1 2322-3839 Alborz University of Medical sciences 461 Special Ultrasonic Findings of Intraventricular Hemorrhage in Preterm Newborns in Shariati Hospital (1391-1392) Agha Ghazvieny L. b Shajari A. c Shajari H. d Valypoor S. e b Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran c Department of Pediatrics, Shahvali Hospital, Islamic Azad University, Yazd, Iran d Department of Pediatrics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran e M.D. Shariati Hospital, Tehran, Iran 1 8 2016 5 3 137 148 09 11 2016 09 11 2016 Background and Objective: Intracranial hemorrhage (ICH) can affect newborn of all gestational ages and often is clinically silent. Germinal matrix hemorrhage and intraventricular hemorrhage (GM-IVH) is most common in the premature population. Estimated of frequency have changed over the last 20 years. Currently, large series report a 15% prevalence in infants <32 weeks GM-IVH is reliably diagnosed with ultrasonography routine screening for GM-IVH is performed in infants <30 weeks or >1250g at birth Material and Methods: All the newborns whom met the inclusion criteria were included in the study, they all had a brain sonography in the first 48 hrs after, and in case of finding any abnormality sonography was performed every week until discharge. For those who had a normal sonography, no further sonography was performed an expert pediatric radiologist performed the sonographies in sagittal and coronal planes the size of corpus collosum, lateral ventricles, inter hemispheric fissure and subarachnoid spaces were measured. (My lab 70 Esaote) Abnormal cystic regions in white and grey matter were evaluated and abnormal findings were documented. Results: Finally, 100 cases were included in the study GMH had a frequency of 28(28%) in our study. Among those with GMH 18 were male and 10 were female. There were no significant differences between the two sex groups in this regard. (P value=0.5.2), 7 of these infants were delivered through normal vaginal delivery and 21 through c/section. There was no significant difference between the two groups in this regard. (p value=0.010). Mean gestational age among the group with positive history of bleeding was 29 weeks and 31 weeks among those with negative history of bleeding. (p value=0.005). Mean birth weight with positive history of bleeding was 1292 gr and 1490 gr with no bleeding. (p value=0.035) in both groups the highest frequency belonged to first time pregnancies. (p value=0.667). Regarding the grade of bleeding, grade I with 23 cases (82.1%) had the highest frequency, grade 3 and 4 each had cases (7.1%) and grade 2 had 1 cases (3.6%). Regarding the frequency of PVL, only 6 infants (6%) had cystic PVL were detected. Conclusion: The prevalence of IVH in our study was close to other studies conducted in Iran, but was significantly higher than the western studies. Also studies showed that the prevalence of IVH decreased during to higher quality of perinatal care and delivery. 
462 Special Comparing the Efficacy and Side Effects of Trans-Cervical Catheter and Vaginal Misoprostol on Cervical Ripening Mallah F. f S. g f Department of Obstetrics and Gynecology, Tabriz University of Medical Science, Tabriz, Iran g Department of Obstetrics and Gynecology, Tehran University of Medical Science, Tehran, Iran 1 8 2016 5 3 149 156 09 11 2016 09 11 2016 Background: The success of labor induction is extremely dependent on the state of the cervix. There are various methods available in modern obstetrics practice for ripening the cervix, such as intravaginal prostaglandins and mechanical devices like transcervical catheters. Although plenty of studies have already compared the two methods for the unripened cervices, more studies are warranted in nulliparous patients only. This study aimed to compare the efficacy of intravaginal misoprostol tablets with transcervical Foley catheter for cervical ripening in nulliparous patients. Methods & Materials: In this randomized clinical trial, 120 nulliparous candidates for labor induction were recruited from two teaching centers in Tabriz within a 17-month period of time. All the enrolled cases had a live singleton fetus with cephalic presentation at term (≥37 weeks), on-admission Bishop Score≤4, intact membranes and reactive non-stress test results. They were randomly assigned to two equal age-matched groups receiving either intravaginal misoprostol (25 microgram, n=59), or transcervical insertion of 16F Foley catheter (n=60). Results: One time successful induction (i.e. successful induction after a single insertion of misoprostol, or expulsion of transcervical Foley catheter within 12 h of insertion) was achieved in all the patients without employment of other methods such as use of syntocinon. Misoprostol was more effective in terms of induction-to-cervical ripening interval (15.16±3.59 h vs. 18.30±1.59 h; p<0.001). Tachysystole, on the other hand, was significantly more frequent in the misoprostol receivers (25.4% vs. 0%; p<0.001). The two groups were comparable for the rate of cesarean section (misoprostol, 37.3%; Folly catheter, 30%; p=0.40). Comparing the two groups, there was no significant difference with regard to change in Bishop Score (misoprostol, 1.90±0.54 h-1; Folly catheter, 1.89±0.74 h-1; p=0.95) and miscellaneous pregnancy-related and fetal complications such as meconium staining of the amniotic fluid, placental abruption/bleeding, uterine atony/hypertonicity, fetal tachycardia/bradycardia, and neonatal apgar. Conclusion: Intravaginal misoprostol is more efficacious than transcervical insertion of Foley catheter for cervical ripening and induction of labor in nulliparous women. 463 Special PCA and Postoperative Pain Management After Orthopedic Surgeries Hashemi S.M. h Hassanzadeh Kiyabi F. i Nikooseresht M. j Hosseini Khmaneie S.M. k Safi E. l Shemiranifar A. m Gudarzi F. n h Department of Pain & Anesthesiology Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran i Department of Pain & Anesthesiology Imam khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran j Department of Pain & Anesthesiology Beasat Hospital, Hamedan University of Medical Sciences, Hamedan, Iran k Department of Orthopedic Suegery Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran l Nursing Department Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran m Nursing Department Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran n گروه پرستاری، بیمارستان اختر، دانشگاه علوم پزشکی شهیدبهشتی، تهران، ایران 1 8 2016 5 3 157 162 09 11 2016 09 11 2016 Background: Patients often suffer from inadequate treatment of postoperative pain. The aim of this study was to investigate effect of PCA on postoperative pain management and patients’ satisfaction from use of PCA. Materials and Methods: In this prospective study, between 2010 to 2011, patients presented by orthopedic specialists to acute and chronic pain service of Akhtar Hospital. A satisfaction questionnaire was given on discharge to this patients, were asked to fill out it . Then collected by ward nurse. Results: patients’ satisfaction from pain relief with use of PCA was high ( 94.9% ). In this patient pain relief at third day after surgery and require analgesic was low, significantly (p=0.0001). Significant patients’ satisfaction from effect of PCA in pain control and products support was high (p=0.0001).     Conclusion: Patient controlled analgesia is a safe, effective and noninvasive method for post operative pain management and in this study patients’ satisfaction for pain management was high for use of PCA and pain service.  464 Special Computing Cost Price by Using Activity Based Costing (ABC) Method in Dialysis Ward of Shahid Rajaei Medical & Education Center, in Alborz University of Medical Sciences Karaj in 2015 Derafshi H. o Kalantri Bengar B. p Kasani E. Nazari M. Rahimi F. Vaseghi M. Alaei M. o University President, Professor Cornea, Alborz University of Medical Sciences, Karaj, Iran p General Physician, Department of Management MBA, Treatment, Alborz University of Medical Sciences, Karaj, Iran General Physician, Management and Resources Development Department, Alborz University of Medical Sciences, Karaj, Iran Ph.D Student of Health Services, Manager, Shahid Rajaei Medical & Education Center, Alborz University of Medical Sciences, Karaj, Iran Student Critical Care Nursing, School of Nursing and Midwifery, Shahed University, Tehran, Iran Computer Software Engineering Technology, Shahid Rajaei Medical & Education Center, Alborz University of Medical Sciences, Karaj, Iran Responsible Secretariat, Shahid Rajaei Medical & Education Center, Alborz University of Medical Sciences, Karaj, Iran 1 8 2016 5 3 163 172 09 11 2016 09 11 2016 Background: Analysis of hospital cost is one of the key subjects for resource allocation. The Activity – based costing is an applicable tool to recognize accurate costs .This technique helps to determine costs. The aim of this study is utilizing activity activity-based costing method to estimate the cost of dialysis unit related to Shahid Rajaei hospital in year 2015. Methods: The type of this research is applied and sectioned descriptive study. The required data is collected from dialysis unit , accounting unit, discharge, the completion of medical equipments of Shahid Rajaei hospital in the first six months 2015 which was calculated cost by excel software. Results and Conclusion: In any month, the average 1238 patients accepted to receive the dialysis services in Shahid Rajaei hospital .The cost of consumables materials was 47.6%, which is the majority percentage of allocated costs. The lowest cost related to insurance deductions about 2.27%. After Calculating various costs of dialysis services, we find out, the personal cost covers only 32% of the all cost. The other ongoing overhead cost is about 11.94% of all cost. Therefore, any dialysis service requires 2.017.131 rial costs, however the tariff of any dialysis service is 1.838.871 rial. So, this center loses 178,260 rial in each session. The results show that the cost of doing any dialysis services is more than the revenue of it in Shahid Rajaei hospital. It seems that the reforming processes of supplying consumable, changing the tariffs in chronic dialysis; especially in set the filter and consumable materials unit besides controlling the cost of human resource could decrease the cost of this unit with Regard to the results recommended using capacity of the private department recommended.  465 Special The Effect of Inhalation Aromatherapy on Physiological and Psychological Parameters of Patient’s Candidate for Coronary Artery Bypass Graft: Pilot Study Rajai N. Teymouri F. Sajadi A. Zareiyan A. Seyedmazhari M. Instructor, Department of Mother and Infant Nursing, Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran Instructor, Department of Pediatrics, Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran MSc of Medical Surgical Nursing, Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran Assistant Professor of Nursing, Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran MSc of Medical Surgical Nursing, Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran 1 8 2016 5 3 173 178 09 11 2016 09 11 2016 Introduction: Anxiety and stress are common problems before coronary artery bypass graft surgery has a destructive effect on the patient's condition. One of the medications therapies that are effective in reducing anxiety level is Aromatherapy. The aim of this study is to assess the effect of inhalation aromatherapy on physiological and psychological parameters of patients who are candidate for coronary artery bypass graft. Method: In this pilot study, 30 patients candidate of coronary artery bypass graft were selected by convenient sampling method. For intervention on the morning of the surgery, patients inhaled Lavender essential oil from a distance of 5 cm of the nose, for 20 minutes. Physiological and psychological parameters of patients the day before surgery and then 5 and 30 minutes after intervention was estimated by Form vital signs and DASS questionnaire. Data were analyzed in three phases using Descriptive Statistics and repeated measures ANOVA by SPSS.17. Results: 20% of patients were female, 80% male with an average age of 65/36±8/05. The results show a significant difference between the three time phases in variable of the pulse (P = 0/041), respiration (P = 0/040) and stress (P=0.046). Discussion: Aromatherapy can be an effective way to reduce stress levels and pulse in patients candidate for coronary artery bypass graft. Since this results study obtained from a pilot study, to Generalize the results, clinical trials with larger sample size is recommended. 466 Special The Effect of Antiepileptic Drug of Lamotrigine, on the Function of Reproductive Hormones in Male Rats Khezri Motlagh R. Mokhtari M. Shariati M. Changizi- Ashtiyani S. Moghadamnia D. PhD Student in Animal Physiology, Islamic Azad University, Fars Science and Research Branch Ph.D. in Physiology, Associate Professor, Department of Biology, Kazerun Azad University. Kazerun, Iran Ph.D. in Physiology, Associate Professor, Department of Biology, Kazerun Azad University. Kazerun, Iran Ph.D. in Medical Physiology, Associate Professor, Department of Physiology, Arak University of Medical Sciences. Arak, Iran PhD Student in Animal Physiology, Islamic Azad University, Fars Science and Research Branch 1 8 2016 5 3 179 186 09 11 2016 09 11 2016 Introduction: Lamotrigine is one of the never anti-epileptic drug. In this study the effects of lamotrigine have been observed on serum concentration of LH (Luteinizing hormone), FSH (Follicle-stimulating hormone), testosterone ,body and testis weight in male rat. Methods: The animal used in this experiment were 40 adult male rat from wistar race which were divided in to 5 group of 8.consisting of control group which received nothings, Sham group which received 0.2 ml distilled water via oral. Experimental group which received 100, 200, 400 mg/kg lamotrigine via oral after 14th day body weight were measured in all group and then the blood sample was taken from heart and concentration of LH.FSH, testosterone was measured. In addition the testis were separated and testis weight were measured in all group. Results: The result show that concentration of LH in experimental group did not show significant difference in compared with control group but in experimental group received 400mg/kg of lamotrigine  show a significant decrease in concentration of FSH and testosterone in comparison with control group .In addition lamotrigine had effect and testis weight in middle and high dose was reduce. Conclusion: Lamotrigine, an antiepileptic drug, reduced reproductive activity by inhibiting of hypothalamic-pituitary-gonadal axis in adult male rats. 467 Special The Effect of 8 Weeks Resistance Training with HMB Supplementary Product on Changes in Growth Hormone and Testosteron Over Un athlete Males Assad M.R. Zoghi R. Fashi M. Associate Professor of Exercise Physiology, University of Payame Noor, Iran Exercise Physiology Ph.D Student, University of Tehran, Iran Assistant Professor of Exercise Physiology, University of Martyr Beheshti Tehran, Iran 1 8 2016 5 3 187 193 09 11 2016 09 11 2016 The purpose of this study was to examine the effect of 8 weeks resistance training program with HMB supplementary product on changes in Growth hormone and testosterone over non athlete males. This  presented research is a semi-experimental research and due to this matter 20 non athlete males participated voluntary  for this research and were divided into 2 groups, experimental groups (n=10) with an average age of 75/28±39/1 years, height 83/179±30/0 centimeters, weight 23/84+-58/3 kilograms and fat percentage 21/29±97/5,2: control group(n=10) with an average of 28+-14/2 years, height 25/180±71/3 centimeters , weight 23/84±58/3 kg and fat percentage 21/29±97/5.both groups performed 8 weeks resistance training  protocol ( 5 moves,3 times per a week, with  an intensity level of 50 to 80% 1RM). The experimental group during the research took 3 gr HMB supplement daily .a drug index is used for the control group. before  the exercise and  48 h after the last training session blood sample was taken from their left  forearm vein while fasting. at last growth hormone and testosterone serum dosage  was analyzed via a micro wells (made in U.S.A). Beside growth hormone and testosterone, fat percentage, BMI and vo2 max  were analyzed before and after the experiment. The analyzed rate via T TEST showed that the usage of HMB supplement doesn’t have a significant effect on GH,TH, FAT PERCENTAGE, BMI, and vo2 max. This presented information doesn’t recommend the HMB supplement dose for increasing level of growth and testosterone serum. 468 Special Treatment Results of Combined Surgery and Brachytherapy, and the Rate of Recurrence in Patients with Recurrent Keloid Scars Taheri A.R. Rahmanpanah N. Aghili M. Nazemi Salman D. Hosseinzadeh Z. Department of Plastic and Reconstructive Surgeon, Tehran University of Medical Science, Tehran, Iran Department of Plastic and Reconstructive Surgeon, Kordestan University of Medical Science, Sanandaj, Iran Department of Radiotherapy, Tehran University of Medical Science, Tehran, Iran Department of Plastic and Reconstructive Surgeon, Zanjan University of Medical Science, Zanjan, Iran Department of Nursing, Imam Khomeini Hospital Tehran, Iran 1 8 2016 5 3 194 200 09 11 2016 09 11 2016 Background: Several options are described to treat keloid scars, none of them being 100% successful. Radiotherapy is suggested to have the most significant effect on recurrence rate. The aim of the study is to evaluate the effectiveness of  High-dose brachytherapy combined with surgery and to evaluate patient satisfaction. Methods and Material: We retrospectively enrolled 5 patients with 10 keloids, treated by surgical excision and high-dose-rate (HDR) brachytherapy. Total dose was 12 Gy in 3 fractions. Results: The median size of the lesions before brachytherapy was 153.48 mm2. The improvement of scars of scoring POSAS by observer and patient were 17.1±3.2 (11-32) and 20.8±11.5 (5-51), respectively. Mean of recurrent time was 26.3±0.9 months. With a median follow-up of 60 months, the overall recurrence-free response rate for all keloids was 20%. Except for one patient, in other patients seen no complications. Conclusion: It seems that keloid excision followed by HDR brachytherapy is effective in the eradication of keloids in treatment. It also resulted in a good cosmetic rate and relief of symptoms.