Evaluation of the Relation between Tuning Fork Tests, Glue ear Presence, and Conductive Hearing Loss in Patients with Otitis Media with Effusion

Background: In the middle ear inflammation, otitis media with effusion (OME) leads to a sterile effusion. Although most OME resolves without any complications, long-lasting OME may cause conductive hearing loss (CHL). Aim: In this article, we investigate the validity of the Rinne and Weber tests in different frequencies of tuning forks in predicting the conductive hearing loss secondary to OME as diagnosed by more modern audiometric tests. Methods: A case series of 25 consecutive patients visited the Loqman Hakim Hospital clinic. Each patient was evaluated by tuning fork tests (256, 512, 1024, 2048 Hz), audiometry, tympanometry, and tympanocentesis. Results: In evaluation of the hearing status in OME patients, there was no significant association between the Weber test, audiometry, and tympanometry. The 256 Hz Rinne test correlated with the level of hearing loss in patients with OME. Results revealed no relationship between the presence of glue ear, audiometric, tympanometric, and tuning fork tests. Conclusion: 256 Hz Rinne test can predict the presence of CHL in cases suffering from OME. Adhesive otitis does not worsen the hearing condition of patients

Evaluation of Delayed Diagnosis of Neck Masses and Related Factors

Background: Due to the importance of time in diagnosis and treatment and, as a result, the prognosis of patients with neck malignancies, we decided to evaluate the causes of delay in diagnosis of neck masses and their associated factors. Aim: In this study, we have evaluated the delay in diagnosing neck masses and the related factors. Methods: This descriptive-analytical study was performed on 500 patients with a neck mass who were referred to Loghman Hakim Hospital in 2019. Demographic data were recorded. The time of the delay to visit a doctor and the time of the delay to diagnosis were recorded. Factors related to the delay in the patient and physician's diagnosis, including the patient's socioeconomic status, literacy and income level, associated symptoms, history of smoking, infections and underlying diseases, were evaluated. Results: the mean age of patients was 46.04 years. 50.4% were female. The mean time interval between feeling neck mass and visiting a doctor was 34.72 days. This time interval between feeling neck mass and visiting a doctor in patients with higher education levels was less than in illiterate patients with low education levels (p = 0.046). This interval time in patients with higher income levels was less than in patients with lower income levels (p = 0.009). This interval was significantly increased with increasing age (p<0.001). Conclusion: Based on our findings, some factors such as age, income and education level significantly influence the process of diagnosis and treatment. On the other side, the presence of some signs and symptoms like dysphagia, sore throat, weight loss, etc., can remarkably reduce delay in that process. Ultimately it seems helpful to make an application which provides essential training for elderly, low-income or unlearned patients and facilitates consulting and referring to doctors for them

A Young Case with Endolymphatic Sac Tumors Presented with Right-sided Hearing Loss and Facial Hemi-paralysis

Background: Endolymphatic sac tumors (ELSTs) are uncommon low-grade, locally invasive epithelial tumor that originates from the endolymphatic sac of the inner ear and temporal bone. It is a rare event with less than 300 cases worldwide. In this article, we present a case of ELTS who presented with facial asymmetry and hearing loss. In this article, we present a case of ELTS who presented with facial asymmetry and hearing loss.                    Case presentation: A 15-year-old female was admitted to our hospital with right-sided facial hemiplegia and hearing loss in her right ear which was started and progressed within two years. Except for facial hemiparalysis, other physical examinations were normal. In her audiological investigations, severe hearing loss of her right ear was evident. Imaging studies were indicative of ELSTs. This diagnosis was confirmed by histopathological investigations. Discussion: ELST is an aggressive papillary tumor that arises from the endolymphatic sac. In most cases, this tumor presents as a solitary growth. It usually presents with hearing loss but can be associated with other symptoms like tinnitus, vertigo and nerve VII paralysis. Imaging studies play a crucial role in the diagnosis of ELST, as it can reveal a characteristic soft-tissue mass involving the temporal bone, with bony erosion and extension into adjacent structures. Surgery is considered as the main form of treatment for ELSTs. Conclusion: ELSTs are exceedingly rare events. Here we presented a case of ESLT with right facial hemiplegia and right ear deafness

A Comparison of Bacteriological Culture, Serology, and Quantitative PCR for Detecting Brucellosis in Ewes with a History of Abortion

The zoonotic disease brucellosis is a serious public health and livestock industry concern. In the present study, we used bacteriological culture, RBT, and qPCR to determine the prevalence of brucellosis in the serum and milk samples of sheep with a history of abortion. Serum and milk samples were obtained from 100 sheep aged 3-5 years. In order to determine the prevalence of brucellosis, a modified RBT was performed on serum samples, Brucella was isolated from milk by bacteriological culture, and qPCR was applied to detect bacterial DNA in milk. The prevalence of brucellosis using modified RBT, bacteriological culture, and qPCR was 32%, 42%, and 44%, respectively. By considering qPCR as the standard, modified RBT showed a sensitivity of 95%, a specificity of 100%, an accuracy of 98%, a PV+ of 100%, and a PV- of 97%. The sensitivity, specificity, accuracy, PV+, and PV- for bacteriological culture were 77%, 100%, 90%, 100%, and 85%, respectively. The agreement between qPCR and modified RBT was 0.959 (95% CI: 0.896-1), between qPCR and bacteriological culture was 0.792 (95% CI: 0.667-0.897), and between modified RBT and bacteriological culture was 0.831 (95% CI: 0.709-0.38). Based on the results, bacterial isolation from sheep milk is not recommended except in specific cases due to its low sensitivity, as well as its time-consuming and hazardous nature. However, the modified RBT can be used as a routine method because of its cost-effectiveness, higher sensitivity, and higher accuracy compared to bacterial isolation. Moreover, qPCR is recommended as the gold standard test for detecting brucellosis in sheep milk, especially in those with a history of abortion

explaining the concept of transformational curriculum in view of its application in developing creativity of students in Iranian educational system.

The aim of this study is explaining the concept of a transformative curriculum in order to Critique the education curriculum of Iran in 2019. In this study, qualitative research method of critical philosophical inquiry was used. The field of research has consisted of books, all articles and scientifically available print and digital resources related to the transformative curriculum from 1979 to 2019. Purposeful sampling method was used and the review of texts and documents related to the transformative curriculum was performed gradually and continued until theoretical saturation. By reviewing three paper and 10 chapters from different books, theoretical saturation was achieved. Information was collected using the "Document Review" tool. In the first and second steps, data were analyzed using the qualitative content analysis method of inductive categorization and thematic coding, and in the third step, the research was analyzed using the reflective method of data. The findings show that the transformed curriculum has six main assumptions: homogeneous and correlated. Comparing the assumptions of the changing curriculum based on the criterion of creativity showed that while converging its dimensions, curriculum as cosmology, fiction creativity, curriculum as complexity, tolerance of ambiguity, curriculum as dialogue, integration Rational thinking and narrative thinking, curriculum as a course, "becoming", curriculum as a community, relationships and curriculum as a set of students' learning experiences emphasize the antecedent and outstanding synchronization and are effective in improving creativity. The transformative curriculum is not predetermined, but a transformational reality

Relationship Between Self-efficacy of Mothers and Health-promoting Behaviors of Their Adolescent Girls in Shiraz, Iran

Background & Aims Adolescence is a period in which people are at risk of engaging in many health-threatening behaviors such as increased food intake, decreased physical activity, and increased developmental vulnerability which can be a threat to their future health. Counseling and changing their unhealthy behaviors can improve various aspects of their health, including mental and physical health. This study aims to determine the relationship between mothers' self-efficacy and health-promoting behaviors of their adolescent girls in Shiraz, Iran. Materials & Methods In this study, participants were 384 high school female students (second term) and their mothers in Shiraz city in 2018. Mothers completed Sherer’s General Self-efficacy Scale and their girls completed Walker's Health-Promoting Lifestyle Profile II (HPLPII) questionnaire. Pearson or Spearman correlation test and t-test were used for statistical analysis in SPSS software, version 22. Results The mean HPLPII score of girls was 169.29±15.97. The mothers' mean self-efficacy score was 46.66±5.77. The results of Pearson's correlation test showed the direct and significant correlation of mothers' self-efficacy scores with health-promoting behaviors of girls and its domains (r=0.556, P<0.05). Conclusion There is a direct significant relationship between mothers' self-efficacy and health-promoting behaviors of their daughters. Considering the importance of health-promoting behaviors and the effect of self-efficacy and living conditions on these behaviors, it is needed to develop strategies to improve people's lifestyle and healthy behaviors. Policy makers in the health system are recommended to promote self-efficacy of mothers by using cultural and educational programs

The Iranian Psychiatric Nurses' perception of transition in psychiatric wards: A qualitative study

Background: Transition means moving from one period to another and it is usually associated with significant changes in objectives, roles, and responsibilities. Considering the challenges of the psychiatric ward, psychiatric nurses experience numerous problems, especially at the early stages of their job engagement. This study aimed to examine the perception of the Iranian psychiatric nurses in psychiatric wards and their transition period. Materials and Methods: The study was designed as a qualitative content analysis study in three referral hospitals in Mazandaran and Tehran, Iran 2016. Participants included 18 nurses who had experienced transition at the psychiatric ward and had at least 3 months job experience in three referral hospitals of Iran and were selected purposefully. Data were collected using unstructured interviews and analyzed using the inductive approach and conventional content analysis. To ensure the trustworthiness of the data, Guba and Lincoln's criteria were used. Results: The major themes of transition among the nurses of psychiatric wards included “inadequate preparation,” “mental stress,” “self-awareness and capabilities,” and “the effective role of nurses' full support in adjustment.” Conclusions: The findings revealed that nurses did not have a decent transition. In this regard, educational systems must provide training courses to prepare nurses to support them in their arrival stage and to facilitate their transition. The findings of this study can help mentally prepare nurses for their preparation to perform their role and improve the quality of care

The effect of group therapy on anxiety level of nursing students in Psychiatry ward

Introduction: Nurses have stressful attitudes towards psychiatric patients who play significant role in their care. This study endeavored to determine the effect of group therapy on the anxiety of nursing students in psychiatric ward of Babol Yahyanejad hospital. Methods: In this quasi-experimental study sample consisted of 36 nursing students of the fifth semester at Babol Islamic Azad university who were randomly assigned to two experimental and control groups. The experimental group participated for six sessions of group therapy while the control group passed training sessions, they did not attend these sessions. The survey instrument included demographic characteristics, Spielbergerr Anxiety Inventory. Data were analyzed through covariance test. Results: The majority of the samples, 11 students (61.1%) had moderate to low anxiety in the experimental and control groups before the treatment group, while the majority of the samples (61.1%) in the experimental group after the group therapy received mild anxiety. According to the results of the covariance analysis, the two groups after the test significantly (p <0.05) were different in terms of anxiety level. Conclusion: These results indicated the effectiveness of group therapy in reducing anxiety of students in the Psychiatry ward. According to the results holding training classes on how to deal with Patients and systematic interview process before attending in psychiatric wards is recommended

بررسی اثربخشی رویکرد یکپارچگی حسی در درمان اختلال آپراکسی ساختاری کودکان اتیسم بالای چهار سال شهر شیراز: یک مطالعه مقدماتی

عنوان: بررسی اثربخشی رویکرد یکپارچگی حسی در درمان اختلال آپراکسی ساختاری کودکان اتیسم بالای چهار سال شهر شیراز: یک مطالعه مقدماتی مقدمه: آپراکسی یکی از اختلالات مطرح در کودکان اتیسم است که همبستگی زیادی با آسیبهای رفتاری و ارتباطی- اجتماعی این کودکان دارد. از میان انواع مختلف آپراکسی یکی از شایع ترین آنها آپراکسی ساختاری است. از آنجایی که رویکرد یکپارچگی حسی به عنوان یکی از درمانهای مرسوم برای این کودکان است لذا با توجه به مناقشه های موجود در خصوص کارآیی این رویکرد مطالعه ی حاضر به هدف بررسی اثربخشی رویکرد یکپارچگی حسی در درمان آپراکسی ساختاری کودکان اتیسم طراحی گردید. مواد و روش ها: این مطالعه از نوع شبه تجربی می باشد و در یکی از مدارس اتیسم شهر شیراز در تابستان 1391 انجام شد. نمونه گیری به شیوه آسان از میان کودکان اتیسمی که خانواده هایشان مایل به همکاری بودند انجام شد. از میان 21 کودک واجد شرایط 11 نفر بطور تصادفی به گروه کنترل و 10 نفر به گروه مداخله اختصاص یافتند. کودکان گروه مداخله به مدت 20 جلسه تحت درمان با رویکرد یکپارچگی حسی قرار گرفتند و کودکان گروه کنترل هیچ گونه درمانی دریافت نکردند. برای اندازه گیری متغیر آپراکسی ساختاری کودکان از آزمون محقق ساخته Block test استفاده شد. آزمون ANCOVA برای ارزیابی نتایج استفاده شد. یافته ها: نتایج آماری تفاوت معناداری را در بهبود آپراکسی ساختاری بین دو گروه کنترل و مداخله نشان نداد (0.2005 =F ، 0.175 =P). نتیجه گیری: از آنجایی که استفاده از رویکرد یکپارچگی حسی از اقبال زیادی در میان کاردرمانگران برخوردار است لذا با توجه به یافته ی این مطالعه توصیه می گردد چنانچه هدف درمانی برای کودک اتیسمی کاهش اختلال آپراکسی ساختاری کودک است علاوه بر استفاده از رویکرد یکپارچگی حسی از سایر رویکردهای درمانی نیز در خلال درمان استفاده شود تا از این طریق بتوان شانس اثر بخشی فرآیند درمان را بالا برد.  کلید واژه ها: اتیسم، رویکرد یکپارچگی حسی، آپراکسی ساختار