Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 6 2014 06 15 418 423 EN Hossein Ali Ghlichnia Department of Neurology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Neurogenetics, Iranian Center of Neurological Research, Tehran, Iran. Abolghasem Kollaee Department of Neurogenetics, Iranian Center of Neurological Research, Tehran, Iran. AND Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Majid Gaffarpoor Department of Neurogenetics, Iranian Center of Neurological Research, Tehran, Iran. Abolfazl Movafagh Department of Medical Genetics, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Babak Ghlichnia Department of Neurogenetics, Iranian Center of Neurological Research, Tehran, Iran. Mahdi Zamani Department of Neurogenetics, Iranian Center of Neurological Research, Tehran, Iran. AND Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Multiple Sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. It is a clinically heterogeneous disorder especially in terms of disease severity. Current investigations suggest that genes and gene-gene interactions not only influence on susceptibility to MS but also affect the disease severity. In this study, we investigated the contribution of the HLADRB1*1501 allele and single nucleotide polymorphism (SNP) in CD24 gene and also combined genotypes of the HLADRB1*1501 and CD24 SNP to disease severity in Iranian MS patients. We have reported previously that the HLA- DRB1*1501 allele and the CD24v/v genotype associated with disease susceptibility and some other studies proposed that HLA-DRB1*1501 allele be associated with MS severity. In this study, the results showed a significant difference in the Multiple Sclerosis Severity Score (MSSS) of the nine different genotypes (F=2.838, P=0.007). Subsequent analysis revealed a statistically significant difference in the MSSS between the MS patients who were carriers of HLA-DRB1*1501/1501 and those who were not carriers of HLA-DRB1*1501/1501 genotypes (P=0.04). Moreover, the MS patients carrying combined genotypes of the HLA- DRB1*1501/x-CD24 v/v had statistically severe disease than the patients who did not carry the HLA- DRB1*1501- CD24 v/v (P=0.047). In conclusion, our findings suggest that, HLA-DRB1*1501/1501 and bigenic genotypes of the HLA- DRB1*1501/x- CD24 v/v may influence on disease severity in Iranian MS patients. https://acta.tums.ac.ir/index.php/acta/article/view/4786 https://acta.tums.ac.ir/index.php/acta/article/download/4786/4452

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 6 2014 06 15 424 429 EN Mohammad Reza Pourmand Biotechnology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Masoud Yousefi Department of Pathobiology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Seyed Alireza Salami Department of Horticulture, Faculty of Agriculture, University of Tehran, Tehran Iran. Mohsen Amini Department of Chemistry, Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Staphylococcus aureus causes a wide variety of infections worldwide. Methicillin-resistant S. aureus is one of most common causes of nosocomial and community acquired infections. The fluoroquinolones are an important class of antibiotics that used to treat infections caused by S. aureus. Today, a significant increase in the rate of ciprofloxacin resistance in methicillin-resistant S. aureus strains is concerning. The norA efflux pump is considered as contributors to antibiotic resistance. Here, we aimed to evaluate the expression of norA efflux pump in the presence of hexahydroquinoline derivative in methicillin and ciprofloxacin resistant S. aureus. We were determined minimum inhibitory concentration of ciprofloxacin and hexahydroquinoline derivative and their combination by broth microdilution method against ciprofloxacin resistant S. aureus. The expression of the norA efflux pump gene was evaluated by quantitative Real-time PCR. This study showed that minimum inhibitory concentrations of ciprofloxacin in the presence of hexahydroquinoline derivative in comparison to ciprofloxacin were decreased. Quantitative Real-time PCR identified the increased expression of norA efflux pump gene in methicillin and ciprofloxacin resistant S. aureus strain. The increased expression of norA efflux pump gene may have resulted in the effort of S. aureus to survive. The results showed that the hexahydroquinoline derivative enhanced the antibacterial effect of ciprofloxacin against methicillin and ciprofloxacin resistant S. aureus. Therefore, the derivatives may be used as inhibitors of antibiotic resistance for combination therapy. https://acta.tums.ac.ir/index.php/acta/article/view/4785 https://acta.tums.ac.ir/index.php/acta/article/download/4785/4453

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 6 2014 06 15 430 437 EN Marzieh Aghahosseini Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ashraf Aleyasin Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Habibeh Yekehtaz Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ladan Kashani Department of Infertility, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 The aim of this study was to evaluate the outcomes of adding low-dose hCG (human chorionic gonadotropin), as an LH active supplement, to a GnRH antagonist protocol in patients undergoing assisted reproduction techniques. In this parallel-group randomized clinical trial, 137 infertile female outpatients aged 20 - 39 years were randomized into two groups: hCG group and non-hCG group. All patients received r-FSH (150-300 IU) and then a GnRH-antagonist, Cetrorelix (0.25 mg/day). Concomitantly with Cetrorelix, patients in the hCG group received low-dose hCG (200 IU daily), but the patients in the non-hCG group did not. 10,000 IU Urinary hCG (10,000 IU) was injected to all patients, and ICSI was performed after oocyte retrieval. The primary outcome of this study was comparing the pregnancy rates between two study groups. Other differences between two groups such as serum estradiol concentration, fertilization rate, etc. were considered as secondary outcomes. A total of 130 patients completed this trial. No significant difference was detected between pregnancy rates of the two groups (P=0.52) as well as the fertilization, implantation and ongoing pregnancy rates (P=0.11, P=0.75 and P=0.06 respectively). The only significant difference between two groups was a higher concentration of estradiol in the hCG-treated patients (P<0.05). HCG-treated patients experienced a shorter treatment duration and a lower r-FSH required dose than the non-hCG group, but none of these differences were statistically significant (P=0.19 and P=0.10, respectively). The findings of the current study did not support advantages of adding low-dose hCG to GnRH antagonist plus r-FSH protocol in an unselected population of patients. Well-designed trials with a larger sample size for specific patients' subgroups are warranted. https://acta.tums.ac.ir/index.php/acta/article/view/4784 https://acta.tums.ac.ir/index.php/acta/article/download/4784/4455

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 6 2014 06 15 438 442 EN Mahshid Talebi-Taher Department of Geriatric Medicine, Antimicrobial-Resistant Research Center, Iran University of Medical Sciences, Tehran, Iran. . Shahin Babazadeh Department of Internal Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. Mitra Barati Department of Pediatrics, Pediatric Infectious Diseases Research Center, AND Iran University of Medical Sciences, Tehran, Iran. Maryam Latifnia Department of Internal Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. 2015 10 11 Differentiating sepsis from other noninfectious causes of systemic inflammation is often difficult in the elderly. The aim of this study was to evaluate the ability of C-reactive protein (CRP), Erythrocyte Sedimentation Rate (ESR), procalcitonin (PCT), and Interleukin-6 (IL-6) to identify elderly patients with sepsis. In this single center prospective observational study, we included all consecutive elderly patients admitted with suspected sepsis and systemic inflammatory response syndrome (SIRS) in an emergency department. Blood samples for measuring CRP, PCT, IL-6, ESR and white blood cells (WBC) count were taken at first day of admission. Sensitivity, specificity, positive and negative predictive values were calculated for each inflammatory markers being studied. A total of 150 elderly patients aged 65 and older, 50 with sepsis and 50 with SIRS, and fifty individuals in a normal health status were included. CRP exhibited the greatest sensitivity (98%) and negative predictive value (98.6%) and performed best in differentiating patients with sepsis from those with SIRS. In a receiver operating characteristic curve analysis, IL-6 performed best in distinguishing between SIRS and the control group (AUC 0.75, 95% CI). On the other hand, both CRP and ESR appeared to be a more accurate diagnostic parameter for differentiating sepsis from SIRS among elderly patients. https://acta.tums.ac.ir/index.php/acta/article/view/4783 https://acta.tums.ac.ir/index.php/acta/article/download/4783/4457

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 6 2014 06 15 443 447 EN Ramji Lal Sahu Department of Medical Laboratory Sciences, Faculty of Paramedicine, SMS&R, Sharda University U.P. New Delhi, India. Pratiksha Gupta Department of Medical Laboratory Sciences, Faculty of Paramedicine, PGIMS &R ESIC, Basaidarapur, New Delhi, India. 2015 10 11 Hoffa fracture is a rare injury consisting of unicondylar tangential posterior fracture of the distal femur and only very few cases have been reported in the literature. These fractures are due to high energy trauma and conservative treatment generally yields poor results, but rigid internal fixation allows early functional rehabilitation and decreases the incidence of complications. The purpose of the study was to prospectively analyse the clinico-radiological and functional outcome following open surgical treatment. From July 2005 to July 2010, 22 patients (14 males and 8 females) were recruited from Emergency and outpatient department having closed and open Hoffa fracture of the femoral condyle. All patients were operated under general or spinal anesthesia. Post-operatively, all the patients were followed for 12 months. Fractures were united in a mean time of 10 weeks (range from 6 - 16 weeks) depending on the type of fracture pattern. Fractures were reduced anatomically in all except in one patient. During follow-up, there were no losses of reduction or fixation. Full weight bearing were started in the mean time of 8.8 weeks. Mean duration of hospital stay were 9.8 days. Complications were stiffness and pain in one patient, collateral laxity in one patient and progression of arthritis in one patient. The results were excellent in 90.90% and good in 9.09% patients. Finally, we conclude that the early anatomical reduction and rigid fixation with screws provide best results and minimal complications. https://acta.tums.ac.ir/index.php/acta/article/view/4782 https://acta.tums.ac.ir/index.php/acta/article/download/4782/4458

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 6 2014 06 15 448 453 EN Raman Sharma Department of Hospital Administration, Government Medical College & Hospital, Chandigarh, India. Ravinder Yadav Department of Medical Records, Government Medical College & Hospital, Chandigarh, India. Meenakshi Sharma Postgraduate Institute of Medical Education & Research, Faculty of Public Health, Chandigarh, India. Varinder Saini Department of Medical Records, Government Medical College & Hospital, Chandigarh, India. Vipin Koushal Department of Hospital Administration, Government Medical College & Hospital, Chandigarh, India. 2015 10 11 Tuberculosis is still one of the leading causes of mortality and morbidity. Besides clinical impact, the disease affects the quality of life (QOL) too. With the rise of 21st century, multi-drug-resistant TB (MDR TB) has risen as a significant public health problem due to emergence of resistance to anti-tuberculosis therapy (ATT) drugs. This study was planned to analyze the impact of MDRTB on QOL. It was a six month analysis, with a sample size of 60 cases each of MDRTB and PTB. It was based on a pre-designed, pre-tested questionnaire using WHOQOL BREF scale.  Out of each group, 38 (63.33%) and 36 (60.0%) were in the 21-40 years of age groups, more than 60% married and were residing in the urban/urban slums. It was found that QoL of MDRTB patients was worse than PTB counterparts. The psychological and environmental domains (MDRTB vs. PTB 17.46 vs. 15.23 and 22.00 vs 18.91) were more affected as compared to physical and social domains (19.03 vs 20.05 and 7.88 vs 9.61) in MDRTB and PTB. Financially, MDRTB patients were worst suffers as compared to PTB as former were not being covered under any program, while both groups are affected socially due to social stigma attached with the disease. Thus, there is a need to design an applicable, reliable measure to better address the quality issues methodologically. This would further enable the health care professionals and management to devise relevant interventions to improve the quality of the patients, as well as the programme. https://acta.tums.ac.ir/index.php/acta/article/view/4781 https://acta.tums.ac.ir/index.php/acta/article/download/4781/4461

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 6 2014 06 15 454 457 EN Soghra Yassaei Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mahdjoube Goldani Moghadam Postgraduate Student, Dental Research Center, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran. Hossein Aghili Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran . Seyed Mahmoud Tabatabaei Department of Psychology, Medical Ethics and History of Medicine Research Center,Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Patient's preoccupations with perceived defect in appearance or excessive concern about minimal flaws are among diagnostic criteria of body dysmorphic disorder (BDD). Sufferers usually seek cosmetic procedures such as orthodontic treatment. Tversity of Medical Sciences, Tabriz, Iran. Zhaleh Bakhtyiari Department of Anesthesiology and Intensive Care, General ICU, Shohada Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Mir Mousa Mirinezhad Department of Anesthesiology and Intensive Care, General ICU, Shohada Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Masoud Hamidi Department of Anesthesiology and Intensive Care, General ICU, Shohada Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Samad Eslam Jamal Golzari Department of Anesthesiology and Intensive Care, General ICU, Shohada Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. 2015 10 11 Because microaspiration of contaminated supraglottic secretions past the endotracheal tube cuff is considered to be central in the pathogenesis of pneumonia, improved design of tracheal tubes with new cuff material and shape have reduced the size and number of folds, which together with the addition of suction ports above the cuff to drain pooled subglottic secretions leads to reduced aspiration of oropharyngeal secretions. So we conducted a study to compare the prophylactic effects of polyurethane-cylindrical or tapered cuff and polyvinyl chloride cuff endotracheal tubes (ETT) on ventilator-associated pneumonia. This randomized clinical trial was carried out in a 12 bed surgical intensive care unit. 96 patients expected to require mechanical ventilation more than 96 hours were randomly allocated to one of three following groups: Polyvinyl chloride cuff (PCV) ETT, Polyurethane (PU) cylindrical Sealguard ETT and PU Taperguard ETT. Cuff pressure monitored every three hours 3 days in all patients. Mean cuff pressure didn't have significant difference between three groups during 72 hours. Pneumonia was seen in 11 patients (34%) in group PVC, 8 (25%) in Sealguard and 7 (21%) in Taperguard group. Changes in mean cuff pressure between Sealguard and PVC tubes and also between Taperguard and PVC tubes did not show any significant difference. There was no significant difference in overinflation between three groups. The use of ETT with PU material results in reducing ventilator-associated pneumonia compared to ETT with PVC cuff. In PU tubes Taperguard has less incidence of ventilator-associated pneumonia compared to Sealguard tubes. https://acta.tums.ac.ir/index.php/acta/article/view/4411 https://acta.tums.ac.ir/index.php/acta/article/download/4411/4589

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 7 2013 07 15 467 471 EN Saeid Abrishamkar Department of Neurosurgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. Nima Khalighinejad Department of Neurosurgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. Payam Moein Department of Neurosurgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. 2015 10 11 In this study, we examined the role of early acetazolamide administration in reducing the risk of cerebrospinal fluid (CSF) leakage in patients with a high risk of permanent CSF leakage. In a randomised clinical trial, 57 patients with a high risk of permanent CSF leakage (rhinorrhea, otorrhea, pneumatocele or imaging-based evidence of severe skull-base fracture) were analysed. In the experimental group, acetazolamide, at 25 mg/kg/day, was started in the first 48 hours after admission. In the control group, acetazolamide was administered after the first 48 hours at the same dose administered to the patients in the experimental group. The following factors were compared between the two groups: duration of CSF leakage, duration of hospital stay, incidence of meningitis, need for surgical intervention and need for lumbar puncture (LP) and lumbar drainage (LD). All of the patients in the experimental group stopped having CSF leakage less than 14 days after the first day of admission, but 6 out of 21 patients (22%) in the control group continued having CSF leakage after 14 days of admission, which was a significant difference (P=0.01). This study showed that early acetazolamide administration can prevent CSF leakage in patients with a high risk of permanent CSF leak. https://acta.tums.ac.ir/index.php/acta/article/view/4410 https://acta.tums.ac.ir/index.php/acta/article/download/4410/4590

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 7 2013 07 15 472 476 EN Alireza Abdollahi Division of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Nasrin Shoar Division of Pathology, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. AND School of Medicine, Kashan University of Medical Sciences, Kashan, Iran. Saeed Shoar Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mehrnaz Rasoulinejad Iranian Research Center for HIV/AIDS (IRCHS), Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Infection with human immunodeficiency virus (HIV) is a progressive condition which may cause endothelial dysfunction and liver damage leading to coagulopathy. With adventure of highly active antiretroviral therapy (HAART), life expectancy has prolonged in HIV positive patients but several acquired immunodeficiency syndrome (AIDS)-related conditions such as coagulopathies are responsible for associated morbidity and mortality. This study aimed to evaluate the extrinsic and intrinsic pathways of coagulation, serum level of fibrinogen and platelet count in HIV positive patients and compare it with negative healthy individuals. Through a case-control study, 114 HIV seropositive patients were compared with 114 seronegative samples in terms of hematological and other coagulation parameters. Mean age of study patients was 37.48 years. Intra venous drug abuse was the most common route of infection transmission with a prevalence of more than 50%. HIV route of transmission had a direct relationship with PTT abnormal levels (P<0.0001). However, this relationship was not significant for PT values. Stages of HIV disease and administration of HAART did not reveal any significant relationship with PT and PTT. There was also a statistically significant correlation between CD4+< 200 and PT in case group (P=0.008). On the other hands, in control group, CD4+ had a weak relationship with PTT (P=0.02) and an inverse correlation with serum fibrinogen (P=0.013). Hematological parameters and serum fibrinogen are decreased in HIV positive patients especially in direct relation with CD4+ cell count<200 cell/µl. PT and PTT abnormal values are also more prevalent in this population. https://acta.tums.ac.ir/index.php/acta/article/view/4409 https://acta.tums.ac.ir/index.php/acta/article/download/4409/4592

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 7 2013 07 15 477 481 EN Seyed Mansour Gatmiri Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mitra Mahdavi-Mazdeh Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran. AND Iranian Tissue Bank & Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mahboob Lessan-Pezeshki Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mohammadreza Abbasi Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Pruritus is a common and bothersome problem among uremic patients which negatively affects life quality and prognosis of the patient. Various factors are known to be involved in the development of pruritus. The aim of this study was to assess the frequency and the factors which may have relationship with uremic pruritus, especially bone mineral metabolism indicators. Current cross-sectional study was done on 99 hemodialysis patients. Having pruritus, its duration, severity and correlation with patient's laboratory data was evaluated. For each patient a questionnaire was filled. The mean age of patients was 55.9±15.4 (23-87) years and 35.7% were female. They were on hemodialysis for 74.79±75.04 months. Frequency of pruritus was 58.6% (58 patients). Considering the severity, 16.2% suffered from severe pruritus, measured by visual analogue scale (VAS). Pruritus was more common in those on dialysis for more than 2 years (0.014). 82.8% of those with VAS of less than 3, in comparison with 37.5% of those with VAS of greater than 7, had no complaint of awakening due to pruritus. The frequency of pruritus and its severity was more in patients with higher serum phosphorus level (P=0.048). It seems that phosphate control which is not mainly attributed to dialysis adequacy and efficiency, needs more attention not only by medical team but also by patient. Decreasing the phosphate content of regimen may be cheap and helpful modality in pruritus management. https://acta.tums.ac.ir/index.php/acta/article/view/4408 https://acta.tums.ac.ir/index.php/acta/article/download/4408/4593

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 7 2013 07 15 482 486 EN Mohammad Abbasinazari Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Azita Hajhossein Talasaz Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Azadeh Eshraghi Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Zahra Sahraei Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 10 11 Any suboptimum treatment in the management of patients can lead to medication errors (MEs) that may increase morbidity and mortality in hospitalized individuals. By establishing well-designed patient care activities within the managed care setting, clinical pharmacists can cooperate with other health care professionals to provide quality care and maximize safety. The aim of this study was to evaluate the frequency and prevention of MEs by clinical pharmacists. This was a cross-sectional interventional study conducted in internal wards of a teaching hospital during a two-month period. During this period, patient records, and physician orders were reviewed by clinical pharmacists. Any prescription error identified was documented. Incorrect drug selection, dose, dosage form, frequency, or route of administration all were considered as medication errors. Then, the clinical pharmacist discuss about findings with the clinical fellows to change faulty orders. The frequency and types of MEs in different wards that were detected and prevented by clinical pharmacists was documented. During the study period, in 132 patients, 262 errors were detected (1.98 per each). Wrong frequency 71 (27%), forget to order 37 (14.1%), wrong selection 33 (12.5%), drug interactions 26 (9.9%), forget to discontinue 25 (9.5%) and inappropriate dose adjustment in renal impairment 25 (9.5%) were the most types of errors. Cardiovascular medications were the class with the highest detected errors (31.6%) followed by gastrointestinal agents (15.6%). Medication errors are common problems in medical wards that their frequency can be restricted by the intervention of clinical pharmacists. https://acta.tums.ac.ir/index.php/acta/article/view/4407 https://acta.tums.ac.ir/index.php/acta/article/download/4407/4595

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 7 2013 07 15 487 493 EN Taraneh Yazdanparast Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sousan Salehpour Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Reza Masjedi Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Seyed Ali Azin Iranian Institute for Health Sciences Research, The Academic Center for Education Culture and Research, Tehran, Iran. Seyed Mohammad Seyedmehdi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Eddie Boyes Environmental Education Research Unit, University of Liverpool, Liverpool, UK. Martin Stanisstreet Environmental Education Research Unit, University of Liverpool, Liverpool, UK. Mirsaeed Attarchi Occupational Medicine Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Study of students' knowledge about air pollution can help authorities to have better imagination of this critical environmental problem. This research examines guidance school and high school students' ideas about air pollution and the results may be useful for the respective authorities to improve cultural and educational aspects of next generation. In this cross-sectional study, a closed questionnaire was used to examine knowledge and ideas of 2140 randomly selected school students of Tehran-Iran about composition of unpolluted air, air pollution and its causes and consequences. Cognitive scores were also calculated. Outcomes were compared with results of similar researches in Australia, Hong Kong and the United Kingdom. While a student's 'cognitive score' could range from -16 to +16, Iranian students' mean cognitive score was equal to +2.97. There was not significant statistical difference between girls and boys (P=0.32). In response to question "most common gas in unpolluted air" nitrogen was mentioned by only 23.7%, While 45.1% of students mentioned oxygen. In general, student's knowledge was not acceptable and there were some misconceptions such as "supposing oxygen as the most prevalent gas in unpolluted air". The findings of this survey indicate that, this important stratum of society of Iran have been received no sufficient and efficient education and sensitization on this matter. https://acta.tums.ac.ir/index.php/acta/article/view/4406 https://acta.tums.ac.ir/index.php/acta/article/download/4406/4596

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 51 7 2013 07 15 494 500 EN Mohammad Jamshidi Ardeshiri Ministry of Science, Research and Technology of Iran, Iran. Mahmood Moosazadeh Faculty of Health, Kerman University of Medical Sciences, Kerman, Iran. Mehran Feizi Masouleh Department of Orthopedics Surgery, Isfahan University of Medical Sciences, Isfahan, Iran. Mehrdad Feizi Masouleh Department of Civil Engineering, Sharif University of Technology Tehran, Iran. Arda Kiani