Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 533 539 EN Mohammad Azimi Alamouti Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mehrdad Bakhtiyari Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Moradi Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Tahmineh Mokhtari Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Azim Hedayatpour Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Fariba Zafari Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Mohammad Barbarestani Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 Multiple Sclerosis (MS) causes loss of the myelin sheath, which leads to loss of neurons. Regeneration of myelin sheath stimulates axon regeneration and neurons’ survival. In this study, olfactory ensheathing cell (OEC) transplantation is investigated to restore myelin sheath in an experimental model of MS in male mice.OECs were isolated from the olfactory mucosa of seven-day-old infant rats and cultured. Then, cells were evaluated and approved by flow cytometry by p75 and GFAP markers. A total of 32 mice (C57BL /6) were studied in four groups; 1) without any treatment (control), 2) Sham (receiving PBS), 3) MS model and 4) MS and OEC transplantation. MS was induced by adding Cuprizon in the diet of animals for six weeks. After the expiration of 20 days, histologic analysis was performed with approval of the presence of cells in the graft area and the removal of myelin and myelin regeneration with two types of luxal fast blue (LFB) staining and immunohistochemistry. The purity of the cells ensheathing the olfactory was 90%.  There was a significant difference in Myelin percentage of PBS and OEC recipient groups (P≤0.05). MBP and PLP of the myelin sheath in the group receiving OECs were more than MS group.According to the findings, in MS model MBP and PLP of the myelin sheath is reduced. In the group receiving OECs, it was returned to a normal level significantly compared to the sham group received only PBS significant differences were observed. The OECs transplantation can improve myelin restoration. https://acta.tums.ac.ir/index.php/acta/article/view/4288 https://acta.tums.ac.ir/index.php/acta/article/download/4288/4243

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 523 532 EN Mansoureh Shayeghi Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Jalil Nejati Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Leila Shirani-Bidabadi Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mona Koosha Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Badakhshan Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mulood Mohammadi Bavani Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Kourosh Arzamani Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Nayyereh Choubdar Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Bagheri Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Abedin Saghafipour Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran. Arshad Veysi Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Fateh Karimian Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Amir Ahamd Akhavan Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Hassan Vatandoost Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 Insects with over 30,000 aquatic species are known as very successful arthropods in freshwater habitats. Some of them are applied as biological indicators for water quality control, as well as the main food supply for fishes and amphibians. The faunistic studies are the basic step in entomological researches; the current study was carried out emphasizing on the fauna of aquatic insects in Karaj River, northern Iran. A field study was carried out in six various sampling site of Karaj River during spring 2013. The aquatic insects were collected using several methods such as D-frame nets, dipping and direct search on river floor stones. Specimens were collected and preserved in Ethanol and identified by standard identification keys. Totally, 211 samples were collected belonging to three orders; Plecoptera, Trichoptera and Ephemeroptera. Seven genuses (Perla, Isoperla, Hydropsyche, Cheumatopsyche, Baetis, Heptagenia and Maccafferium) from five families (Perlidae, Perlodidae, Hydropsychidae, Batidae, Heptagenidae) were identified. The most predominant order was Plecoptera followed by Trichoptera. Karaj River is a main and important river, which provides almost all of water of Karaj dam. So, identification of aquatic species which exist in this river is vital and further studies about systematic and ecological investigations should be performed. Also, monitoring of aquatic biota by trained health personnel can be a critical step to describe water quality in this river. Understanding the fauna of aquatic insects will provide a clue for possible biological control of medically important aquatic insects such as Anopheles as the malaria vectors. https://acta.tums.ac.ir/index.php/acta/article/view/4293 https://acta.tums.ac.ir/index.php/acta/article/download/4293/4248

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 585 589 EN Feridoun Sabzi Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Donya Khosravi Department of Gynecology and Obstetrics, Preventive Gynecology Research center, Imam Hussein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran. 2015 10 06 2015 10 06 Hemolytic anemia is exceedingly rare and an underestimated complication after aortic valve replacement (AVR).The mechanism responsible for hemolysis most commonly involves a regurgitated flow or jet that related to paravalvar leak or turbulence of subvalvar stenosis. It appears to be independent of its severity as assessed by echocardiography. We present a case of a 24-year-old man with a history of AVR in 10 year ago that developed severe hemolytic anemia due to a mild subvalvar stenosis caused by pannus formation and mild hypertrophic septum. After exclusion of other causes of hemolytic anemia and the lack of clinical and laboratory improvement, the patient underwent redo valve surgery with pannus and subvalvar hypertrophic septum resection. Anemia and heart failure symptoms gradually resolved after surgery. https://acta.tums.ac.ir/index.php/acta/article/view/4299 https://acta.tums.ac.ir/index.php/acta/article/download/4299/4254

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 11 593 593 EN Alireza Ghanadan Department of Pathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Kambiz Kamyab Department of Pathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mazaher Ramezani Department of Pathology, Kermanshah University of Medical Sciences, Kermanshah, Iran. Azadeh Goodarzi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Maryam Daneshpazhooh Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Kamran Balighi Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Ansari Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Seyed Farzad Mirfallah Nassiri Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Soroush Daklan Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 https://acta.tums.ac.ir/index.php/acta/article/view/4323 https://acta.tums.ac.ir/index.php/acta/article/download/4323/4257

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 540 546 EN Bagher Larijani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran Iran. Hamidreza Aghayan cGMP Grade Stem Cell Facility, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Parisa Goodarzi School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Fereshteh Mohamadi-Jahani Department of Biology, Payame Noor University, Tehran, Iran. Abbas Norouzi-Javidan Brain and Spinal Cord Injury Research Center, Cellular Fanavaran Knowledge-Based Organization, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Khadijeh Fallahzadeh cGMP Grade Stem Cell Facility, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Forough Azam Sayahpour Department of Molecular Systems Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. Kazem Bidaki Department of Biology, Payame Noor University, Tehran, Iran. Babak Arjmand Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 2015 10 06 In this study, our aim was to produce a generation of GMP-grade adipose tissue-derived mesenchymal stem cells for clinical applications. According to our results, we fulfill to establish consistent and also reproducible current good manufacturing practice (cGMP) compliant adipose tissue-derived mesenchymal stem cells from five female donors. The isolated cells were cultured in DMEM supplemented with 10% fetal bovine serum and characterized by standard methods. Moreover, karyotyping was performed to evaluate chromosomal stability. Mean of donors’ age was 47.6 ± 8.29 year, mean of cell viability was 95.6 ± 1.51%, and cell count was between 9×106 and 14×106 per microliter with the mean of 12.2×106 ± 2863564.21 per microliter. The main aim of this project was demonstrating the feasibility of cGMP-compliant and clinical grade adipose tissue-derived mesenchymal stem cells preparation and banking for clinical cell transplantation trials. https://acta.tums.ac.ir/index.php/acta/article/view/4290 https://acta.tums.ac.ir/index.php/acta/article/download/4290/4244

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 590 592 EN Nima Hosseinzadeh School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Shahram Samadi Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mihan Jafari Javid Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Takzare Department of Anesthesiology and Intensive Care, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 06 Reinforced tubes are commonly used to minimize the opportunity of upper airway obstruction in patients at risk. There are a few reports of the airway obstruction resulted from kinked reinforced tubes. This report describes the obstruction of a reinforced tube in an adult patient who underwent tonsillectomy. Under general anesthesia; an armoured endotracheal tube was inserted into the trachea uneventfully. A few minutes after starting the surgery, the anesthesia machine detected a high airway pressure and an increased ETCO2 (end-tidal show any significant alteration. CCl₄-induced cirrhosis is accompanied by increased content of oxidative stress markers, especially protein carbonyl of RBC membrane and plasma enzyme activities. This study shows that the progression of liver cirrhosis and the ameliorative effect of NTX can be followed through alterations of these markers. https://acta.tums.ac.ir/index.php/acta/article/view/5169 https://acta.tums.ac.ir/index.php/acta/article/download/5169/4846

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 640 643 EN Alireza Tavassoli Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Ghodratollah Maddah Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Sadjad Noorshafiee Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Maryam Salehi Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Shima Imannezhad Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Ehsanollah Ghorbanian Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 11 11 2016 08 02 Resection is the most common treatment choice for sigmoid volvulus, a common complication in our region. A new minimally invasive technique for sigmoid resection with local anesthesia was done in this study. This method is invented to avoid general on regional anesthesia in high-risk patients. Nineteen patients were evaluated and then 14 were enrolled in this study. Sigmoidectomy with a left lower quadrant incision was performed and demographic data, the length of hospital stay, complications and procedure time were recorded. The mean age of participants was 65.68, and the male to female ratio was 1:2.7. The mean duration of the operation was 91.42 min. Complications include one case each of wound hematoma and wound infection. The intraoperative pain score was 1.2/10 and postoperative pain score was 2.35/10. The mean hospital staying was 8.3 days. By meticulous patient selection, sigmoidectomy under local anesthesia for sigmoid volvulus could be a surgeons’ armamentarium in special situations. https://acta.tums.ac.ir/index.php/acta/article/view/5129 https://acta.tums.ac.ir/index.php/acta/article/download/5129/4847

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 644 650 EN Ghodratollah Maddah Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Abbas Abdollahi Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Hamid Etemadrezaie Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Babak Ganjeifar Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Behnaz Gohari Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Mohsen Abdollahi Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Masoumeh Hassanpour Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 10 28 2016 03 04 Retrorectal tumors are rare lesions in adults, which remains a difficult diagnostic and management problem. The purpose of this study was to evaluate the results of surgical management of retrorectal tumors in our institution. In a retrospective study, a consecutive series of patients who underwent surgical excision of a retrorectal tumor were identified from a database. Medical records, radiology, pathology reports and surgical approach were checked retrospectively. The data was analyzed using SPSS statistical software (version 18). From 50 patients, 24 were male, and 26 were female with the mean age of 41.7 years. The origin of mass was congenital in 46% (23 cases) and neurogenic in 14% (7 patients), bone origin in 12% (6 cases) and miscellaneous in 24% (12 cases). In total, 56.7% (21 cases) were malignant. Surgical approaches included laparotomy in 11 cases, the sacral approach in 17 cases, the anterior-posterior approach in 14 cases and one case through abdomino-sacral approach. The mean follow-up was 56.7 (10-277) month. Ten patients died due to extensive metastases with a mean survival of 46.6 (1-158) months. Primary urethrorectal tumors are very rare. Successful treatment of these tumors requires careful clinical evaluation and expertise in pelvic surgery. https://acta.tums.ac.ir/index.php/acta/article/view/5086 https://acta.tums.ac.ir/index.php/acta/article/download/5086/4848

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 651 656 EN Fatereh Momeni Javid Department of Reproductive Health and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Masoumeh Simbar Department of Reproductive Health and Midwifery, Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mahrokh Dolatian Department of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Hamid Alavi Majd Department of Biostatics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zohre Mahmoodi Department of Social Determinant, Health Research Center, Alborz University of Medical Sciences, Alborz, Iran. 2016 01 26 2016 02 06 Gestational diabetes increases the risks for mother and fetus during pregnancy. As a principle of caring for diabetes, recommending patients to lose weight through more physical activities and a restrictive diet has a long history. The present study was carried out aiming at determining and comparing dietary style and physical activity in women with gestational diabetes and healthy pregnant women. This descriptive-comparative study was carried out simultaneously on 200 pregnant women (with gestational diabetes and healthy). Tools for data collection were questionnaires of dietary style and physical activity during pregnancy. After obtaining research informed consent from samples, sampling was done by multi-stage convenience random sampling. Data was analyzed using SPSS 21. The results of the study revealed that the demographic and obstetric variables were identical. The mean scores for the dietary style of case and control groups were 65.05 and 74.12, P<0.001 respectively. The mean scores for physical activity (inactive cases) in the two groups were 5.64 and 4.70, P<0.223, the mean scores for light activity in the two groups were 9.07 and 10.75 (P<0.059), and the mean scores for moderate activity in the two groups were 4.62 and 5.69, (P<0.042) respectively. Lower status of nutrition and physical activity of women with gestational diabetes comparing to non-diabetic pregnant women suggests a need providing sufficient and accurate information on appropriate dietary and physical activities during pregnancy. https://acta.tums.ac.ir/index.php/acta/article/view/5406 https://acta.tums.ac.ir/index.php/acta/article/download/5406/4849

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 657 661 EN Gholamreza Pouryaghoub Occupational Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ramin Mehrdad Department of Occupational Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Valipouri Department of Occupational Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 16 2016 06 06 Cardiovascular adverse effects are interesting aspects of occupational noise exposure. One possible mechanism of these effects is an alternation in hypothalamic-pituitary-adrenal axis. Our aim was to measure salivary cortisol response to relatively high-intensity noise exposure in a controlled randomized trial study. We exposed 50 male volunteers to 90 dBA noise for 20 minutes and compared their level of salivary cortisol with 50 non-exposed controls. Salivary samples obtained before and after exposure. Before intervention means (SD) salivary cortisol level were 3.24 (0.47)ng/ml and 3.25 (0.41)ng/ml for exposed and non-exposed groups respectively. Mean salivary cortisol level increased to 4.17 ng/mlafter intervention in exposure group. This increment was statistically significant (P=0.00). Mean salivary cortisol level of the non-exposed group had statistically non-significant decrement after this period (0.2 ng/ml). The difference between salivary cortisol level of non-exposed and exposed groups after the intervention was statistically significant. Noise exposure may affect the hypothalamic-pituitary-adrenal axis activity, and this may be one of the mechanisms of noise exposure cardiovascular effects. https://acta.tums.ac.ir/index.php/acta/article/view/5582 https://acta.tums.ac.ir/index.php/acta/article/download/5582/4850

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 662 666 EN Farzad Fatehi Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Neurology, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran. Alireza Monajemi Department of Philosophy of Sciences, Institute for Humanities and Cultural Studies, Tehran, Iran. Anahita Sadeghi Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Rita Mojtahedzadeh Department of E-Learning in Medical Education, Center of Excellence for E-Learning in Medical Education, Tehran University of Medical Sciences, Tehran, Iran. Azim Mirzazadeh Department of E-Learning in Medical Education, Center of Excellence for E-Learning in Medical Education, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Medical Education, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2016 03 09 2016 05 17 The widespread use of internet has caused new psychological, social, and educational problems for the students. The aim of this study was to examine the quality of life in medical students who suffer from internet addiction. This cross-sectional survey was carried out in Tehran University of Medical Sciences, and a total of 174 fourth-to seventh-year undergraduate medical students were enrolled. The quality of life was assessed by WHOQOL-BREF questionnaire which covers four domains of physical health, psychological, social relationships, and the environment. For assessing internet addiction, we used Internet Addiction Test (IAT) of Young. The students with IAT score higher than 50 were considered as addicted. For evaluating academic performance, the students were requested to report their grade point average (GPA). The mean IA score (±SD) was 34.13±12.76. Twenty-eight students (16.90%) had IAT score above 50. The mean quality of life score in internet addicted group was 54.97±11.38 versus 61.65±11.21 in normal group (P=0.005). Furthermore, there was a negative correlation between IA score and physical domain (r=-0.18, P=0.02); psychological domain (r=-0.35, P=0.000); and social relation domain (r=-0.26, P=0.001). Mean GPA was significantly lower in the addicted group. It seems that quality of life is lower in the internet addicted medical students; moreover, such students academically perform poorer in comparison with non-addicts. Since internet addiction is increasing at a rapid pace which may provoke considerable academic, psychological and social implications; as a result, it may require screening programs to the immediate finding of such problem to give consultations to prevent unwanted complications. https://acta.tums.ac.ir/index.php/acta/article/view/5503 https://acta.tums.ac.ir/index.php/acta/article/download/5503/4851

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 10 2016 11 19 667 677 EN Seyed Mohammad Hadi Mousavi Health Information Research Center, Tehran University of Medical Sciences, Tehran, Iran. Hossein Dargahi Department of Health Care Management, Health Information Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Health Care Management, School of Allied Medicine, Tehran University of Medical Sciences, Tehran, Iran. Sara Mohammadi Department of Health Care Management, Health Information Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2016 03 12 2016 05 18 Creating a safe of health care system requires the establishment of High Reliability Organizations (HROs), which reduces errors, and increases the level of safety in hospitals. This model focuses on improving reliability through higher process design, building a culture of accreditation, and leveraging human factors. The present study intends to determine the readiness of hospitals for the establishment of HROs model in Tehran University of Medical Sciences from the viewpoint of managers of these hospitals. This is a descriptive-analytical study carried out in 2013-2014. The research population consists of 105 senior and middle managers of 15 hospitals of Tehran University of Medical Sciences. The data collection tool was a 55-question researcher-made questionnaire, included six elements of HROs to assess the level of readiness for establishing HROS model from managers’ point of view. The validity of the questionnaire was calculated through the content validity method using 10 experts in the area of hospitals’ accreditation, and its reliability was calculated through test-retest method with a correlation coefficient of 0.90. The response rate was 90 percent. The Likert scale was used for the questions, and data analysis was conducted through SPSS version 21 Descriptive statistics was presented via tables and normal distributions of data and means. Analytical methods, including t-test, Mann-Whitney, Spearman, and Kruskal-Wallis, were used for presenting inferential statistics. The study showed that from the viewpoint of senior and middle managers of the hospitals considered in this study, these hospitals are indeed ready for acceptance and establishment of HROs model. A significant relationship was showed between HROs model and its elements with demographic details of managers like their age, work experience, management experience, and level of management. Although the studied hospitals, as viewed by their managers, are capable of attaining the goals of HROs, it seems there are a lot of challenges in this way. Therefore, it is suggested that a detailed audit is conducted among hospitals’ current status regarding different characteristics of HROs, and workshops are held for medical and non-medical employees and mana> Farnoosh Golband Department of E-learning in Medical Education, Virtual School, Tehran University of Medical Sciences, Tehran, Iran. Agha Fatemeh Hosseini Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. Rita Mojtahedzadeh Department of E-learning in Medical Education, Virtual School, Tehran University of Medical Sciences, Tehran, Iran. Fakhrossadat Mirhosseini Department of E-learning in Medical Education, Virtual School, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Anesthesia, School of Allied Health Sciences, Kashan University of Medical Sciences, Kashan, and PhD Student, Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Shoaleh Bigdeli Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, school of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2015 10 11 E-learning as an educational approach has been adopted by diverse educational and academic centers worldwide as it facilitates learning in facing the challenges of the new era in education. Considering the significance of virtual education and its growing practice, it is of vital importance to examine its components for promoting and maintaining success. This analytical cross-sectional study was an attempt to determine the relationship between four factors of content, educator, learner and system, and effective e-learning in terms of demographic variables, including age, gender, educational background, and marital status of postgraduate master's students (MSc) studying at virtual faculty of Tehran University of Medical Sciences. The sample was selected by census (n=60); a demographic data gathering tool and a researcher-made questionnaire were used to collect data. The face and content validity of both tools were confirmed and the results were analyzed by descriptive statistics (frequency, percentile, standard deviation and mean) and inferential statistics (independent t-test, Scheffe's test, one-way ANOVA and Pearson correlation test) by using SPSS (V.16). The present study revealed that There was no statistically significant relationship between age and marital status and effective e-learning (P>0.05); whereas, there was a statistically significant difference between gender and educational background with effective e-learning (P<0.05). Knowing the extent to which these factors can influence effective e-learning can help managers and designers to make the right decisions about educational components of e-learning, i.e. content, educator, system and learner and improve them to create a more productive learning environment for learners. https://acta.tums.ac.ir/index.php/acta/article/view/4533 https://acta.tums.ac.ir/index.php/acta/article/download/4533/4663

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 11 2014 11 15 865 867 EN Hossein Nough Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mostafa Bagherinasab Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahmood Emami Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mohammadtaghi Sarebanhassanabadi Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Leila Hadiani Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2015 10 11 Aneurysm can develop in all arteries of the human body. Pseudoaneurysm induced by trauma is known as a rare condition in peripheral arteries. This complication is known as late sequelae of trauma. The incidence of pseudoaneurysm in upper extremities artery is less than lower extremities. Atherosclerotic aneurysms are often seen in large arteries and by aging, but pseudoaneurysm can be seen in penetrating or blunt trauma in patients of every age or every location. Delayed treatment of pseudoaneurysm leads to bleeding, venous edema at the extremities and compression on the adjacent nerve as a result of pseudoaneurysm enlargement. Early diagnosis of pseudoaneurysm is very important, because this complication can induce disabilities such as u