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تنوع ژنتیکی مرحله لاروی اکینوکوکوس گرانولوزوس در میزبانان واسط مختلف در ایران: مرور سیستماتیک و متاآنالیز 2 0 0 2013/04/21 1392/2/1 2013/05/28 1392/3/7 جهانگیر عبدی Jahangir Abdi مرکز تحقیقات میکروب شناسی بالینی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران jahangirabdi@yahoo.com ## ##

ارزشیابی روش های تشخیصی لیشمانیازیس احشائی در ایران: مطالعه متاآنالیز 2 0 0 2013/04/212019/06/19 1398/3/29 2013/05/282015/06/7 1394/3/17 اسد میرزائی Asad Mirzaei مرکز تحقیقات بیماری‌های مشترک انسان و دام، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران amirzaeii@yahoo.com ## ##

Effectiveness of self-efficacy enhancing intervention on self-management of patients with type 2 diabetes in shahid Mostafa Khomeini Hpspital, Ilam, Iran, year 2015-2016 بررسی تاثیر مداخله ی آموزشی بر اساس نظریه خودکارآمدی بر میزان خود مراقبتی در بیماران دیابت نوع 2 مراجعه کننده به مرکز بهداشتی درمانی شهید مصطفی خمینی (ره) در سال1394 2 1 دیابت از گروه بیماری های متابولیک و اختلالی چند عاملی است که با افزایش مزمن قند خون یا هیپرگلیسمی مشخص میشود و ناشی از اختلال ترشح یا عمل انسولین و یا هر دوی آن ها است. از دیابت به عنوان اپیدمی خاموش نام برده می شود و به عنوان یک مشکل بهداشت عمومی عمده قلمداد می گردد و مسئول 9 درصد کل مرگ ها در جهان است (Ahmadi et al., 2009).  دیابت با افزایش خطر بیماری های قلبی-عروقی و کلیوی مرتبط بوده و مرگ و میر افراد دیابتی 2 تا 3 باربر بیشتر از افراد سالم است. در ایران بیش از 3 میلیون نقر دجار دیابت هسنتد که با میزان شیوع 7 درصد دیابت و 13 درصد دیابت پنهان در جمعیت بزرگسالان تقریبا 20 درصد جمعیت ایرانی مبتلا به دیابت و یا مستعد ابتلا به ان می باشد (Shirinzadeh & Shakerhosseini, 2009). بر اساس آمار سازمان بهداشت جهانی  با افزایش جمعیت شیوع دیابت از 4 درصد در سال 1995 به 5.4 درصد در سال 2025 خواهد رسید و تعداد کل افراد مبتلا  به دیابت 122 درصد افزایش خواهد یافت (Jalilian et al., 2014). هزینه های مربوط به دیابت را سالانه 99 میلیارد دلار برآورد می کنند که شامل هزینه های مراقبت مستقیم و هزینه های غیر مستفیم مربوط به ناتوانی معلولیت و مرگ و میر زودرس می باشد (Maher, 1993). در مورد کنترل عوارض دیابت باید گفت که یکی از دلایل عدم موفقیت و حصول نتایج درمانی مطلوب در بیماران دیابتی کمبود مشارکت بیماران در درمان دیابت است ; چرا که بیماران مبتلا به دیابت و خانواده های آن ها , نیاز به یادگیری و تمرین مهارت های سبک زندگی جدید شامل: پایش قند خون, انتخاب رژیم غذایی صحیح و فعال بودن بیشتر دارند. این مهارت ها هم در کنترل دیابت و هم در پیشگیری یا به تاخیر انداختن عوارض آن مهم است (Gagliardino & Etchegoyen, 2001). 2 The theory of self-efficacy is the central concept of social cognitive theory with emphasis on the constructs of efficacy expectation, outcome expectation. Efficacy expectation is defined as the person’s confidence to carry out a specific behavior. Outcome expectation is beliefs that carrying out a specific behavior will lead to a specific outcome. While the benefit of measuring outcome expectations has been established, there has been no large scale within the Iranian context. The purpose of this study is to examine the reliability-validity of the Persian version of the Perceived Therapeutic Efficacy Scale (PTES). Methods: This study was conducted among 160 patients with type 2 diabetes mellitus (T2DM) using a self-administered instrument measuring outcome expectation. We used a methodological study design to assess the validity and reliability of the translated Persian version of the instrument. Results: The findings of the present study support the uni-dimensionality of the Persian version of the instrument. The 10 items of the scale account for 73.54% of the total variance and the un-rotated factor loadings ranged from 0.66 to 0.93. Moreover, this study offers support for convergent validity and internal consistency of the scale. Conclusion: Our study demonstrated good convergent validity, factor structure and internal consistency in a sample of 160 Iranian adults with T2DM. Therefore, the Persian version of the scale is a valid and reliable instrument and can be used in research and clinical settings. 0 0 2013/04/212019/06/192015/07/27 1394/5/5 2013/05/282015/06/72015/07/26 1394/5/4 ساناز اعظمی Sanaz Azami گروه آموزشی آموزش پزشکی، دانشکده مرکز توسعه آموزش پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران aazamisanaz@gmail.com مصیب مظفری Mosayeb Mozafari گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران mozafaric@yahoo.com بهزاد بدخش Behzad Badakhsh گروه آموزشی داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران behzad.b1962@yahoo.com Confirmatory factor analysis Convergent validity Exploratory factor analysis Outcome expectation scale Persian version of outcome expectation scale Cite this article as: Azami G Lam SK Shariff-Ghazali S Said SM Aazami S Mozafari M et al. Validat Aalto, A.-M., & Uutela, A. (1997). 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Prevalence of burnout among nurses: a systematic review and meta-analysis بررسی شیوع فرسودگی شغلی در پرستاران جهان: مطالعه مرور سیستماتیک و متاآنالیز 2 1 یکی از عوامل درون سازمانی موثر بر کاهش بهره وری شغلی کارکنان سازمانها سطح بهداشت روانی کارکنان سازمان است به عبارت دیگر فرسودگی شغلی کارکنان می تواند به عنوان یک عامل بازدارنده سطح کارایی سازمان را تنزل دهد و از این جهت سازمان متحمل زیانهای فراوانی می شود بنابراین آگاهی از میزان فرسودگی شغلی آنان می تواندبه عنوان یک مقدمه ای بر تلاشها در جهت رهایی افراد از فرسودگی شغلی درسازمان تلقی شود 2 The main part of any society is its working population. These people who are employed in different organizations face problems according to the atmosphere of the organization, the type of job and their duties. One of the concepts that has attracted the attention of organizational industrial psychologists in recent years is exhaustion, lethargy, lethargy, laziness and lethargy of the job manager, which is called burnout. Burnout is a negative change in a person's attitude, mood and behavior in the face of job stress.One of the factors affecting the reduction of job productivity of employees is the level of mental health of employees. In other words, burnout can reduce the level of efficiency of the organization as a deterrent and therefore the organization suffers a lot of losses. The extent of their burnout can be considered as an introduction to the efforts to relieve people from burnout in the organization. 0 0 2013/04/212019/06/192015/07/272016/05/21 1395/3/1 2013/05/282015/06/72015/07/262016/07/12 1395/4/22 طاهره بسطامی tahereh bastami ایران taherh.bastami93@gmail.com کورش سایه میری Kourosh Sayehmiri مرکز تحقیقات آسیب‌های روانی و اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران sayehmiri-k@medilam.ac.ir Prevalence + burnout among nurses+ a systematic review and meta-analysis شیوع فرسودگی-پرستاران جهان -مطالعه مرور سیستماتیک و متاآنالیز . Moradi Y, Baradaran2 HR, Yazdandoost M, Atrak Sh, Kashanian M. Prevalence of Burnout in residents of obstetrics and gynecology: A systematic review and meta-analysis. Med J Islam Repub Iran 2015 (6 July). Vol. 29:235.##2. TRUFELLI D.C., BENSI C.G., GARCIA J.B., NARAHARA J.L., ABRÃO M.N., DINIZ R.W.,DA COSTA MIRANDA V., SOARES H.P. & DEL GIGLIO A.Burnout in cancer professionals: a systematic review and meta-analysis. (2008) European Journal of Cancer Care 17, 524–531.##3. Moreira Dde S1, Magnago RF, Sakae TM, Magajewski FR. Prevalence of burnout syndrome in nursing staff in a large hospital in south of Brazil. Cad Saude Publica. 2009 Jul;25(7):1559-68.##4. Ribeiro Vivian F & et al. Prevalence of burnout syndrome in clinical nurses at a hospital of excellence. Int Arch Med. 2014; 7: 22.##. Moradi Y, Baradaran2 HR, Yazdandoost M, Atrak Sh, Kashanian M. Prevalence of Burnout in residents of obstetrics and gynecology: A systematic review and meta-analysis. Med J Islam Repub Iran 2015 (6 July). Vol. 29:235.##2. TRUFELLI D.C., BENSI C.G., GARCIA J.B., NARAHARA J.L., ABRÃO M.N., DINIZ R.W.,DA COSTA MIRANDA V., SOARES H.P. & DEL GIGLIO A.Burnout in cancer professionals: a systematic review and meta-analysis. (2008) European Journal of Cancer Care 17, 524–531.##3. Moreira Dde S1, Magnago RF, Sakae TM, Magajewski FR. Prevalence of burnout syndrome in nursing staff in a large hospital in south of Brazil. Cad Saude Publica. 2009 Jul;25(7):1559-68.##4. Ribeiro Vivian F & et al. Prevalence of burnout syndrome in clinical nurses at a hospital of excellence. Int Arch Med. 2014; 7: 22. ##

Identification of Carbapenemase genes and evaluation of their prevalence among E.coli and Klebsiella pneumoniae Isolated from patients who admitted to Ilam hospitals by phenotypic and genotypic method بررسی شیوع و شناسایی انواع کارباپنمازهای تولید شده توسط اشریشیا کلی و کلبسیلا نومونیه جدا شده از بیماران مراجعه کننده به مراکز درمانی ایلام به روش فنوتیپی و ژنوتیپی 2 1 برای انتخاب درمان آنتی بیوتیکی مناسب و جلوگیری از گسترش روز افزون سویه های مقاوم به کارباپنم ها و جلوگیری از انتقال آنها به سایر سویه های باکتریایی و همچنین جهت طراحی و ساخت آنتی بیوتیک ها و حتی واکسن های جدید بر علیه سویه های مولد کارباپنمازها، این چنین مطالعاتی مبنی بر بررسی باکتری های تولید کننده کارباپنماز و شناسایی الگوی انواع کارباپنمازهای تولید شده امری ضروری به نظر میرسد.  از آنجا که در کشورعزیزمان ایران مطالعه جامعی مبنی بر بررسی شیوع و شناسایی انواع کارباپنمازهای تولید شونده توسط باکتری های اشریشیا کلی و کلبسیلا نومونیه انجام نشده است لذا هدف از این مطالعه بررسی شیوع و شناسایی کارباپنمازهای تولید شده توسط اشریشیا کلی و کلبسیلا نومونیه جدا شده از بیماران مراجعه کننده به مراکز درمانی ایلام بالینی میباشد.  مهمترین یافته ها: فراوانی ژن های دخیل در مقاومت به انتی بیوتیک های بتالاکتام  در درمان عفونت های حاصل باکتری های ذکر شده قابل ملاحظه می باشد. به طوری که در درصد بالایی از جدایه های کلبسلا پنمونیه و اشرشیا کلای، آنزیم کارباپنماز ردیابی گردید.  پیشنهاد برای کاربرد نتایج:  ارائه الگوی مقاومت به جامعه پزشکی جهت بکار گیری درمان موثرتر باکتری های مقاوم به بتالاکتم 2 Abstract Objectives: Drug resistance among gram-negative bacteria is a worldwide challenge. Due to the importance of drugresistant Klebsiella pneumoniae and Escherichia coli strains in hospital-acquired infections, we aimed to determine the phenotypic and genotypic characteristics of ESBL-, AmpC-, and carbapenemase-producing isolates obtained from hospitalized patients in Tehran and Ilam (Iran). Materials and Methods: In total, 90 K. pneumoniae isolates and 65 E. coli isolates were collected from various infections. Phenotypic identification of bacterial isolates was performed using standard methods. Phenotypic screening of ESBL, AmpC, and carbapenemase enzymes was carried out. Detection of ESBL, AmpC, and carbapenemase genes was also performed by the PCR method. Results: Phenotypic detection tests showed that 36 (40%) K. pneumoniae and 23 (35.4%) E. coli isolates were ESBL producers. Moreover, 18 (20%) and 6 (9.2%) K. pneumoniae and E. coli isolates were AmpC producers, respectively. Modified Hodge test results indicated that 39 H.K. and H.H. contributed equally to this work as first authors. This is an Open Access article licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense), applicable to the online version of the article only. Usage and distribution for commercial purposes requires written permission. 2 Med Princ Pract Kazemian et al. DOI: 10.1159/000500311 (43.3%) K. pneumoniae and 18 (27.7%) E. coli isolates produced carbapenemase. Molecular tests showed that 40% of K. pneumoniae and 36.9% of E. coli isolates were ESBL positive. AmpC was detected in 24.4 and 13.8% of K. pneumoniae and E. coli isolates. Carbapenemase was detected in 34 (37.8%) K. pneumoniae and 13 (20%) E. coli isolates. Conclusion: In this study, 3 K. pneumoniae isolates simultaneously carried ESBL, AmpC, and carbapenemase genes. Upto- date strategies such as combination therapy or utilization of new antimicrobial agents might help to combat such drug-resistant organisms. © 2019 The Author(s) Published by S. Karger AG, Basel Introduction Drug resistance in gram-negative bacteria is a worldwide challenge [1]. Major resistance to gram-negative pathogens is related to Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa [2]. In the Enterobacteriaceae family, Klebsiella pneumoniae and Escherichia coli have notable drug resistance. Also, they are the common cause of hospital- and community-acquired infections [3, 4]. The wide distribution of extended-spectrum β-lactamases (ESBLs) amongst Enterobacteriaceae has been attributed to the over- or misuse of these antibiotics [5]. ESBLs are able to hydrolyze various types of β-lactam antibiotics, including cephalosporins and monobactams. Therefore, treating infections caused by ESBL-producing bacteria has become a complicated issue [5, 6]. Dissemination of hospital-acquired infections can be prevented via early detection of infections caused by such microorganisms [7]. Carbapenems have been considered as the treatment of choice for ESBL-producing gram-negative bacterial infections. Carbapenemase-producing strains cause serious infections in hospitalized patients and are associated with mortality [8]; hence, the use of molecular techniques could be helpful in accurately diagnosing infections caused by ESBL- and carbapenemase-producing organisms. Drug-resistant strains of K. pneumoniae and E. coli in hospital-acquired infections are important [9]; thus, the aim of the present study was to determine the phenotypic and genotypic characterization of ESBL-, AmpC-, and carbapenemase-producing isolates of K. pneumoniae and E. coli obtained from hospital-associated infections in Tehran and Ilam (Iran). Materials and Methods Bacterial Strains A total of 90 K. pneumoniae and 65 E. coli isolates were obtained from various infections of hospitalized patients between April 2016 and March 2017 in Tehran and Ilam. Phenotypic and biochemical identification of bacterial isolates was performed according to standard methods [10]. Phenotypic Screening of ESBL, AmpC, and Carbapenemase Enzymes All isolates were initially screened for ESBL production by a combined disk method according to the guidelines of the Clinical Laboratory Standards Institute (CLSI) [11]. Briefly, susceptibility to cefotaxime (30 μg), cefotaxime/clavulanate (30/10 μg), ceftazidime (30 μg), and ceftazidime/clavulanate (30/10 μg) (Mast Co., UK) was determined on Müller-Hinton agar (Merck Co, Germany). ESBL-producing strains were recognized by an at least 5-mm increase in zone diameter around cefotaxime/clavulanate and ceftazidime/clavulanate disks in comparison with disks without clavulanic acid. E. coli ATCC 35218 was used as the control strain [11]. Cefoxitin disks (30 μg) were used to screen AmpC-producing isolates according to CLSI recommendations [11]. A cefoxitincloxacillin double-disk synergy test was carried out to confirm AmpC production, as previously described [12]. The modified Hodge test (MHT) was performed to screen carbapenemase- producing isolates [11]. K. pneumoniae ATCC BAA- 1705 and BAA-1706 were used as MHT-positive and -negative controls [11]. Detection of ESBL-, AmpC-, and Carbapenemase-Related Genes Polymerase chain reaction was performed using specific primers to detect genes encoding ESBLs (blaTEM, blaSHV, blaCTX-M, and blaPER), AmpC (blaACC, blaDHA, blaEBC, blaFOX, blaMOX, and blaCIT), and carbapenemase (blaIMP, blaVIM, blaNDM, blaKPC, and blaOXA-48-like), as previously described [13–17]. The products were separated by electrophoresis in 1% agarose gel with 1× TBE (Tris/ borate/EDTA) buffer, stained with safe stain load dye (CinnaGen Co., Tehran, Iran) and visualized under ultraviolet illumination. Statistical Analysis The distribution of resistance genes among resistant and susceptible isolates was calculated using χ2 and Fisher’s exact tests for each gene. p values ≤0.05 were considered to be statistically significant. 0 0 2013/04/212019/06/192015/07/272016/05/212016/11/25 1395/9/5 2013/05/282015/06/72015/07/262016/07/122017/01/4 1395/10/15 ایرج پاکزاد Iraj Pakzad مرکز تحقیقات میکروب شناسی بالینی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران pakzad_i2006@yahoo.com حسین کاظمیان Hossein Kazemian گروه آموزشی میکروب شناسی، دانشکده پزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران h.kazemian@outlook.com Klebsiella pneumoniae · Escherichia coli · ESBLs · AmpC · Carbapenemase کارباپنماز اشریشیا کلی کلبسیلا نومونیه 1 Frieri M, Kumar K, Boutin A. 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Association of mast cells and macrophage density with tumor angiogenesis in various type of oral and skin squamous cell carcinomas مقایسه ارتباط بین تراکم ماست سلهاو ماکروفاژها و ریز عروق خونی در انواع اسکواموس سل کارسینومای دهان و پوست 2 1 Alam M, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med 2001; 344:975-83. 2. Khiavi MM, Abdal K, Abbasi MM, et al. Comparison of injectable doxorubicin & its nanodrug complex chemotherapy for the treatment of 4-nitroquinoline-1-oxide induced oral squamous cell carcinoma in rats. Indian J Med Res 2017; 145:112. 3. Manfredini M, Longo C, Ferrari B, et al. Dermoscopic and reflectance confocal microscopy features of cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017; 31:1828-33. 4. Zaidi MA, Mallick AK. A study on assessment of mast cells in oral squamous cell carcinoma. Ann Med Health Sci Res 2014; 4:457–60. 5. Carlile J, Harada K, Baillie R. Vascular endothelial growth factor (VEGF) expression in oral tissues: possible relevance to angiogenesis, tumour progression and field cancerisation. J Oral Pathol Med 2013; 30:449-57. 6. Macluskey M, Chandrachud LM, Pazouki S. Apoptosis, proliferation, and angiogenesis in oral tissues. Possible relevance to tumour progression. J Pathol 2010; 191:368-75. 7. Gudiseva S, Santosh AB, Chitturi R, et al. The role of mast cells in oral squamous cell carcinoma. Contemp Oncol 2017; 21:21. 8. Cheema VS, Ramesh V, Balamurali PD. The relevance of mast cells in oral squamous cell carcinoma. J Clin Diagn Res 2012; 6:1803-07. 9. Conti P, Castellani ML, Kempuraj D, et al. Role of mast cell in tumor growth. Ann Clin Lab Sci 2007; 37:315-22. 10. Shivamallappa SM, Venkatraman NT, Shreedhar B, et al. Role of angiogenesis in oral squamous cell carcinoma development and metastasis: An immunohistochemical study. Int J Oral Sci 2011; 3:216-24. 11. Wadhwan V, Sharma P, Saxena C, et al. Grading angiogenesis in oral squamous cell carcinoma: A histomorphometric study. Indian J Dent Res 2015; 26:26-30. 12. Florence ME, Massuda JY, Bröcker EB, et al. Angiogenesis in the progression of cutaneous squamous cell carcinoma: An immunohistochemical study of endothelial markers. Clinics (Sao Paulo) 2011; 66:465-68. 13. Dodani A, Siadati S, Salehinejad J, et al. Comparative evaluation of the frequency ofAlam M, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med 2001; 344:975-83. 2. Khiavi MM, Abdal K, Abbasi MM, et al. Comparison of injectable doxorubicin & its nanodrug complex chemotherapy for the treatment of 4-nitroquinoline-1-oxide induced oral squamous cell carcinoma in rats. Indian J Med Res 2017; 145:112. 3. Manfredini M, Longo C, Ferrari B, et al. Dermoscopic and reflectance confocal microscopy features of cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017; 31:1828-33. 4. Zaidi MA, Mallick AK. A study on assessment of mast cells in oral squamous cell carcinoma. Ann Med Health Sci Res 2014; 4:457–60. 5. Carlile J, Harada K, Baillie R. Vascular endothelial growth factor (VEGF) expression in oral tissues: possible relevance to angiogenesis, tumour progression and field cancerisation. J Oral Pathol Med 2013; 30:449-57. 6. Macluskey M, Chandrachud LM, Pazouki S. Apoptosis, proliferation, and angiogenesis in oral tissues. Possible relevance to tumour progression. J Pathol 2010; 191:368-75. 7. Gudiseva S, Santosh AB, Chitturi R, et al. The role of mast cells in oral squamous cell carcinoma. Contemp Oncol 2017; 21:21. 8. Cheema VS, Ramesh V, Balamurali PD. The relevance of mast cells in oral squamous cell carcinoma. J Clin Diagn Res 2012; 6:1803-07. 9. Conti P, Castellani ML, Kempuraj D, et al. Role of mast cell in tumor growth. Ann Clin Lab Sci 2007; 37:315-22. 10. Shivamallappa SM, Venkatraman NT, Shreedhar B, et al. Role of angiogenesis in oral squamous cell carcinoma development and metastasis: An immunohistochemical study. Int J Oral Sci 2011; 3:216-24. 11. Wadhwan V, Sharma P, Saxena C, et al. Grading angiogenesis in oral squamous cell carcinoma: A histomorphometric study. Indian J Dent Res 2015; 26:26-30. 12. Florence ME, Massuda JY, Bröcker EB, et al. Angiogenesis in the progression of cutaneous squamous cell carcinoma: An immunohistochemical study of endothelial markers. Clinics (Sao Paulo) 2011; 66:465-68. 13. Dodani A, Siadati S, Salehinejad J, et al. Comparative evaluation of the frequency ofAlam M, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med 2001; 344:975-83. 2. Khiavi MM, Abdal K, Abbasi MM, et al. Comparison of injectable doxorubicin & its nanodrug complex chemotherapy for the treatment of 4-nitroquinoline-1-oxide induced oral squamous cell carcinoma in rats. Indian J Med Res 2017; 145:112. 3. Manfredini M, Longo C, Ferrari B, et al. Dermoscopic and reflectance confocal microscopy features of cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017; 31:1828-33. 4. Zaidi MA, Mallick AK. A study on assessment of mast cells in oral squamous cell carcinoma. Ann Med Health Sci Res 2014; 4:457–60. 5. Carlile J, Harada K, Baillie R. Vascular endothelial growth factor (VEGF) expression in oral tissues: possible relevance to angiogenesis, tumour progression and field cancerisation. J Oral Pathol Med 2013; 30:449-57. 6. Macluskey M, Chandrachud LM, Pazouki S. Apoptosis, proliferation, and angiogenesis in oral tissues. Possible relevance to tumour progression. J Pathol 2010; 191:368-75. 7. Gudiseva S, Santosh AB, Chitturi R, et al. The role of mast cells in oral squamous cell carcinoma. Contemp Oncol 2017; 21:21. 8. Cheema VS, Ramesh V, Balamurali PD. The relevance of mast cells in oral squamous cell carcinoma. J Clin Diagn Res 2012; 6:1803-07. 9. Conti P, Castellani ML, Kempuraj D, et al. Role of mast cell in tumor growth. Ann Clin Lab Sci 2007; 37:315-22. 10. Shivamallappa SM, Venkatraman NT, Shreedhar B, et al. Role of angiogenesis in oral squamous cell carcinoma development and metastasis: An immunohistochemical study. Int J Oral Sci 2011; 3:216-24. 11. Wadhwan V, Sharma P, Saxena C, et al. Grading angiogenesis in oral squamous cell carcinoma: A histomorphometric study. Indian J Dent Res 2015; 26:26-30. 12. Florence ME, Massuda JY, Bröcker EB, et al. Angiogenesis in the progression of cutaneous squamous cell carcinoma: An immunohistochemical study of endothelial markers. Clinics (Sao Paulo) 2011; 66:465-68. 13. Dodani A, Siadati S, Salehinejad J, et al. Comparative evaluation of the frequency ofAlam M, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med 2001; 344:975-83. 2. Khiavi MM, Abdal K, Abbasi MM, et al. Comparison of injectable doxorubicin & its nanodrug complex chemotherapy for the treatment of 4-nitroquinoline-1-oxide induced oral squamous cell carcinoma in rats. Indian J Med Res 2017; 145:112. 3. Manfredini M, Longo C, Ferrari B, et al. Dermoscopic and reflectance confocal microscopy features of cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2017; 31:1828-33. 4. Zaidi MA, Mallick AK. A study on assessment of mast cells in oral squamous cell carcinoma. Ann Med Health Sci Res 2014; 4:457–60. 5. Carlile J, Harada K, Baillie R. Vascular endothelial growth factor (VEGF) expression in oral tissues: possible relevance to angiogenesis, tumour progression and field cancerisation. J Oral Pathol Med 2013; 30:449-57. 6. Macluskey M, Chandrachud LM, Pazouki S. Apoptosis, proliferation, and angiogenesis in oral tissues. Possible relevance to tumour progression. J Pathol 2010; 191:368-75. 7. Gudiseva S, Santosh AB, Chitturi R, et al. The role of mast cells in oral squamous cell carcinoma. Contemp Oncol 2017; 21:21. 8. Cheema VS, Ramesh V, Balamurali PD. The relevance of mast cells in oral squamous cell carcinoma. J Clin Diagn Res 2012; 6:1803-07. 9. Conti P, Castellani ML, Kempuraj D, et al. Role of mast cell in tumor growth. Ann Clin Lab Sci 2007; 37:315-22. 10. Shivamallappa SM, Venkatraman NT, Shreedhar B, et al. Role of angiogenesis in oral squamous cell carcinoma development and metastasis: An immunohistochemical study. Int J Oral Sci 2011; 3:216-24. 11. Wadhwan V, Sharma P, Saxena C, et al. Grading angiogenesis in oral squamous cell carcinoma: A histomorphometric study. Indian J Dent Res 2015; 26:26-30. 12. Florence ME, Massuda JY, Bröcker EB, et al. Angiogenesis in the progression of cutaneous squamous cell carcinoma: An immunohistochemical study of endothelial markers. Clinics (Sao Paulo) 2011; 66:465-68. 13. Dodani A, Siadati S, Salehinejad J, et al. Comparative evaluation of the frequency of 2 Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC.Mast cells and microvessel play an important role in tumor development and progression through angiogenesis. Because of the more aggressive potential and poor prognosis of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC), the aim of the present study was to compare of density of mast cells and microvessel between in oral and cutaneous squamous cell carcinoma. In this study cross-sectional study, we performed an immuno histochemical analysis in 100 paraffin blocks that included 40 cases of OSCC and 40 CSCC and 20 cases of normal skin and normal oral mucosa. Mast cells and microvascular density were stained by mast cell tryptase and immunohistochemistry assay using CD34. Statistical analyses were performed in SPSS 16 software. There was a significant statistical correlation (*P<0.05) between mast cell concentration and microvascular density in OSCC and CSCC compared to control groups. In OSCC the mast cell concentration and microvascular density were significantly higher (*P<0.05) compared with the CSCC. Therefore, according findings present study, mast cell concentration and microvascular density may be used as a factor for detecting the progression, malignant potential and invasion of OSCC compared to CSCC. 0 0 2013/04/212019/06/192015/07/272016/05/212016/11/252017/01/24 1395/11/5 2013/05/282015/06/72015/07/262016/07/122017/01/42017/02/20 1395/12/2 خدیجه ابدال محمودآبادی Khadijeh Abdal mahmoodabadi گروه آموزشی پاتولوژی دندان، دانشکده دندانپزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران dr.faribaabdal@yahoo.com Key words: Squamous cell carcinoma Mast cell Microvessel Prognosis ##سرطان دهان یک مشکل جدی و در حال افزایش در بخش وسیعی از جهان است. بروز سالانه سرطان دهان ، 275000 مورد است که دو سوم آن در کشورهای در حال توسعه اتفاق می افتد. ##کارسینوم سلول سنگفرشی 1شایع ترین بدخیمی حفره دهان می باشد که درمان آن، شامل جراحی و پرتودرمانی و شیمی درمانی می باشد. بقای پنج ساله کارسینوم سلول سنگفرشی دهان در جهان بین 30 تا 80 درصد و در ایران 30 درصد گزارش شده است . به علت پیشرفتهایی که در زمینه تشخیص و درمان سرطان در سالهای اخیر صورت گرفته است بقاء بیماران در مورد سرطانهای پستان، کولون، تخمدان و ... افزایش یافته است. اما در زمینه سرطان دهان در 50 سال گذشته بقاء بیماران تغییر نکرده است.##ماست سلها و ماکروفاژها از سلولهای بنیادی در مغز استخوان منشعب می شوند و نه تنها در واکنشهای حساسیت بلکه در آماس، خود ایمنی و پاسخهای ایمنی با واسطه لنفوسیتهای T دارای نقش هستند .ماست سلها و ماکروفاژها در اطراف عروق به صورت موضعی قرار داشته و یک منبع مهم برای سایتوکاین ها و کموکاینهای مختلف هستند .##ماست سلها ممکن است سبب از بین رفتن تومور از طریق تولید مولکولهایی نظیر اینترلوکین‌های 1 ، 4 ، 6 و TNF شوند. علیرغم این مساله، ماست سلها ممکن است سبب رشد تومور بوسیله گسترش ذخایر خونی (آنژیوژنز) بواسطه ماتریکس خارج سلولی شوند. آنژیوژنز (رگ زایی) به معنی تشکیل مویرگهای جدید از عروق اولیه است که در رشد تومورهای توپر ضروری می باشد. ماست سل ها ،تولید کننده چندین عامل آنژیوژنیک مانند هیستامین، هپارین ،تریپتاز bFGF, Chymase، VEGF میباشند. ##در سرطانهای پروستات ،لنفوم ، و دستگاه گوارش افزایش تراکم ماست سلها با نتایج درمانی ضعیف همراه بوده است. ##در بعضی مطالعات به نقش محافظتی ماست سلها در سرطان اشاره شده است. به عنوان مثال به رابطه مثبت بین ماست سلها و نتایج بهتر درمانی در تومورهای پروستات اشاره گردیده است . ##نقش ماست سلها در سرطان دهان نیز مورد مطالعه قرار گرفته است .در یک مطالعه آزمایشگاهی مشخص شد که ماست سلها اثر بازدارندگی روی تکثیر سلولهای SCC مخاط دهان دارند. اما در مطالعه ی حیوانی انجام شده، فعالیت ماست سلها همراه با افزایش تکثیر سلولهای تومورال حفره دهان بوده است .##در این مطالعه مقایسه ارتباط بین تراکم ماست سلهاو ماکروفاژها و ریز عروق خونی در اسکواموس سل کارسینومای دهانی و پوستی مورد مقایسه قرار خواهد گرفت تا علاوه بر مشخص شدن رابطه ماست سلها با تراکم ریز عروق خونی و تراکم ماکروفاژهادر اسکواموس سل کارسینوما ، مقایسه انواع این کانسر بدخیم در دو نوع داخل دهانی و پوستی مورد مقایسه قرار گیرد. ##

The prevalence of job burnout in Iran: A systematic review and metanalysis شیوع فرسودگی شغلی در ایران: مطالعه مرور سیستماتیک و متاآنالیز 2 1 یکی از مفاهیمی که در سالهای اخیر توجه روانشناسان صنعتی سازمانی را به خود جلب کرده است ، خستگی ، بی حالی ، بی حالی ، تنبلی و بی حالی مدیر شغل است که به آن فرسودگی شغلی می گویند (1). بخشی از زندگی روزمره هر شخصی در محل کار سپری می شود ، همیشه عوامل متعددی به عنوان منبع استرس در محل کار وجود دارد که اگر فردی نتواند به طور م withثر با این فشارهای روانی کنار بیاید ، از بسیاری از عوارض جسمی ، روانی و رفتاری رنج می برد. و در نهایت منجر به فرسودگی شغلی شوید .اول ، مقالات مربوط به شیوع فرسودگی شغلی در ایران با مراجعه به پایگاه های اطلاعاتی معتبر در داخل و خارج از کشور جمع آوری می شود. مقالات جمع آوری شده بین سالهای 1974 تا 2016 خواهد بود. مقالات مربوط به موضوع تحقیق جمع آوری می شوند و مقالاتی که دارای معیارهای ورود به پژوهش هستند انتخاب شده و برای تجزیه و تحلیل نهایی بررسی می شوند. 2 One of the concepts that has attracted the attention of organizational industrial psychologists in recent years is fatigue, lethargy, lethargy, sluggishness and lethargy of the job manager, which is called burnout (1). Part of every person's daily life is spent at work, there are always several factors as a source of stress in the workplace that if a person is not able to cope effectively with these psychological pressures, he will suffer from many physical, psychological and behavioral complications and eventually lead Get into burnout .First, articles related to the prevalence of burnout in Iran are collected by referring to reputable databases inside and outside the country. The collected articles will be between 1974 and 2016. The articles related to the research topic will be collected and the articles that have the criteria for entering the research will be selected and will be reviewed for the final analysis. 0 0 2013/04/212019/06/192015/07/272016/05/212016/11/252017/01/242017/01/24 1395/11/5 2013/05/282015/06/72015/07/262016/07/122017/01/42017/02/202017/03/13 1395/12/23 طاهره بسطامی Tahereh Bastami ایران- ایلام، انتهای بلوار پژوهش ایران taherh.bastami93@gmail.com کورش سایه میری Kourosh Sayehmiri مرکز تحقیقات آسیب‌های روانی و اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران sayehmiri-k@medilam.ac.ir prevalence + job burnout in Iran+A systematic review and metanalysis شیوع +فرسودگی شغلی در ایران+ مطالعه مرور سیستماتیک و متاآنالیز 1.Saatchi M.[Mental Hygiene In Work].Tehran: Virayesh; 2014.(Persian)##2.Roghanizad N, Vatanpoor M, SeddighOraee S, Sharifi V, Abbasi M. Prevalence of Burnout Syndrome and Its Three Dimensions in Dental Faculty Members of Azad Dental University in 2008. The Journal of Islamic Dental Association of IRAN (JIDA) . 2013; 25 (1) :45-52.##3.Akhondi N, Aghaalikhani A.M.[Positive Psychology]. Tehran: Neyvand; 2015.[Persian].##4. Ziaei M, Yarmohammadi H, Karamimatin B, Yarmohammadi S, Nazari Z, Gharagozlou F. Prevalence and risk factors of occupational burnout among nurses of a hospital in Kermanshah in 2013. Journal of Ergonomics. 2014; 2 (2) :67-74.##5. BehboodiMoghadm Z,Maleki N,Rahimikian F.Prevalence of burnout in midwives working in teaching hospitals and health centers.PAYESH;2014.13;3.339-346.##6.Khatiban1 M, Hosseini S,BikmoradiA ,Roshanaei GH.Karampourian A. Occupational Burnout and Its Determinants among Personnel ofEmergency Medical Services in Iran.ActaMedica Iranica,.2015: 53;11.##7.Bahrami F, Mokhtari S. prevalence of burnout and its associated factors among Isfahan university master.Journal of Career and Organization Consulting.2008:2:2.##1.Saatchi M.[Mental Hygiene In Work].Tehran: Virayesh; 2014.(Persian)##2.Roghanizad N, Vatanpoor M, SeddighOraee S, Sharifi V, Abbasi M. Prevalence of Burnout Syndrome and Its Three Dimensions in Dental Faculty Members of Azad Dental University in 2008. The Journal of Islamic Dental Association of IRAN (JIDA) . 2013; 25 (1) :45-52.##3.Akhondi N, Aghaalikhani A.M.[Positive Psychology]. Tehran: Neyvand; 2015.[Persian].##4. Ziaei M, Yarmohammadi H, Karamimatin B, Yarmohammadi S, Nazari Z, Gharagozlou F. Prevalence and risk factors of occupational burnout among nurses of a hospital in Kermanshah in 2013. Journal of Ergonomics. 2014; 2 (2) :67-74.##5. BehboodiMoghadm Z,Maleki N,Rahimikian F.Prevalence of burnout in midwives working in teaching hospitals and health centers.PAYESH;2014.13;3.339-346.##6.Khatiban1 M, Hosseini S,BikmoradiA ,Roshanaei GH.Karampourian A. Occupational Burnout and Its Determinants among Personnel ofEmergency Medical Services in Iran.ActaMedica Iranica,.2015: 53;11.##7.Bahrami F, Mokhtari S. prevalence of burnout and its associated factors among Isfahan university master.Journal of Career and Organization Consulting.2008:2:2. ##

Epidemiology of celiac disease in irritable bowel syndrome patients in Iran: a systematic review and met analysis study اپیدمیولوژی سلیاک در بیماران سندرم روده ی تحریک پذیر ایران: یک مطالعه ی مرور سیستماتیک و متاآنالیز 2 1 زمینه:  با توجه به مشابهت علایم بیماری سلیاک (CD) و سندرم روده تحریک پذیر(IBS)، هر دو در تشخیص افتراقی دیگری قرار می گیرند. لذا مطالعه حاضر با هدف بررسی اپیدمیولوژیک CD در بیماران IBS ایران با استفاده از روش های مرور سیستماتیک و متاآنالیز انجام شده است. روش کار: مطالعه کنون براساس گایدلاین PRISMA انجام شد. پایگاه داده های آنلاین بین المللی و ملی (Scopus، PubMed، Science Direct ، Cochrane ، Embase، Web of Science، Magiran ، Iranmedex، SID، Medlib ، IranDoc و هم چنین موتورجستجوی Google Scholar) به صورت سیستماتیک جستجو شدند. برای ارزیابی ناهمگنی مطالعات از آزمون کوکران و شاخص I2 استفاده شد. انالیز داده ها براساس مدل اثرات تصادفی انجام شد. آنالیز آماری با استفاده از Comprehensive Meta-Analysis Software انجام شد. سطح معنا داری آزمون ها 0.05 P< در نظر گرفته شد. نتایج: 11 مطالعه وارد متاآنالیز شدند. میانگین سنی بیماران مبتلا به IBS 33.14 (95% CI: 31.33-34.95) سال برآورد گردید. شیوع CD در بیماران 2367 بیمار  IBS ایرانی 6.13% (95% CI: 4.11-6.05) براورد گردید. نسبت زن و مرد CD (OR= 1.69 (95%CI: 0.86-3.32, P=0.127)) بود. شیوع سرولوژیک Anti tTG-IgA (11 مطالعه با حجم 29.1 بیمار IBS) و AGA-IgG CD (4 مطالعه با 936 بیمار IBS) به ترتیب 5.35% (95% CI: 3.60-7.89) و 6.35% (95% CI: 2.05-18.03) برآورد گردید. شیوع علائم بالینی CD در میان بیماران IBS به صورت اسهال غالب(IBS-D) [47.78% (95% CI: 22.46-74.43)] ، یبوست غالب(IBS-C) [17.34% (95% CI: 9.17-30.35)] و الترنیتیو اسهال و یبوست (IBS-M) [27.84% (95% CI: 11.57-53.23)] بود. براساس طبقه بندی Marsh، شیوع استیج های 1، 2 و 3 سلیاک به ترتیب 30.89% (95% CI: 13.25-56.68)، 36.56% (95% CI: 21.74-54.45) و 52.82% (95% CI: 14.48-88.13) برآورد گردید. نتیجه گیری: شیوع CD در بیماران IBS ایران بالا می باشد و نسبت به برآوردهای جهانی بالاتر می باشد. به نظر می رسد بررسی تمام بیماران IBS از نظر CD ضروری می باشد. 2 Aim: The present study was conducted to evaluate the prevalence, clinical symptoms and pathological findings of celiac disease (CD) in IBS patients in Iran. Background: Several studies show high prevalence of CD in IBS patients, but the results are contradictory Methods: The present study was conducted based on PRISMA protocol. The search was done using national and international online databases including Scopus, PubMed, Science Direct, Cochrane Library, Embase, Web of Science, Google Scholar search engine and Iranian databases. Results: The pooled prevalence of CD in 2367 Iranian IBS patients was estimated to be 6.13% (95%CI: 4.11-6.05). The CD female-to-male ratio was: OR = 1.69 (95%CI: 0.86-3.32, P = 0.127). The serological prevalence of Anti tTG-IgA (11 studies with 2901 IBS patients) and AGA-IgG CD (4 studies with 936 IBS patients) was estimated to be 5.35% (95%CI: 3.60-7.89) and 6.35% (95% CI: 2.05-18.03), respectively. The clinical symptoms of CD among IBS patients included predominant diarrhea (47.78% [95%CI: 22.46-74.43]), predominant constipation (17.34% [95%CI: 9.17-30.35]), and alternative diarrhea and constipation (27.84% [95%CI: 11.57-53.23]). According to pathological findings based on Marsh classification, the prevalence of CD at stages 1, 2 and 3 were 30.89% (95%CI: 13.25-56.68), 36.56% (95%CI: 21.74-54.45) and 52.82% (95% CI: 14.48-88.13), respectively. Conclusion: CD prevalence in Iranian IBS patients is higher than global estimates. It seems that examination of all IBS patients in terms of CD is necessary 0 0 2013/04/212019/06/192015/07/272016/05/212016/11/252017/01/242017/01/242018/06/19 1397/3/29 2013/05/282015/06/72015/07/262016/07/122017/01/42017/02/202017/03/132019/01/20 1397/10/30 میلاد اعظمی Milad Azami دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران milad98azami@gmail.com Celiac disease Irritable bowel syndrome Meta-Analysis Iran. بیماری سلیاک سندرم روده تحریک پذیر 1. Green PHR, Cellier C. Celiac disease. N Engl J Med. Mass Medical Soc; 2007;357(17):1731-1743.##2. Ahadi Z1, Shafiee G, Razmandeh R, Keshtkar AA, Najafi Sani M, Azemati B, Sanaei M, Heshmat R. Prevalence of celiac disease among the Iranian population: A systematic review and meta-analysis of observational studies. Turk J Gastroenterol. 2016 Mar;27(2):122-8. doi: 10.5152/tjg.2015.150191.##3. Green PH. Themany faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology 2005; 128(4 Suppl 1): S74-8.##4. Farrell RJ, Kelly CP. Celiac sprue. N Engl J Med 2002; 346(3): 180-8.##5. Green PHR. The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology. Elsevier; 2005;128(4):S74-78.##6. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Harrison’s principles of internal medicine. NewYork: Mc Graw- Hill; 2008.p.1899-1903.##7. Dickson BC, Streutker CJ, Chetty R. 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Epidemiology of Multiple Sclerosis in Iran: A Systematic Review and Meta-analysis اپیدمیولوژی بیماری مولتیپل اسکلروزیس در ایران: یک مطالعه مرور سیستماتیک و متاآنالیز 2 1 شیوع MS در ایران بصورت متفاوت در بازه 5.3 تا 89 در 100،000 گزارش شده است. با توجه به controversy در گزارش میزان شیوع MS، این مطالعه به روش مرور سیستماتیک همه مستندات و ترکیب آن ها به روش متاآنالیز جهت برآورد کلی شیوع MS در ایران صورت گرفت. روش کار: بررسی سیستماتیک حاضر با تمرکز بر اپیدمیولوژی MS در ایران بر اساس گایدلاین PRISMA برای مطالعات مرور سیستماتیک و متاآنالیز انجام شد. چهار پایگاه های فارسی زبان Magiran، Iranmedex، SID، Medlib و هفت پایگاه انگلیسی زبان بین المللی Scopus، PubMed، Science Direct ، Cochrane، Web of Science،  Embase، PsycINFO  و هم چنین موتور جستجوی Google Scholar برای مطالعات  peer-reviewed منتشر شده بدون محدودیت زمانی تا May سال 2018 جستجو شدند. داده ها با استفاده از نرم افزار Comprehensive meta-analysis ver. 2 آنالیز شدند. نتایج: با توجه به جستجو در پایگاه های مختلف، 39 (15٪) مقاله نهایی شد. بر اساس مدل اثرات تصادفی: شیوع MS در ایران 29.3/ 100,000 (95%CI: 25.6-33.5) برآورد شد. شیوع MS در زنان و مردان به ترتیب16.5/ 100,000 (95%CI: 13.7-23.4)  و  44.8/ 100,000 (95%CI: 36.3-61.6)تخمین زده شد. بروز MS در ایران3.4/ 100,000 (95%CI: 1.8-6.2)  بر اساس مدل اثرات تصادفی محاسبه شد. بروز MS در مردان 1.2/ 100,000 (95%CI: 1.0-1.4)  و بروز MS در زنان 48.2/ 100,000 (95%CI: 39.3- 59.1) بود. مدل رگرسیون فراوانی برای شیوع و و بروز  MS بر حسب سال به طور معنی داری سیر صعودی داشت. نتیجه گیری: نتایج این مطالعه می تواند یک تصویر کلی اپیدمیولوژیک از MS در ایران ارائه دهد.  متاآنالیز حاضر نشان می دهد شیوع MS در ایران بالا و با گذشت زمان به سرعت در حال افزایش است. 2 Background Multiple sclerosis (MS) is one of the most common neurological disorders and is one of the main causes of disability. The prevalence and incidence of MS in Iran is reported to range from 5.3 to 89/ 100,000and 7 to 148.1/ 100,000, respectively. There are no systematic and meta-analysis studies on MS in Iran. Therefore, this study was conducted to investigate the prevalence and incidence of MS in Iran using meta-analysis. Method  A systematic review of the present study focused on MS epidemiology in Iran based on PRISMA guidelines for systematic review and meta-analysis. We searched eight international databases including Scopus, PubMed, Science Direct, Cochrane Library, Web of Science, EMBASE, PsycINFO, Google Scholar search engine and six Persian databases for peer-reviewed studies published without time limit until May 2018. Data were analyzed using Comprehensive meta-analysis ver. 2 software. The review protocol has been registered in PROSPERO with ID: CRD42018114491. Results According to searching on different databases, 39 (15%) articles finalized. The prevalence of MS in Iran  was estimated 29.3/ 100,000 (95%CI: 25.6-33.5) based on random effects model. The prevalence of MS in men and women was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and 44.8/ 100,000 (95%CI: 36.3-61.6), respectively. The incidence of MS in Iran was estimated to be 3.4/ 100,000 (95%CI: 1.8-6.2) based on random effects model. The incidence of MS in men was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and the incidence of MS in women was 44.8/ 100,000 (95%CI: 36.3-61.6). The meta-regression model for prevalence and incidence of MS was significantly higher in terms of year of study (p<0.001). Conclusions The results of this study can provide a general picture of MS epidemiology in Iran. 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The Effect of Acupuncturing Pericardium 6 (nei guan) on Nausea and Vomiting in Patients under Appendectomy Operation with General Anesthesia تاثیر طب سوزنی نقطه شماره 6پریکاردیال بر تهوع و استفراغ در بیماران تحت عمل جراحی آپاندکتومی با بیهوشی عمومی 2 1 مقدمه:استفاده از طب سوزنی در حال گسترش است.مطالعات فراوانی از طب سوزنی بر نقطهp6  برای کاهش تهوع و استفراغ بعد از عمل های جراحی استفاده کرده اند،و نتایج متفاوت وگاه متناقضی را گزارش کرده اند.مطالعه حاضر با هدف تعیین تاثیر طب سوزنی نقطه p6 بر تهوع و استفراغ در بیماران پس از عمل جراحی آپاندکتومی انجام شده است. مواد و روشها: این مطالعه به روش کارآزمایی بالینی و دوسوکور برروی 150 بیمار آپاندکتومی شده انجام شد.بیماران به صورت تصادفی به سه گروه مداخله، پلاسبو و کنترل تقسیم شدند. در گروه مداخله نیم ساعت قبل از القای بیهوشی سوزن مخصوص طب سوزنی در نقطه p6 قرار داده شد.در گروه پلاسبو سوزن تلسکوپیک در نقطهp6 تعبیه شد و در گروه کنترل هیچ مداخله ای صورت نگرفت.شدت تهوع و استفراغ بیماران پس از جراحی و تا 24 ساعت بعد توسط پرسشنامه رودزاندازه گیری و ثبت شد. داده ها با استفاده از نرم افزار spss16 و آزمونهای توصیفی و استنباطی(ANOVA  ،  Chi-Square  وkruskal-wallis ) آنالیز شدند. یافته ها: تفاوت آماری معنی داری بین سه گروه از نظر سن، جنس، شاخص توده بدنی و سطح تحصیلات مشاهده نشد. شدت تهوع و استفراغ در گروه مداخله در تمام ساعات پس از جراحی کمتر از گروه پلاسبو و کنترل بود، ولی در طی 6 ساعت اول پس از جراحی از نظر آماری معنا دار نبود(54/0p= ).در ساعات 12-7 بعد از جراحی(00/0p=  )ودر ساعات 24-13پس از جراحی معنی دار بود. (009/0p=)در مجموع 7 بیمار تهوع و استفراغ شدید  داشتند (1نفر گروه مداخله، 2نفر گروه پلاسبو و 4 نفر گروه کنترل). نتیجه گیری: طب سوزنی نقطه p6 تاثیر معنی داری در کاهش تهوع و استفراغ در بیماران تحت عمل آپاندکتومی دارد.   2  مقدمه:استفاده از طب سوزنی در حال گسترش است.مطالعات فراوانی از طب سوزنی بر نقطهp6  برای کاهش تهوع و استفراغ بعد از عمل های جراحی استفاده کرده اند،و نتایج متفاوت وگاه متناقضی را گزارش کرده اند.مطالعه حاضر با هدف تعیین تاثیر طب سوزنی نقطه p6 بر تهوع و استفراغ در بیماران پس از عمل جراحی آپاندکتومی انجام شده است. مواد و روشها: این مطالعه به روش کارآزمایی بالینی و دوسوکور برروی 150 بیمار آپاندکتومی شده انجام شد.بیماران به صورت تصادفی به سه گروه مداخله، پلاسبو و کنترل تقسیم شدند. در گروه مداخله نیم ساعت قبل از القای بیهوشی سوزن مخصوص طب سوزنی در نقطه p6 قرار داده شد.در گروه پلاسبو سوزن تلسکوپیک در نقطهp6 تعبیه شد و در گروه کنترل هیچ مداخله ای صورت نگرفت.شدت تهوع و استفراغ بیماران پس از جراحی و تا 24 ساعت بعد توسط پرسشنامه رودزاندازه گیری و ثبت شد. داده ها با استفاده از نرم افزار spss16 و آزمونهای توصیفی و استنباطی(ANOVA  ،  Chi-Square  وkruskal-wallis ) آنالیز شدند. یافته ها: تفاوت آماری معنی داری بین سه گروه از نظر سن، جنس، شاخص توده بدنی و سطح تحصیلات مشاهده نشد. شدت تهوع و استفراغ در گروه مداخله در تمام ساعات پس از جراحی کمتر از گروه پلاسبو و کنترل بود، ولی در طی 6 ساعت اول پس از جراحی از نظر آماری معنا دار نبود(54/0p= ).در ساعات 12-7 بعد از جراحی(00/0p=  )ودر ساعات 24-13پس از جراحی معنی دار بود. (009/0p=)در مجموع 7 بیمار تهوع و استفراغ شدید  داشتند (1نفر گروه مداخله، 2نفر گروه پلاسبو و 4 نفر گروه کنترل). نتیجه گیری: طب سوزنی نقطه p6 تاثیر معنی داری در کاهش تهوع و استفراغ در بیماران تحت عمل آپاندکتومی دارد.   0 0 2013/04/212019/06/192015/07/272016/05/212016/11/252017/01/242017/01/242018/06/192018/06/192019/06/19 1398/3/29 2013/05/282015/06/72015/07/262016/07/122017/01/42017/02/202017/03/132019/01/202019/01/202020/01/21 1398/11/1 معصومه شوهانی Masoumeh Shohani گروه آموزشی پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران msh282000@gmail.com ابراهیم خلیقی Ebrahim Khalighi گروه آموزشی هوشبری، دانشکده پیراپزشکی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران ebkh1343jrm@yahoo.com کورش سایه میری Kourosh Sayehmiri مرکز تحقیقات آسیب‌های روانی و اجتماعی، دانشگاه علوم پزشکی ایلام، ایلام، ایران ایران sayehmiri-k@medilam.ac.ir Keywords:Acupuncture appendectomy nausea vomiting P6 کلید واژه ها: طب سوزنی آپاندکتومی تهوع استفراغ نقطهp6 . 1. Hana OH ،Hwan BO. Comparing effects of two different##type of nei-guan acupuncture stimulation device in##reducing postopearative nausea and vomiting. J##PeriAnesthesia Nurs. 2017; 32(3):177-187.##2. Frey UH, Sharman p, ¨haling C, Peters J. P6 acu stimulation effectively decreases postoperative nausea and vomiting in high-risk patients. J Anaesth 2009; 102(5):620-5.##3. Saleh RH. Efficacy of laser acupuncture in attenuating hemodynamic response to orotracheal intubation and postoperative nausea and vomiting in children undergoing strabismus surgery.2014; 30(4):411-416.##4. Allen TK, Habib AS. P6 Stimulation for the Prevention of Nausea and Vomiting Associated with Cesarean Delivery Under Neuraxial Anesthesia. Anesth analg.2008; 107(4):1308-12.##5. Michae Arnberger M, Stadelmann K, Alischer P, Ponert R, Melber A, Robert Greif. Monitoring of Neuromuscular Blockade at the P6 Acupuncture Point Reduces the Incidence of Postoperative Nausea and Vomiting. Anesthesiology 2007; 107:903–8.##6. Huei -Mein Chen, Fang -Yi Chang, Ching-Tai.effect of acupressure on nausea, vomiting, anxiety and pain among post-cesarean section women in taiwan. J medical scince. 2005; 21(8):341-350.##7. Li S, Zheng M, wu w, Guo J, zheng Z. effects of electroacupuncture administered 24 hours prior to surgery on postoperative nausea and vomiting and pain in patients undergoing gynecologic laparoscopic surgery. explore (NY). 2017; 13(5):313-318.##8. Apfel CC, Kinjo British journal of anesthesia (2009); volume102, number (5):585-7.##9. Gruenberg SM. chemotherapy-induced nausea and vomiting: prevention, detection, and treatment how are we doing? J support oncol2004; 2(1):1-10.##10. parsa yekta Z, Ibrahim SM, Hosseini M, nikbakht nasrabadi A, sedighi S, Salehi surmaghi MH. Appeal of herbal plants as a mechanism for the relief of acute vomiting induced by chemo Therapy.J medical sciences.2012;18(93):9-33.##11. Molassiotis A, Helin AM, Dabbour R, Hummerston S. the effect of p6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast Cancer patients. J Complement Ther med .2007; 15(1):3-12.##12. taspinar A, Sirin A. effect of acupressure on chemotherapy-induced nausea and vomiting in gynecologic cancer patient in turkey. J oncology nurse.2010; 14(1):49-54.##13. Liao GS, Apaya MK, Shyur LF. Herbal medicine and acupuncture for breast cancer palliative care and adjuvant therapy. evid based complement alternat Med.2013; 2013: 437948.##14. Puangsricharen A, Mahasukhon S. effectiveness of auricular acupressure in the treatment of nausea and vomiting in early pregnancy. J med assocthai.2008Nov; 91(11):1633-8.##15. Sadat Husseini AS. [ effect of music therapy on chemotherapy nausea and vomiting in children with malignany]. Hayat, Journal of school of nursing and Midwifery, J Tehran university of medical science.2009;15920:5-14.##16. Molassiotis A, Russell W, Hughes J, Brackens M, Lloyd - Williams M, Richardson J, et al. The Effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: a randomized controlled trial. J pain symptom manang.2014 Jan; 47:12-25.##17. Noroozinia H, Mahorais A, Hassani E, Gerami -fahim M, Sepehrvand M. the effect of acupressure on nausea and vomiting after cesarean section under spinal anesthesia Acute Med Iran.2013Apr;51(3):163-7.##18. Sheng-Teng Huang, Gau-Yang Chen, Huey-Ming Lo, Jaung-Gang Lin, Yin-Shiung Lee, Cheng-Deng Kuo. Increase in the Vagal Modulation by Acupuncture at Neiguan Point in the Healthy Subjects. The American Journal of Chinese Medicine. 2005; 33(1): 157–164.##19. Schlager A, Boehler M. puhringer Corean hand acupressure reduce. postoperative vomiting in children after strabismus surgery. british journal of anesthesia2000; 85 (2): 267- 270.##20. Sadri B, Maddah M, Rahimzadeh Bajgiran P. Evaluation of Acupressure Effects on the Control of postoperative Nausea and Vomiting after Gynecologic Diagnostic Laparascopy under General Anesthesia in Hazrat-Rasool Medical Complex. JMedical Sciences Iran university.2005; 12(48):113-117.##21. Naseri k, shami SH, zogagikohan M. The effect of acupressure on postoperative nausea and vomiting. hormozgan medical journal.2006; 4(1):353-7.##Masoumeh Shohani, et al.: The effect of acupuncturing pericardium##40 Journal of Advanced Pharmacy Education & Research | Oct-Dec 2018 | Vol 8 | Issue S2##22. Nikbakht N, Alizadeh z, imanpoor m, hosseini SM, sadrosadate SH, heshmat R. The effect of acupressure on nausea reduction in patient undergoing strabismus surgery. J Tehran medical science 2011; 17(4):26-35.##23. Agarwal A, Bose N MD, Gaur A, Singh U, Gupta MK MD, Singh D. Acupressure and ondansetron for postoperative nausea and vomiting after laparoscopic cholecystectomy. J Anaesth 2002; 49(6):554-60.##24. chen B, ho SH, lio BH, zhao TY, li B, lio Y, et al. Efficacy and safety of electroacu puncture with different acu points for chemotherapy-induced nausea snd vomiting. j trials 2015; 16:212.##25. Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology. 2012; 77(1):162-184.##26. Lin X, Liang J, Ren J, Mu F, Zhang M, Chen JD. Electrical stimulation of acupuncture points enhances gastric my oelectrical electrical activity in humans. Am J Gastroenterol. 2007; 92:1527-1530.##27. Zhou Q. O’Brien B. Soeken K. Rhodes index of Nausea and vomiting form 2 in pregnant women: confirmatory factor analysis. Nursing Research. 2001; 50: 251-257.##28. Noori SH. investigation factors associated with nausea and vomiting in the first trimester of pregnancy. Iran nursing journal. 2003; 17 (37):8-13.##29. Lee A, mary L. 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The effect of acu puncture on pain, nausea and vomiting after appendectomy. quarterly journal of complementary medicine.2012;2.##منابع##1. Hana OH، 1. Hwan BO. Comparing effects of two different type of nei-guan acupuncture stimulation device in reducing postoperative nausea and vomiting. J Pere Anesthesia Nurse. 2017; 32(3): 177-187. ## 2. Frey UH, Sharman p, ¨haling C, Peters J. P6 acustimulation effectively decreases postoperative nausea and vomiting in high-risk patients. J Anaesth 2009; 102(5): 620-5. ##3. Saleh RH. Ecacy of laser acupuncture in attenuating hemodynamic response to orotracheal intubation and postoperative nausea and vomiting in children undergoing strabismus surgery. 2014; 30(4): 411-416. ##4. Allen TK, Habib AS. P6 Stimulation for the Prevention of Nausea and Vomiting Associated with Cesarean Delivery under Neuraxial anesthesia. Anesthanalg. 2008; 107(4): 1308-12. ##5. Michae Arnberger M , Steadman K, Alisha P, Ponert R, Melber A, Robert Greif. Monitoring of Neuromuscular Blockade at the P6 Acupuncture Point Reduces the Incidence of Postoperative Nausea and Vomiting. Anesthesiology 2007; 107: 903–8. ##6. Huei -Mein Chen, Fang -Yi Chang, Chin –Tai. effect of acupressure on nausea, vomiting, anxiety and pain among post-cesarean section women in Taiwan##. J medical science. 2005; 21(8): 341-350. ##7. Li S, Zheng M, woo w, Gao J, Zheng Z. effects of electro acupuncture administered 24 hours prior to surgery on postoperative nausea and vomiting and pain in patients undergoing gynecologic laparoscopic surgery. Explore (NY). 2017; 13(5): 313-318. ##8. Apfel CC, Kinjo British journal of anesthesia (2009); volume102, number (5): 585-7##9. Gruenberg SM. chemotherapy-induced nausea and vomiting: prevention, detection, and treatment how are we doing? J support oncol2004; 2(1): 1-10. ##10. Sheng-Ten Huang, Gao-Yang Chen, Huey-Ming Lo, Jaung-Gang Lin, Yin-Shying Lee, Cheng-Deng Kuo. 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