Medical Science, Shiraz, Iran. Zahed Malekmohammadi Department of Neurosurgery, Shiraz University of Medical Science, Shiraz, Iran. Nasrin Saki Department of Dermatology, Shiraz University of Medical Science, Shiraz, Iran. 2015 09 28 Traumatic brain injury (TBI) is an important cause of death and disability in young adults ,and may lead to physical disabilities and long-term cognitive, behavioral psychological and social defects. There is a lack of definite result about the effect of thyroid hormones after traumatic brain injury in the severity and no data about their effect on mortality of the injury. The aim of this study is to evaluate the effect of thyroid hormones after traumatic brain injury in the severity and mortality and gain a clue in brain injury prognosis. In a longitudinal prospective study from February 2010 until February 2011, we checked serum levels of T3, T4, TSH and TBG of severely brain injured patients and compared the relationship of them with primary Glasgow Coma Scale (GCS) score and mortality of patients. Statistical analysis used SPSS 11.5 software with using chi-square and Fisher exact test. Serum levels of T3 and T4 were decreased after brain trauma but not TSH and TBG. Mortality rates were higher in patients with lower T4 serum levels. The head injury was more severe in whom with low T3 and T4. Follow a severe brain injury a secondary hypothyroidism is happened due to pituitary dysfunction. Also, serum level of T3 and T4 on the first day admission affect on primary GCS score of patients which is an indicator of severity of brain injury. In addition, mortality rates of severely brain injured patients have a high correlation with the serum level of T4 in the first day admission. https://acta.tums.ac.ir/index.php/acta/article/view/3868 https://acta.tums.ac.ir/index.php/acta/article/download/3868/3843

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 117 121 EN Amir Farhang Zand Parsa Department of Cardiology, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Ladan Haghighi Department of Obstetrics and Gynecology, Shahid Akbarabadi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Right bundle branch block (RBBB) is considered as an important predictor of poor outcome in patients with acute myocardial infarction, but the prognostic implication of RBBB in patients with suspected coronary artery disease (CAD) is unclear. Furthermore, the association between RBBB and incidence of CAD also its influence on the severity of stenosis in coronary arteries has not been established. This study was designed to assess the relationship between RBBB and the presence and the severity of CAD in patients with suspected CAD. The study population consisted of 172 patients with RBBB and 174 patients with normal resting electrocardiography (ECG). Severity of CAD was defined as estimated Gensini score according to the degree, quantity and distribution of lesions in angiographic study. According to our study based on angiographic investigations, in patients with RBBB the prevalence of CAD was 77.3 percent versus 70.1 percent in patients with normal resting ECG (P=0.13). Also, there was no significant association between the presence of RBBB and magnitude of Gensini score (OR=0.87, P=0.62). However, male gender and history of diabetes mellitus were associated with higher Gensini score (OR=3.41; 95% CI: 1.96-5.93, P<0.0001 and OR=3.22; 95% CI: 1.77-5.87, P<0.0001 respectively). This study suggests that although RBBB was associated with more severity of stenosis in left coronary system (LAD&LCX), but as a whole there was no association between RBBB and the presence and severity of CAD. https://acta.tums.ac.ir/index.php/acta/article/view/3869 https://acta.tums.ac.ir/index.php/acta/article/download/3869/3844

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 122 126 EN Hossein Kakooei Department of Occupational Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Abdollah Gholami Department of Occupational Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Ghasemkhani Department of Occupational Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mostapha Hosseini Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Davoud Panahi Department of Occupational Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Golamreza Pouryaghoub Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Dust can be produced by almost all production processes in Portland cement factory. Dust exposure potentially can affect respiratory function. But evidence for respiratory effect of cement dust exposure has not been conclusive. In this study we assessed effect of cement dust exposure on respiratory function in a cement production factory. A respiratory symptoms questionnaire was completed and pulmonary function tests were carried out on 94 exposed and 54 non exposed workers at a cement factory in the east of Iran. Additionally, respirable dust level was determined by the gravimetric method. X-ray fluorescence (XRF) technique was performed to determine the silica phases and the SiO2 contents of the bulk samples. The arithmetic means (AM) of personal respirable dust were 30.18 mg/m3 in the crushing, 27 mg/m3 in the packing, 5.4 mg/m3 in the cement mill, 5.9 mg/m3 in the kiln and 5.48 mg/m3 in the maintenance that were higher than threshold limit value (TLV) of the American Conference of Governmental Industrial Hygienists (ACGIH) which is 5 mg/m3 . This value in the unexposed group was 0.93 mg/m3 . In this study cough, sputum, wheezing and dyspnea were more prevalent among exposed subjects. Exposed workers compared to the unexposed group showed significant reduction in Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), and Forced Expiratory Flow between 25% and 75% of the FVC (FEF25-75%) (P<0.05). It can be concluded that in our study there was close and direct association between cement dust exposure and functional impairment among the cement factory workers. https://acta.tums.ac.ir/index.php/acta/article/view/3870 https://acta.tums.ac.ir/index.php/acta/article/download/3870/3845

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 127 132 EN Mohammad Sadegh Ahmad Akhoundi Department of Orthodontics, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran. Javad Chalipa Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Reza Hashemi Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran. Tahereh Hosseinzadeh Nik Department of Orthodontics, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Sodagar Department of Orthodontics, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran. Rose Afzalifar Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Templates are very useful tools for diagnosis of malocclusions. A number of templates have been provided for some populations in previous years. Since craniofacial characteristics of different ethnic groups are not the same, each population needs its own norms. The aim of this study was to provide orthodontic craniofacial templates for 8-16 year old Iranian boys and compare dentoskeletal features between Iranian and western populations. 3330 boys with the age range of 8-16 years were examined in Tehran, and 107 cases were finally chosen for the study and their lateral cephalograms were traced. Since there is no universal, consensus about the selection of one specific point or line for cephalometric superimposition, both the sella nasion (SN) and basion nasion (Ba-N) lines were chosen for this purpose. Based on both SN and Ba-N lines, a template was prepared for each age. Simple linear regression analysis was used to evaluate the angles and the multivariant regression analysis for evaluation of landmark vectors. Posterior cranial base, maxillary and mandibular lengths, upper and lower anterior facial heights (N-ANS and ANS-Me) and posterior facial height (S-Go) are greater in Iranian population. But anterior cranial base, height and inclination of the incisors and molar height are similar in two populations. https://acta.tums.ac.ir/index.php/acta/article/view/3871 https://acta.tums.ac.ir/index.php/acta/article/download/3871/3846

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 133 137 EN Zahra Basseda Iranian Center for Neurological Research, Imam Khomeini Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Homayoun Amini Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Vandad Sharifi Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Hosein Kaviani Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Psychology, University of Bedfordshire, Luton, UK. Hamid Reza Pooretemad Department of Psychology, Shahid Beheshti University, Tehran, Iran. AND Institute for Cognitive Sciences Studies, Tehran, Iran. Asieh Zadbood Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 09 28 This study was aimed to evaluate the Emotional Intelligence (EI) of a group of patients with first episode psychosis in Iran as compared with a healthy control group. A case-control design was used. EI was assessed using Persian version of Bar-On Emotional Quotient inventory (EQ-i) administered on 25 patients with history of a single psychotic episode in the last two years, as well as 64 healthy participants. The mean (±SD) of EI scores of patients' and healthy controls' group was 319.8 (±40.9) and 328.8 (±33.3), respectively. Two-independent sample t-test revealed no significant difference in the EI scores of two groups (P=0.29). In contrast with chronic schizophrenia, the patients with first-episode psychosis were not different from the healthy subjects in terms of emotional intelligence score. It might be implied that the low emotional intelligence of the patients with chronic psychotic disorders is an accumulative result of the underlying disease over time. https://acta.tums.ac.ir/index.php/acta/article/view/3872 https://acta.tums.ac.ir/index.php/acta/article/download/3872/3847

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 138 146 EN Hossein Dargahi Department of Health Care Management, Tehran University of Medical Sciences, Tehran, Iran. Golsa Shaham Department of Health Care Management, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Healthcare workers suffer from work-related or occupational stress. This can lead to severe distress, burnout or physical illness, and finally to decrease quality of work life and services provision. Nurses must be aware of retential stressors, because they add to the cumulative effect of other stressful events. Holmes and Rahe both found a relationship between life change unit as stressors and health changes. This research reported here aims to measure the life change units as stressors among Iranian Hospitals Nurses by LCU rating. A cross - sectional, descriptive and analytical study was conducted among 389 nurses working in 15 teaching hospitals in Tehran, Iran. The respondents were asked to select each of 54 events that cause stress ranked in order of their life change units developed by Holmes and Rahe as stress scale. Before beginning the main study, the reliability and coincidental validity was performed. All data were analyzed using SPSS for windows version 18, t-test, Anova statistical methods. Approximately, half of the nurses associated major mortgage, foreclosure of mortgage or loan. More than 50% of the Iranian nurses had 150-300 and more than 300 LCU rating which had the chance to expose to extremely serious risk to health. Iranian hospitals nurses suffer from stress that caused by Life Change Units organizational factors such as change in the financial state, change in the work environment and major mortgage. We recommend to Iranian nursing policy-makers to choose strategies to help nurses' cope effectively with workplace stressors. Nursing managers and / or nursing management should develop strategies to address and improve the quality of working conditions for nurses in the hospitals. Providing educational and career prospects can contribute to decrease nurses' occupational stress level, the maintaining their work ability. https://acta.tums.ac.ir/index.php/acta/article/view/3873 https://acta.tums.ac.ir/index.php/acta/article/download/3873/3848

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 147 150 EN Shokoufeh Hajsadeghi Department of Cardiology, Rasul-e-AkramHospital, Tehran University of Medical Sciences, Tehran, Iran. Maral Hejrati Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran. Samar Moghadami Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran. Sahar Rismantab Internal Medicine, Rasul-e-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran. Parva Namiranian Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran. 2015 09 28 Xerodermapigmentosum (XP), is an autosomal recessivegenetic disorder of DNA repair in which the ability to repair damage caused by ultraviolet (UV) light is deficient. The oxidative stress caused by decline catalase activity as an antioxidant enzyme, has been illustrated in these patients. This is the first case report of dilated cardiomyopathy in two patients with XP, A 26 year old girl and her younger brother. Laboratory studies demonstrated severe vitamin D deficiency in both of them. Cardiac dysfunction in the presented cases with XP might be caused by vitamin D deficiency. But this question still remains: whether chronic oxidative stress can involve the heart and can be a predisposing factor or even an underlying factor for dilated cardiomyopathy in XP, or not. More studies are needed for demonstrating this hypothesis. https://acta.tums.ac.ir/index.php/acta/article/view/3874 https://acta.tums.ac.ir/index.php/acta/article/download/3874/3849

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 50 2 2012 02 15 151 152 EN Jalal Hussaini Department of Otorhinolaryngology, School of Medicine, Malaya University, Kuala Lumpur, Malaysia. Somasundran Mutusamy Department of Otorhinolaryngology, School of Medicine, Malaya University, Kuala Lumpur, Malaysia. Rahmat Omar Department of Otorhinolaryngology, School of Medicine, Malaya University, Kuala Lumpur, Malaysia. Raman Rajagopalan Department of Otorhinolaryngology, School of Medicine, Malaya University, Kuala Lumpur, Malaysia. Prepageran Narayanan Department of Otorhinolaryngology, School of Medicine, Malaya University, Kuala Lumpur, Malaysia. 2015 09 28 We report a rare case of base of tongue tuberculosis following pulmonary tuberculosis. Patient presented to us with chief complaints of sore throat and pain on swallowing for period of 3 months. On examination with 70 degree telescope, we observed an ulcer on right side of base of tongue. The edges of the ulcer appeared to be undermined with whitish slough at the centre of the ulcer. Examination of neck showed a multiple small palpable middle deep cervical lymph nodes on right side of neck. Biopsy of the ulcer was taken, which showed granulomatous inflammation, suggestive of tuberculosis. Laboratory investigations revealed a raise in erythrocyte sedimentation rate, sputum for acid fast bacilli was strongly positive. Chest X ray was performed for patient showed multiple areas of consolidation. Patient was referred to chest clinic for further management of tuberculosis and was started on anti-tuberculous drugs. In conclusion tuberculosis of oral cavity is rare, but should be considered among one of the differential diagnosis of the oral lesions and biopsy is necessary to confirm the diagnosis. https://acta.tums.ac.ir/index.php/acta/article/view/3875 https://acta.tums.ac.ir/index.php/acta/article/download/3875/3850