Patients hunt for genuine empathy from their medical doctor. Empathy is an affective mode of understanding. Empathy involves being enthused by another's experiences. However, a leading group medical doctors defines empathy as 'the act of correctly acknowledging the emotional state of another without experiencing that state oneself'. Beyond the field of medicine, empathy is an approach to understanding that precisely involves emotional resonance. However, mentioned definition of empathy primarily gives emphasis to an intellectual component rather than emotional form. Medical educationist and medical professional bodies increasingly recognise the importance of empathy because there are a lot report published regarding poor empathy level among medical doctors. This article will try to discuss emphasising on educational intervention which improves empathy level and its influence on healthcare.

Background: The objective of this survey was predictors of quality of life for parents with Autism disorder (AD) children in Hamadan City. Materials and Methods: The sample size was included 82 mothers and 81 fathers of children with AD. The questionnaires of Parenting Stress Index-Short Form (SF) and SF-34 were used. The three stress subscales (Parental Distress; Parent–Child Dysfunctional Interaction [PCDI] and Difficult Child [DC]), age of diagnosis of AD, age of child and number of siblings were considered as predictors. Results: These analyses showed that the model among mothers and fathers was able to predict high a significant of variance in quality of life (F = 7.841, P < 0.001; R² = 0.34) and (F = 8.149, P < 0.001; R² = 0.35), respectively. Conclusion: The predictors of this study were PCDI, DC and number of siblings.

Objectives: The present study aimed at assessing the prevalence of cervical cancer and premalignant lesions of the cervix in patient referred to colposcopy unit in Zanjan, and to determine what extent colposcopy is conducted based on the scientific indications. Materials and Methods: In this registry-based cross-sectional study, all women who were referred to the Colposcopy unit of Zanjan Ayatollah-Mousavi Hospital to undergo colposcopy during 2012–2017 were studied. The required data were collected from the registered medical records in the Pathology Department of the hospital. The Bethesda System Terminology was used for classifying premalignant cervical lesions. Results: In the present study, the most common abnormal clinical signs were abnormal vaginal bleeding, whereas atypical squamous cells of undetermined significance (39.5%) remained the most common abnormal Pap smear test result. The clinical appearance of the cervix in 104 patients (62.3%) showed cervical erosion. The results of colposcopy showed some signs of inflammation in all patients. Out of these patients, 5.4% were reported with acute inflammation, and 39.5% with chronic inflammation. Conclusions: It can be concluded that the patients' referral for a colposcopy must be based on the scientific indications and unnecessary colposcopy should be avoided.

Objective: Progressive loss of memory has a prominent role in devastating neurodegenerative diseases such as amnesia, dementia and Alzheimer's disease. The present study was, thus, designed to investigate the potential of Hibiscus abelmoschus (H. abelmoschus) in scopolamine-induced amnesic Swiss Albino mice. Materials and Methods: Phytochemical and acute toxicity studies of H. abelmoschus ethanolic extract (HAEE) were performed. Memory loss was induced by scopolamine (1 mg/kg, i.p), a muscarinic antagonist, and evaluated by using Morris water maze (MWM), elevated plus maze (EPM) and modified passive avoidance tests on Swiss Albino mice. Besides this, locomotor activity, serum biochemical parameters such as total cholesterol and triglyceride levels were evaluated. Lipid peroxidation (LPO), glutathione (GSH) level and catalase (CAT) activity were also checked. HAEE at a dose of 200 and 400 mg/kg body weight administered orally to the animals. Donepezil hydrochloride (1 mg/kg) was taken as standard. Results: Pre-treatment of mice with HAEE significantly reversed scopolamine-induced memory impairments, as evidenced by a significant decrease in escape latency in the MWM task, transfer latency in EPM task and an increase in step-down latency in the modified passive avoidance task. HAEE also exhibited a remarkable cholesterol and triglyceride-lowering property in the present study. Moreover, treatment with HAEE (200 and 400 mg/kg, p.o) to scopolamine-induced rats significantly decreased the LPO and increased the GSH and catalase levels. Conclusion: The memory restorative effects of H. abelmoschus in amnesia may involve its multiple functions including antioxidative and lipid-lowering properties and the presence of phytoconstituents. Thus, H. abelmoschus may act as memory enhancer and may also be useful as a supportive adjuvant in the treatment of impaired memory functions.

Introduction: Proteins are the essential part of all organism cells. Nutrition plays the most important role in the structure and function of the brain. CA1 region belongs to hippocampus and plays a vital role in converting short-term to long-term memory. This study was designed to assess the effects of low-protein diet on hippocampal region CA1 and learning deficit in rats. Materials and Methods: In this study, 30 male rats were randomly assigned to two groups: control group and low-protein diet group (8% protein). Animals in a low-protein diet group have eaten food with low protein daily for 10 months. Body weight was measured. Transcardiac perfusion method was applied to tissue fixation. Passive avoidance learning of animals was examined by the shuttle-box apparatus technique. The number of dendritic spines was investigated by the Golgi staining technique. Furthermore, Cresyl violet staining method was used to determine the number of neurons in the hippocampal region CA1. Results: The passive avoidance learning of the low-protein diet rats was reduced significantly compared to the control ones (P < 0.001). Low-protein diet decreased the body weight, number of neuronal dendritic spines and neurons compared to the control group (P < 0.001). Conclusion: It seems that administration of low-protein diet had harmful effects of structure and function of hippocampal region CA1 in rats.

Background: As an important inflammatory marker, study of C-reactive protein (CRP) changes over time may lead to better identification of risk factors of cardiovascular disease. We evaluated the relationship between CRP changes and lifestyle, metabolic syndrome (MS) and body mass index (BMI) in middle-aged women and explored potential bias from attrition. Materials and Methods: We studied 1234 participants in the Isfahan cohort study – a longitudinal population-based study of adults older than 35 years living in urban and rural areas of three counties in central Iran. Data were collected every 6 years since 2001 (3 points). Random effects model was used to evaluate the effects of behavioural risk factors and MS on CRP, with pattern mixture model to account for cohort attrition. Results: Mean CRP levels decreased over time (Est = −0.066, P < 0.001). MS (Est = −0.195, P < 0.001), BMI (Est = 0.022, P < 0.001), physical activity (Est = −0.009, P = 0.002) and history of smoking (Est = −0.399, P = 0.002) were independently associated with increases in CRP. Pattern mixture model showed that CRP decreased in participants with monotone measurement (Est = −0.032, P < 0.001), as well as intermittent measurement (Est = −0.022, P < 0.001), with no association in participants who responded at all points (Est = −0.015, P = 0.083). Conclusion: In this study, the rate of changes in CRP level in middle-aged women over time was higher in participants who were irregularly measured than those who measured continuously. MS, BMI and physical activity may be related to the CRP changes over time in middle-aged women.

Background: Laptops are not ergonomically being designed as the same as a desktop computer and are not suitable for prolonged use. The current study aimed to assess the different postures laptop users, especially in non-official places, and its effect on musculoskeletal disorders (MSDs). Study Design: This was a cross-sectional study. Methods: One hundred and fifty university students were chosen that have continuous use of laptop for 5 years. Data were gathered by questionnaire (demographic data, laptop use-related questions and visual posture questions) and posture analysis using Rapid Upper Limb Assessment method. T-test, Chi-square and Spearman correlation coefficient tests were used in data analysis. Results: The mean of body weight in males and females was 77.58 ± 13.34 kg and 62.35 ± 10.67 kg, respectively. Two postures, including E (sitting on the sofa and put the laptop on the table) and F (sitting and working on an office chair and desk), were the most current postures by the users. Postures M and K had been as the most inappropriate postures, while postures D and G were defined as postures that are more appropriate. Conclusion: Laptop is using frequently as a popular device at home, dormitory or other non-official places. Due to nature of these places and inherent characteristics of laptops, it is not possible to make it adjust for the body based on ergonomic principals. Neck, upper and lower back, shoulder and wrist are organs that influence more by laptop based on body configuration.

Introduction: Academic self-efficacy is an important key structure along students' academic progress which can lead to increase learning. The aim of this study was to examine academic self-efficacy and related factors among the students of Tehran University of Medical Sciences. Materials and Methods: This cross-sectional study was done on 385 students of Tehran University of Medical Sciences. Samples were selected through stratified sampling method. Data were collected through questionnaire of academic self-efficacy scale 32 that reliability and validity of that was confirmed. Data analysis was done through SPSS18 software. Descriptive statistics and independent t-test, ANOVA and correlation coefficient were performed at statistical significance level of 0.05. Results: The mean academic self-efficacy in boys was 107/75 (standard deviation [SD] = 16/10) and in girls 107/19 (SD = 15/82). The Pearson correlation test results showed that there was a statistically significant relationship between age with academic self-efficacy (P = 0.001, r = 0.170). Independent t-test results indicate that there is no significant statistical relationship between self-efficacy and location. According to the ANOVA, there was a significant correlation between the college degrees and academic self-efficacy (P = 0.003). Conclusion: The findings of this study indicate the importance of age and college degrees in forecasting academic self-efficacy of students.

Introduction: The different studies assessed quality of life (QOL) in patients with spinal cord injury with different research tools and showed that QOL scores less are considered in national and international studies and in different cultures. Therefore, the aim of this study was to assess the QOL of patients undergoing lumbar spinal surgery in Hamadan Province, West of Iran. Materials and Methods: This retrospective cross-sectional study was performed of 300 patients underwent elective lumbar laminectomy (partial or complete) or fusion between 2012 and 2015, at a single tertiary care centre for non-traumatic and non-neoplastic indications in Hamadan, Iran. We used the Iranian version of the brief questionnaire of the World Health Organisation on QOL (WHOQOL-BREF). Stata software version 12 (StataCorp, College Station, TX, USA) was used to perform all the analytical operations. Results: In regard of psychological health (P = 0.21), social relationships (P = 0.64) and environment health (P = 0.85), patients underwent fusion surgery were obtained higher score and in regard of physical health patients underwent partial laminectomy were obtained higher score (P = 0.09). However, only in physical health domain differences between three groups was relatively significant. Mean QOL scores in each WHOQOL-BRIEF domains according to patients pain duration are presented, as shown in physical health (P = 0.06) and psychological health (P = 0.04) domains, patients with pain duration <1 year were reported higher scores. Conclusion: The results of the present study can be used in the post-operative patient information and aid the surgeon and the patient in a shared decision-making process.

Context: The addiction problem negatively affects the addicted person's mental health and his/her family. Aims: The aim of this study was to compare the emotional-behavioural and functional states of children aged 6–16 years old with addicted and non-addicted parents. Settings and Design: In this case–control study, using convenience sampling method, a total of 50 addicted parents with children aged 6–16 years old were selected from among people in addiction treatment centres in Qom; in addition, using simple random sampling, 50 non-addicted parents with children aged 6–16 years old were selected as the control group. Subjects and Methods: Data were collected using two questionnaires, including standard Child Behaviour Checklist questionnaire and Children's Global Assessment Scale questionnaire. Statistical Analysis Used: Data were analysed by SPSS version 20 using Chi-square, independent t-test and ANOVA. Results: There was a significant difference between children with addicted and healthy parents in terms of functional disorders (P < 0.001), as a higher percentage of children with addicted parents (as compared with those with healthy parents) had a functional disorder. Different types of behavioural disorders, except for physical problems, were significantly more prevalent in children with addicted parents than in children with healthy parents (P < 0.05). Internalisation and extrapolation of problems were more prevalent in children with addicted parents than in children with healthy parents (P < 0.05). Conclusions: Based on the results, children with addicted parents have undesirable emotional, behavioural and functional states. This suggests that the parents' addiction has a great impact on the health of the family, including children.

Aims: The aim of the study was to investigated competencies and the role of nursing team members in managing the nosocomial infections (NIs) in a large military teaching hospital in Iran. Settings and Design: The study data were collected using standard 3-part questionnaire including demographic characteristics, self-rated competency ability rating and role in competency activities. Subjects and Methods: Nurses were selected by stratified random sampling and proportional to size between wards. Statistical Analysis Used: The answers were analysed by Chi-square test and one-way analysis of variance in Stata 14. Results: The results showed that only 12% of nurses were expert and the majority (48.8%) were proficient for each of the 8 core competency activities. Preventing/controlling the transmission of infectious agents had the highest proportion of nurses who self-rated competency level as novice (53%), followed by surveillance and epidemiologic investigations and environment of care (52% and 45%, respectively). Competency differences by sex, age, experience, occupation unit, job category and working hours a week were obtained (P < 0.05). Only, 26% of nurses reported that they did not have role in each competency activity. Conclusions: The results showed that the majority of nurses were involved in different tasks, while their competencies were at the novice level. Considering the vital role of nurses in providing the services and preventing the infection, low levels of competency will be an alert for hospitals about the prevalence of NIs and its consequences, which should be taken into consideration in the future programs seriously.

Objective: Thyroid cancer is one of the most common malignancies, with an incidence rate of about two fold in the last 25 years and accounting for 2% of all cancers. The Human Development Index (HDI) is used to measure the development of countries level. The aim of this study was to investigate thyroid cancer morbidity and mortality and its association with HDI. Methods: The present analysis is a descriptive cross-sectional study that is based on cancer incidence data and cancer mortality rates extracted from the World Bank for Cancer in 2018. The incidence and mortality rates and thyroid cancer distribution maps were drawn for world countries. To analyse data, correlation and regression tests were used to evaluate the correlation between incidence and mortality with HDI. The statistical analysis was carried out by Stata 14, and significance level was estimated at the level of 0.05. Results: The results showed a positive correlation between incidence and thyroid cancer (r = 0.497, P < 0.05); however, the correlation observed between mortality and HDI was negative, which was not statistically significant (r = −0.06, P > 0.05). There was a positive and significant correlation between incidence with gross national income per 1000 capita (r = 0.328, P < 0.0001), Mean years of schooling (r = 0.445, P < 0.0001) life expectancy at birth (r = 0.509, P < 0.0001) and expected years of schooling (r = 0.463, P < 0.0001); however, this correlation was not statistically significant in mortality rate (P > 0.05). Linear regression model showed that increase in LEB (B = 0.2, confidence interval [CI] 95%: [0.01, 0.4]) significantly increased thyroid cancer incidence (P < 0.05). The regression analysis showed that increase in life expectancy at birth (B = 0.02, CI 95% [0.008, 0.04]) increased mortality (P < 0.05). The study showed that the mean incidence and thyroid cancer mortality in female were significantly higher than males (P < 0.05). Conclusion: The thyroid cancer incidence in high-HDI countries and the mortality rate in countries with low HDI are increasing. Therefore, HDI can be used to provide a clear picture for the distribution of this cancer in different parts of the world.

Background: So far, there has not been conducted the study in Iran about the role of ultrasound in the prediction of successful induction of labour. Therefore, the aim of this study was to investigate the role of sonographic parameters that may help clinicians to improve the prediction of the outcome of induction and need for ripening of cervix before induction. Materials and Methods: In this prospective study, the number of 298 singleton pregnancies that attended for the induction of labour at Shariati and Arash Hospitals in 2017 was evaluated. Immediately before the induction, transvaginal sonography was performed for the measurement of cervical length and posterior cervical angle, and a transabdominal scan was carried out to determine the position of the foetal occiput. Cox proportional hazard model was used for determination of the effects of independent predictor variables on the induction-to-delivery time. Results: The most common indication for the induction was movement reduction and prolonged pregnancy with 20.5% and 18.5% of cases, respectively. The mean of posterior cervical angle in patient delivered vaginally was 124 ± 18 and in patient delivered by caesarean section was 100 ± 26.5 (P < 0.001). The sensitivity, specificity, positive predictive value and negative predictive value of sonography compared Bishop score for the likelihood of vaginal delivery within 24 h and was 93.98%, 47.56%, 75% and 82.52%, respectively. Conclusion: The use of parameters of sonographic to predict the outcome of induction enables the clinician to present precise information to mothers and plan for the further management of the pregnancy.

Loss of teeth in the anterior region leads to compromised aesthetics. It is physiologically as well as socially damaging situation. Tooth loss can be due to excessive bone loss, trauma or other endodontic reasons. The replacement of lost tooth depends on several factors. After removal of the tooth for a time being, temporisation may be required before placement of permanent restoration. Permanent replacement can be in the form of removable prosthesis or fixed partial dentures. The first line of treatment after extraction of anterior teeth, irrespective of final restoration, is placement of temporary prosthesis. This article describes a case of natural tooth used as a pontic splinted to adjacent teeth using a fibre-reinforced splint and composite following extraction of tooth in the maxillary anterior region.