Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 8 2013 08 15 513 519 EN Hamed Montazeri Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran. Saeid Bouzari Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran. Kayhan Azadmanesh Department of Virology, Pasteur Institute of Iran, Tehran, Iran. Seyed Nasser Ostad Department of Toxicology Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Hossein Ghahremani Department of Toxicology-Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Molecular Medicine, School of Advanced Technology in Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Cyclin E, HER-2 and p53, are considered as major prognostic markers in breast cancer. As they are related in patho-clinical level, we aimed to check if they have any direct interaction on expression of each other. To study the effect of cyclin E on HER-2 expression, cell lines stably overexpressing cyclin E or its low molecular weight (LMW) isoforms were generated. To understand the results of p53 silencing either alone or in combination with cyclin E overexpression, we created three different p53 stably knocked down cell lines. Protein expression was analyzed by western blot, HER-2 expression in the established cell lines were determined using SYBR green real time PCR and data analyzed by REST software. Results indicate that HER-2 expression is only downregulated following p53 silencing and none of cyclin E isoforms can alter its expression. The presence of cyclin E isoforms in p53 silenced clones also does not altered HER-2 expression. Given the fact that p53 degradation is increased by HER-2 overexpression, these data can draw a regulatory loop in which a non-mutated functional p53 and HER-2 can bidirectionally regulate the expression of these two genes. This study improves our understandings of these pathways and these proteins can be introduced either as a marker or as a target in cancer treatment. https://acta.tums.ac.ir/index.php/acta/article/view/4400 https://acta.tums.ac.ir/index.php/acta/article/download/4400/4259

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 8 2013 08 15 520 524 EN Alireza Fahim Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran. Bijan Rezvan Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran. Hassan Hashemi Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran. AND Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 This study aimed to assess changes in contrast sensitivity and aberrations in cases of myopia greater than 5.0 diopter (D) who had photorefractive keratectomy (PRK). In this semi-experimental study, 20 eyes of ten patients were studied. Inclusion criteria were at least 5.0 D of myopia, stable refraction in the past year, no history of refractive surgery, a minimum corneal thickness of 480 μm, and having surgery in both eyes. Exclusion criteria were the presence of any corneal condition. In addition to the routine tests, aberrometry and assessment of contrast sensitivity was done using the WaveLight Allegro Analyzer and the VectorVision CSV-1000. After PRK using the Concerto Excimer Laser (WaveLight, Alcon), patients were scheduled to have follow-up visits at 1 month, 3 months, and 1 year after surgery. Contrast sensitivity with glare showed an increasing trend only at the spatial frequency of 3 cycles per degree (cpd) (P=0.013). Contrast sensitivity without glared increased postoperatively at special frequencies of 3, 6, and 18 cpd (P<0.05). The preoperative level of higher order aberrations root mean square (HOA RMS) of 0.24±0.08 reached 0.71±0.25 at 12 months after surgery. Assessment of comma and trefoil showed no significant difference between preoperative and postoperative values, but the amount of spherical aberration changed from a mean preoperative value of 0.0±0.09 to 0.27±0.15 at 12 months after surgery. In the treatment of myopia greater than 5.0 D, PRK with the Concerto Excimer Laser can improve contrast sensitivity in certain spatial frequencies. This is while HOA RMS and spherical aberration increase. https://acta.tums.ac.ir/index.php/acta/article/view/4399 https://acta.tums.ac.ir/index.php/acta/article/download/4399/4261

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 8 2013 08 15 525 529 EN Ebrahim Razmpa Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran. Babak Saedi Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran. Amin Dostee Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran. Mohsen Ordobadee Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Chronic rhinosinusitis (CRS) is a common disease which is usually diagnosed clinically, considering the combination of natural history, physical examination and imaging studies. This study aimed to evaluate the clinical value of routine postoperative histopathologic examination (POHE) in patients with a clinical diagnosis of chronic rhinosinusitis with polyposis (CRSWP), or without polyposis (CRSWOP One hundred of patients with clinically approved CRSWP and CRSWOP were enrolled in this study. All patients underwent complete physical examination, scoring paranasal sinuses involvement by Lund-Mackay (LM) CT scoring scale, determining the extent of polyposis by Stumberger's endoscopic classification, and assessing health related quality of life by Sinonasal Test 22 (SNOT22) questionnaire. After FESS, histopathologic results were compared with preoperative clinical diagnosis. Among our patients, 65% were male, and the rest of them were female. Also, 66% of them suffered from CRSWP, and the rest of them were CRSWOP. LM CT score and SNOT22 score was 36.62±12, 17.11±6, and 43.62±20 respectively. Only in one of patients with CRSWP, POHE was other than what was expected preoperatively (adenoid cystic carcinoma). In all other cases,  POHE was well correlated with preoperative clinical diagnosis. HRQOL was better in males, absence of septal deviation and CRSWOP (P<0.05). Para nasal sinuses involvement in preoperative CT was more severe in the presence of eosinophil in POHE (P=0.008) and in patients with class 3 Stumberger's classification (P<0.001). This study suggested preoperative clinical diagnosis of CRS considering the combination of natural history, physical examination and imaging studies can be accurate, and POHE is indicated only in suspicious cases. https://acta.tums.ac.ir/index.php/acta/article/view/4398 https://acta.tums.ac.ir/index.php/acta/article/download/4398/4266

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 8 2013 08 15 530 536 EN Seyed Hadi Samimi Ardestani Department of Otolaryngology, Head and Neck surgery, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Hossein Dadgarnia Department of Otolaryngology, Head and Neck Surgery, Rhinology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mohammad Hossein Baradaranfar Department of Otolaryngology, Head and Neck Surgery, Rhinology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mona Mazidi Department of Otolaryngology, Head and Neck Surgery, Rhinology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahtab Rabbani Department of Otolaryngology, Head and Neck Surgery, Rhinology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Nasim Behniafard Researcher of Rhinology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Amin Baradaranfar Student of Medical School, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Simple snoring is a social problem, one that can gravely affect the patient's married life. About 40% of men and 20% of women are affected, and it often goes along with sleep-disordered breathing. Up to now various surgical techniques have been defined such as UPPP(uvulopalatopharyngo plasty), and laser-assisted uvulopalatoplasty (LAUP). Among the surgical methods, RAUP (radiofrequency assisted uvulopalatoplasty) is a minimal invasive, an easy performed, and time and cost effective one. We designed a before and after a clinical trial. The inclusion criteria were age >18 years, complaint of nocturnal snoring, have a bed partner to assess snoring, AHI<5 events per hour in the polysomnography, malampathy score (soft palate position) I or II, an elongated uvula, grade I and II of pharyngeal webbing and patient consent was needed too. A 10-score visual analog scale (VAS) of snoring severity was completed by bed partner. All of 35 included patients underwent RAUP under local anesthesia by the same expert surgeon. After 3 months, 6 months and one year, subjective snoring decreased significantly compared to the preoperative period. The decline in VAS in 6 month compared to 3 months postoperatively, was not significant (P=0.223). When comparing 1 year and 6 months after treatment, the VAS scores were increased, but they were not significant (From 1.8 to 1.9, P=0.78). Three months after treatment minor complications consisted of: nasal regurgitation in 2 patients (5.7%), nasal speech in 2 (5.7%) and exacerbation of snoring in 2 (5.7%) patients.There was no major complication including mucosal laceration, uvular damage and obstruction of the airway. The rate of snoring decrease did not correlate with age, sex and BMI. Based on this study and literature review, it seems RAUP is a safe surgery, which may decrease symptoms of snoring, at least, in short-term follow-up. https://acta.tums.ac.ir/index.php/acta/article/view/4397 https://acta.tums.ac.ir/index.php/acta/article/download/4397/4272

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 8 2013 08 15 537 542 EN Mehdi Sanatkar Department of Anesthesiology, Razi Hospital, AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences,Tehran, Iran. AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Sadeghi Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Nafiseh Esmaeili Autoimmune Bullous Disease Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Hassan Naseri Department of Cardiac Surgery, Baqiyatallah University of Medical Sciences, Tehran, Iran. Hossein Sadrossadat Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mehrdad Shoroughi Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Hamid Reza Fathi Department of Plastic Surgery, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shahrokh Ghazizadeh Department of Plastic Surgery, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 The use of local anesthesia with lidocaine containing epinephrine in patients with cardiac disease is controversial in the literature. The aim of our study was determining the safety of use the local anesthesia contain epinephrine in patients with ischemic heart disease that undergoing reconstructive surgery. Thirty two patients that had known ischemic heart disease and candidate to undergo reconstructive surgery for skin tumor enrolled in this study.  All patients continued their medication for cardiac disease till morning of the operation. 10 ml lidocaine 2% containing 1:100,000 epinephrine was injected in patients for local anesthesia. The hemodynamic changes and electrocardiographic variables before injection were compared with them after injection, during surgery and till 6 hours postoperation period. A 12 lead electrocardiogram was recorded in all our cases for detection of myocardial ischemic changes. The mean age, weight and height were 58.2±10.4, 74.8.±14.4 kg and 164.5± 8 cm respectively. Twelve patients (37.5%) were diagnosed with systemic hypertension and 10 patients with diabetes (31.2%). The comparison of change of systolic, diastolic and mean blood pressure between baseline, during procedure and after operation defined that our subjects did not have any significant disturbance in blood pressure in perioperative period. The comparison of baseline heart rate with heart rate after injection, during procedure and in postoperation period indicated a significant changes in this variable (P=0.044). The heart rhythm during the perioperative period also failed to exhibit alterations. The ischemic change was not recorded in our patients before injection compared to after injection. None of our patients have any early complications because of infiltration of local anesthetic containing epinephrine in our patients. The use of 10 ml 2% lidocaine with epinephrine 1:100,000 in patients with cardiac disease represent a safe anesthetic procedure. These patients experienced a more profound anesthesia with hemodynamic stability and without myocardial ischemic changes. https://acta.tums.ac.ir/index.php/acta/article/view/4396 https://acta.tums.ac.ir/index.php/acta/article/download/4396/4274

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 8 2013 08 15 543 547 EN Homayoon Bashiri Department of Internal Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. 2015 10 11 Over the past three decades physicians have used light level laser therapy (LLLT) for the management and the treatment of diabetic peripheral neuropathy and have obtained results that calls for further investigations. This study aimed to investigate the effectiveness of LLLT in treatment of pain symptoms in patients with diabetic polyneuropathy. In this study 60 patients with diabetic peripheral neuropathy were matched based on their sex, age, BMI, type of diabetes, duration of diabetes, and duration of pain, and randomized to case and control groups based on their established scores on the visual analog scale (VAS) and the Toronto clinical scoring system (TCSS). Cases received laser therapy with wavelength of 78 nm and 2.5 j/cm2 two times a week, each time for 5 min, for one month. During the same period, controls received sham laser therapy. Comparing the differences between the two groups' VAS and TCSS mean scores before the intervention with that of the 2 weeks and 4 weeks after the intervention we were able to see a statistically significant difference between the two groups (P<0.05). On the other hand, when we compared their VAS and TCSS mean scores 4 weeks and 2 weeks after the intervention we did not find any statistically significant difference between the two groups. We achieved the same results when we examined cases' and controls' pre and post VAS and TCSS scores independent from each other; no improvement in the assessment based on their 2 and 4 weeks comparisons tests. Laser therapy resulted in improved neuropathy outcomes in diabetic patients who received it relative to the group that received sham therapy, evaluating before and after LLLT assessments. Further studies are needed to test types of lasers, as well as different dosage and exposure levels required in different phase of neuropathic care, so as to obtain reproducible results. https://acta.tums.ac.ir/index.php/acta/article/view/4395 https://acta.tums.ac.ir/index.php/acta/article/download/4395/4279

Tehran University of Medical Sciences 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.