Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 737 239 EN Zahid Hussain Khan Department of Anesthesiology and Intensive Care, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 No Abstract https://acta.tums.ac.ir/index.php/acta/article/view/4355 https://acta.tums.ac.ir/index.php/acta/article/download/4355/4456

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 740 250 EN Fattah Sotoodehnejadnematalahi Department of Regenerative Biomedicine at Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. Bernard Burke Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, LE1 9HN, UK. 2015 10 11 One of the main members of the large aggregating proteoglycans (PGs) family is versican which is able to bind to hyaluronate. Versican is a chondroitin sulfate proteoglycan and is a key ingredient of the extracellular matrix.  Due to its widespread expression in the body, versican is involved in cell adhesion, proliferation and migration. Induced expression of versican is often observed in tissues such as breast, brain, ovary, gastrointestinal tract, prostate, and melanoma. In addition, versican has important role in development. For example, versican conducts the embryonic cell migration which is essential in the formation of the heart and outlining the path for neural crest cell migration. Several studies in the past decade up to now have shown that versican produced by mononuclear cells has an important role in wound healing and blood vessel formation and suggested that it promotes tumorigenesis and angiogenesis. In this mini-review, we summarise and discuss the role of versican in healthy and pathological tissues and suggest the possible function of transcription factors and signalling pathway in regulation of versican. https://acta.tums.ac.ir/index.php/acta/article/view/4354 https://acta.tums.ac.ir/index.php/acta/article/download/4354/4462

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 751 756 EN Anthony Carl Hackney Department of Exercise & Sport Sciences, Applied Physiology Laboratory, University of North Carolina, Chapel Hill, North Carolina, USA. AND Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA. 2015 10 11 The Overtraining Syndrome (OTS) is a physically debilitating medical condition that results in athletes being totally compromised in their capacity to perform and compete. Many physiological systems are affected by the process of overtraining and the development of the OTS which results from it; but one system in particular, the immune, is highly susceptible to degradation resulting in a reduction in overall health and physical performance. The aim of this paper is to review; 1) the evidence-based proactive steps and actions to take to greatly reduce the risk of development of an infection or a compromised immune system in athletes; and 2) the course of action for clinicians to take when they are dealing with an athlete displaying overt signs of an infection and, or inflammation. Evidenced reported here within support that it is essential for clinicians to take practical preventative and management steps - actions with athletes (involved in intensive exercise training) in order to help preserve and maintain a healthy and robust immune system if they are going to perform optimally. https://acta.tums.ac.ir/index.php/acta/article/view/4353 https://acta.tums.ac.ir/index.php/acta/article/download/4353/4467

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 757 764 EN Payman Dabirmoghaddam Otorhinolaryngology Research Center, Department of Otorhinolaryngology, Tehran University of Medical Sciences, Tehran, Iran. Amin Amali Otorhinolaryngology Research Center, Department of Otorhinolaryngology, Tehran University of Medical Sciences, Tehran, Iran. Maziar Motiee Langroudi Otorhinolaryngology Research Center, Department of Otorhinolaryngology, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Samavati Fard Otorhinolaryngology Research Center, Department of Otorhinolaryngology, Tehran University of Medical Sciences, Tehran, Iran. Mona Hejazi Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran. Masoud Sharifian Razavi Department of Gastroenterology, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 10 11 Laryngopharyngeal reflux (LPR) is a variant of gastroesophageal reflux disease (GERD) in which the stomach contents go up into the pharynx and then down into the larynx. LPR causes a wide spectrum of manifestations mainly related to the upper and the lower respiratory system such as laryngitis, asthma, chronic obstructive pulmonary disease, cough, hoarseness, postnasal drip disease, sinusitis, otitis media, recurrent pneumonia, laryngeal cancer and etc. The object of this study was to examine the effect of N-acetyl Cysteine (NAC) with and without Omeprazole on laryngitis and LPR. Ninety patients with laryngitis or its symptoms were referred and randomly assigned into three groups. The first group was treated by Omeprazole and NAC. The second group was treated by Omeprazole and placebo and the last group was treated by NAC and placebo. Duration of treatment was 3 months and all patients were evaluated at the beginning of study, one month and three month after treatment of sign and symptoms, based on reflux symptom index (RSI) and reflex finding score (RFS). Based on the results of this study, despite therapeutic efficacy of all treatment protocols, the RSI before and after 3 months treatment had significant difference in (NAS+ Omeprazole) and (Omeprazole+ placebo) group (P<0.001 in the first group, P<0.001 in the second group and P=0.35 in the third group). Whereas RFS before and after 3 month treatment had significant difference in all groups. (P<0.001 in each group in comparison with itself) but this results had not significant difference after 1 month treatment. Our results showed that the combination therapy with Omeprazole and NAC treatment had the most effect on both subjective and objective questionnaire at least after 3 months treatment. Based on the results of the present study, it seems that the use objective tools are more accurate than subjective tools in evaluation of therapeutic effects in patients with GERD-related laryngitis. https://acta.tums.ac.ir/index.php/acta/article/view/4352 https://acta.tums.ac.ir/index.php/acta/article/download/4352/4470

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 765 770 EN Mohammad Sadeghi Department of Otolaryngology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Babak Saedi Department of Otolaryngology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Aydin Mahdkhah Cheif Resident of Otolaryngology, School of medicine, Tehran University of Medical Sciences, Tehran, Iran. Azin Tabaree Cheif Resident of Otolaryngology, School of medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 To evaluate results of concurrent functional endoscopic sinus surgery (FESS) and nasal plastic surgery in terms of safety, efficacy and patient satisfaction, and compare them with the results of single procedures. We conducted a prospective case control study in three groups of patients with chronic sinusitis and nasal deformity; 25 cases had concurrent FESS and rhinoplasty, 25 controls had FESS, and 25 controls had rhinoplasty alone. The patients preoperative and postoperative sino-nasal outcome test (SNOT22) and also patients' satisfaction using the visual analogue scale were evaluated after one year. There were no significant differences between aesthetic indexes of concurrent surgery and control groups. Also, we found no significant inter-group difference between SNOT22 scores. There was no major complication in the studied patients. Conducting nasal plastic surgery and FESS concurrently can be a feasible surgery with functional and aesthetic results comparable to those with individual FESS or rhinoplasty. https://acta.tums.ac.ir/index.php/acta/article/view/4351 https://acta.tums.ac.ir/index.php/acta/article/download/4351/4476

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 771 778 EN Mohammad Parsa Hosseini Department of Electrical and Computer Engineering, Wayne State University, Detroit, MI, USA. AND Medical Image Analysis Laboratory, Radiology and Research Administration Departments, Henry Ford Health System, Detroit, MI, USA. Hamid Soltanian-Zadeh Medical Image Analysis Laboratory, Radiology and Research Administration Departments, Henry Ford Health System, Detroit, MI, USA. AND Control and Intelligent Processing Center of Excellence, School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran. Shahram Akhlaghpoor Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Two main forms of COPD (Chronic Obstructive Pulmonary Disease) refer to a group of lung diseases that block airflow and cause a huge degree of human suffering. A new method for identifying and estimating the severity of COPD from three-dimensional (3-D) pulmonary X-ray CT images would be helpful for evaluation of treatment effects and early diagnosing is presented in this paper. This method has five main steps. Firstly, corresponding positions of lungs in inspiration and expiration are found based on anatomical structures. Secondly, lung regions are segmented from the CT images by active contours. Next, the left and right lungs are separated using a sequence of morphological operations. Then, parenchyma variations of three main cuts which selected by a feed-forward neural network are found based on the inspiratory and expiratory states. Finally, a pattern classifier is used to decide about the disease and its severity. Twenty patients with air-trapping problems and twelve normal adults were enrolled in this study. Based on the results, a mathematical model was developed to relate variations of lung volumes to severity of disease. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the accuracy of our method for right regions were %81.6, %80.5, %87.5, %72.5 and %81.3 respectively. And these parameters for left regions were %90, %83.3, %90, %83.3 and %87.5 respectively. The proposed method may assist radiologists in detection of Asthma and COPD as a computer aided diagnosis (CAD) system. https://acta.tums.ac.ir/index.php/acta/article/view/4350 https://acta.tums.ac.ir/index.php/acta/article/download/4350/4481

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 779 783 EN Mohammad Moazeni-Bistgani Department of Surgery, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran. Reza Imani Department of Infectious Diseases, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran. 2015 10 11 To prevent post cholecystectomy infection, the most common microorganisms causing it and their antibacterial susceptibility pattern should be determined. Therefore, the aim of the present study was to determine the exact incidence and nature of the microbial flora in the bile of the patients with cholelithiasis and chronic cholecystitis as well as their antibiotic sensitivity pattern. In this study, a total of 132 samples from the patients were tested for bacterial strains using the appropriate methods for testing them. The isolated bacteria were subsequently subjected to antibacterial susceptibility test using Kirby-Bauer method. The data were analyzed using Frequency, Chi-square and t-test. Fifty of 132 (37.87%) studied patients were positive for bacteria. The most common isolated organisms were Escherichia coli (13; 26%), Enterobacteriaceae (9; 18%), and Salmonella typhi (7; 14%). The most effective antibiotics were sequentially Amikacin, Ceftriaxone, and Clindamycin. Isolating bacteria and determining their sensitivity to different antibiotics may be help physicians take prophylactic measures against postoperative infection of cholelithiasis and chronic cholecystitis. https://acta.tums.ac.ir/index.php/acta/article/view/4349 https://acta.tums.ac.ir/index.php/acta/article/download/4349/4483

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 784 788 EN Khosro Sadeghniiat Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. Alaleh Rajabzadeh Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Ghajarzadeh Brain and Spinal Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. Majid Ghafarpour Department of Neurology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 The aim of this study was to determine the sleep quality and level of depression among Iranian migraineurs. Among 380 cases that were selected by simple random selection from those who attended Outpatient Neurology Clinic of Imam Khomeini Hospital, 332 patients participated in this cross-sectional study. After an inclusive examination by a neurologist, the participants were asked to fill valid and reliable Persian versions of Pittsburg Sleep Questionnaire (PSQI) and Beck Depression Inventory (BDI). They also requested to score headache severity by means of a visual analogue scale graded from 1-10. According to frequency of attacks, patients were divided into three groups: with 1-4 migraine days per month, 5-7 migraine days in a month and more than 7 migraine days per month. Mean age of participants was 36.3±10.1 years and mean headache severity score was 6.0±1.9. The PSQI total score and headache severity score were highest among patients with frequent attacks. Mean BDI, PSQI and headache severity scores significantly differ between male and female participants. There was significant positive correlation between BDI and PSQI scores (r=0.5, P<0.001) also there was a positive correlation between headache severity score and PSQI score (r=0.6, P<0.001). Decreased sleep quality with other co-morbidities such as depression in migraineurs cases should be considered. https://acta.tums.ac.ir/index.php/acta/article/view/4348 https://acta.tums.ac.ir/index.php/acta/article/download/4348/4485

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 11 2013 11 15 https://acta.tums.ac.ir/index.php/acta/article/view/4939 https://acta.tums.ac.ir/index.php/acta/article/download/4939/4273

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 1 2015 01 15 39 45 EN Azam Baheiraei Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Azar Shamsi Department of Maternal and Child Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. Afshin Mohsenifar Department of Toxicology, School of Medicine, Tarbiat Modares University, Tehran, Iran. Anoshirvan Kazemnejad Department of Biostatistics, School of Medicine, Tarbiat Modares University, Tehran, Iran. Zinat Hatmi Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Milani Department of Pediatrics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Ali Keshavarz Department of Nutrition and Biochemistry, School of Health, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Mother's and infant exposure to cigarette smoke is one of the most important public health problems. There is no study in Iran evaluating the impact of cigarette smoke on infant growth and development. The purpose of this study was to determine the effects of cigarette. This prospective cohort study was conducted on 51 cigarette smoke-exposed infants (exposed group) and 51 non-exposed infants (non-exposed group). They were evaluated for weight, height and head circumference three times; five to seven days, two months and four months after birth. Urine samples were also collected in each turn. Exposure to secondhand smoke was assessed through questionnaires and urinary cotinine levels. The analysis was performed using an independent t-test, Mann-Whitney U test, chi-square and Fisher's exact and Kappa tests. Mean urinary cotinine level in the exposed group was 38.57±2.85 ng/mg creatinine at baseline, 86.95±1.16 at two months and 63.32±2.08 at four months of age. These indicated a gradual reduction of exposure from two to four months. The weight and height of the exposed group were significantly lower than the non-exposed group (P< 0.001) at two and four months after birth. The results of the present study showed that the exposure to secondhand smoke during infancy may lead to weight and height growth reduction in the first four months of life. https://acta.tums.ac.ir/index.php/acta/article/view/4938 https://acta.tums.ac.ir/index.php/acta/article/download/4938/4278

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 1 2015 01 15 46 50 EN Alireza Abdollahi Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND Thrombosis Hemostasis Research Center, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Hana Saffar Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Hiva Saffar Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Sara Sheikhbahaei Department of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Mehrnaz Rasoulinejad Department of Infectious Diseases, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Amoebiasis caused by Entamoeba histolytica (E. histolytica) is one of the most problematic parasitic infections worldwide. Data regarding the effect of HIV-induced immunodeficiency on the status of E. histolytica infection are sparse in Iran. This study aimed to assess the seroprevalence of anti-E. histolytica IgG among Iranian HIV patients. Further, it determined whether the advancement of immunodeficiency accompanies an increased risk of amoebiasis. A total of 91 HIV-infected patients and 91 controls were enrolled in this case-control study. Controls were matched to cases with respect to age, gender, and where possible socioeconomic status. Patients with a history of treatment for intestinal parasitism within last two weeks were not included in the study. Blood samples were obtained from all participants. Serum IgG against E. histolytica measured using a commercial enzyme-linked immunosorbent assay (ELISA). The mean serum anti-E. histolytica IgG was significantly higher in HIV patients than controls (9.34 ± 4.18 vs. 2.07 ± 0.60, P<0.001). HIV-infected patients showed a significantly higher positive serology for E. histolytica IgG comparing healthy controls (30.8% vs. 0% P<0.001). There was no statistical difference in the serology of E. histolytica among AIDS stage and non-AIDS HIV patients. This study demonstrated that HIV is significantly associated with higher prevalence of E. histolytica infection. Early evaluation and treatment of E. histolytica in this population is recommended to prevent and control this infection. https://acta.tums.ac.ir/index.php/acta/article/view/4937 https://acta.tums.ac.ir/index.php/acta/article/download/4937/4280

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 1 2015 01 15 51 56 EN Manzar Vakili Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shapour Shirani Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Omalbanin Paknejad Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Fardin Yousefshahi Women Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Acute Respiratory Distress Syndrome (ARDS) is a potential complication of cardiac surgery, given that patients undergoing CABG frequently have hypoxemia and pulmonary dysfunction during initial hours after surgery. Thus, ARDS criteria in these patients are more likely to be positive while these criteria may not match the patient`s clinical picture. We aimed to investigate frequency of rapid onset hypoxemia in Pressure of Arterial Oxygen to Fractional Inspired Oxygen Concentration (PaO2/FiO2) less than 200 and diffuse pulmonary infiltrates as two diagnostic criteria forwards and compared these criteria with the clinical picture of the patients after Coronary Artery Bypass Graft (CABG) in this study. The study was prospective case series which carried out in about six months. All patients admitted to intensive care unit of Tehran Heart Center, who had undergone CABG on cardiopulmonary pump (CPB) recruited in the study. After considering inclusion criteria, age, sex, duration of intubation, arterial blood gas and chest radiography, on 24 hours and 48 hours after admission to the ICU were recorded. Then, patients with rapid onset of hypoxemia (PaO2/FiO2≤200mmHg) and diffuse pulmonary infiltrates and without sign or symptoms of obvious heart failure (probable positive ARDS cases) criteria were recorded and comparison between these probable positive cases with clinician`s clinical diagnosis (blinded to the study) was performed. In this study, a total of 300 patients after on-pump coronary artery bypass surgery were included. Postoperatively, 2 (0.66 %) in the 24 hours and 4 (1.33%) patients in 48 hours after surgery were positive for the two ARDS criteria according to the checklists, but; nobody had saved persistently ARDS criteria persistently during 48 hours after surgery. At the same time, clinician did not report any case of ARDS among 300 patients. In this study patients with ARDS criteria had no significant differences in age (P.value=0.937) and sex (P.value=0.533). Duration of intubation in patients with ARDS (14.26 ± 4.25 hours) in the first 48 hours was higher but not statistically different from the group without ARDS (11.60 ± 5.45 hours) (P.value=0.236). ARDS diagnosis based on rapid onset of hypoxemia (PaO2/FiO2≤200 mmHg) and diffuse pulmonary infiltrates and without signs or symptoms of obvious heart failure criteria in patients undergoing CABG could lead to overdiagnosis or misdiagnosis in less than 24 hours follow up. We recommend following patients for more than 24 hours and revise the current ARDS criteria for CABG patients. https://acta.tums.ac.ir/index.php/acta/article/view/4936 https://acta.tums.ac.ir/index.php/acta/article/download/4936/4287

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 1 2015 01 15 57 61 EN Mahdi Haddadzadeh Department of Surgery, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahtab Motavaselian Department of Surgery, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Ali Akbar Rahimianfar Department of Surgery, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Seyed Khalil Forouzannia Department of Surgery, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahmood Emami Department of Surgery, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Kazem Barzegar Department of Surgery, Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. 2015 10 11 The most common type of arrhythmia following coronary artery bypass graft (CABG) is atrial fibrillation (AF) with an incidence rate of 20-30%. Pericardial effusion is one of the etiologic factors of atrial fibrillation occurring after CABG. Posterior pericardiotomy (PP) causes the drainage of blood and fluids from the pericardial space into the pleural space leading to a decreased pericardial effusion. Most of the studies dealing with the occurrence of AF in the surgical operation of CABG have focused on patients undergoing on-pump CABG. The purpose of the present study was to determine the effect of posterior pericardiotomy on pericardial effusion and atrial fibrillation following the off-pump CABG. This study was a clinical trial conducted on 207 patients. The patients were randomly assigned to groups A, and B. Posterior pericardiotomy was performed on the patients in Group A. This was not done on patients in Group B. Following general anesthesia and median sternotomy, the left internal mammary artery (LIMA) and saphenous vein were harvested simultaneously. Following the injection of heparin, distal and proximal anastomosis was performed and at the end of surgery, a longitudinal incision with a length of 4 cm was performed parallel and posterior to the left phrenic nerve from the left vein to diaphragm for patients in the pericardiotomy group. 105 patients in the pericardiotomy group and 102 patients in the control group were examined regarding demographic variables, AF incidence, and pericardial effusion. There was no statistically significant correlation between two groups. There was no statistically significant difference between the two groups regarding the rate of AF incidence (P=0.719) and the rate of pericardial effusion (P=1). Posterior pericardiotomy has no effect on postoperative AF incidence and pericardial effusion in patients undergoing the off-pump CABG. https://acta.tums.ac.ir/index.php/acta/article/view/4935 https://acta.tums.ac.ir/index.php/acta/article/download/4935/4292

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 1 2015 01 15 62 68 EN Seyed Abolhasan Naghibi Department of Public Health, Health Sciences Research Center, School of Health, Mazandaran University of Medical Sciences, Sari, Iran. Davood Shojaizadeh Department of Health Education and Promotion, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran. Ali Montazeri Department of Mental Health, Health Metrics Research Center, Iranian Institute for Health Sciences Research,Tehran University of Medical Sciences, Tehran, Iran. Jamshid Yazdani Cherati Departments of Biostatistics, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran. 2015 10 11 Of the ways to fight breast cancer and reduce deaths hazard due to early detection is one of early detection programs in women's breast self- examination. Examining breast by oneself increase individuals knowledge of her breast health that helps in detecting breast cancer early. Different cultural, social, family and individual factors play roles in women's behavior about breast self- examination applying PEN-3 model in this study is to analyze factors influencing on breast self-examination. The research is a descriptive- analytical, cross-sectional type. Research community consists of women at fertility age of 20-49 in sari. Sample volume is 415 individuals and sampling method is cluster method. In this study, a 50-item questionnaire based on PEN-3 was used. Questions were answered by Likert scoring method. Questionnaire was gathered by personal presence of questioners. Data was analyzed via descriptive statistics and logistic regression methods. Based on the study findings, the most significant positive behaviors related to perceptual factors included effectiveness of disease background in family and relatives (73%), believing in breast self- examination for pursuing health (93%) and the most important negative behaviors were shyness and modesty (83.9%) and increased worry (78.9%). The most remarkable positive behaviors regarding enabling factors covered the skill to do breast examination oneself (35.2%), the availability of health and therapeutic centers (80.7%) and the most significant negative behavior was being busy and lack of time (85.3%). The most important positive behavior about nurturing factors included family consent (68.9%) and the most significant negative one was the inappropriate treatment of health and therapeutic personnel (61.8%). In this study, there is a meaningful difference between employment ages, education with PEN-3 model constituents. Since behaviors due to enabling and nurturing perceptual factors have been important in doing or not doing breast self- examination; thus its worth to take measures to plan some educational and administrative intervention programs about women breast cancer early detection through sufficient knowledge of influential sociocultural factors. https://acta.tums.ac.ir/index.php/acta/article/view/4934 https://acta.tums.ac.ir/index.php/acta/article/download/4934/4298

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 1 2015 01 15 69 73 EN Hosein Dalili Department of Pediatrics, Breast Feeding Research Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Dalili Kajan Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Guilan, Iran. 2015 10 11 This case report presents an eight-year-old girl having periauricular swelling and severe pain during mouth opening on the right-side temporomandibular joint (TMJ). CBCT showed extensive destruction of the base of the skull and the roof of the glenoid fossa on the right side. The findings based on CT and MRI images with and without contrast are discussed herein. This report highlights a skull base eosinophilic granuloma that mimics TMJ disorder and the importance of proper evaluation of CBCT images to make an early diagnosis. https://acta.tums.ac.ir/index.php/acta/article/view/4933 https://acta.tums.ac.ir/index.php/acta/article/download/4933/4301

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 1 2015 01 15 74 77 EN Azadeh Jabbari Nooghabi Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Kasra Raoufian Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Mohammad Reza Motie Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 2015 10 11 Hydatid disease has a worldwide spreading. The most common site of the disease is the liver, lungs, kidney, bones, and brain. Splenic hydatid disease has been reported to constitute 2% to 6% of patients with abdominal hydatid disease. Because of the rarity of splenic hydatid disease, the probable concomitance of