Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 5 2015 05 15 257 265 EN Seyed Kazem Malakouti Department of Psychiatry, Mental Health Research Centre, School of Behavioral Sciences and Mental health, Iran University of Medical Sciences, Tehran, Iran. Farnoush Davoudi Mental Health Research Centre, Iran University of Medical Sciences, Tehran, Iran. Saeed Khalid World Health Organization, Regional office for the Eastern Mediterranean Region, Mental Health and Substance Abuse Unit, Regional Advisor, Washington, DC, United States of America. Masoud Ahmadzad Asl Mental Health Research Centre, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran. Murad Moosa Khan Department of Psychiatry, Aga Khan University, Pakistan. Narges Alirezaei Mental Health Research Centre, Iran University of Medical Sciences, Tehran, Iran. Arash Mirabzadeh Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Diego DeLeo Department of Psychiatry, Australian institute for Suicide Research and Prevention,National Centre of Excellence in Suicide prevention, Griffith University, Queensland, Australia. 2015 10 11 This systematic review aimed to help better to understand the epidemiology of suicidal behaviors among Eastern Mediterranean Region (EMR) countries. The PubMed, EMR medex, Scopus, PsychInfo, ISI, and IMEMR were searched with no language limitation for papers on the epidemiology of suicidal behaviors in the general population, published up to August 2013. A total of 13 articles were reviewed. The incidence (per 100.000) of committed suicide ranged from 0.55 to 5.4. The lifelong prevalence of attempted suicide, suicidal plan and thoughts were 0.72-4.2%, 6.2-6.7%, and 2.9-14.1%, respectively. The figures for suicide are higher than those officially reported. Suicide behaviors' statistics is susceptible to underestimation presumably due to the socio-cultural, religious and legal barriers, not to mention the lack of well-organized registries and methodologically sound community-based surveys. https://acta.tums.ac.ir/index.php/acta/article/view/4895 https://acta.tums.ac.ir/index.php/acta/article/download/4895/4451

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 5 2015 05 15 266 269 EN Mohammad Hasan Namazi Department of Cardiology, Cardiovascular Research center, Shahid Beheshti Univercity of Medical Sciences, Tehran, Iran. Morteza Safi Department of Cardiology, Cardiovascular Research center, Shahid Beheshti Univercity of Medical Sciences, Tehran, Iran. Hosein Vakili Department of Cardiology, Cardiovascular Research center, Shahid Beheshti Univercity of Medical Sciences, Tehran, Iran Habibollah Saadat Department of Cardiology, Cardiovascular Research center, Shahid Beheshti Univercity of Medical Sciences, Tehran, Iran. Saeed Alipour Department of Cardiology, Cardiovascular Research center, Shahid Beheshti Univercity of Medical Sciences, Tehran, Iran. Abdulkarim Alhuthaifi Department of Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Shamseddin Pedari Department of Cardiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Amin Abbasi Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 2015 10 11 Myocardial fractional flow reserve (FFR) is a new index of the functional significance of intermediate coronary stenoses that is calculated from pressure measurements made during coronary arteriography. The aim of this study was to evaluate the correlation between non-hyperemic coronary pressure dicrotic notch and fractional flow reserve (FFR). A consecutive of 114 patients (73 men and 41 women) was enrolled in this study. Data were shown as means ± SD. Statistical analyses were performed with SPSS software. The statistical significance of differences was determined by chi-square analysis with Yates correction. Significance was defined as P< 0.05. Positive dicrortic notch was observed in 97 patients (85%). Significant association was detected between coronary pressure notch (dicrotic notch), and FFR as loss of the dicrotic notch was detected in 93.8% (15/16) of patients with FFR less than 0.75 (P=0.001). Upon ROC curve, a cutoff FFR value of approximately 0.75 demonstrated sensivity and specifity of 93.8% and 98%, respectively for loss of the dicrotic notch. The positive predictive value for loss of the dicrotic notch was 88.2%. Our study demonstrated loss of non-hyperemic coronary pressure diacrotic notch correlates significantly with FFR and may predict an FFR < 0.75 with high accuracy. In patients with functionally significant coronary stenosis, loss of non-hyperemic diacrotic notch appears to be a useful index of the functional severity of the stenoses and the need for coronary revascularization. https://acta.tums.ac.ir/index.php/acta/article/view/4894 https://acta.tums.ac.ir/index.php/acta/article/download/4894/4454

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 5 2015 05 15 270 275 EN Mohammad Arbabi Department of Psychiatry, Tehran University of Medical Sciences. Tehran, Iran. Naista Zhand Department of Psychiatry, Tehran University of Medical Sciences. Tehran, Iran. Sana Eybpoosh Department of Psychiatry, Tehran University of Medical Sciences. Tehran, Iran. Narges Yazdi Department of Psychiatry, Tehran University of Medical Sciences. Tehran, Iran. Sahar Ansari Department of Psychiatry, Tehran University of Medical Sciences. Tehran, Iran. Marjan Ramezani Department of Psychiatry, Tehran University of Medical Sciences. Tehran, Iran. 2015 10 11 The aim of the study was to find whether there is an association between subjective memory complaint and memory impairment and probable underlying psychological conditions. A total of 90 patients with subjective memory complaint enrolled in this study. Short history and demographic information were obtained and then the patients underwent memory and mental health assessments, using Wechsler Memory Scale (WMS), Hospital Anxiety and Depression Scale (HADS) and Minnesota Multiphasic Personality Inventory (MMPI) test tools. The mean age of the participants was 52.31 ± 17.97. Forty patients out of 90 (44.4%) were male. The prevalence of depression, anxiety and memory impairment was 10%, 12.2%, and 28.8%, respectively. Memory impairment has only shown a significant association with the presence of anxiety disorder according to the HADS findings (P=0.001). Regarding the MMPI, considerable differences were observed in the average grade of hysteria among patients with and without memory impairment: 8.38 ± 2.27 vs. 4.35 ± 1.96. There was also significant statistical association between the average score of depression on the MMPI in patients with and without memory impairment that were 13.7 ± 3.33 and 8.31 ±3.86, (P=0.03). The result of the current study shows that underlying psychological conditions such as anxiety, depression, and histrionic personality are associated with memory impairment. https://acta.tums.ac.ir/index.php/acta/article/view/4893 https://acta.tums.ac.ir/index.php/acta/article/download/4893/4459

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 5 2015 05 15 276 280 EN MohammadKazem Bakhshandeh Bali Bahrami Children Hospital, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran. Ali Akbar Rahbarimanesh Bahrami Children Hospital, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran. Manelie Sadeghi Department of Community Medicine, Research Development Center of Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Sedighi Department of Pediatrics, Kermanshah University of Medical Sciences, Kermanshah, Iran. Parvaneh Karimzadeh Department of Pediatric Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohammad Ghofrani Department of Pediatric Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2015 10 11 Migraine involves 5-10% of children and adolescents. Thirty percent of children with severe migraine attacks have school absence and reduced quality of life that need preventive therapy. The purpose of this randomised control trial study is to compare the effectiveness, safety and the tolerability of pregabalin toward Propranolol in migraine prophylaxis of children. From May 2011 to October 2012, 99 children 3-15 years referred to the neurology clinic of Mofid Children's Hospital with a diagnosis of migraine enrolled the study. Patients randomly divided into two groups (A&B). We treated children of group A with capsule of pregabalin as children of group B with tablet of propranolol for at least 8 weeks. In this study, 99 patients were examined that 91 children reached the last stage. The group A consistsed of 46 patients, 12(26.1%) girls, 34 (73.9%) boys and the group B consisted of 45 patients, 14(31.1%) girls, 31 (68.9%) boys. Basis of age, gender, headache onset, headache frequency, migraine type, triggering and relieving factors there was no significant difference among these groups (P>0.05). After 4 and 8 weeks of Pregabalin usage monthly headache frequency decreased to 2.2±4.5 and 1.76±6.2 respectively. Propranolol reduced monthly headache frequency up to 3.73±6.11 and 3.34±5.95 later 4 and 8 weeks respectively. There was a significant difference between these two groups according to headache frequency reduction (P=0.04). Pregabalin efficacy in reducing the frequency and duration of pediatric migraine headache is considerable in comparison with propranolol. https://acta.tums.ac.ir/index.php/acta/article/view/4892 https://acta.tums.ac.ir/index.php/acta/article/download/4892/4465

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 5 2015 05 15 281 286 EN Amrollah Roozbehi Department of Anatomy, Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. Mohammad Taghi Joghataei Department of Anatomy, Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran. Mehrdad Bakhtiyari Department of Anatomy, Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran. Jamshid Mohammadi Department of Physiology, Herbal Medicine Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. Parastou Rad Department of Midwifery, School of Midwifery, Yasuj University of Medical Sciences, Yasuj, Iran. Hamdollah Delaviz Department of Anatomy, Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran. 2015 10 11 This study was conducted to evaluate the association between aging and regenerative potential of spinal cord injury. Three groups of male Sprague-Dawley rats, including young (40 days), mature (5-6 months) and old (28-29 months) were spinally hemisected at the L1 level. The locomotor performance was assessed weekly for eight weeks after lesion using locomotors' rating scale developed by Basso, Bresnahan and Beattie (BBB). In the tracing study, retrograde labeled neuron was counted in the lateral vestibular nucleus for axonal regeneration. From 4-8 weeks, the functional recovery of the young and mature age rats was significantly increased in comparison to the old age group. At 8 weeks, young and mature animals achieved a plateau score of (mean ± SD), 17 ± 1.47 and 16.8 ± 0.70 respectively, and the old rats reached an average score of 13.8±1.63 (P<0.05). The mean number of labeled neurons in the vestibular nucleus in the young group (mean ± SD): 32.05 ± 1.03 increase significantly compared to the older age group 5.01 ± 1.31 (P<0.05). Current findings suggest that axonal repair and functional improvement decrease in aged animals after partial spinal cord injury. Thus, the aging process may affect the regenerative capacity of the injured central nervous system, and axonal regeneration is age dependent. https://acta.tums.ac.ir/index.php/acta/article/view/4891 https://acta.tums.ac.ir/index.php/acta/article/download/4891/4473

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 5 2015 05 15 287 292 EN Ramin Mehrdad Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. Sara Aghdaei Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. Gholamreza Pouryaghoub Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Exposure to air pollutants, steel dust or other occupational and environmental hazards as oxidative stress have adverse effects on subway workers' health. Oxidative stress generates an excessive amount of reactive oxygen species (ROS) and Oxygen Free Radicals during their work time in the tunnels. Once DNA is repaired, Urinary 8-hydroxy-deoxyguanosine (8-OHdG) is excreted in the urine. Therefore, urinary level of 8-OHdG can reflect the extent of oxidative DNA damage. The aim of this study was to document the oxidative stress caused by exposure to these hazards by measuring 8-OHdG in workers urine. We collected urine samples of 81 male subway workers after their working shift. The concentration of urinary 8-OHdG was measured by ELISA method. We used linear regression analysis to compare the level of urinary 8-OHdG as a biomarker of oxidative stress between workers in tunnels and other staff. The mean concentration of urinary 8-OHdG for workers in the tunnel was 58.05 (SD=28.83) ng/mg creatinine and for another staff was 54.16 (SD =26.98) ng/mg creatinine.  After adjustment for age, smoking, driving and a second job in a linear regression model, the concentration of 8-OHdG for the exposed group was significantly higher than unexposed group (P=0.038). These findings confirm that the concentration of urinary 8-OHdG for workers who work in tunnels was significantly higher than the other staff. Additional investigations should be performed to understand that which ones of occupational exposures are more important to cause oxidative stress. https://acta.tums.ac.ir/index.php/acta/article/view/4890 https://acta.tums.ac.ir/index.php/acta/article/download/4890/4478

Tehran University of Medical Sciences Acta Medica Iranica https://acta.tums.ac.ir/index.php/acta/article/view/4539 https://acta.tums.ac.ir/index.php/acta/article/download/4539/4657

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 11 2014 11 15 831 836 EN Setila Dalili Department of Pediatric Center, Pediatric Growth Disorder Research Center, Guilan University of Medical Sciences, Guilan, Iran. AND Departments of Health Center, School of Health, Guilan University of Medical Sciences, Guilan, Iran. Seyed Mahmood Rezvani Departments of Health Center, School of Health, Guilan University of Medical Sciences, Guilan, Iran. Hossein Dalili Departments of Pediatrics, Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran. Zahra Mohtasham Amiri Department of Social and Preventive Medicine, School of Medicine, Guilan University of Medical Sciences, Guilan, Iran. Hamid Mohammadi Departments of Pediatrics, Pediatric Growth Disorder Research Center, Shiraz University of Medical Sciences, International Branch, Fars, Iran. Abdolreza Medghalchi Department of Ophthalmology, Eye Research Center, Guilan University of Medical Sciences, Guilan, Iran. Mohamad Hossein Novin Departments of Health Center, School of Health, Guilan University of Medical Sciences, Guilan, Iran. Hajar Gholamnezhad Departments of Health Center, School of Health, Guilan University of Medical Sciences, Guilan, Iran. 2015 10 11 Rising obesity incidence and its complications have lead to change of our view about cardio-metabolic risk factors and need of reassessment of these complications in childhood age. The aim of current study was to evaluate prevalence of obesity and related cardio-metabolic risk factors of children. This was a cross-sectional study in a representative sample of 12 years old children in Rasht, the biggest city in north of Iran. Participants were interviewed and examined by a trained research team and demographic characteristics, detailed examination (height - weight - blood pressure) were recorded. Blood samples were drawn for biochemical testing including Fasting blood sugar, Triglyceride, Cholesterol, HDL & LDL. Data analysis was done using SPSS software. Total participants were 858 children and 550(64%) were male. Prevalence of underweight, normal weight, overweight, obese were 22.5%, 54.4%, 11.3%, 11.8%, respectively. The prevalence of cardio-metabolic risk factors included hypercholesterolemia (6.7%), hypertriglyceridemia (33.6%), high LDL (5.9%), low HDL (28 %), high systolic (7.6%) & diastolic blood pressure (10.6%) (> percentile) and abnormal carbohydrate metabolism (12%) revealed hypertriglyceridemia as the most common dyslipidemia. Correlation analysis didn't show significant correlation between BMI & FBS but LDL, Cholesterol and TG had week positive correlation with BMI (Pearson correlation: 0.161, 0.285, 0.222 respectively, p value <0.001). Obesity and dyslipidemia are common problems in this area and we should note to screen cardiometabolic risk factors in addition of obesity, especially in children with rapid weight gain. This study highly recommended more investigation to evaluate final effect of these factors in adulthood. https://acta.tums.ac.ir/index.php/acta/article/view/4538 https://acta.tums.ac.ir/index.php/acta/article/download/4538/4658

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 11 2014 11 15 837 843 EN Abbas Norouzi Javidan Brain and Spinal Cord Injury Research Center (BASIR), Tehran University of Medical Sciences, Tehran, Iran. Fedyeh Haghollahi Vali-E-asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Ramezanzadeh Vali-E-asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mir Saeed Yekaninejad Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Zohre Amiri Department of Basic Science, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Science, Tehran, Iran. Mansoreh Noroozi Vali-E-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Sadat Hosseini Vali-E-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. Elham Azimi Nekoo Vali-E-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Marvelon®, a combined oral contraceptive, contains 30 μg ethinyl estradiol (EE) and 150 μg desogestrel (DE), and has been shown to be a well-tolerated and effective combination that provides high contraceptive reliability and good cycle control. However, its efficacy has not been yet evaluated among Iranian women. Thus, the study aimed to determine the effect of oral contraceptive pill on treating premenstrual symptoms and on various parameters associated with well-being and health in a sample of Iranian. This clinical trial (before- after) study was performed at the family-planning clinic of the centers under the supervision of Tehran University of Medical Sciences on sixty-one women. The study protocol was approved by the Ethics Committee of Tehran University of Medical Sciences and all participants received a 21/7-day regimen of oral contraceptive containing 150 μg desogestrel (DE) and 30 μg ethinyl estradiol (EE) for six cycles. Efficacy parameters included changes in premenstrual symptoms were also assessed. Clinical data was collected by calendar of premenstrual experiences (COPE) at baseline and treatment cycles 1,2, 3 and 6. Clinical variables were measured including low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride levels for two timing periods (baseline and last visit). Linear mixed model analyses were used to analyze differences in changes of the four factors of premenstrual syndrome (PMS), weight and blood pressure during these timing periods. The mean age of the women was 28.52 (SD=6.75) years. Participants on average had been pregnant 1.13 (SD=1.16) times. The linear mixed model analyses indicated that premenstrual syndrome symptoms reduced significantly over time (P0.05). A combined oral contraceptive containing ethinyl estradiol and desogestrel has a positive effect on women's health and reduces premenstrual symptoms. https://acta.tums.ac.ir/index.php/acta/article/view/4537 https://acta.tums.ac.ir/index.php/acta/article/download/4537/4659

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 11 2014 11 15 844 847 EN Alireza Mahoori Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Heydar Noroozinia Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Ebrahim Hasani Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Nazli Karami Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Nahid Pashaei Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. Sanaz Hatami Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. 2015 10 11 Emergence from general anesthesia can be associated with coughing, agitation, and hemodynamic disturbances. Remifentanil may attenuate these responses. We have examined the effect of remifentanil on the hemodynamic response to the emergence from anesthesia and tracheal extubation. In a double-blind, randomized trial, we enrolled 50 adult patients undergoing abdominal surgery. All patients received a standard general anesthetic comprising propofol, atracurium and 1% isoflurane with 50% nitrous oxide in oxygen. At the end of surgery, a bolus dose of remifentanil 0.2 microgram/kg (n = 25) or saline placebo (n = 25) was given and tracheal extubation was performed when standard criteria were achieved. Arterial pressure and heart rate were measured non-invasively, immediately after tracheal extubation and then at 1-min intervals. Remifentanil attenuated the increase in both systolic and diastolic arterial pressure and heart rate after extubation compared to the control group. No differences in SpO2, cough and laryngospasm were observed between two groups. Use of a low-dose remifentanil has clinically acceptable effect in blunting the cardiovascular changes induced by tracheal extubation. https://acta.tums.ac.ir/index.php/acta/article/view/4536 https://acta.tums.ac.ir/index.php/acta/article/download/4536/4660

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 11 2014 11 15 848 854 EN Mohammad Taghi Talebian Pre-Hospital Emergency Research Center, Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Mahdi Zamani Department of Anesthesiology and Pain Medicine, Tehran University of Medical Sciences, Tehran, Iran. Alireza Toliat Pre-Hospital Emergency Research Center, Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Rezvaneh Ghasemzadeh Department of Medicine, University of Wisconsin, Madison, WI, USA. Morteza Saeedi Pre-Hospital Emergency Research Center, Department of Emergency Medicine, Shariati Hospital, Tehran Univeristy of Medical Sciences, Tehran, Iran. Mehdi Momeni Pre-Hospital Emergency Research Center, Department of Emergency Medicine, Shariati Hospital, Tehran Univeristy of Medical Sciences, Tehran, Iran. Amir Nejati Pre-Hospital Emergency Research Center, Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 An electrocardiogram (ECG) leads physicians to diagnose many potentially life-threatening cardiac, metabolic, electrolyte, and toxicological conditions. This study was designed to evaluate the competency of emergency medicine residents (EMRs) in comparison with cardiologists in the interpretation of ECG when an interpretation checklist is used. This clinical trial was done in the emergency wards of the first grand general hospital of Iran. Patients were categorized in three classes of disorder severity based on ECG abnormalities. The two stages of the study included the survey phase (Stage I), training phase and intervention phase (Stage II). Accuracy of ECG interpretation by EMRs and cardiologists was compared before and after using a Daily ECG Check List (DECKList). One hundred and fifty ECGs were evaluated in Stage I, before DECKList usage, and 150 ECGs were evaluated in stage II, after DECKList usage by EMRs. Mean age of participants was 60.13 years in Stage I and 61.66 years in Stage II. Stage I and II were similar to each other in terms of disorder severity (P=0.22). Mean the ECG interpretation score was significantly different between Stages I and II (P<0.001). Concordance of ECG diagnosis between EMRs and cardiologists was significantly different in Stages I and II (P<0.01). In first-year EMRs, ECG diagnosis scores in stages I and II were not changed significantly. However, ECG interpretation scores increased significantly in first-year EMRs (P=0.04). In second-year EMRs, both ECG interpretation and ECG diagnosis scores improved significantly (P<0.05 and P<0.01, respectively). In third year EMRs, ECG interpretation was not improved but ECG diagnosis based on two methods improved significantly (P<0.05). The significant increase in accuracy of ECG interpretation and final diagnosis can be attributed to the utilization of a checklist by EMRs especially in the first year and second residents. https://acta.tums.ac.ir/index.php/acta/article/view/4535 https://acta.tums.ac.ir/index.php/acta/article/download/4535/4661

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 52 11 2014 11 15 855 859 EN Mohammad Ali Abbasi Moghadam Department of Healthcare Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Fayaz Bakhsh Department of Healthcare Management, school of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 Hospital information system (HIS) should ideally allow different forms of data to be stored and used for decision making by clinicians and managers alike. This system has been developed since the early 1980's, and many hospitals gradually converted from an unrelated system into an integrated one. In successful implementation of HIS plans, the role of human factors, either individually or as a group, is expected to be very important and decisive. In this phenomenological qualitative research, in-depth personal interviews were conducted with the hospital's senior managers, and discussions were conducted in six to eight member focus groups. To include participants for interviews, purposive sampling was used in an Iranian hospital among doctors, nurses and other healthcare providers who had experience in using HIS. Data collection continued until saturation stage. The meetings took about 90 to 120 minutes, in which the participants were asked about discovering needs as well as facilitating and inhibiting factors regarding HIS application. Two members of the research team independently analyzed the interview transcripts.  As a result, problems in HIS isolation were reported to be related to the following: software, hardware, manpower, management and training. About the last point, it was stated that adequate continuing professional development programs did not exist for proper use of computers in the hospital. To achieve the ultimate goal of HISs (e.g. increasing patient satisfaction and decreasing hospital costs), it is necessary to create basic changes in the training system, and to get feedback from hospital personnel. Other steps include addressing software and hardware shortcomings as well as moving towards reinforcing the facilitating factors and refraining from inhibiting ones discovered in this study. https://acta.tums.ac.ir/index.php/acta/article/view/4534 https://acta