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Background and purpose: This study was designed in order to compare the effects of spinal and epidural analgesia on labour and also several maternal and fetal factors in vaginal delivery.
Materials and Methods: The study was a randomized clinical trail and participatnts were 120 gravid 1 and gravid 2 women in the active phase of delivery, admitted to the labour room of Fatemieh Hospital in Hamedan in 1381-1382. Sixty patients were randomly divided into two groups of 30, analgesia was induced by single spinal sufentanil injection in one group and, bupivacaine plus lidocaine injection in the other group. Maternal vital signs and pain score were recorded (VAS) at 1, 5, 15 and 30 minutes after administration of analgesia and every 30 minutes thereafter. Fetal heart rate every 15 minutes, vaginal examination every hour, urinary output every 4 hours after delivery and the incidence of headache and back pain, one week after delivery were the variables under study.
Results: Both groups were matched regarding demographic, gravida and Parity factors. There was no significant difference between groups regarding pain score, (based on VAS),duration of the first and second delivery phase, the incidence of fetal distress, meconium excretion, apgar scores at 1 and 5 minutes after delivery, abnormal laboar, operative or assisted delivery. Average analgesic duration was longer in spinal analgesia than single epidural injection analgesia.
Conclusion: Considering the difficulty of the technique, the need for anaestheticianHs supervision and injection repeatition in epidural analgesia, it seems that spinal analgesia is a suitable replacement which is more practical, less expensive, easy to perform and induces a desirable analgesia.

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Background and purpose: Symptoms of chronic rhinisinositis (CRS) are cumbersome and refractory to most systemic medications and even after surgical intervention, the recurrence of symptoms are frequent. In order to study the beneficial effects of Origanum vulgar inhaler in relaxing the symptoms, this study was conducted in Boo Ali Sina Hospital, Sari, Iran.
Materials and Methods: The study was a randomized double blind placebo controlled clinical trial carried out from April to December 2005. The diagnosis of CRS was made by an ENT specialist upon clinical and CT scan findings and or signs during functional endoscopy sinuses surgery (FESS). Patients younger than 15 years old, with a history of allergic eye disease and symptoms of infections were excluded. Patients were randomized in case and control groups (32 in each) according to age, sex and disease chronicity. After verbal explanation of the trial, an informed consent form was signed by each patient. The study was approved by the medical ethics committee of the Mazandaran University of Medical Sciences, Iran. Origanum vulgar was gathered from local mountains (Kojor area, Nour, Mazandaran, Iran), and identified by an experienced botanist. The airial organs of the herb were dried, macerated followed by 75% hydroalcoholic extraction and standardized by Emerson method. The active ingredient and placebo in the same bottles were administered to the patients and they were asked to add 5 ml of the liquid to boiling water and inhale it for 15 minutes, three times a day for two weeks. A telephone contact was made to the patients, to increase the compliance to treatment. A questionnaire was filled in for each patient before and after the intervention by a doctor blind to groups. Chi square test was used for comparing the differences in symptoms and P< 0.05 was considered statistically significant.
Results: Sixty four patients were recruited and allocated equally in case and control groups matched for age, sex and duration of symptoms. 15.6 and 25 percent of the cases and controls had history of sinuses surgery. All symptoms including headache, nasal congestion, sinus pain, post nasal discharge, eye pain and purulence in nasal cavity were significantly reduced after the intervention except hyposmia and nasal discharge (p<0.00). No side effect was reported.
Conclusion: Inhalation of 75% hydroalcoholic extrac of Origanum vulgar is effective in relaxing most symptoms of CRS.

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Background and purpose: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Its pathophysiology is described by canalolithiasis theory. A safe and simple treatment has been proposed in recent years (canalith repositioning maneuver). This study has been performed to compare the effectiveness of physical maneuver and medical therapy in the treatment of BPPV.
Materials and Methods: The study was a clinical trial. Patients with BPPV (Being diagnosed based on positive Dix – Hallpike test and history) were randomized into 2 groups on first visit. They were matched for sex, age and cause of BPPV. 23 patients received Epley maneuver and 22 patients received Betahistine. Patients were evaluated at first week and first month after the beginning of the treatment.
Results: After one week, 58.3 % of patients in drug group and 94.1 % of patients in maneuver group had negative Hallpike test. After 1 week, all patients were asked about the resolution of symptoms. After 1 week, 39.77% of patients in drug group and 81.52 % of patients in maneuver group improved. This difference between the 2 groups was statistically significant (2 = -4/338 p< 0/001). After 1 month, 56. 83 % of patients in drug group and 86.98 % of patients in maneuver group improved (z =- 3/ 305 p<0/01). The difference of subjective improvement was statistically significant between 1 week and 1 month follow up in drug group (z = -2/85 p<0.01), this difference however was not statistically significant in maneuver group (z= -1.5 NS).
Conclusion: In short term the Epley maneuver is much more effective than medical therapy to control symptoms of BPPV and is the best treatment for this disease.

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Background and Purpose: The most common complication of pregnancy is abortion. The etiology of recurrent pregnancy loss is not completely known. There are few therapeutics and diagnostic strategies in recurrent abortion. The aim of this study was to compare the use of heparin with aspirin vs prednisolone with aspirin in patients with recurrent pregnancy loss (RPL).
Materials and Methods: This randomized clinical trial study comprised of 50 patients with RPL referred to Fatemieh Hospital, Hamadan. These patients were selected when β-HCG test was positive and were divided into two groups (n=25 for each group). Patients in the first group received subcutaneous heparin (5000 U twice a day) and oral microcoated aspirin (80 mg once a day) up to 20th week of pregnancy. Ultrasonography was repeated 3 times for these patients. Ca tablet was administrated in order to prevent osteoporosis. Antiphospholipid and anticardiolipin antibodies were checked for all patients. Neonates were visited by a neonatologist and followed up for one month. Finally, the data were analyzed by t-test and Fisher’s exact test.
Results: The mean age of prednisolone with aspirin group were 31.8±3.3 years while, it was 30.7±3.2 years in heparin with aspirin group and, this difference was not significant (P>0.05). The mean pregnancy loss number was 2.8±1.1 while 2.4±1 in prednisolone with aspirin and heparin with aspirin groups respectively, which was not statistically significant (P>0.05). Anticardiolipin antibody was positive in 4 (8%) patients, and antiphospholipid antibody was also positive in 4(8%) patients. Pregnancy loss with heparin+aspirin was significantly higher than prednisolone+aspirin (P<0.05). There was not any case of complications in two groups.
Conclusion: The results of this study showed that prednisolone with aspirin are more effective than heparin with aspirin in the management of recurrent pregnancy loss and are preferred to use in these patients.

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Background and purpose: Termination of pregnancy in fetus with severe anomaly is legal in Iran. This study was done in order to compare the rate of effectiveness and complications of intra-amniotic PG and oxytocin, with rising induction in patient candidates for second trimester abortion, at Fatemieh Hospital, in Hamadan.
Materials and methods: In a randomized clinical trial study, 40 pregnant women in their second trimester with fetal CNS anomalies, were divided into two groups (N=20). In the first group, one PG E2 Amp was injected intra-amniotic at first and then, 20 IU oxytocin was infused in 500 ml serum ringer for each patient. The infusion rate was increased up to induced effective concentrations every 15 to 30 minutes. In the second group, 50 IU oxytocin was infused with 1000 ml serum ringer and thereafter, an- other infusion of 50 IU oxytocin was added into the remaining 500 ml of serum. The rate of infusion was regulated on the basis of induced effective concentrations. Finally, both groups were compared for labor duration and probable side effects.
Results: The rate of success in both groups was 100%. The mean duration of labor was 19.75±5.9 hours and 30.2±6.49 hours in the group with intra-amniotic PG with oxytocin and rising induction group, respectively. This difference was statistically significant (P<0.00). Diarrhea was seen in only one case with intra-amniotic PG injection. Differences between the frequency of side effects in both groups was not statistically significant.
Conclusion: This study showed that the mean duration of laboring intra-amniotic PG with oxytocin method, is less than of rising induction method.

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Background and purpose: Ëvaluation of medicinal plants has shown potential antimicrobial effects which introduced many drugs with antibiotic properties. Âs there were controversies about antimicrobial action in the literature, this study evaluates the antibacterial effect of ethanolic (80%) extract of the seeds of Foeniculum vulgare plant.
Materials and methods: The disc diffusion method and determination of minimum inhibitory concentration (MÏÇ) of the extract against Staphylococcus aureus PTÇÇ 1112, Bacillus subtilis PTÇÇ 1023, Ëscherichia coli PTÇÇ 1330, and Salmunella typhi PTÇÇ 1639 were employed and Gentamycin and Âmikacin were used as standards.
Results: The hydroalcoholic extract of the seeds of Foeniculum vulgare showed concentration-dependent antibacterial activity against all tested bacteria. The hydroalcoholic extract was more effective against Ë. coli and less effective on B. subtilis. The MÏÇs were 3.2 mg/ml and 12.8 mg/ml for quoted bacteria respectively.
Çonclusion: The results concluded that the ethanolic extract of Foeniculum vulgare is a potential natural antibacterial agent, however its effect is dependent on the source and extraction method.

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Background and purpose: Since there is no test to evaluate body dysmorphic metacognition, the purpose of this study is to construct and determine the validity, reliability, and the factor structure of Body Dysmorphic Metacognition Questionnaire (BDMÇQ).
Materials and methods: Data were collected through Body Dysmorphic Metacognition Questionnaire which was filled out by 200 students (100 male and 100 female), 20 patients with body dysmorphic disorder (BDD) and 20 students without BDD.
Results: Çoncurrent validity of BDMÇQ with Yale –Brown Ôbsessive Çompulsive Scale modified for BDD was r=0.74 (P<0.001). Ïn an exploratory factor analysis, four factors were identified and labeled as follows: metacognition control strategies, thought –action fusion, positive and negative metacognitive beliefs about appearance, and safety–seeking behaviors that explained 48 % of the questionnaire variance. Ïn addition, scores of the group with BDD were significantly higher than that of the healthy group showing good diagnostic validity of the questionnaire. The Çronbach's alpha for the four factors was above 0.70.
Çonclusion: Âccording to the results, BDMÇQ has a good reliability and validity to assess the metacognition problems in patients with BDD.

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Background and purpose: Utilization of evidence-based research can increase the validity and quality of nursing care and nurses’ responsibility. In order to have research based performance by nurses, identifying the barriers to utilization of research findings is essential. This study aimed at recognizing these barriers from clinical nurses’ prospective. Materials and methods: A cross-sectional study was carried out on 313 nurses working in three hospitals of Babol University of Medical Sciences in 2011. In this study a questionnaire containing two sections was used in which first part questioned scientific and professional knowledge of subjects, and the other part was extracted from Funk’s barriers scale. Results: Four dimensions were identified using factor analysis. These were report, research, nursing and organization. Important barriers were insufficient time to study for implementing new ideas, lack of timely and fast publication of research papers, and lack of physicians’ collaborations in implementing the results of nursing researches. These were classified in a different dimension. Some barriers were not included in any dimensions, such as low trust of nurses to research findings, unjustified conclusions drawn from researches, conflicting results, and English publication of most studies. Conclusion: The important finding of this study was that the subjects identified the barriers in nearly all dimensions. According to the first three barriers, authorities should provide nurses with facilities to utilize and implement research findings. Moreover, they should promote educational programs to develop knowledge, skills and positive attitude to research among nurses.

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Background and purpose: To prevent or minimize hypotension during cesarean section by applying spinal anesthesia, different methods are used. This study compared the maternal hemodynamic changes and fetal well-being following bolus of administration phenylephrine and ephedrine. Materials and methods: In a randomized study, 100 pregnant women undergoing elective cesarean section were divided into two groups. Prevention of hypotension after spinal anesthesia, bolus dose of 100 micrograms phenylephrine for the first group and 10 mg ephedrine for second group was administered. Changes in blood pressure and heart rate, and umbilical cord blood gases were compared. Results: Changes in mean blood pressure of mothers were similar in both groups (P= 0.86). Incidence of bradycardia was similar in both groups (group E 12% and group P 18%, P=0.4). 9 patients received Phenylephrine in one group and 25 patients in the other group had heart rate greater than 120 (P=0.001). Changes in PH were similar in both groups (P= 0.83).Phenylephrine group had higher base excess (P=0.001). Conclusion: Both dose of 100 µg of phenylephrine and 10 mg of ephedrine have similar effects on maternal blood pressure, Apgar score and umbilical cord blood PH of neonate. Therefore, both drugs as a vasopressor can be used based on maternal hemodynamic (Clinical Trials Registry Number: IRCT201208136148N2)

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Background and purpose: The use of bioactive glass-ceramics in medicine has been noticed because of their ability in directly connection to bony tissue and bone repairing. Chitosan is also nontoxic material and biologically is compatible with the capability of biodegradation. However, due to the minimally invasive nature of injectable systems and their ability to make scaffold in place of using, they can take the shape of bone defect and eliminate the need for fabricated implants. The aim of this study was evaluation of rat's connective tissue reaction to injectable glass-ceramic-chitosan nanocomposite it looks to be a good substitute synthetic material in filling bone defects and its production is possible in Iran. Materials and methods: In this animal study, 40 rats were divided into 5 groups of 8. Polyethylene tubes filled with glass-ceramic-chitosan nanocomposite as case group and the empty tube as control group were implanted in subcutaneous tissue of rats. Biopsy samples from case and control sites were histologically examined after 7, 15, 30, 60, and 90 days and the number of inflammatory cells and blood vessels were counted. T and analysis of variance (ANOVA) tests were used to examine differences at the significance level of P < 0.05. Results: Overall, no significant differences in severity of inflammation and vessel counts were found between case and control groups on different days (P > 0.05 for all). Conclusion: It seems that injectable glass-ceramic-chitosan nanocomposite was biocompatible.

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Background and purpose: Astigmatism is a common optical dysfunction, effective on various visual outcomes and one of the important criteria of refractive surgery. The aim of present study was to evaluate the correlation between refractive, corneal and residual astigmatism in refractive surgery candidates. Materials and methods: In this cross-sectional descriptive, analytical study, 200 patients referred to the Farabi hospital, Iran, for refractive surgery were enrolled. Refraction survey and topography were done to determine refractive, corneal and residual astigmatism for all of participants and statistical analyses were performed. Results: Overall, 400 eyes of 200 subjects with the average age of 28.2 ± 6.24 participated in this study. 62.7% of cases were women. According to spherical equivalent, 94.2% were myope, 3.3% were hyprope and 78.9% had refractive astigmatism more than 0.75 D. Mean spherical equivalent refractive errors was -3.59 ± 1.95 D in myopic group and 2.72 ± 0.97 D in hyperopic group mean astigmatism was 1.97 ± 1.3 D in myopic and 1.3 ± 1.37 D in hyperopic group. The correlation ratio was (r = 0.223) between lenticular and refractive astigmatism (P < 0.001), (r = 0.111) between lenticular and corneal astigmatism (P = 0.027), and (r = 0.942) between refractive and corneal astigmatism (P < 0.001). Conclusion: Significant correlations were found between refractive, corneal, and residual astigmatism there was a strong correlation between corneal and refractive astigmatism and 81% of the changes in refractive astigmatism could be justified with corneal astigmatism changes. Separating the type of astigmatism and determining its origin (cornea or lens) could be helpful for refractive surgery.

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Abstract Background and purpose: Estimating dosimetric parameters for small fields at non-reference conditions lead to significant errors if they are done based on the conventional protocols used for large fields and reference conditions. The aim of this study was to determine and compare small fields correction factors (K_NR and K_NCSF) based on a novel protocol by using different types of detectors. Materials and methods: Specific circular cones were constructed and attached to a medical linac head to produce small field sizes down to 30 and 5mm diameters. Then, the K_NR and K_NCSF correction factors based on a recent protocol (TG155), proposed for small field dosimetry formalism, were determined for different active detectors (a pinpoint chamber, EDP20 and EDP10 diodes) in a homogeneous and a nonhomogeneous phantom at the above fields when irradiated to 6 and 18 MV beams of a Varian linac.
Results: The K_NR correction factors for the circle field of 30mm estimated for the pinpoint chamber, EDP20 and EDP10 diodes were 0.993, 1.020 and 1.054 at 6 MV and 0.992, 1.054 and 1.005 at 18 MV, respectively. The K_NCSF correction factor for the 5mm circle field estimated for the pinpoint chamber, EDP20 and EDP10 diodes were 0.994, 1.023 and 1.040 at 6MV and 1.000, 1.014 and 1.022 at 18MV, respectively. Conclusion: Our results indicated that implementing the correction factors estimated for the small fields based on the new proposed dosimetry protocol increases the dosimetric precision and accuracy of such fields in radiotherapy practices. Also, considering the perturbations happening between the boundaries of non-homogeneous area could increase the accuracy of the dosimetry procedures in such conditions.

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Abstract Background and purpose: Diabetic foot ulcers are one of the major causes of morbidity and mortality in diabetic patients. For centuries Aleo vera has been used in treatment of diabetic foot ulcers. In this study, a mixture of honey and Aloe vera was used for diabetic foot ulcer healing. Materials and methods: In a double-blind clinical trial, patients with nonischemic, noninfected diabetic foot ulcers (attending Imam Khomeini Hospital Diabetes Center, Sari, Iran) were divided into two groups, a treatment group (n= 24) and a placebo group (n=15). To compare the effect of the mixture t-test and qui square were applied. Results: A total of 39 patients (19 males and 20 females) with diabetic foot ulcers were enrolled. Mean age of the patients, mean body mass index, and mean duration of diabetes were 56.3 ±10.2, 31.2 ± 4.2, 16.2 ± 6.6, respectively which were not significantly different between the two groups. Wound size was determined using a ruler that showed no significant difference between the two groups (P=0.36). Debridement, offloading and washing were done for all participants. Combined gel of Aleo vera and honey was used for treatment group. Wound healing was seen in 21 (95.5%) patients in treatment group and in 11 (78.6%) patients in placebo group. Conclusion: In small, non-infected, non-ischemic ulcers the effect of honey and Aloe vera gel was the same as that of the placebo. Offloading, debridement and washing with normal saline have similar effect to the mixture in healing diabetic foot ulcers.

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Background and purpose: Lavender is a medicinal plant with antioxidant activity. Stroke causes long term disability and is associated with oxidative stress. The present study was conducted to evaluate the protective effect of lavender extract against blood brain barrier permeability and its possible mechanisms in an experimental model of stroke. Materials and methods: In this experimental study, 42 male Wistar rats weighing 250 to 300 g were used. The rats were divided into 6 groups (n= 7 per group). Group 1 was ischemic, groups 2 and 3 were ischemic that were given 100 and 200 mg/kg lavender extract, respectively. Group 4 were intact and groups 5 and 6 were intact groups which received lavender extract with dose of 100 and 200 mg/kg. Group 7 was also considered as the sham. Focal cerebral ischemia was induced in rats by the transient occlusion of the middle cerebral artery for 1 hr. Data were analysed with SPSS and comparison of means were compared using One Way Anova. Results: The ethanolic extract of lavender at 200 mg/kg significantly reduced the blood brain barrier permeability in rat stroke model compared with ischemic group. Conclusion: The results indicate that lavender extract has neuroprotective activity against cerebral ischemia and alleviated neurological function in rats.

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Background and purpose: Sexual dysfunction caused by contraceptive methods threatens sexual health. The aim of this study was to determine the relationship between sexual health and contraceptive methods in women attending health centers in Urmia, Iran.

Materials and methods: A descriptive- analytical study was conducted in 2014 in which 198 women were randomly recruited. Data was collected by a standard questionnaire consisting of three parts: socio-demographic characteristics, Female Sexual Function INDEX (FSFI), and Index of Sexual Satisfaction (ISS). Data was then analyzed applying descriptive statistics, t-tests, one-way ANOVA, and Pearson’s correlation coefficient in SPSS V. 22. P-values less than 0.05 were considered significant.

Results: The mean age of participants was 29.89 ± 7.01 years. The mean scores for sexual function and satisfaction were 20.99 ± 6.73and 35.93 ± 16.10, respectively. ANOVA analysis showed a significant relationship between sexual function and contraceptive methods. Also, a significant association was found between contraceptive methods and sexual satisfaction (P= 0.00). The most common cause of sexual dysfunction and satisfaction was contraceptive injections, while withdrawal method resulted in the lowest incidence of sexual dysfunction and satisfaction.

Conclusion: In this study, the most common contraceptive methods in women were withdrawal method and taking oral contraceptive pills (OCPs). The results showed that hormonal methods of contraception particularly contraceptive injections could negatively influence the women's sexual health. Therefore, more training programs should be carried out in family planning counselors, so that appropriate contraceptive methods are implemented while considering women’s sexual satisfaction and function.

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Background and purpose: False positive in newborn hearing screening increases cost and maternal anxiety. We aimed to evaluate the effect of mode of delivery and screening age on false positive result of first screening test. Identifying and controlling these factors could reduce the rate of false positive tests.

Materials and methods: In this study, 2784 infants were evaluated by otoacoustic emissions test. The test was performed before hospital discharge. Then, the rates of false-positive were compared in infants born by vaginal delivery and cesarean section based on the screening age.

Results: False positive rate in the first screening test in neonates born through vaginal delivery was significantly higher than that of the newborns delivered by cesarean section. The rate of false positive significantly decreased with increase of screening age in infants born by cesarean delivery.

Conclusion: Hearing screening test in neonates born through cesarean section should be conducted just prior to hospital discharge. In this way, false positive results could be reduced by about 6 times and the cost and concerns caused by the rate of false positives are also minimized.

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Background and purpose: Drug interaction (DI) decreases the success rate of treatments and lead to longer hospitalization and increased treatment cost. Also, it can seriously endanger patient's lives or cause many complications. The purpose of this study was to evaluate the incidence and management of drug interactions in neonatal intensive critical care unit (NICU) in a teaching hospital. Materials and methods: This cross-sectional descriptive study was performed in 50 neonates admitted to Sari Bu-Ali Sina NICU, 2013-2014. Patients’ data and parameters related to drugs were recorded. Results: Drug interactions were observed in 21 patients. From 1131 prescriptions DIs appeared in 386 cases. The mean number of DIs in each neonate was 3.5±1.6 and most of them occurred in patients concurrently receiving 5 to 10 drugs per day. Conclusion: The majority of neonates in NICU have critical conditions and need multiple therapies so it is necessary to conduct some interventions such as determination of serum concentration, dose adjustment and laboratory parameters monitoring.

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Background and purpose: The human body is composed of various inhomogenous tissues with a variety of physical and radiological properties. These inhomogeneities could change isodose distributions, increase the probability of geometric errors, and eventually lead to missing of the target irradiation or incorrect isodose coverage in conformal radiation therapy (CRT) due to the uncertainties resulted from the effect of such inhomogeneties on isodose curves. In this study, the effect of inhomogeneities on dosimetric accuracy of the CRT of prostate was investigated using Monte Carlo simulation method.

Materials and methods: An anthropomorphic pelvis phantom was used in two modes representing a homogeneous and heterogeneous phantom. Three dimensional (3D) CRT planning composed of five fields were performed on the CT images of the phantoms using the CorPLAN treatment planning system (TPS) of a 2100C/D Varian linac. Delivery of 3DCRT was also simulated by EGSnrc Monte Carlo code for the same conditions used in the CorPLAN TPS. The dose distributions resulted from the MC simulations were compared with those of the CorPLAN TPS for both of the phantoms based on the "dose difference (DD) percentages" and "distance to agreement (DTA)" parameters.

Results: Findings indicated that the heterogeneity leads to an overdose estimation at the target location up to 2.8% and 4.4% for the 6 and 18 MV energies, respectively by the CorPLAN TPS compared with the MC simulation data. The average DD and DTA for the homogeneous phantom were 2.7%-3.4mm and 1.6%-2.3 mm while for the inhomogeneous phantom they were 5.5%-3.7 mm and 6.0%-2.5 mm at the 6 and 18 MV energies, respectively.

Conclusion: Our results indicates that the accuracy of the dosimetry parameters estimated by the CorPLAN TPS at 18 MV is more than that of 6 MV energy. But, the heterogeneity deteriorates more the accuracy level of such dosimetry parameters estimated by this commercial TPS at 18 MV energy.

                

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Background and purpose: Violence against women is considered a form of domestic violence. During pregnancy it could cause a range of adverse outcomes for mother and baby. This study aimed to determine the prevalence of violence against women during pregnancy and postpartum and its related factors.

Materials and methods: This cross-sectional study was conducted on the incidence of maternal mortality in 2015 in six provinces in Iran. In each province 24 public health centers were selected using stratified random sampling. In each center, 15-20 mothers who had at least one session of prenatal care were examined. Data was collected simultaneously from the records available in health centers and interviewing the mothers, then analyzed in SPSS18 at a significance level of α <0.05.

Results: Among 2704 mothers participating in the study, the prevalence of physical violence during pregnancy and postpartum was 8.10% and 28% suffered from psychological violence. Among 31 variables studied, 10 had a significant relationship with both physical abuse and psychological violence (P>0.05). Multistage multivariate analysis of variance showed that 7 variables had significant relationship with physical violence, and 6 variables were associated with psychological violence (P>0.05).

Conclusion: Despite records available in family’s’ files, a considerable rate of domestic violence was observed against mothers in Iran, therefore, health providers are ought to prevent this by taking appropriate actions.

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Background and purpose: Influenza viruses annually spread around the world in seasonal epidemics. The A/H1N1 virus causes more severe conditions compared to other types of Influenza A. This study is an epidemiological survey of influenza A/H1N1 virus in patients attending health care centers in north of Iran during 2013-2017.
Materials and methods: Sampling was done in 3037 patients. Influenza-RNA was extracted from the samples using Viral RNA/DNA Kit PureLink^TM. Identification of influenza A/H1N1 virus
was done using special primers and probes (Invitrogen), and Quantitative Real Time PCR System (SuperScript III Platinum).
Results: The samples were obtained from both males (39.9%) and females (60.1%). Patients aged 31-40 years of old included the majority of samples. Influenza A/H1N1 positive samples were seen more in patients aged 61-70 (18.51%) (14.55%). Out of the 442 confirmed cases of influenza A/H1N1, 23 (5.88%) deaths were reported.
Conclusion: Influenza A virus is constantly evolving by mutation or by reassortment. It evolves rapidly, and new strains quickly replace the older ones, therefore, new vaccines should be developed for immunization against new strains of influenza.