39 2228-7043 Iran University of Medical Sciences 3468 Medical Conceptual and Practical Evolution of the Virtual Hospital Moghaddasi Hamid b Kamkarhaghighi Mehran c b Shahid Beheshti University of Medical Sciences c Shahid Beheshti University of Medical Sciences 1 1 2015 21 127 1 11 06 01 2015 06 01 2015  Background: ICT development has led to the emergence of virtual organizations phenomenon. Virtual hospital is one of these virtual organizations which present digital version of services and information of a hospital. In scientific literature, the term “virtual hospital” covers other concepts as well as the concept of a hospital. The study aimed at analyzing conceptual and practical evolution of virtual hospital. Considering these purpose different documents of the 1950s were reviewed and categorized under four conceptual terms. Practically, we related some actions to each term, as well. Methods: This study was conducted as a review of articles collected from PubMed, Web of Sciences and Google Scholar databases. Findings: Definitions of virtual hospital were differed from time to time. There is also different experience of implemented virtual hospitals in different countries. The first virtual hospital refers to the medical digital library to provide telemedicine services, in which then was named a virtual medical university. In the first decade of the 21st century, virtual hospital as a three-dimensional environment based on virtual reality emerged. Of those countries which adopted this technology were Germany, United Kingdom, United States, New Zealand, China and Singapore.  Conclusion: By advancing virtual reality techniques and development of Nano-electronics, we will be witnesses of production of advanced “point of care systems" with a kind of interaction between patients and physicians in a way that they feel they are really in a real hospital with possibility of track and care of patients instead real hospitalization
3469 Educational Health Effectiveness of educational intervention on exclusive breast feeding in primipara women: application of planned behavior theory Mohammadi Zeidi Isa d Pakpour Hajiagha Amir e Mohammadi Zeidi Banafsheh f d Qazvin University of Medical Sciences, Qazvin, Iran e Qazvin University of Medical Sciences, Qazvin, Iran f Tonekabon Azad University 1 1 2015 21 127 12 23 06 01 2015 06 01 2015 Background: Breast-feeding is the recommended method of infant feeding because it is clearly associated with health benefits for infants and their mothers. Yet, many women who initiate breast-feeding fail to meet their own personal goals or recommended standards for duration of breast-feeding. To refine a Theory of Planned Behavior (TPB) based on structural model for explaining variability in breast-feeding intention and duration. This study was aimed to assess the effectiveness of an educational intervention to continue breastfeeding among primiparas in Tonekabon city. Methods: This is a quasi-experimental study with 110 primiparas who were in their seventh and eighth months of pregnancy referred to two health centers in Tonekabon city. The subjects were randomly selected from health centers in Tonekabon city and assigned to either control (n=55) and experimental group (n=55). The research tool was a self constructed questionnaire with two sections demographic questions and the TBP constructs i.e. knowledge, attitude, subjective norms, intention and breast feeding behavior. Face and content validity was appointed by an expert’s panel. Internal consistency and reliability was confirmed by Cronbach's alpha and test-retest coefficients. Mothers in the experimental group received an educational intervention based on the TBP constructs in terms of how proper feeding infants with breast milk, the benefits of exclusive breast feeding, nutritional characteristics for infants with low birth weight, frequency and duration of breastfeeding and how to store breast milk in mothers who work. The data were collected two months before delivery and four months after delivery. The chi-square, t-test and and two-way ANOVA were used for data analysis. The confidence level was 95%. Results: the average age of the mothers who participated in the study in experimental and control groups were 23.84 and 23.59, respectively. More than 60% of the mothers were educated until diploma and had an intermediate family income. There were no differences between the groups before educational intervention. The educational intervention resulted in a significant increase in attitude, subjective norm, perceived behavioral control, self-efficacy, behavioral intentions and breast feeding behavior (p<0.001) while there was no significant change in the control group. Breastfeeding behavior had no significant difference between the two groups before the educational intervention. A significant change in feeding behavior was observed in the experimental group once the educational intervention was implemented. Conclusion: our results indicated that the theory of planned behavior is an appropriate theory to explain the impact of psychosocial factors for the design and implementation of educational programs to increase exclusive breast-feeding among primiparas 3471 Clinical Psychiatry Prediction of Postpartum Depression Based on Parental Bonding, History of Anxiety, and Depression among Women Attended Health Care Centers in Shiraz norouzi ziba 1 1 2015 21 127 24 30 07 01 2015 07 01 2015  Background: Depression has often been considered as a major cause of human health threats in the world. The goal of the current study was to predict postpartum depression among women attended health care centers in Shiraz based on parental bonding, history of anxiety, and depression . Methods: In this regard, 120 women with postpartum depression were selected among the women who had delivered in hospitals of Shiraz using convenience sampling method. The tools were Parental Bonding Instrument (PBI), Postnatal Depression Scale (Edinburgh), and the checklist of anxiety and depression using diagnostic criteria of anxiety and mood disorders (DSM- IV-IR). Data were analyzed using multiple regression analysis with stepwise method through SPSS v.16. Findings: The linear regression model showed that extraordinary protective factors of caring father (p<0.001) and mother (p<0.001) have significant effect on depression. Considering the calculated coefficient determinant (R2=0.44), the extraordinary protective factors of caring father and mother, predicted 44% of postpartum depression. It means that 44% of changes by postpartum depression in caused by the extraordinary protective factors of caring father and mother.  Conclusion: Result of regression analysis indicated that protective factors of caring father and mother are able to predict postpartum depression. The overall results of this study indicated that emotional connection between parents and their children, leads to(determine) the formation of mental disorders in children in different periods of life 3472 Epidemiology Epidemiology and Mortality of burned patients referred to Motahari Hospital, Tehran Amani Lale i Soleymanzadeh Moghadam Somayeh j Roudbari Masoud k Roustapoor Roya l Armat Marziyeh m Rastegar Lari Abdolaziz n i Iran University of Medical Sciences j Iran University of Medical Sciences k Iran University of Medical Sciences l Iran University of Medical Sciences m Iran University of Medical Sciences n Iran University of Medical Sciences 1 1 2015 21 127 31 38 07 01 2015 07 01 2015  Background: Burn is from the main causes of death, and studies show that prevention is the best way to reduce deaths from burns. This study aimed to evaluate the epidemiological burns, as well as evaluating the relationship between different variables.  Methods: This cross-sectional study performed on 335 patients, from September 2011 to March 2012 in Motahari Hospital, Tehran. Information includes age, sex, total burn surface area (TBSA), cause of burn, length of hospitalization, burn extent and death rate and morbidity were extracted from patients' records. Results:  result showed that 78.6% of patients were male and the rest female and 34 patients died. Also TBSA of 86.2% of patients was less than 40%. In this study, explosions and scalds are the highest causes of burns, respectively. Length of hospitalization varied from 1 to 105days and the mean was 13 days. Conclusion: Identifying factors influencing burns, prevention and preventive education is important for control and reduce burns 3473 Clinical Psychiatry Effect of group Logotherapy education on quality of life and general health in women of sanatorium Zanjiran Shayesteh o Borjali Ahmad p Kraskian Adis o Islamic Azad university, Karaj, Iran p PhD. Professor of Psychology, Department of Psychology, Karaj Branch, Islamic Azad university, Karaj, Iran PhD. Professor of Psychology, Department of Psychology, Karaj Branch, Islamic Azad university, Karaj, Iran 1 1 2015 21 127 39 51 07 01 2015 07 01 2015  Background:The elderly are one of increasing social groups in the present communities which has gained importance with respect to the age pyramid of our country. The study purpose was evaluating the effectiveness of group logotherapy education on quality of life and general health in women of sanatorium. Methods: The population included all elderlies living in private sanatorium in city of Shahriar. Sample selection was via convenience sampling. Subjects (n=24) were assigned to 2 groups. The control group (N=12) received the usual nursing care and experimental group (N=12) participated in the group training consisted of 10-day sessions for 5 weeks (every session, 2 hours). Effects were measured using questionnaire for quality of life in the elderly (Lipad) and general health (GHQ-28) analysis of covariance was used for analysis of data. Results: Results indicated a significant difference between pretest and posttest of experimental group. Conclusion: The group logotherapy education is effective on increasing quality of life and general health in women of sanatorium.  3474 medical education Comparison of patients’ demand and need to receive restorative dental services Daryazadeh Saeideh Kuhpayehzadeh Jalil Hashemzadeh Mehdi Shajari Jila Jafari Ahmad Tehran University of Medical Sciences, Tehran, Iran Iran University of Medical Sciences, Tehran, Iran Isfahan University of Medical Sciences, Isfahan, Iran Iran University of Medical Sciences, Tehran, Iran Tehran University of Medical Sciences, Tehran, Iran 1 1 2015 21 127 52 60 07 01 2015 07 01 2015  Background: Survey of patients’ demand and need to receive dental services, has a special role in providing these services and meeting the community therapeutic needs. This study compares patients’ demand and need to receive restorative dental services in a dental clinic in Isfahan. Methods: This was a descriptive-cross sectional study and data gathering was by checklist. The data of identified demands and needs of restorative dental services of ‎‏‏‎ refered patients to Farhangian dental clinic chosen by non-‎random ‎consecutive sampling during three months were entered into statistical software SPSS (version 17. Chi-square test was used for data analyzing. P <0.05 was considered as significant level. Results: Totally 1040 patients were studied that included 603 peoples (58.2 %) were in 15-49 years age group. The most referring reason of patients were respectively related to endodontic (24.8%), restorative and prosthetic included 193 peoples (each 18.5 %) and periodontics included 133 peoples (12.8%) and the least of referring reason was oral diseases included 7 peoples (0.7 %). 1027 patients (98.75%) needed to restorative dental services but just 195 patients (18.8%) had demand for these services (p<0.05). Conclusion: Most people do not visit dentist until they have tooth pain that indicate lack of knowledge of patients in role of preventive examination and periodic controls in increasing oral health. Many patients are not aware of their dental services needs. To meet these services, patients’ demand of receiving the services should be increased. Thus, there would be establisged a balance between the demands and real needs of people 3475 Community Medicine Determining Factors related to health services utilization: Nooraiee Motlagh Soraya Saber Mahani Asma Barooni Mohsen Asadi Lari Mohsen Vaez Mahdavi Mohamad Reza Hadian Mohammad Iran University of Medical Sciences, Tehran, Iran Kerman University of Medical Sciences, Kerman, Iran Kerman University of Medical Sciences, Kerman, Iran Iran University of Medical Sciences, Tehran, Iran Shahed University, Tehran, Iran Iran University of Medical Sciences, Tehran, Iran 1 1 2015 21 127 61 72 07 01 2015 07 01 2015  Background: Having knowledge about utilization of health care services is necessary for resource allocation and scheduling in health sector. The general consensus is that the inequality in the utilization of health care is unjust and unfair and health care systems should ensure equal access to health care based on need. Methods: The main objective of this study was to identify factors influencing the utilization of health services, inpatient and outpatient both in the public and private sectors using logit econometric models. Domain of this study is 2011 and all regions of Tehran are considered. Urban HEART questioners’ data was used in this research. Gathered data were analyzed and interpreted in several stages and in the form of several logit models for inpatient services, outpatient services and private and public services.  Results: The research findings showed that in 2011, overall 40.07% of the populations of Tehran have used outpatient health services and 18.69% of inpatient services. The main reasons for not utilization of outpatient services was reported existing of medicine and self-treatment at home and after that were having no money and services expensiveness and resolve the problem. Between reasons for not utilization of inpatient services, having no money and services expensiveness and lack of the expertise required for households were more important than other factors. After estimation of logit models the income, education, employment status, insurance and household size have been diagnosed effective on health services utilization. Existence of patients with chronic disease in households was the most effective factor on health care utilization in both inpatient and outpatient service groups. Discussion: Policy makers in health sector need to improve financial or economical access to health services, and in this regard, the identification of households in the bottom expenditure deciles, living in deprived regions, households with people over 60 and less than 5 years or patient with chronic disease will be a good help for planning for increase in health services accessibility.  3480 Endocrinology & Metabolism The prevalence of autoimmune thyroid disease in patients with type I diabetes mellitus admitted to Ali-Asghar and Hazrat-Rasool hospitals in Tehran during the years 2006 to 2011 Soheilipour Fahimeh Razaghi-Azar Maryam. Maryam Khoshlesan Abolfazl Iran University of Medical Sciences Iran University of Medical Sciences Iran University of Medical Sciences 1 1 2015 21 127 73 81 10 01 2015 10 01 2015  Background: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease co-occurred with a high incidence of other autoimmune disorders including thyroid function abnormalities. This study investigated the prevalence of autoimmune thyroid disorders in patients with T1DM. Methods: In this retrospective cross sectional study, 150 patients with T1DM aged 7 - 17 years old, admitted in Ali-Asghar and Hazrat-e-Rasool Hospitals during 2006 to 2011 were studied. The records of patients in terms of sex, age, age at onset of diabetes, duration of diabetes, HbA1c levels of patients and thyroid hormones T3, T4 and hormone TSH, thyroid antibodies such as anti-thyroid peroxidase (anti -TPO) and thyroglobulin antibodies (anti-Tg) were investigated. The collected data were analyzed using SPSS 11 software. Results: Eighty two patients (54.7%) were female and 68 (45.3%) were male and their mean (SD) age was 11.5 ± 2.8 years. Anti-thyroid peroxidase antibody (anti-TPO) was positive in 41 patients (27.3%) and thyroglobulin antibody (anti-Tg) in 23 patients (15.3%) and in 16 patients (10.6%) anti-TPO and anti-Tg were positive simultaneously. Prevalence of clinical hypothyroidism (21.9%) and subclinical hypothyroidism (7.3%) in patients with positive anti-TPO were higher than patients with anti-TPO negative. The presence of anti-thyroid antibodies were associated with factors, including female gender, older age, longer duration of diabetes and higher levels of HbA1c. Conclusion: According to high prevalence of autoimmune thyroid disorders in children with T1DM evaluating these patients in terms of thyroid function and thyroid auto-antibodies is suggested.  3483 Gynecology Etiology of pelvic inflammatory disease Mehraban zahra Alizadeh Leila Amirmozafari nour Islamic Azad University, Ardabil, Iran Islamic Azad University, Ardabil, Iran Iran University of Medical Sciences ,School of Medicine Microbiology Department 1 1 2015 21 127 82 94 11 01 2015 11 01 2015  Background: Pelvic inflammatory disease (PID) is one of the most common infections between women during reproductive age which is associated with major long-term complication, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. In addition, treatment of acute PID and its sequelae impose health care costs. Prevention of these long-term complications is dependent on clinicians having a high level of recognition in order to make an early diagnosis and improvement of treatment strategies based on knowledge of the microbiologic etiology of acute PID.  Methods: This is a systematic review of more than 2580 papers about the etiology of pelvic inflammatory disease, which had been published until 2012.   Results: In most cases, PID is a polymicrobial infection and of sexually transmitted organisms Neisseria gonorrhoeae and Chlamydia trachomatis were most prevalent. Recently Mycoplasma genitalia are known as a cause of acute PID. Treatment regimen for acute PID should be covered a wide variety of drugs against these microorganisms.  Conclusion: Determining risk factors and patients’ clinical symptoms play a vital role in diagnosis, treatment and prevention of PID, leading a decrease in disability rate and side effects of PID.  3484 Forensic Medicine Evaluating the role of gender in the etiology, demographic features and prognosis of burn patients admitted to Shahid Motahari hospital: a five-year retrospective study Aghakhani Kamran Aram Samira Mehrpisheh Shahrokh Memarian Azadeh Hoseini Rozita Ghorbani Mazaher Iran University of medical sciences,Tehran,Iran Tehran University of medical sciences,Tehran,Iran Qazvin University of medical sciences,Qazvin,Iran Iran University of medical sciences,Tehran,Iran Iran University of medical sciences,Tehran,Iran Tehran University of medical sciences,Tehran,Iran 1 1 2015 21 127 95 101 11 01 2015 11 01 2015  Introduction: Burn is one of the leading causes of disability and mortality in the world that has serious economic and social consequences. This study aims at evaluating gender differences as an important role in risk exposure and burn injury characteristics and prognosis of burn patients. Methods and Materials: In this retrospective study we extracted the data of burn patients admitted to Shahid Motahari hospital in Tehran from 2007 to 2012 to find about the role of gender in the etiology, burn severity, hospitalization duration, prognosis, mortality rates and other demographic features of the patients. Results: A total number of 7021 patients were studied (25.9% female and 74.1% males) with the mean age 28.5 years for women and 28.8 years for men. There was a statistically significant difference in mortality rate, the degree and the percentage of burn, marital status, hospitalization duration between two genders. The most common cause of burning in women was boiling water and in men, electrical burning. The mortality rate in women was more than men (22.3% vs. 13.6%). The degree of burn in women was often grade 2 and in men grade 3. The mean of hospitalization was longer in men however the average of burn percentage was more in women. The number of self-burning as aد suicidal attempt was seen significantly more in women than men.   Conclusion: The most common cause of burn in women is boiling water. It seems that boiling water due to sloping down and heat loss results in a greater extent and lesser degree of burns. Women immunologic situation is another cause of mortality. Considering more self-burning in women, it seems that psychological counseling and improving psychological attitude can result in reducing women suicidal attempts. Also preventive education particularly during cooking  and using boiling water in women and providing conservation facilities for men in the workplace can enhance the survival of patients after burn in the future studies.  3485 Psychiatry The comparison of depression and quality of life in the obese women with different body mass indices (BMI) with the normal women residing in Tehran Amiri Hamid Borjali Ahmad Sohrabi Faramarz Pazouki Abdolreza Iran University of Medical Sciences, Tehran, Iran Allameh Tabataba’i University, Faculty of Psychology and Educational Sciences, Tehran, Iran Allameh Tabataba’i University, Faculty of Psychology and Educational Sciences, Tehran, Iran Iran University of Medical Sciences, Tehran, Iran 1 1 2015 21 127 102 112 11 01 2015 11 01 2015  Background: Obesity is a complex physical disorder caused by different biological, psychological, and social factors. Identification of the psychological factors and consequences of obesity is one of the main elements of its control and treatment. The present study was carried out to compare depression and quality of life in the obese women with different body mass indices (BMIs) with the normal women. Methods: for each three groups of obesity 40 and in total 120 women were selected of all the visitors of the Minimally Invasive Surgery Research Center of Tehran University of Medical Sciences using convenience sampling method and based on the BMI table in a causal-comparative design. Forty women were the normal women sample. Instruments of the study were composed of a questionnaire of personal information, Beck Depression Inventory (second version), and Health-Related Quality of Life Questionnaire (SF-36). The data were analyzed using Multi-Variable Analysis of Variance (MANOVA), One Way Analysis of Variance (ANOVA), Bonferroni Post hoc test, and Pearson’s correlation coefficient as well as the SPSS software. Results: the results suggested a significant difference between the obese women in different levels of BMI and the normal ones concerning depression and quality of life at p<0.001. In addition, it was revealed that there is a significant negative difference among the obese women in different levels of BMI concerning depression and quality of life at p<0.001. Conclusion: Regarding the different psychological variables such as depression in obesity, psychological interventions can be useful in the prevention, control, and treatment of obesity as well as promotion of the patients’ quality of life.