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Quality assessment of care provided to patients with type 2 diabetes based on Clinical Practice Guidelines 2 2 Introduction: Diabetes is one of the usual medical problems that had an important negative effect on patient’s health. Researches demonstrate that there is a wide gap between recommended medical actions and received care by patients with diabetes. The aim of study was to assess the quality of care provided to patients with type 2 diabetes. Materials and methods: A cross-sectional study was carried out among 180 people with type 2 diabetes in diabetic’s clinics using convenience sampling method in Tabriz, Iran in 2011. Using a questionnaire we assessed the reported adherence to minimum recommended annual care for 23 processes indicators based on Iranian Diabetes Guidelines.  Results: The proportions of the participants who received recommended annual care for all three top clinical and all six top lifestyle indicators were 82.26% and 43.96%, respectively. For lifestyle and management indicators, reported adherence rates to guidelines were low (38.9% for medication review, 67.7% for self-management evaluation, 55% for physical activity review, and 58.3% for nutrition consultation). From the participants' perspective, most of the participants (87%) had well-controlled diabetes. Conclusion: A substantial proportion of people with type 2 diabetes indicated receiving suboptimal care and there is a notable gap between their expectations and what they have actually received in most aspects of the provided care. 1 7 2016/03/8 1394/12/18 2016/05/24 1395/3/4 Jafar Sadegh Tabrizi Jafar Sadegh Tabrizi Tabriz Health Services Management Research Center, Department of Health Services Management, School of Health Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran Iran js.tabrizi@gmail.com Yeganeh Partovi Yeganeh Partovi Tabriz Health Services Management Research Center, Department of Health Services Management, School of Health Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran Iran modirpy@yahoo.com Amir Bahrami Amir Bahrami Department of Glands, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran Iran modirpy@yahoo.com Mohammad Asghari Mohammad Asghari Department of Statistics and Epidemiology, Faculty of Health and Nutrition, Tabriz University of Medical sciences, Tabriz, Iran Iran modirpy@yahoo.com Type 2 diabetes Quality assessment Clinical practice guideline 1. Larijani B, Zahedi F. [Epidemiology of diabetes mellitus in Iran]. J Diabetes Lipid 2001;1(1):1-8.(Persian)##2. LeRoith D, Taylor S, Olefsky J. Diabetes Mellitus. A fundamental and clinical text: Philadelphia: Lippincott Williams and Wilkins; 2004.##3. Bethel M, Alexander J, Lane J, Barkauskas C, Feinglos M. Diabetes on a cardiovascular ward: adherence to current recommendations. South Med J. 2004; 97(11):1031-7.##4. ADA. Standards of medical care for patients with diabetes mellitus. Diabetes Care. 2003; 26:S33-S50.##5. Knight K, Badamgarav E, Henning J, Hasselblad V, Gano A, Ofman J, et al. A systematic review of diabetes disease management programs. Am J Manag Care. 2005;11(4):242-50. ##6. Coon P, Zulkowski K. Adherence to American Diabetes Association Standards of Care by rural health care providers. Diabetes Care. 2002; 25(12):2224-9.##7. Gross R, Tabenkin H, Porath A, Heymann A, Greensein M, Porter B, et al. The relationship between primary care physicians' adherence to guideline for the treatment of diabetes and patients satisfaction: finding from a pilot study. Fam Pract. 2003; 20(5):563-9.##8. McDermott R, Tulip F, Schmidt B, Siha A. Sustaining better diabetes care in remote indigenous Australian communities. BMJ. 2003;327(7412):428-30.##9. Kerssens J, Groenewegen P, Sixma H. Comparison of patient evaluations of health care quality in relation to WHO measures of achievement in 12 European countries. Bull World Health Organ. 2004; 82(2):106-14.##10. Clancy D, Cope D, Magruder K, Huang P, Wolfman T. Evaluating concordance to American Diabetes Association Standards of Care for Type 2 diabetes through group visits in an uninsured or inadequately insured patient population. Diabetic Care. 2003; 26(7):2032-6.##11. Valk G, Renders C, Kriegsman D, Newton K, Twisk J, Eijk J, et al. Quality of care for patients with type 2 diabetes mellitus in the Netherlands and the United States: a comparison of two quality improvement programs. Health Serv Res. 200439; (4pt 1):709-17.##12. Kenagy J, Berwick D, Shore M. Service quality in health care. J Am Med Assoc. 1999; 281(7):661-5.##13. Murray C, Frenk J. A framework for assessing the performance of health systems. Bull World Health Organ. 2000; 78(6):717-32.##14. Blumental D. Quality of health care. Part 1: quality of care. What is it? N Engl J Med. 1996; 335(12):891-4.##15. Murray C, Evans DE. Health systems performance assessment: Debates, Methods and Empiricism. 2003.##16. Delavari A, Mahdi hezave A, Norozi nejad A, Yar ahmadi SH. [National Diabetes Prevention and Control programs]. Second ed. Tehran: Sound Publishing Center; 1383.(Persian)##17. McGlynn E, Asch S, Adams J, Keesey J, Hicks J, DeCristofaro A, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003; 348(26):2635-45.##18. Granville R. Diabetes Mellitus: Diagnosis and Treatment (4th Edition). Bethesda: Association of Military Surgeons of the United States; 1999.##19. listed Na. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352(9131):837-53.##20. Arday D, Fleming B, Keller D, Pendergrass P, Vaughn R, Turpin J, et al. Variation in diabetes care among states. Diabetes Care. 2002; 25(12):2230-7.##21. Saaddine J, Engelgau M, Beckles G, Gregg E, Thompson T, Narayan K. A diabetes report card for the United States: quality of care in the 1990s. Ann Int Med. 2002; 136(8):565-74.##22. Colagiuri S, Colagiuri R, Ward J. National Diabetes Strategy and Implementation Plan: Diabetes Australia; 1998.##23. Harris M. Health care and health status and outcomes for patients with Type 2 diabetes. Diabetes Care. 2000; 23(6):754-8.##24. Pollard G. Queensland Health, 2000 Chronic Diseases Surveys: Diabetes Prevalence and Management Report. 2002. ## ##

Effect of endurance exercise training on morphological changes in rat heart tissue following experimental myocardial infarction 2 2 Introduction: Cardiac remodeling after myocardial infarction, is associated with progressive ventricular dysfunction and cardiovascular death. The purpose of this study was to examine the effect of endurance exercise training on morphological changes in rat heart tissue following experimental myocardial infarction. Materials and methods: Rats used in this experiment (8-10 weeks old, 235 ± 5 g body weight) after homogenization according to body weight, were randomly divided to three groups: Healthy (Sham), control (Sedentary) and endurance training groups. Myocardial infarction was induced by subcutaneous injection of isoprenaline (150 mg/kg) in two consecutive days with an interval of 24 hours. Endurance training initiated 2 days after infarction and continued for 4 weeks. In order to assess the necrosis lesion and fibrosis tissue, Hematoxylin–Eosin and Masson's trichrome staining were used, respectively. Data were analyzed by using one-way analysis of variance (ANOVA) at P< 0.05 level. Results: The results indicated that subcutaneous injection of isoprenaline, induced myocardial infarction in rat heart tissue. Rate of necrotic lesion in the Endurance training group was significantly higher than Sedentary (control) group (P=0.005).        Also, the size of fibrosis tissue in the Endurance training group was significantly higher than the sedentary         (control) group (P= 0.001). Conclusion: In general, results of this study showed that 4 weeks of endurance exercise training after myocardial infarction exacerbate tissue injury in rat heart. 8 16 2016/03/82015/05/24 1394/3/3 2016/05/242015/07/26 1394/5/4 Akbar Azamian Jazi Akbar Azamian Jazi Department of Exercise Physiology, Faculty of Literature and Human Sciences, Shahrekord University, Shahrekord, Iran Iran abdi_197866@yahoo.com Hadi Abdi Hadi Abdi Department of Physical Education, Payam-e-noor University, Tehran, Iran Iran azamianakbar@yahoo.com Mohammad Reza Haffezi Ahmadi Mohammad Reza Haffezi Ahmadi Department of Pathobiology, Faculty of Medicine, Ilam University of Medical Science, Ilam, Iran Iran reza.ahmadi56@yahoo.com Javad Cheraghi Javad Cheraghi Department of Physiology, Faculty of Veterinary Medicine, Ilam University, Ilam, Iran Iran j.cheraghi@ilam.ac.ir Endurance training Myocardial infarction Morphological changes Rat 1. Lardizabal JA, Deedwania PC. Benefits of statin therapy and compliance in high risk cardiovascular patients. Vasc Health Risk Manag. 2010;6:843-53. ##2. Organization WH. World health statistics 2010: World Health Organization; 2010.##3. Jorge L, Rodrigues B, Rosa KT, Malfitano C, Loureiro TC, Medeiros A, et al. Cardiac and peripheral adjustments induced by early exercise training intervention were associated with autonomic improvement in infarcted rats: role in functional capacity and mortality. Eur Heart J. 2011;32(7):904-12.##4. Chen CY, Hsu HC, Lee BC, Lin HJ, Chen YH, Huang HC, et al. Exercise training improves cardiac function in infarcted rabbits: involvement of autophagic function and fatty acid utilization. Eur J Heart Fail. 2010;12(4):323-30.##5. Sun Y. Myocardial repair/remodelling following infarction: roles of local factors. Cardiovasc Res. 2009;81(3):482-90.##6. Batista DF, Gonçalves AF, Rafacho BP, Santos PP, Minicucci MF, Azevedo PS, et al. Delayed rather than early exercise training attenuates ventricular remodeling after myocardial infarction. Int J Cardiol. 2013;170(1):e3-4.##7. Jain M, Liao R, Ngoy S, Whittaker P, Apstein CS, Eberli FR. Angiotensin II receptor blockade attenuates the deleterious effects of exercise training on post-MI ventricular remodelling in rats. Cardiovasc Res. 2000;46(1):66-72.##8. Haykowsky M, Scott J, Esch B, Schopflocher D, Myers J, Paterson I, et al. A meta-analysis of the effects of exercise training on left ventricular remodeling following myocardial infarction: start early and go longer for greatest exercise benefits on remodeling. Trials. 2011; 12:92.##9. Xu X, Wan W, Ji L, Lao S, Powers AS, Zhao W, et al. Exercise training combined with angiotensin II receptor blockade limits post-infarct ventricular remodelling in rats. Cardiovasc Res. 2008;78(3):523-32.##10. de Waard MC, van der Velden J, Bito V, Ozdemir S, Biesmans L, Boontje NM, et al. Early exercise training normalizes myofilament function and attenuates left ventricular pump dysfunction in mice with a large myocardial infarction. Circ Res. 2007;100(7):1079-88.##11. Gaudron P, Hu K, Schamberger R, Budin M, Walter B, Ertl G. Effect of endurance training early or late after coronary artery occlusion on left ventricular remodeling, hemodynamics, and survival in rats with chronic transmural myocardial infarction. Circulation. 1994;89(1):402-12.##12. Wan W, Powers AS, Li J, Ji L, Erikson JM, Zhang JQ. Effect of post-myocardial infarction exercise training on the renin-angiotensin-aldosterone system and cardiac function. Am J Med Sci. 2007;334(4):265-73.##13. Orenstein TL, Parker TG, Butany JW, Goodman JM, Dawood F, Wen W-H, et al. Favorable left ventricular remodeling following large myocardial infarction by exercise training. Effect on ventricular morphology and gene expression. J Clin Invest. 1995;96(2):858-66.##14. Serra AJ, Santos MH, Bocalini DS, Antônio EL, Levy RF, Santos AA, et al. Exercise training inhibits inflammatory cytokines and more than prevents myocardial dysfunction in rats with sustained β‐adrenergic hyperactivity. J Physiol. 2010;588(Pt 13):2431-42.##15. Jugdutt BI, Michorowski BL, Kappagoda CT. Exercise training after anterior Q wave myocardial infarction: importance of regional left ventricular function and topography. J Am Coll Cardiol. 1988;12(2):362-72.##16. Galvão TF, Matos KC, Brum PC, Negrão CE, Luz PLd, Chagas ACP. Cardioprotection conferred by exercise training is blunted by blockade of the opioid system. Clinics. 2011;66(1):151-7.##17. Xu X, Zhao W, Lao S, Wilson BS, Erikson JM, Zhang JQ. Effects of exercise and L-arginine on ventricular remodeling and oxidative stress. Med Sci Sports Exerc. 2010;42(2):346-54.##18. Hammerman H, Schoen FJ, Kloner RA. Short-term exercise has a prolonged effect on scar formation after experimental acute myocardial infarction. J Am Coll Cardiol. 1983;2(5):979-82.##19. Zaafan MA, Zaki HF, El-Brairy AI, Kenawy SA. Protective effects of atorvastatin and quercetin on isoprenaline-induced myocardial infarction in rats. Bulletin of Faculty of Pharmacy, Cairo University. 2013; 51(1):35-41.##20. Shukla SK, Sharma SB. β-Adrenoreceptor Agonist Isoproterenol Alters Oxidative Status, Inflammatory Signaling, Injury Markers and Apoptotic Cell Death in Myocardium of Rats. Indian J Clin Biochem. 2015;30(1):27-34.##21. Zouhal H, Jacob C, Delamarche P, Gratas-Delamarche A. Catecholamines and the effects of exercise, training and gender. Sports Med. 2008;38(5):401-23.##22. Husain K, Hazelrigg SR. Oxidative injury due to chronic nitric oxide synthase inhibition in rat: effect of regular exercise on the heart. Biochim Biophys Acta. 2002;1587(1):75-82.##23. Sorescu D, Griendling KK. Reactive oxygen species, mitochondria, and NAD (P) H oxidases in the development and progression of heart failure. Congest Heart Fail. 2002;8(3):132-40.##24. Dhalla AK, Singal PK. Antioxidant changes in hypertrophied and failing guinea pig hearts. Am J Physiol. 1994;266(4 Pt 2):H1280-5.##25. Cleutjens JP, Kandala JC, Guarda E, Guntaka RV, Weber KT. Regulation of collagen degradation in the rat myocardium after infarction. J Mol Cell Cardiol. 1995;27(6):1281-92.##26. Chiong M, Wang Z, Pedrozo Z, Cao D, Troncoso R, Ibacache M, et al. Cardiomyocyte death: mechanisms and translational implications. Cell Death Dis. 2011;2:e244.##27. Guazzi M, Tumminello G, Reina G, Vicenzi M, Guazzi M. Atorvastatin therapy improves exercise oxygen uptake kinetics in post‐myocardial infarction patients. Eur J Clin Invest. 2007;37(6):454-62. ## ##

E-test antibiotic susceptibility of E.coli strains isolated from hospital acquired infections of Imam Khomeini hospital, Ilam, Iran 2 2 Introduction: Escherichia coli (E.coli) as a main cause of both nosocomial and community-acquired infections in humans have a relative potential to develop resistance. Nowadays, most infections caused by ESBL-producing E.coli (ESBLEC) had mostly been described as nosocomial acquired or nursing home related. In this study, we employed E-test assay to detect antibiotic resistance of E.coli strains and determine MIC of antibiotics. Materials and methods: Thirty E.coli strains gathered from Imam Khomeini hospital of Ilam, and cultured on TSB and bacterial suspension prepared by 0.5 µF concentration for E-test. Mueller Hinton agar and E-test strips of Amikacin, Cefepime, Ceftazidime, Ceftriaxone, Gentamicin, Meropenem, Nitrofurantoin, Piperacillin/Tazobactam, Tetracycline, Ticarcillin/ Clavulanic acid, Tobramycin, Trimethoprim were used Results: Resistance to Ceftriaxone, Tobramycin, Gentamicin, Ticarcillin/ Clavulanic, Amikacin were 19.8%, 26.4%, 23.3%, 62.7%, 70.3%, respectively. Conclusion: the results indicated, E.coli strains in this study were high sensitivity to Meropenem ,Nitrofuratoin, Ciprofloxacin , Ceftazidime, Cefepime. 17 21 2016/03/82015/05/242015/07/5 1394/4/14 2016/05/242015/07/262015/10/5 1394/7/13 Lida Bimanand Lida Bimanand Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam Iran lidabimanand@yahoo.com Norkhoda Sadeghifard Norkhoda Sadeghifard Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam Iran pakzadi2006@gmail.com Farid Azizi Jalilian Farid Azizi Jalilian Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam Iran sadehifard@gmail.com Hassan Hossainzadegan Hassan Hossainzadegan Department of Microbiology, Faculty of Nursing , Maragheh University of Medical Sciences, Iran Iran azizifarid@gmail.com Sattar Mohammadi Darbidi Sattar Mohammadi Darbidi Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam Iran pakzadi2006@gmail.com Ali Hemahian Ali Hemahian Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam Iran r.azizian65@yahoo.com Sobhan Ghafourian Sobhan Ghafourian Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam Iran mohamadi.sattar@yahoo.com Iraj Pakzad Iraj Pakzad Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam Iran pakzadi2006@gmail.com E-test Antibiotic susceptibility E.coli Ilam Iran 1. Lark RL, Saint S, Chenoweth C, Zemencuk JK, Lipsky BA, Plorde JJetal. Four-year prospective evaluation of community-acquired bacteraemia: epidemiology, microbiology and patient outcome. DiagnMicrobiol Infect Dis. 2001؛15(2):22-41.##2. Karlowsky JA, Kelly LJ, Thornsberry C, Jones ME, Sahm DF. Trends in antimicrobial resistance among urinary tract infection isolates of Escherichia coli from female outpatients in the United States. Antimicrob Agents Chemother. 2002;46(8):2540-5. ##3. Foxman B. The epidemiology of urinary tract infection. Nature Rev Urol. 2010;7(12):653-60.##4. Hisanaga T, Decorby M, Laingk N, editors. Antibiotic resistance in outpatient urinary isolates: final results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA). 41st Annual Meeting of the Infectious Diseases Society of America; 2003;15(3):21-29.##5. Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Clin Infect Dis. 1999;29(4):745-59.##6. Bradford PA. Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev. 2001;14(4):933-51.##7. Wiener J, Quinn JP, Bradford PA, Goering RV, Nathan C, Bush K, et al. Multiple antibiotic–resistant Klebsiella and Escherichia coli in nursing homes. JAMA. 1999;281(6):517-23.##8. Hadadi A, Rasoulinejad M, Maleki Z, Mojtahedzadeh M, Younesian M, Ahmadi S, et al. [Antimicrobial resistance patterns among Gram-negative bacilli isolated from patients with nosocomial infections: Disk diffusion versus E-test]. Tehran Uni Med J. 2007;65(4):1-10 (Persian).##9. Torabi S, Falak-ul-Aflaki B, Moezzi F. In vitro Antimicrobial Drug-Resistance of Urinary Tract Pathogens in Patients Admitted to Vali-e-Asr Hospital Wards. ZUMS J. 2007;15(61):79-88.## ##

Effects of Flaxseed oil supplementation on renal dysfunction due to ischemia/reperfusion in rat 2 2 Introduction: This study was designed to evaluate the effects of treatment with flaxseed oil (FSO) on renal ischemia-reperfusion (RIR) injuries in rats. Materials and methods: In this study, 32 Wistar rats were randomly studied in four groups: Co+NS (Control group with normal saline administration), Sh+NS (sham group with normal saline administration), RIR+NS and RIR+FSO. FSO (0.2 ml) was administered orally (gavage) for 14 days (~ 800 mg/kg body weight).  Blood samples were collected for the detection of blood urea nitrogen (BUN) and creatinine levels.  Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were evaluated in the renal tissue. Tubular damages were examined using histopathological studies. Results: Significantly elevated MDA (P<0.05) and depressed SOD levels (P<0.05) Comparison between RIR+NS group and Control+NS and Sh+NS groups revealed in the condition of RIR. Treatment with FSO, however, significantly lowered the MDA (P<0.05) and enhanced SOD levels (P<0.05) after RIR injury. Histopathological results confirmed the biochemical studies and tubular necrosis score was reduced in the RIR+FSO group. Conclusion: This study therefore suggests that the aqueous flaxseed oil may be useful agents for the prevention of renal ischemia-reperfusion (RIR)-induced oxidative injury in rats. 22 29 2016/03/82015/05/242015/07/52016/05/20 1395/2/31 2016/05/242015/07/262015/10/52016/07/16 1395/4/26 Tahmineh Mokhtari Tahmineh Mokhtari Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Iran mokhtari.tmn@gmail.com Hedyeh Faghir Ghanesefat Hedyeh Faghir Ghanesefat Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Iran mokhtari.tmn@gmail.com Gholamreza Hassanzadeh Gholamreza Hassanzadeh Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Iran mokhtari.tmn@gmail.com Ardeshir Moayeri Ardeshir Moayeri Department of Anatomy, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran moosavimovahed@gmail.com Seyed Mohammad Jafar Haeri Seyed Mohammad Jafar Haeri Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran moosavimovahed@gmail.com Alireza Rezaee Kanavee Alireza Rezaee Kanavee Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Iran moosavimovahed@gmail.com Seyyed Majid Mousavi Movahed Seyyed Majid Mousavi Movahed Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran Iran moosavimovahed@gmail.com Flaxseed oil Renal ischemia-reperfusion Oxidative injury MDA SOD 1. Simmons MN, Hillyer SP, Lee BH, Fergany AF, Kaouk J, Campbell SC. Functional recovery after partial nephrectomy: effects of volume loss and ischemic injury. J Urol. 2012;187(5):1667-73.##2. Simmons MN, Schreiber MJ, Gill IS. Surgical renal ischemia: a contemporary overview. J Urol. 2008;180(1):19-30.##3. Himmelfarb J, Joannidis M, Molitoris B, Schietz M, Okusa MD, Warnock D, et al. Evaluation and initial management of acute kidney injury. Clin J Am Soc Nephrol. 2008;3(4):962-7.##4. Carden DL, Granger DN. Pathophysiology of ischaemia–reperfusion injury. The Journal of pathology. 2000;190(3):255-66.##5. Masztalerz M, Włodarczyk Z, Czuczejko J, Słupski M, Kedziora J, editors. Superoxide anion as a marker of ischemia-reperfusion injury of the transplanted kidney. Transplantation proceedings. Transplant Proc. 2006 Jan-Feb;38(1):46-8.##6. Chatterjee PK. Novel pharmacological approaches to the treatment of renal ischemia-reperfusion injury: a comprehensive review. Naunyn Schmiedebergs Arch Pharmacol. 2007;376(1-2):1-43.##7. Yamakura F, Taka H, Fujimura T, Murayama K. Inactivation of human manganese-superoxide dismutase by peroxynitrite is caused by exclusive nitration of tyrosine 34 to 3-nitrotyrosine. J Biol Chem. 1998;273(23):14085-9.##8. Kaçmaz A, Polat A, User Y, Tilki M, Özkan S, Şener G. Octreotide improves reperfusion-induced oxidative injury in acute abdominal hypertension in rats. J Gastrointest Surg. 2004;8(1):113-9.##9. Glantzounis GK, Salacinski HJ, Yang W, Davidson BR, Seifalian AM. The contemporary role of antioxidant therapy in attenuating liver ischemia‐reperfusion injury: A review. Liver Transplantation. 2005;11(9):1031-47.##10. Manna P, Sinha M, Sil PC. Arsenic-induced oxidative myocardial injury: protective role of arjunolic acid. Arch Toxicol. 2008;82(3):137-49.##11. Lee JC, Krochak R, Blouin A, Kanterakis S, Chatterjee S, Arguiri E, et al. Dietary flaxseed prevents radiation-induced oxidative lung damage, inflammation and fibrosis in a mouse model of thoracic radiation injury. Cancer Biol Ther. 2009;8(1):47-53.##12. Rizwan S, Naqshbandi A, Farooqui Z, Khan AA, Khan F. Protective effect of dietary flaxseed oil on arsenic-induced nephrotoxicity and oxidative damage in rat kidney. Food Chem Toxicol. 2014;68:99-107.##13. Kitts D, Yuan Y, Wijewickreme A, Thompson L. Antioxidant activity of the flaxseed lignan secoisolariciresinol diglycoside and its mammalian lignan metabolites enterodiol and enterolactone. Mol Cell Biochem. 1999;202(1-2):91-100.##14. Khundmiri SJ, Asghar M, Banday AA, Khan F, Salim S, Levi M, et al. Effect of ischemia reperfusion on sodium-dependent phosphate transport in renal brush border membranes. Biochim Biophys Acta.2005;1716(1):19-28.##15. Kaya H, Sezik M, Ozkaya O, Dittrich R, Siebzehnrubl E, Wildt L. Lipid peroxidation at various estradiol concentrations in human circulation during ovarian stimulation with exogenous gonadotropins. Horm Metab Res. 2004;36(10):693-5.##16. Misra HP, Fridovich I. The role of superoxide anion in the autoxidation of epinephrine and a simple assay for superoxide dismutase. J Biol Chem.1972;247(10):3170-5.##17. Solez K, Kramer EC, Fox JA, Heptinstall RH. Medullary plasma flow and intravascular leukocyte accumulation in acute renal failure. Kidney international. 1974;6(1):24-37.##18. Aragno M, Cutrin JC, Mastrocola R, Perrelli M-G, Restivo F, Poli G, et al. Oxidative stress and kidney dysfunction due to ischemia/reperfusion in rat: attenuation by dehydroepiandrosterone. Kidney Int. 2003;64(3):836-43.##19. Barnes J, Osgood R, Reineck H, Stein J. Glomerular alterations in an ischemic model of acute renal failure. Lab Invest. 1981;45(4):378.##20. Donohoe JF, Venkatachalam MA, Bernard DB, Levinsky NG. Tubular leakage and obstruction after renal ischemia: structural-functional correlations. Kidney Int. 1978;13(3):208-22.##21. Bonventre JV, Zuk A. Ischemic acute renal failure: An inflammatory disease&quest. Kidney Int. 2004;66(2):480-5.##22. Yano T, Nozaki Y, Kinoshita K, Hino S, Hirooka Y, Niki K, et al. The pathological role of IL-18Rα in renal ischemia/reperfusion injury. Lab Inves. 2015;95(1):78-91.##23. Baker GL, Corry RJ, Autor A. Oxygen free radical induced damage in kidneys subjected to warm ischemia and reperfusion. Protective effect of superoxide dismutase. Ann Surg. 1985;202(5):628.##24. Qiao X, Li R-S, Li H, Zhu G-Z, Huang X-G, Shao S, et al. Intermedin protects against renal ischemia-reperfusion injury by inhibition of oxidative stress. Am J Physiol Renal Physiol.2013;304(1):F112-F9.##25. Valko M, Morris H, Cronin M. Metals, toxicity and oxidative stress. Current Med Chem. 2005;12(10):1161-208.##26. Shokeir AA, Hussein AM, Awadalla A, Samy A, Abdelaziz A, Khater S, et al. Protection against renal ischaemia/reperfusion injury: A comparative experimental study of the effect of ischaemic preconditioning vs. postconditioning. Arab J of Urol. 2012;10(4):418-24.##27. Kinniry P, Amrani Y, Vachani A, Solomides CC, Arguiri E, Workman A, et al. Dietary flaxseed supplementation ameliorates inflammation and oxidative tissue damage in experimental models of acute lung injury in mice. J Nutr.. 2006;136(6):1545-51.##28. Lee JC, Bhora F, Sun J, Cheng G, Arguiri E, Solomides CC, et al. Dietary flaxseed enhances antioxidant defenses and is protective in a mouse model of lung ischemia-reperfusion injury. Am J Physiol Lung Cell Mol Physiol. 2008;294(2):L255-L65.##29. Hosseinian FS, Muir AD, Westcott ND, Krol ES. AAPH-mediated antioxidant reactions of secoisolariciresinol and SDG. Org Biomol Chem. 2007;5(4):644-54.##30. Agarwal A, Sharma RK, Desai NR, Prabakaran S, Tavares A, Sabanegh E. Role of oxidative stress in pathogenesis of varicocele and infertility. Urology. 2009;73(3):461-9. #### ##

Effect of olfactory ensheathing cells (OECs) transplantation on functional recovery in acute phase of spinal contused rats 2 2 Introduction: Spinal cord injuries (SCI) lead to permanent irreversible functional deficits.  Poor prognosis of patients is the motivation of searching a treatment for the chronic injury.  Planting stem cells provides us with a promising strategy. In the meanwhile, the use of olfactory ensheathing cells (OECs) has shown very good results.  This study aims at evaluating the effect of transplanted OECs on functional recovery of acute SCI in rats. Materials and methods: In this study, eighteen adult male Wistar rats weighting approximately 210 ± 10 gr were used to study spinal cord injury. They were randomly divided into four groups: Sham (n = 3), Control (n = 6), Vehicle (n=3) and Treatment (n=6). In the Sham Group, only laminectomy was performed in the area of T9 spinal cord. In three groups of Control, vehicle and Treatment, after laminectomy, spinal cord contusion model was performed using the Weight drop technique. Immediately after the injury, 10μl Dulbecco's Modified Eagle Medium (DMEM) alone or with 106 cells were injected to vehicle and Treatment Group animals. For culturing cells, the olfactory mucosa of 7-day-old male Wistar rats was used. Motor function of animals in all groups, was evaluated in the first 48 hours daily and then weekly for eight weeks. Results: Comparing the results of the second to eighth week of the study showed significant differences in the group receiving the OECs with the control group (P<0.05). Conclusion: The results indicate a positive influence of the olfactory ensheathing cells in functional improvement of spinal cord injury in the acute phase of injury. 30 36 2016/03/82015/05/242015/07/52016/05/202015/09/28 1394/7/6 2016/05/242015/07/262015/10/52016/07/162016/06/16 1395/3/27 Somayeh Heidarizadi Somayeh Heidarizadi Department of Anatomy, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran azizi.moaz@gmail.com Naser Abbasi Naser Abbasi Department of Pharmacology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran somaye6001@yahoo.com Khairollah Asadollahi Khairollah Asadollahi Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran Iran ilamfarma@gmail.com Sara Rezaei Sara Rezaei Department of Anatomy, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran masoud_1241@yahoo.co.uk Ardeshir Moayeri Ardeshir Moayeri Department of Anatomy, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran rezaei7194@yahoo.com Monireh Azizi Monireh Azizi Department of Anatomy, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran azizi.moaz@gmail.com Spinal cord injury Olfactory ensheathing cells 1. Yaojian R, Wenxiao Z, Huijuan L, Chunxia J, Qingan Z , Yongjun W. Clinical application of olfactory ensheathing cells in the treatment of spinal cord injury. J Inter Med Res. 2013; 41(2): 473-81.##2. Beattie MS, Hermann GE, Rogers RC, Bresnahan JC. Cell death in models of spinal cord injury. Prog Brain Res. 2002; 137:37-47.##3. Ropper AH, Braunwald, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jaameson JL. Traumatic injuries of the head and spine: Harrison principles of internal medicine. 5th ed. New York: McGraw-Hill; 2001.P. 2441-42.##4. Hulsebosch C. Recent advances in pathophysiology and treatment of spinal cord injury. Adv Physiol Edu. 2002; 26(1-4): 238-55.##5. Makhani M. The uphill battle against spinal cord injury. MURJ. 2006; 14:7-9.##6. Widenfalk J, Lundstromer K, Jubran M, Brene S, Olson L. Neurotrophic factors and receptors in the immature and adult spinal cord after mechanical injury or Kainic acid. Neuroscience. 2001; 21(10):3457-75.##7. Woolf CJ, Salter MW. Neuronal plasticity: Increasing the gain in pain. Science. 2000; 288:1765-9.##8. De Winter F, Oudega M, Lankhorst AJ, Hamers FP, Blits B, Ruitenberg MJ, et al. Injury include class 3 semaphorin expression in the rat spinal cord. Exp Neurol. 2002; 175(1):61-75.##9. Ronsyn MW, Berneman ZN, Van Tendeloo VF, Jorens PG, Ponsaerts P. Can cell therapy heal a spinal cord injury? Spinal Cord. 2008:46(8):532-9.##10. Raisman G. Olfactory ensheathing cell-another miracle cure for spinal cord injury? Nat Rev Neurosci. 2001; 2(5):369-74.##11. Mayeur A, Duclos C, Honore A, Gauberti M, Drouot L, do Rego JC, et al. Potential of olfactory ensheathing cells from different sources for spinal cord repair. PLoS ONE.2013; 8(4): e62860.##12. Li Y, Field PM, Raisman G. Regeneration of adult rat corticospinal axon induced by transplanted olfactory ensheathing cells. J Neurosci. 1998; 18(24):10514-24.##13. Li Y, Field PM, Raisman G. Repair of adult rat corticospinal tract by transplant of olfactory ensheating cells. J Neurosci. 1997; 277(5334):2000-2.##14. Verdu E, Garcia- Alias G, Joaquimfore S, Lopez-Valez R , Navarro X. Olfacrory ensheathing cells transplanted in leisoned spinal cord prevent loss of spinal cord parenchyma and promote functhional recovery. Glia. 2003; 42(3):275-86.##15. Woodhall E, West AK, Chuah MI. Culture olfactory ensheathing cells express nerve growth factor,brain-derived neurotrophic factor, glia cell line-derived neurotrophic factor and their receptors. Brain Res. 2001; 88(1-2):203-13. ##16. Lu J, Feron F, Ho SM, Mackay Sim A, Waite PM. Transplantation of nasal olfactory tissue promote partial recovery in paraplegic adult rats. Brain Res. 2001; 889(1-2):344-57.##17. Richter WW, Flectcher PA, Liu J, Tetzlaff W, Roskams AJ. Lamina Propria and olfactory bulb ensheathing cells exhibit differential integration and migration and promote differential axon sprouting in the lesion spinal cord. Neuroscience. 2005; 25(46):10700-11.##18. Joghataei MT, Bakhtiari M, Farahmand Ghavi F, Zandi M, Imani M. A Moaieri, et al. Purity determining of cultured OECs from olfactory mucosa of rats' pups. J Bas Res Med Sci. 2016; 3(4):12-21.##19. Azizi M. Fabricathion of chondroitinase ABC-loaded nanoparticles and assessment of their effects in combination with OECs in the fanctional recovery in the induced SCI rats. (A PhD thesis). Iran University of Medical Sciences & Health Service Faculty of Medicine. 2013:86-91.##20. Basso DM, Beattie MS, Bresnahan JC. Grade histological and locomotor outcomes after spinal cord contusion using the NYU weight-drop device versus transaction. Exp Neurol.1996; 139(2):244-56.##21. Lu J, Feron F, Macky-sim A, Phil M, Wait E. Olfactory ensheathing cell promote locomotor recovery after delayed transplantation into transected spinal cord. Brain. 2002; 125(1):14-21.##22. Lopez-Vales R, Gracia-Alias G, Fores J, Navarro X, Verdu E. Chronic transplantation of olfactory ensheathing cells promotes partial recovery after complete spinal cord transaction in the rat. Glia. 2007; 55:303-11.##23. Tharion G, Indirani K, Durai M. Motor recovery following olfactory ensheathing cell transplantation in rats with spinal cord injury. Neurol Ind. 2011; 59(4):566-72.## ##

Predicting the behavioral intention of pregnant women’s choice of delivery method based on the theory of planned behavior: A cross-sectional study 2 2 Introduction: Cesarean, as a major abdominal surgery, if done without a medical indication, may impose numerous complications on the mothers and the babies and increase frequency of cesarean deliveries in subsequent pregnancies. This study aimed to predict the behavioral tendencies of pregnant women in selecting their delivery approaches, based on the theory of planned behavior (TPB). Materials and methods: This cross-sectional study was performed on 100 pregnant women referred to healthcare centers of Kermanshah city (western Iran). A researcher-made questionnaire was applied, based on TPB constructs including attitudes, perceived behavioral controls, subjective norms, and behavioral tendencies. To analyze the data, Pearson correlation, Spearman, s regression, and ANOVA were used via the SPSS statistical software, version 20. Results: The average age of pregnant woman was 23.7±3.93 years old. The results demonstrated a significant correlation between the subjective norms and behavioral tendencies (r=0.335, P=0.001). A significant relationship was seen between the perceived behavioral controls and tendencies (r=0.277, P=0.004). A significant relationship was found between the perceived behavioral control and the attitude (r=0.293, P=0.002). The results of the regression results demonstrated that the subjective norms and perceived behavioral controls can significantly predict 14.1 percent of changes in the variable of tendencie. Conclusion: The findings indicate the strength of the variable of subjective norms as the most effective factor in predicting the delivery approach; therefore, systematic and planned training seems necessary, not only for the pregnant women, but also the individuals affecting this group. Thus, to reduce caesarean sections, physicians, as an effective factor, need to be urged to boost natural childbirth. 37 44 2016/03/82015/05/242015/07/52016/05/202015/09/282015/12/28 1394/10/7 2016/05/242015/07/262015/10/52016/07/162016/06/162016/07/10 1395/4/20 Bahareh Soheili Bahareh Soheili Department of Health Education, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran Iran bahareh.soheili@gmail.com Amin Mirzaei Amin Mirzaei Department of Health Education, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran Iran Amin.mirzaei@modares.ac.ir Kourosh Sayemiri Kourosh Sayemiri Research Center for Prevention of Psychosocial Injuries, Ilam University of Medical Sciences, Ilam, Iran Iran ghazanfari-z@medilam.ac.ir Zeinab Ghazanfari Zeinab Ghazanfari Department of Social Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran ghazanfari-z@medilam.ac.ir Natural childbirth Cesarean section Theory of planned behavior Pregnant women 1. Anjali K, Emily W, John K. Web based education and attitude to delivery by Caesarean section in nulliparous women. J Obstet Gynaecol Can. 2014;36(9):768-75.##2. Gibbons L, Belizan J, Lauer J, Betran A, Merialdi M, Althabe F. The global numbers and costs of additionally needed and unnecessary Caesarean sections performed per year: overuse as a barrier to universal coverage. Geneva: World Health Organization. 2010.##3. Gallagher F, Bell L, Waddell G, Benoit A, Cote N. Requesting cesareans without medical indications: an option being considered by young canadian women. Birth. 2012; 39(1):39-47.##4. Gass CW. It is the right of every anaesthetist to refuse to participate in a maternal-request caesarean section. Int J Obstet Anesth. 2006; 15(1):33-5.##5. Hart D, Norman J, Callander R, Govan A. Gynaecology illustrated. 5th ed. London: Churchill Livingstone. 2000:301-38.##6. Karami-Matin B, Ataee M, Mirzaei Alavijeh M, Mahboubi M, Aghaei A, Mohammadi P. Cognitive factors related to cesarean intention among Iranian pregnant women. J Biol Todays World. 2014;3(11):251-55.##7. Latif RR, Zakeri HM, Merghati Khoei E. Socio-cultural beliefs, values and traditions regarding women’s preferred mode of birth in the north of Iran. Int J Commun Bas Nurs Midwifery. 2015;3(3):165-76.##8. Souza JP, Betran AP, Dumont A, de Mucio B, Gibbs Pickens CM, Deneux-Tharaux C, et al. A global reference for caesarean section rates (C-Model): a multi country cross-sectional study. Int J Obstetric Gynaecoly. 2016;123(3):427-36.##9. Sanavi FS, Ansari-Moghaddam A, Shovey MF, Rakhshani F. Effective education to decrease elective caesarean section. J Pak Med Assoc. 2014;64(5):500-5.##10. Perry AR, Langley C. Even with the best of intentions: paternal involvement and the theory of planned behavior. Fam Proc. 2013;52(2):179-92.##11. Sivell S, Edwards A, Elwyn G, Manstead A. Understanding surgery choices for breast cancer: how might the Theory of Planned Behaviour and the common sense model contribute to decision support interventions? Health Expect. 2011;14(Suppl1):6-19.##12. Tolma EL, Reininger BM, Evans A, Ureda J. Examining the theory of planned behavior and the construct of self-efficacy to predict mammography intention. Health Educ Behav. 2006;33(2):233-51.##13. Ajzen I. Perceived behavioral control, self-efficacy, locus of control, and the Theory of Planned Behavior. J Appl Soc Psychol. 2002;32(4):665-83.##14. Sharma M, Romas J. Theoretical foundations of health education and health promotion. 2nd ed. United States of America. Jones and Bartlet publishers. 2008.##15. Conner M, Armitage C. Extending the theory of planned behavior: a review and avenues for further research. J Appl Soc Psychol. 1998;28(15):1429-64.##16. Rahmati Najar Kolaei F, Eshraghi T, Dopeykar N, Zamani O, Mehdizadeh P. [Determinants of delivery type selection by using Theory of Planned Behaviors (TPB). J Urmia Nurs Midwifery. 2014;12(4):305-13]. (Persian)##17. Sanavi FS, Rakhshani F, Ansari-Moghaddam A, Edalatian M. Reasons for elective cesarean section amongst pregnant women; A qualitative study. J Reprod Infertil. 2012;13(4):237-40.##18. Rafati S, MadanI A, Mashayekhi F, Rafati F, Pilevarzadeh M. [Related factors to choose cesarean section among Jiroft pregnant women]. J Prevent Med. 2014; 1(1):23-30. (Persian)##19. Besharati F, Hazavehei S, Moeini B, Moghimbeigi A. [Effect of educational interventions based on Theory of Planned Behavior (TPB) in selecting delivery mode among pregnant women referred to Rasht health centers]. J Zanjan Uni Med Sci. 2011;19 (77):94-106. (Persian)##20. Sharifirad G, Rezaeian M, Soltani R, Javaheri S, Mazaheri MA. A survey on the effects of husbands' education of pregnant women on knowledge, attitude, and reducing elective cesarean section. J Educ Health Promot. 2013; 2:50.##21. Salehian T, Delaram M, Safdari F, Jazayeri F. [Knowledge and attitudes of pregnant women about mode of delivery in health centers of Shahrekord]. J Toloo-e-behdasht. 2007;6(2):1-10. (Persian)## ##

Psychological factors related to musculoskeletal pain among Iranian female adolescents 2 2 Introduction: Musculoskeletal pain accompanied by psychological problem lead to reduce the efficiency of adolescents; so, this study aimed to determine the prevalence of musculoskeletal pain and its association with psychological factors among female adolescents. Materials and methods: The target population of this cross sectional study was female students (3625 in total) from both private and state funded high school children in Gorgan, northern Iran. Self - assessment questionnaires were distributed to 255 students across 8 female high schools. Self-report version of the Strengths and Difficulties (SDQ) questionnaires was used to screen adolescents with Psychiatric symptoms. To evaluate musculoskeletal pain Nordic questionnaire and numeric pain rating scale was used. Data were analyzed by binary logistic regression and the cumulative odds ratio (COR) was carried out for the ordinal level of musculoskeletal symptoms. Results: The prevalence rate of neck, shoulder and low back pain was reported, 23.1%, 27.8% and 27.7%, respectively.  Hyperactivity-inattention (OR=2. 82; CI: 1.14-6.97) and peer problem (OR= 2.72; CI: 1.01-7.32) had significant relationship with neck pain, and prosocial behaviors (OR= 3.11; CI: 1.09-10.73) were associated with low back pain in the multivariate model. Ordinal regression showed that the increasing numbers of musculoskeletal symptoms related only to prosocial behavior (COR= 2.78; CI: 1.12-6.91). There was no significant association between shoulder pain and psychological factors. Conclusion: Based on the results, psychological factors were associated with musculoskeletal pain; so, it seems suffering from musculoskeletal pain need to be concurrently noticed with mental feeling for more effective response to attenuate pain. 45 52 2016/03/82015/05/242015/07/52016/05/202015/09/282015/12/282016/01/29 1394/11/9 2016/05/242015/07/262015/10/52016/07/162016/06/162016/07/102016/07/15 1395/4/25 Mohammad Aryaie Mohammad Aryaie Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran Iran aryaie@goums.ac.ir Zahra Khombehbini Zahra Khombehbini Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran Iran khombehbini.2013@gmail.com Fozieh Bakhsha Fozieh Bakhsha Department of Anesthesiology, Faculty of Paramedical Sciences, Golestan University of Medical Science, Gorgan, Iran Iran bakhsha_fo@yahoo.com Zahra Yousefi Zahra Yousefi Department of Anesthesiology, Faculty of Paramedical Sciences, Golestan University of Medical Science, Gorgan, Iran Iran stu.yousefi@yahoo.com Omid Behravesh Omid Behravesh Department of Anesthesiology, Faculty of Paramedical Sciences, Golestan University of Medical Science, Gorgan, Iran Iran omidbehravesh1344@yahoo.com Psychological problems Neck Shoulder Low back pain 1. Astfalck RG, O'Sullivan PB, Straker LM, Smith AJ. A detailed characterisation of pain, disability, physical and psychological features of a small group of adolescents with non-specific chronic low back pain. Man Ther. 2010 Jun;15(3):240-7.##2. E-Metwally A, Salminen JJ, Auvinen A, Macfarlane G, Mikkelsson M. Risk factors for development of non-specific musculoskeletal pain in preteens and early adolescents: a prospective 1-year follow-up study. BMC Musculoskelet Disord. 2007;8(1):46.##3. Mohammadi MR, Arman S, Dastjerdi JK, Salmanian M, Ahmadi N, Ghanizadeh A, et al. Psychological Problems in Iranian Adolescents: Application of the Self Report Form of Strengths and Difficulties Questionnaire. Iran J Psychiatry. 2013; 8(4):152-9.##4. Yao W, Luo C, Ai F, Chen Q. Risk Factors for Nonspecific Low‐Back Pain in Chinese Adolescents: A Case‐Control Study. Pain Med. 2012; 13(5):658-64.##5. Nieto Rn, Raichle KA, Jensen MP, Miro J. Changes in pain-related beliefs, coping, and catastrophizing predict changes in pain intensity, pain interference, and psychological functioning in individuals with myotonic muscular dystrophy and facioscapulohumeral dystrophy. Clin J Pain. 2012; 28(1):47-54.##6. Shan Z, Deng G, Li J, Li Y, Zhang Y, Zhao Q. Correlational Analysis of neck/shoulder Pain and Low Back Pain with the Use of Digital Products, Physical Activity and Psychological Status among Adolescents in Shanghai. PloS One. 2013;8(10):e78109.##7. Spyropoulos P, Papathanasiou G, Georgoudis G, Chronopoulos E, Koutis H, Koumoutsou F. Prevalence of low back pain in Greek public office workers. Pain Physic. 2007;10(5):651.##8. Auvinen JP, Tammelin TH, Taimela SP, Zitting PJ, Jarvelin M-R, Taanila AM, et al. Is insufficient quantity and quality of sleep a risk factor for neck, shoulder and low back pain? A longitudinal study among adolescents. Eur Spine J. 2010; 19(4):641-9.##9. Pollock CM, Harries RL, Smith AJ, Straker LM, Kendall GE, Sullivan PB. Neck/shoulder pain is more strongly related to depressed mood in adolescent girls than in boys. Man Ther. 2011 Jun;16(3):246-51.##10. Gunilla M, Sundblad B, Saartok Tn, T. Engstrom. Prevalence and co-occurrence of self-rated pain and perceived health in school-children: Age and gender differences. Eur J Pain. 2007;11(2):171-80.##11. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003; 60(8):837-44.##12. Sawyer MG, Arney FM, Baghurst PA, Clark JJ, Graetz BW, Kosky RJ, et al. The mental health of young people in Australia: key findings from the child and adolescent component of the national survey of mental health and well-being. Aust N Z J Psychiatry. 2001;35(6):806-14.##13. Diepenmaat A, Van der Wal M, De Vet H, Hirasing R. Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents. Pediatrics. 2006;117(2):412-6.##14. Harma A-M, Kaltiala-Heino R, Rimpela M, Rantanen P. Are adolescents with frequent pain symptoms more depressed? Scand J Prim Health Care. 2002;20(2):92-6.##15. Mikkelsson M, Sourander A, Piha J, Salminen JJ. Psychiatric symptoms in preadolescents with musculoskeletal pain and fibromyalgia. Pediatrics. 1997; 100(2):220-7.##16. Chiu TT, Lam T-H, Hedley AJ. Maximal isometric muscle strength of the cervical spine in healthy volunteers. Clin Rehabil. 2002;16(7):772-9.##17. Torgen M, Swerup C. Individual factors and physical work load in relation to sensory thresholds in a middle-aged general population sample. Eur J Appl Physiol. 2002; 86(5):418-27.##18. Wijnhoven HAH, de Vet HCW, Picavet HSJ. Explaining sex differences in chronic musculoskeletal pain in a general population. Pain. 2006; 124(1):158-66.##19. Wedderkopp N, Andersen LB, Froberg K, Leboeuf-Yde C. Back pain reporting in young girls appears to be puberty-related. BMC Musculoskelet Disord. 2005;6(1):52.##20. Shamsedini A, Hellisaz MT, Dalvand H, Khatibi A, Sobhani V. The investigation of prevalence of musculoskeletal symptoms and discomfort caused by them in students of Tehran. HBI J. 2011;8(4):271-6.##21. Naghavi M, Abolhassani F, Pourmalek F, Lakeh MM, Jafari N, Vaseghi S, et al. The burden of disease and injury in Iran 2003. Popul Health Metr. 2009;7(1):9.##22. Shahrivar Z, Tehrani-Doost M, Pakbaz B, Rezaie A, Ahmadi F. Normative data and psychometric properties of the parent and teacher versions of the strengths and difficulties questionnaire (SDQ) in an Iranian community sample. J Res Med Sci. 2009;14(2):69-77.##23. Aryaie M, Roshandel G, Semnani S, Asadi-Lari M, Aarabi M, Vakili MA, et al. Predictors of Colorectal Cancer Survival in Golestan, Iran: A Population-based Study. Epidemiol Health. 2013;35:e2013004.##24. Ghanizadeh A, Izadpanah A, Abdollahi G. Scale validation of the strengths and difficulties questionnaire in Iranian children. Iran J Physic. 2007; (2):65-71.##25. Jussila L, Paananen M, Nayha S, Taimela S, Tammelin T, Auvinen J, et al. Psychosocial and lifestyle correlates of musculoskeletal pain patterns in adolescence: A 2 year followo up study. Eur J Pain. 2014;18(1):139-46.##26. Rees CS, Smith AJ, O'Sullivan PB, Kendall GE, Straker LM. Back and neck pain are related to mental health problems in adolescence. BMC Public Health. 2011;11(1):382.##27. Bruusgaard D, Smedbraten BK, Natvig B. Bodily pain, sleep problems and mental distress in schoolchildren. Acta Paediatrica. 2000;89(5):598-600.##28. Jones GT, Silman AJ, Macfarlane GJ. Predicting the onset of widespread body pain among children. Arthritis Rheum. 2003;48(9):2615-21.##29. Larsson B, Sund AM. Emotional/behavioural, social correlates and one year predictors of frequent pains among early adolescents: Influences of pain characteristics. Eur J Pain. 2007;11(1):57-65.##30. Stanford EA, Chambers CT, Biesanz JC, Chen E. The frequency, trajectories and predictors of adolescent recurrent pain: a population-based approach. Pain. 2008;138(1):11-21.##31. Bergbom S, Boersma K, Linton SJ. Both early and late changes in psychological variables relate to treatment outcome for musculoskeletal pain patients at risk for disability. Behav Res Therap. 2012;50(11):726-34.##32. Sullivan MJL, Adams H, Thibault P, Corbire M, Stanish WD. Initial depression severity and the trajectory of recovery following cognitive-behavioral intervention for work disability. J Occup Rehabil. 2006;16(1):60-71.##33. Speckens AE, Van Hemert AM, Spinhoven P, Hawton KE, Bolk JH, Rooijmans HG. Cognitive behavioural therapy for medically unexplained physical symptoms: a randomised controlled trial. BMJ. 1995;311(7016):1328-32.##34. Williams C, Wilson P, Morrison J, McMahon A, Andrew W, Allan L, et al. Guided self-help cognitive behavioural therapy for depression in primary care: a randomised controlled trial. PloS One. 2013; 8(1):e52735.##35. Nielsen LA, Henriksson KG. Pathophysiological mechanisms in chronic musculoskeletal pain (fibromyalgia): the role of central and peripheral sensitization and pain disinhibition. Best Pract Res Clin Rheumatol. 2007; 21(3):465-80.##36. Balagu F, Dudler J, Nordin M. Low-back pain in children. Lancet. 2003;361(9367):1403-4.##37. Watson KD, Papageorgiou AC, Jones GT, Taylor S, Symmons DPM, Silman AJ, et al. Low back pain in schoolchildren: the role of mechanical and psychosocial factors. Arch Dis Child. 2003;88(1):12-7.##38. Siivola SM, Levoska S, Latvala K, Hoskio E, Vanharanta H, Keinanen-Kiukaanniemi S. Predictive factors for neck and shoulder pain: a longitudinal study in young adults. Spine. 2004; 29(15):1662-9.##39. 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Investigating the prevalence rate of hypertension in Iranian men and women: A study of systematic review and meta-analysis 2 2 Introduction: Based on the serious complications which are followed, hypertension is a common and asymptomatic health problem. This study aims to present a general statistics of the rate of the prevalence of systolic and diastolic hypertension in Iranian men and women based on the age range through the systematic review and meta-analysis method. Materials and methods: In this study of systematic review and meta-analysis, some databases such as Google Scholar, Scope.com, Magiran, Iran Medex, Medlib, Sid, and Pubmed were searched by using keywords such as hypertension, men and women, Iran, and prevalence. The first and the last published articles in this field were in 1999 and 2012, respectively. Data were combined by random effects meta-analysis model and they were analyzed by STATA11. Results: From 100 articles which were found in the searched references, 22 of them were finally analyzed. Among the selected final articles from 1999 to 2012, 96689 subjects were used in this study. The mean prevalence of hypertension was 17% (confidence coefficient of 95%, 17-17%). The prevalence rate of hypertension among the people above 20 was between 10-32% and its mean was 24% (confidence coefficient of 95%, 23-24%). The mean prevalence of hypertension among the people below 20 was 5% (confidence coefficient of 95%, 4-5%). Conclusion: In the studies done in Iran, the prevalence rate of hypertension was high. Noticing that hypertension is an important and dangerous factor for cardiovascular diseases, it is a worrying issue in Iran and it is necessary to be programmed in order to control and prevent this disease. 53 62 2016/03/82015/05/242015/07/52016/05/202015/09/282015/12/282016/01/292015/09/29 1394/7/7 2016/05/242015/07/262015/10/52016/07/162016/06/162016/07/102016/07/152016/04/28 1395/2/9 Yousof Mohsenzadeh Yousof Mohsenzadeh Department of Cardiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran Morteza Motedayen Morteza Motedayen Department of Cardiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran Iran Farhad Hemmati Farhad Hemmati Department of Sports Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran Iran Kourosh Sayehmiri Kourosh Sayehmiri Department of Biostatistics, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran Iran Mohammad Taher Sarokhani Mohammad Taher Sarokhani Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran Iran Diana Sarokhani Diana Sarokhani Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran Iran Hypertension Men and Women Iran Prevalence 1. 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