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Introduction: Spinal anesthesia is a conventional way of anesthesia for cesarean section (CS), which nausea and vomiting is a common complication of it. Metoclopramide is the standard medication used for preventing intraoperative nausea and vomiting (IONV). Because of extrapyromidal side effects of Metoclopramide and known antiemetic effects of low-dose Propofol and Dexamethasone, this study was performed to compare the effectiveness of these drugs for preventing IONV. Materials and Methods: This study, is a randomized clinical trial which is done on 144 parturients who were admitted for emergency CS. Patients were divided randomly into four groups and received: Metoclopramide 0.1 mg/kg IV, Dexamethasone 150 g/kg IV, Propofol 0.1mg/kg every 5 minutes from clamping umbilical cord till the end of operation and the fourth group received 2 ml distilled water. During the operation parturients were monitored for IONV. Data was analyzed using Kruskal-Wallis and one way ANOVA. Results: The Number of patients having nausea was lowest in Propofol and highest in Dexamethasone group. There was no statistical significant difference between Dexamethasone and placebo groups. The lowest rate of vomiting was in Metoclopramide and Propofol groups and there was no significant difference between them. Also the lowest level of retching was in the Prepofol group. Conclusion: According to results, the antiemetic effects of Propofol and Metoclopramide are similar. Amount of retching in Propofol was slightly lower than Metoclopramide and administration of Propofol was simple, cheap and without serious complications, so we recommend it for emergency CS.

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Background: Prevalence and incidence of end stage renal diseases requiring renal replacement therapies such as dialysis and kidney transplantation is on the rise. However, no qualitative research studies have been done to explore the experiences of people living with dialysis and kidney transplant in depth. Therefore, this qualitative study was done to explore the experiences of patients living with dialysis and those with kidney transplant. Materials and Methods: This qualitative study was carried out through content analysis approach. Sampling was done from the beginning and continued until data saturation. Semi-structured interviews were tools of data collection. A total of 18 participants were interviewed. The interviews were analyzed through Graham and Landman content analysis method. Results: After analyzing the data, two main themes including, dialysis, a grueling event, and renal transplantation, a normal life with healthy kidney transplant, were reported. Conclusion: Compared with hemodialysis, receiving a kidney through transplantation provides a significantly more pleasant quality of life for patients. However, there are certain obstacles in transplantation and graft survival in the views of transplantation patients. Hence, it is suggested that health officials design programs to provide support and instruction to facilitate the process of kidney transplantation for eligible patients even before entering the dialysis stage.

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Background: Multiple sclerosis is a chronic and degenerative disease of the central nervous systemthat due to such reasons as its chronic nature, no prognosis, and absence of a definitive treatment causes stress in patients. Thus, this study was designed to examine the impact of peer educational program on stress in patients with multiple sclerosis in 2011. Materials and Methods: In this clinical trial, 110 patients with multiple sclerosis were randomly allocated to test and control groups (each group including 55 patients). After preparing 5 multiple sclerosis patients as the peer group, six training sessions forthe test group were held by the peer group over two months. Data collection tool was DASS 21 questionnaire that assessed patients’ stress before and after 4 months which was completed by both groups. In order to analyze the results, SPSS software 16 was used. Results: The results showed that before intervention, there was not astatistically significant difference between the two groups in stress score(p=0.24) while a statistically significant difference was seen between the two groups after intervention (p=0.001). Also, stress score in test group was statistically significant (p=0.001) but there was not a statistically significant difference between the stress scores of the patients in the control groups (p=0.39). Conclusion: Peer group educational program caused stress reduction in patients with multiple sclerosis. Hence, it is recommended that peer groups be used for education of multiple sclerosis.

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Background: Leukemia, due to its widespread prevalence, high mortality rate, high treatment expenses, and long hospital stay, influences the families and their children to a great extent. This study was done to explore the experiences of parents whose children suffer from leukemia. Materials and Methods: Using qualitative research approach with applying content analysis method, 22 participants were interviewed in two teaching hospitals during 2 months. The study started by purposive sampling and continued by a theoretical one till data saturation. The obtained data were constantly analyzed through content analysis method. Results: Data analysis showed that “finding no solution in life, having a lot of problems, errors in treatment, concealing the illness, faith in God, parents’ devotion, hospital facilities, and consistency were the level 3 codes of parents’ experiences and “parents’ reaching a dead-end in life” was the main theme or core category of this study. Conclusion: Using a qualitative approach for exploring the experiences of parents with a child suffering from blood cancer helped recognize them more profoundly than quantitative methods. On the other hand, “parents’ reaching a dead-end in life” as the theme shows the importance of attention to parents’ problems. Using these experiences can increase hope among parents and help conduct the treatment more effectively.

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Background: Balance is one of the basic needs for daily activities. It has an important role in static and dynamic activities. The purpose of this study is to evaluate the balance of people with peripheral neuropathy after 4-weeks of functional and balance exercise program.

Materials and methods: In this quasi-experimental study, 22 diabetic patients with diabetic peripheral neuropathy (experimental group, n=11 control group, n=11) with the mean age of 53.79 years, mean height of 163.41cm, and mean weight of 71.49 kg, were randomly selected. Berg and T.G.U.G tests were used to evaluate the balance of patients. 12 sessions of combined training (balance and functional training) were used as intervention program. A paired t-test was used for the differences of pre-post test and independent t-tests were used to compare the experimental and control groups.

Results: The paired sample t-test showed that training program has significant effect on functional and dynamic balance. The comparison between the two groups showed no significant deference between pre-functional balance tests and significant post-functional balance test after training program.

Conclusion: Patients with diabetic neuropathy may have an impaired balance. The most important reason is the damage of proprioceptive receptors as combined training (balance and functional training) may improve balance and blood circulation in this organ also putting extra load on the visual system, vestibular and proprioceptive stimulation system and improves balance. Hence, it can be recommended as exercises to improve balance.

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Background: Due to high risk of physical inactivity in children with autism spectrum disorders (ASD) and its adverse consequences, evaluating their level of physical activity (PA) using accelerometry and investigating its relation with age and severity of the disorder are integral.

Materials and Methods: Fifty two boys and sixteen girls aged 7-14 years -from autism schools in Tehran- participated in current cross sectional study. Level of daily PA was evaluated for seven consecutive days using accelerometers. Autism severity was also assessed in the areas of communication, sociability, sensory and cognitive awareness, and health and physical behavior using Autism Treatment Evaluation Checklist (ATEC).

Results: On the whole 91 percent of participants encountered low level of PA. Girls were remarkably less active than boys and were more inactive. Level of PA significantly reduced as they aged. Level of PA was adversely and significantly correlated with autism severity in the area of sensory and cognitive awareness. Moreover, level of vigorous PA was adversely and significantly correlated with total autism severity. Finally, age, sex, and sensory and cognitive awareness were partially predictors of PA.

Conclusion: It appears that children with HFA are physically inactive and considerably engage in more sedentary activities as they age. Age and gender can be considered as physical activity determinants among this population.

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Background: According to the organizational intelligence to increase access of the knowledge in organizations and can to create competitive advantage in order to improve efficiency & effectiveness in organization, but that are affected by the structural dimensions of centralization, formalization, complexity (which reflects the characteristics of the internal organizations). This study aimed to investigate the relationship between organizational structure & organizational intelligence in Arak Medical University affiliated teaching hospital was performed.

Materials and Methods: In this study, the research community was comprised official staff that have high school diploma, working in hospitals that were selected for this study by sample stratified random studied. Tool for data collection, was questionnaire Robbins organizational structure and standardized questionnaire Alberkht about organizational intelligence. After confirming the validity and reliability of questionnaires, these were distributed between colleagues in teaching hospitals and then were collected. Using data collected from 16 SPSS software testing was analyzed by Spearman correlation coefficient.

Results: From 87 respondents, most of them have had a bachelor's degree and about 52 people who (74%) had experience about five years. The results were shown of the significant correlation between the organizational structure &intelligence in teaching hospital (r=-0.612 and p=0.001). The relationship between the complexity of organizational with organizational intelligence was not significant (r=0.157 and p=0.53), but by two other organizational dimension of structures (i.e., degree of formalization, centralization) with organizational intelligence was obtained significant respectively (r=-0.693 and p=0.001) and (r=-0.711 and p=0.001).

Conclusion: Based on findings from this research, teaching hospitals must be review current situation about organizational structural dimensions particular through decreasing centralization, formalization, to provide necessary field for developing and implementation of organizational intelligence

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Background: Head circumference (and its related morphologic factors such as head length and width) is one of the morphologic indices that people with autism spectrum disorders (ASD) have different developmental patterns in comparison to their peers. So the aim of this study is to assess head circumference indices in relation to cognitive factors in ASD children and adolescents.

Materials and Methods: In this cross-sectional study, the case group was consisted of 129 students with ASD aged 7-18 years old. The control group was consisted of 103 students with intellectual disability (ID) aged 7-18 years old. Head circumference, head length and width was measured by meter and caliper respectively. In addition, socio- cognitive factors questionnaire was responded by parents.

Results: Results showed that the head circumference, length and width of ASD group was significantly greater than ID group (p<0.001). Moreover, ASD group achieved lower score on SSIS questionnaire than ID group (p<0.001). Furthermore, results showed that in ASD group with increasing the size of head circumference the score on socio-cognitive abilites and skills decreased (p<0.05).

Conclusion: Generally, this study indicated that the developmental trajectory as well as the relation of anthropmetric indices of head circumference and socio-cognitive factors in children and adolescents with ASDs is different from ID population.

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