ABSTRACT: Introduction & Objective: Breast cancer is the second most common malignancy in the word.. This disease and their treatments such as chemotherapy decrease QOL in the patients. Side effect of chemotherapy can be effective on physical, emotional and social function. Complementary medicine can be effective on QOL. The purpose of this study was survey effect of Benson relaxation on QOL in breast cancer who are undergoing chemotherapy. Materials & Methods: There is quasi-experiment study that 25subjects who have breast cancer non metastasis and receiving chemotherapy with (Ciclofosfamid ,Taxotere, Adriamycin) entries . Subjects completed demographic data, C-30 and BR23 QOL questioners in first and 3week after. Then we thought Benson relaxation to subjects. They received audiotape of relaxation we asked to practice the technique daily 15-20 minute at home for 3 weeks. Then they completed questioners again .Information analyzed by SPSS soft ware. Results: There was statistically significant improvement in QOL and fatigue, n and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea and systemic therapy side effects, Breast symptoms, Arm symptoms Upset by hair loss there wasn’t statistically significant improvement in Financial difficulties after Benson relaxation .Paired t test shows this results, too as before intervention Conclusion: according to the result of study, it can be used as an effective approach for improving QOL in these patients.

Abstract Introduction & Objective: Cervicovaginal infections are the most common causes of reffereing to clinics and health centers. The primary aim of present study was to determine the prevalence of genital infections in Pap smear specimens and it's relationship with varriables such as age and contraceptive methods. Materials & Methods: This was a cross-sectional study that carried out in 2010 in Ahvaz, Iran. The number of 1353 Pap smear reports were selected from Ahvaz pathology laboratories using cluster sampling. Data were analyzed using chi square and ANOVA tests in SPSS. Results: The results of study showed that the prevalence of cervicovaginal infections was 10.4 on which, 8.2% of them were candida, 1.4% were trichomonas and 0.8% were gardnerella. In 87.3% of cases various degrees of inflammation of 1+ to 4+ grades were reported. There was no relationship between age and cervical infection or inflammation. There was no significan relationship between infection' type and inflammation rate and age. There was significant correlation between contraceptive methods and reports of cervicovaginal infections and inflammation. Conclusion: The cervicovaginal infections have association with use of contraceptins. For prevention of recurrent infections and precancerous cervical changes, women with risk factors for cervical cancer are recommended to make informed choices about contraceptive methods.

Abstract Introduction & Objective: The prevalence of overweight and obesity among children and teenagers in developed and developing countries is increasing rapidly. Few studies have been carried out on relationship between obesity and amount of physical activity of children in Iran. The aim of this study was to recognize the prevalence of over weight and at risk for overweight and its relation with the amount of physical activity among male students of public schools in Ahvaz, Iran. Materials & Methods: In this cross-sectional study 628 students aged 10-14 from ahvaz using the two-stages cluster sampling method were selected. Height and weight of students were measured and Body Mass Index (BMI ) was calculated. Those who their BMI was 85 to 95 (85th ≤BMI≤95th percentile) considered to be at risk of over weight and those with BMI over 95 (BMI ≥95th percentile) considered overweight . data were analyzed by spss soft ware. Results:The prevalence of at risk for over weight and over weight was 18.8 and 12.3 respectively. The age group of 11-13 year had the most overweight percentages and only students with age of 10 were not at risk of overweight. Conclusion: In comparison to other studies, overweight and at risk for overweight students in Ahvaz, Iran are on warning aspect. According to these findings, the policy makers and educational organizations should consider regular physical activity in schools programs to prevent and reduce the obesity in the society.

Abstract Introduction & Objective: Breast cancer is the most disturbing factor in women's health. Chemotherapy is one of the main treatments for cancer. Nausea and vomiting are distressing and frightening side effects of chemotherapy. Since anxiety can aggravate symptoms of nausea and vomiting, any factor that could increase relaxation, it can have a beneficial effect on these factors. Massage is a method of relaxation. This study investigated determination of effect of massage therapy on nausea in patient with breast cancer patient undergoing chemotherapy. Materials & Methods: This study was a quasi-experimental research. Thirty four patients with breast cancer who received chemotherapy regimen TAC (Taxoter, Aderiamycin, Cychlophosfamid) were selected. All patients complained nausea during previous period of chemotherapy and they randomly divided into two groups. Data gathered via a questionnaire. Control group only received usual care and intervention group in addition received three sessions back massage Stroke and Kneading addition to usual care. Twenty four hours after each massage Visual Analogue Scale (VAS) were completed. Results: The results showed that the mean scores of nausea in the control group was increased from 2.97 on the first day to 3.26 and in the intervention group was decreased from 3.44 to 1.52 at the end of trial. However there was not any significant difference in the first , second , third and fourth days between two groups. Conclusion: Massage can reduce nausea. However further studies with larger sample size and sever nausia will recommended.

Abstract Introduction: Chronic obstructive pulmonary disease is currently the fourth cause of mortality worldwide. Patients with chronic obstructive pulmonary disease experience periods of dyspnea and disability, which lead to a worsening of their quality of life. This study aimed to evaluate correlation between quality of life and disease severity in patients with chronic obstructive pulmonary disease. Materials & Methods: In this cross-sectional study, 40 patients with chronic obstructive pulmonary disease referred to the hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences were recruited. St. George's quality of life questionnaire was applied to collect data. Data was analyzed using descriptive and analytical statistics in SPSS software version 16. Results: The result revealed that the quality of life in patients with chronic obstructive pulmonary disease is low in all levels of disease. There was a significant relationship between total scores of the quality of life and its two dimensions (activity and symptom) with disease severity (p<0.05). Whereas no significant relations were observed between the impacting dimension and disease severity. Conclusion: The quality of life in patients with chronic obstructive pulmonary disease deteriorates by increasing disease severity.

Abstract Introduction: Multiple Sclerosis (MS) is one of the most common diseases of central nervous system. Being chronic, having no certain cure, the nature of progressive of disease, the plight of the disease in youth and increasing number of patients with MS, explain that paying attention to this disease is essential. This study aimed to compare the different featres of MS disease between men and women in Ahvaz, Iran. Materials & Methods: In this descriptive study, 180 patients with MS (90 men, 90 women) who reffered to Ahvaz MS clinic in 2011 were enrolled. Data was collected by a questionnaire. Patients were selected randomly among all MS patients who had medical records in MS clinic. Data were analyzed with SPSS ver 18 and descriptive and analytical statistics including Chi-Square and Independent t-test were used for statistical purposes. Results: Mean age of participants was 37.8 yrs. Most male participants (61.1%) were employed and 38.9% were unemployed. Numbness and visual problems were the most common presenting symptoms of the disease. Over the past year, the average number of attacks inpatients was 1.2.Cinnovex and Betaferon were the medicines which were most used by patients. Conclusion: According to results, disease was started about age of 30 and 9.38% of male patients lost their work due to multiple sclerosis, these two factors, namely multiple sclerosis and unemployment may affect other aspects of patient's lives. In order to evaluate patients for mention above factors to a greater extent considering further research is vital for others related important life style features to improve patients' health.

Abstract Introduction & Objective: Nursing burnout is main characteristic of job stress that is a delayed reaction to chronic stressful causes in working place. Affected nurses have not enough emotional energy to contact and communicate with patients. They also think that they don’t have required capabilities for their jobs. The goal of this study was to evaluate nursing burnout among nurses working in Shahrekord Medical and Educational centers. Material & Method: This descriptive study was performed on 340 nurses working in Shahrekord Medical and Educational Centers in 2009. Samples were selected using proportional sampling (QUATA). Demographic information and Maslach questionnaire were filled for all samples. Data were analyzed using SPSS software. Results: Our results demonstrated that 53/5% of nurses had emotional exhaustion, 49/7% had high depersonalization and 99/6% had high reduced personal accomplishment. Conclusion: Nursing burnout degree among Nurses in Shahrekord Medical and Educational Centers was moderate to high, that need to be intentioned. Inappropriateness between number of nurses and patients, workload and income are the most effective nursing burnout factors that need to best attention as nurses are healthy facilitators and have important role in healthy team. Because of the importance of nursing in society health, policy makers should take some strategies for increasing the capability of satisfaction of nurses.

Abstract Introduction: Myocardial infarction is one of the most common diseases in Iran. Cardiac arrhythmia has been reported as the most common cause of death in patients with acute myocardial infarction. Given the importance of arrhythmias, this study aimed to determine the prevalence of cardiac arrhythmia in patients with acute myocardial infarction admitted to the CCU of Vasei hospital in Sabzevar, Iran Materials & Methods: This cross-sectional study was conducted on 132 patients with myocardial infarction, which were admitted to the CCU of Vasei hospital in Sabzevar city during 24 months from 2009 to 2011. Patients were selected by convenient non- randomly sampling. Demographic data and medical history of patients were collected using a questionnaire. A check list was applied for recording infarction and arrhythmias diagnosed by electrocardiogram, the 24-hour monitoring of the patients and72 hours after hospitalization. Data was analyzed by SPSS ver11.5; descriptive and analytical statistics including Chi-square test, ANOVA and Kruskal-Wallis test were used for statistical purposes. Results: A total number of 59.1% of patients had arrhythmia; where 19.6% of them had ventricular premature beats and 17.4% had episodes of ventricular tachycardia. The results showed that there was a significant relationship between the location of heart attack and type of arrhythmias (χ2 14.4, p=0.002), there was no statically significance relationship between age, gender and type of arrhythmias (P> 0.05). Conclusion: Because of the higher incidence of premature ventricular arrhythmia than others, hence, more awareness of the risk factors and treatment of these arrhythmias are necessary for medical and nursing staff.

Abstract Introduction: Many sexually active women with sickle-cell anemia can be pregnant and tend to use contraceptive methods. Access to an effective family planning is important for women with sickle-cell anemia, because their pregnancy can be more problematic. Objective: This study aimed to evaluate the different methods of family planning among women with sickle-cell anemia and their relationship with the crisis's onset of these diseases. Methods: This is a cross-sectional study which was conducted on 50 reproductive age women with sickle-cell anemia referred to Shafa hospital in Ahvaz during 2011-2012. Demographic data and patients' telephone numbers were extracted by referring to the medical records archive of patients. Data pertaining to the blood tests and electrophoresis of patients were extracted from the records. A questionnaire pertaining to the demographic data, history of midwifery and disease and sickle-cell anemia crises was completed via a telephone interview with the patient. Data were analyzed using the descriptive statistics, chi-square and Spearman's Rho test for assessing the relationship between sickle-cell anemia crises and contraceptive methods. Results: The most common contraceptive methods used by patients were; withdrawal (34%), barrier method (30%), tubal ligation (16%), oral contraceptive pills (12%), intra uterine device (2%) and Depot-Medroxy Progesterone Acetate (DMPA) (2%) respectively. Four percent of women did not use any contraceptive method. There was not any significant relationship between sickle-cell anemia crises and contraceptive methods. However, when we classified contraceptive methods to two groups of hormonal and non- hormonal methods, a significant relationship was found between crises of sickle-cell anemia and hormonal and non- hormonal methods. Conclusion: Results of this study showed that there is no relationship between contraceptive methods and sickle-cell anemia crises, but showed a significant relationship between crises and hormonal and non- hormonal methods. These findings require confirmation in other studies with larger sample size. Keywords: Sickle-cell anemia, Crises of Sickle-cell anemia, Contraceptive methods

Abstract Introduction: Approximately 80 million people in the world suffer from infertility. Laparoscopy is a golden standard method which helps diagnose peritoneal and the fallopian tube problems. It is also provides the opportunity to examine all the pelvic organs. The aim of this study was to assess the pregnancy rate after laparoscopy in the infertile women reffered to the Paymanieh hospital, Jahrom. Materials & Methods: In this cross-sectional study,162 infertile women referring to the Honari Clinic of Jahrom from 2008 to 2010 were enrolled. Laparoscopy was applied for these women due to other unsuccessful treatments. Information about patients including age, job, number of marriages, type of infertility, results of hysterosalpingography and rate of pregnancy after surgery was collected. Data was analysed using descriptive statistics including frequenc, mean and standard deviation by SPSS 16. Results: The mean age was 27.2±5.31 (16-43 years). The rate of pregnancy after laparoscopic surgery was 54.9%, which most of them (84.6%) had happened after cauterization of polycystic ovaries. All of these pregnancies were spontaneous, of which 83.15% had led to termination and 16.85% has ended in abortion. None of the cases were ectopic pregnancy or any other problem. Conclusion: The most common cause of women's infertility in Jahrom is polycystic ovaries, 89 out of 162 cases were concieved, which most of them (84.26%) concieved after electro-cautery, ovarian cyst removals or treatment of polycystic ovaries. This shows that the spontaneous ovulation after ovarian cauterization have been very satisfactory, which in turn is comparable to other similar studies. Hence cauterization of ovaries by laparoscopy has proved as an effective treatment for infertility.

Abstract Introduction: Heart transplantation is an important option for patients with heart failure who are at the final phases and have not responded to other treatments. The process complexity for heart transplantation may strict and severe patients who enjoy inadequate support system and their lifestyle is below the standard after transplantation. This research intended to study the experience of the heart transplant recipients of supportive sources. Materials & Methods: This study applied a qualitative approach using a descriptive phenomenology method. The purposive sampling was conducted with 9 participants and collected data was analyzed through Colaizzi method. Results: Four concepts were extracted from data including lack of social support, role of spouse, medical staff support and peers support. Conclusion: The findings of this study on part of the heart transplant recipients’ experience can help to develop the care of these patients and the supportive sources and ultimately provide appropriate area to improve the life and life style of patients.

Abstract Introduction: Diabetes mellitus is the most prevalent cause for non- traumatic amputations, which starts with an ulcer in the lower limb. About 15% of patients with diabetes suffer from this ulcer. By controlling blood sugar, we can highly prevent the ulcer. The study was aimed to survey the barriers to control blood sugar in the patients with diabetic foot ulcer in three fields of interpersonal factors, extra-personal factors, and barriers related to the health system. Materials & Methods: A descriptive study was conducted on 56 patients with diabetic foot ulcer admitted Ahvaz Razi Hospital. The Study population was selected applying a convenience sampling. Collected data through researcher- made questionnaire were analyzed using statistical descriptive elements (mean and standard deviation, frequency and percentage). The analytical statistical methods of Mann-Whitney and Kruscal-Wallis tests were also applied analyzing data using SPSS version 19. Results: Extracted findings showed intrapersonal barriers are the most important factors for blood sugar control failures in diabetic foot ulcer patients. The total mean score for intrapersonal barriers, extra personal barriers, and barriers related to the health system were 38.30±7.8, 33.91±8.03 and 32.66±7.15, respectively. No significant relation existed between the mean score of intrapersonal barriers with the sex, age, and education. However, a significant relation existed between the mean score of intrapersonal barriers and the Arabian ethnicity (P<0.05). Conclusion: Intrapersonal barriers had the most importance in blood sugar controlling for patients with diabetic foot ulcer compared to extra personal and health system barriers with a significant correlation in Arabian ethnicity.

Abstract Introduction: Chronic obstructive pulmonary disease is currently the fourth cause of mortality worldwide. Patients with chronic obstructive pulmonary disease experience periods of dyspnea and disability, which lead to a worsening of their quality of life. This study aimed to evaluate correlation between quality of life and disease severity in patients with chronic obstructive pulmonary disease. Materials & Methods: In this cross-sectional study, 40 patients with chronic obstructive pulmonary disease referred to the hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences were recruited. St. George's quality of life questionnaire was applied to collect data. Data was analyzed using descriptive and analytical statistics in SPSS software version 16. Results: The result revealed that the quality of life in patients with chronic obstructive pulmonary disease is low in all levels of disease. There was a significant relationship between total scores of the quality of life and its two dimensions (activity and symptom) with disease severity (p<0.05). Whereas no significant relations were observed between the impacting dimension and disease severity. Conclusion: The quality of life in patients with chronic obstructive pulmonary disease deteriorates by increasing disease severity.

Abstract Introduction: Oral and dental health is an important public health indicator and general health is more depends on the oral and dental health and if not dealt with in childhood and adolescence ages the future health of the community will be compromised. The purpose of this study was to assess DMFT (Decay, Missing, Filled, Teeth) index and dental carries for 12-14 years old students.. Materials & Methods: A descriptive-cross sectional research was conducted to assess DMFT index and dental carries. The research units included 1000 boys aged between 12-14 years old, from first to third grade, which were selected randomly from secondary schools, based on multistage sampling. The data collection tools were a questionnaire and an observation record sheet. Using descriptive and inferential methods collected data was analized by SPSS ver. 15 statistical software. Results: Results extracted from this study showed that the mean of decay, missed and filled permanent teeth in all the age groups of 12-14 years, were 2.37, 0.61 and 0.32 respectively, and mean of DMFT was 1.1. Also, 76 percent of the DMFT score was related to decayed teeth and mann-whitney test shows that there is no significant relationship between DMFT index and brushing teeth. Conclusion: Considering the high percentage of dental caries in this study, it is necessary that students, especially in this growth ages have paid attention from the education authorities and must be done basic measures to reduce or eliminate this problem in health planning for these ages.

Abstract: Introduction & Objective: Brain stroke is one of the important factors causing long-term disability which creates various social and individual problems for a person and a society. This problem is the third cause of death after cancer and heart diseases in many parts of the world. The purpose of this research is to determine the quality of life and mental health in patients with brain stroke in Tehran Shariati Hospital. Materials & Methods: The present research is a cross-sectional descriptive study which performed on 146 patients with brain stroke referred to neurologic ward of Tehran Shariati Hospital by simple randomized sampling between January and March 2009. For data collection used a GHQ questionnaire and SF-36 questionnaire. Finally, data was analyzed by SPSS and statistics tests (Stepwise regression, t-test, one-way Anova and Coefficient correlation). Results: According to the results, quality of life of patients is not equal and most patients (73 percent) had an average quality of life. Also, life quality of patients is not related with gender, age, occupation, income and education but, is associated with marital status and depression. Mental health just had a direct relationship with the education and depression. Conclusion: Regarding the findings of this research it is proposed that patients showed higher level of depression must more support by rehabilitating affords from the family and society.

Abstract Introduction: Changes in body composition after menopause are including; decreased muscle mass, increased fat mass and central obesity with central fat accumulation ,which can increase the risk of cardiovascular diseases and metabolic syndrome. Body composition and its changes in postmenopausal women associate with osteoporosis and metabolic syndrome. Metabolic syndrome is the key factor for cardiovascular disease that is become a major health problem in many countries .We performed this study to recognize the relationship of reproductive period and menopause age with body composition among non-obese post menopausal women. Materials & Methods: In this cross sectional research, we selected 140 healthy non-obese postmenopausal women who had a BMI less than30 Kg/m2, in 2010 in Iran. Data were obtained through interview that included demographic information (age, age at menarche, age at menopause, date of last menstrual period, parity), measured height and weight, skin folds (tricepse, superiliac, thigh), BMI and WHR. We used the Pearson correlation and multiple regression analysis by SPSS 15 software for statistical purposes. Results: In this study a significant correlation was found between reproductive period and fat mass ( r=0.22, p=0. 007) and weight (r=0.16, p=0. 04). A significant relationship was observed between menopausal age and fat mass (r=0.26, p=0. 002) weight (r=0.24, p=0. 004) and BMI(r=0.19, p=0.02), but menopausal age with WHR and fat-free mass was not significantly associated. Conclusion: The increasing of reproductive period and menopausal age is associated with increased body weight and fat mass and increasing of menopausal age is associated with higher BMI.

Abstract Introduction & Objective: Nowadays, one of the vital and essential concepts in the world is the health concept. From the psychology point of view, mental health is including the individual abilities to enjoy of life and find a balance between life activities and effort to achieve of the psychological flexibility. The purpose of this study was the comparison between mental health of smokers and non-smokers university student in Islamic Azad University of Gachsaran-2010. Materials & Methods: This study was a comparative descriptive study. In this study, 360 male students (225 smoker student and 135 non-smokers student) of Gachsaran Azad University between September and November 2010 with a stratified random sampling were selected and examined. A data collection tool was a General Health Questionnaire of Goldberg. P values less than (0.05) were considered statistically significant. Results: The results showed that the mean of anxiety, depression, physical symptoms and social perversity of smoking was significantly more than the non-smoking students. This means that non-smokers had better mental health than smokers. Conclusion: To promote motivation of the students and increase their awareness, holding of seminars and workshops, as well as educate the students to give up smoking, and entering the smokers students in the field of research about the smoking are recommended.

Abstract Introduction: Hemodialysis treatment process in patients with chronic renal failure affects the patient from clinical, psychosocial and economic aspects. Today, life quality is considered as the main indicator to assess the health status. The purpose of this study was to determine the correlation between life quality and health status in hemodialysis patients with end-stage renal disease. Materials & Methods: A descriptive correlational study on 122 was conducted for hemodialysis patients using simple random sampling. The instrument used is a questionnaire consisting of three-parts of demographic information, quality of life (SF-36) and health status. Data were analyzed by pearson correlation coefficient and paired t-test with SPSS, ver 17. Results: The lowest mean for scores obtained from the aspects of health status belongs to the physical aspect. The majority (53.4%) received a poor score for health status. In addition, the mean score of life quality in patients was 46.85. Life quality had a significant relationship with the physical, psychological and social aspects of health status however, it did not show any significant relationship with the medical and economic aspects. Furthermore, its correlation with the physical and psychological aspects is more than other aspects. Life quality (r=0.76) and general health status (p<0.01) showed also a strong correlation. Conclusion: Life quality and health status correlation demonstrated that patients’ attitudes towards themselves are affected by the health. Having a useful life, that is, in addition to the physical impairments caused by chronic renal failure and hemodialysis, the patient's psychological structure and social environment can affect their motivation and life expectancy.

Abstract Introduction: Depression is the most common mental disorder in patients with multiple sclerosis which is along with disability, disease recurrence and enormous economic burden. Hence, this study was designed to examine rates of depression in multiple sclerosis patients and relationship between depression and associated factors. Materials & Methods: A descriptive study was carried out on a total of 110 multiple sclerosis patients from Iran MS Society applying selected convenient method. Data collection was conducted applying a questionnaire with both individual and disease characteristics related questions as well as the beck depression scale (BDI). The SPSS 16 software version and descriptive inferential statistics were used analyzing data. Results: The data showed that 6% of multiple sclerosis patients had no depression, and the rest had suffered depression, ranged from mild (46%), moderate (26%) and severe (22%). Examination of the applied variables showed a significant difference for depression associated with education level, frequent disease recurrence and family economic status (p <0.05). Conclusion: This study showed a high rate depression in multiple sclerosis patients which could jeopardize patients health. Hence, a timely diagnosis is recommended for depression treatment through psychiatric periodically examinations.

Abstract Introduction: Poor sleep quality affects many hemodialysis patients and can leave a significant negative impact on their quality of life and health status. The purpose of the present study was to evaluate the effect of a collaborative care model on sleep quality of hemodialysis patients. Materials & Methods: A total of 52 patients with maintenance hemodialysis in this clinical trial study, were selected and randomly divided into two equal groups; intervention and control (26 patients per each group). Demographic Data Questionnaire and Pittsburgh Sleep Quality Index (PSQI) questionnaire were applied as instruments. Collecting data in the pre-test stage, a collaborative care model was developed for patients undergoing maintenance hemodialysis according to their four steps (motivation, readiness, involvement and evaluation) for the intervention group over three months. the average score of sleep quality for one month after the intervention were compared against previous intervention. Data were analyzed using SPSS v. 19 and chi-square tests, t-independent, repeated values, Man-Whitney and Wilcox on. Results: Repeated measures showed a significant difference between the means of Pediatrics PSQI dimensions in all aspects, except sleep disorders and hypnotic drug use (p≤0.009). Moreover, the paired t-test showed a significant difference in the Pediatrics Pittsburgh Sleep Quality Index dimensions of the intervention group before and after the intervention (p<0.001). Conclusion: Overall, the findings revealed that the collaborative care model was effective on the increasing sleep quality in patients with undergoing maintenance hemodialysis. Keywords: Collaborative Care Model, Hemodialysis, Sleep Quality

Abstract Introduction: Dyspnea is described as a sensation of difficulty awareness in breathing and it is a common complaint of patients with chronic obstructive pulmonary disease (COPD). This study aimed to investigate the related factors of exersional dyspnea and determine the predictors of it. Materials and Methods: Across-sectional study was developed on 37 patients with chronic obstructive pulmonary disease referred to Specialized Pulmonary Clinic of Aria Hospital in Ahvaz in 2011. Purposive sampling method was used gathering the samples. The 6Minute Walk Test (6MWT) was performed at the end of the test based on American Thorax Society’s protocol exersional dyspnea was measured by Borg scale. Also the health related quality of life was assessed by the St George’s Respiratory Questionnaire (SGRQ). The data was analyzed using Pearson’s linear correlation coefficient, Spearman’s correlation coefficient and Multivariate linear regression. Results: The finding revealed that there was a negative significant relation between dyspnea and exercise tolerance(r=-0.33, P<0.05).A positive correlation was observed between dyspnea and quality of life (r=0.60, P<0.001).Moreover, no statistically significant correlation was found between dyspnea and blood pressure, respiratory rate, heart rate and O2sat before 6MWT. Multiple regression analysis indicated that the O2sat and respiratory rate after exercise and forced expiratory flow the middle 50% of the FVC (FEF25-75) was identified as independent predictor of the exersional dyspnea(P<0.05). Conclusion: The result showed that the patients with more dyspnea had a lower exercise tolerance and quality of life. Tree factors consist of the O2sat and respiratory rate after exercise and FEF25-75 maybe were the predictors of exersional dyspnea.

Abstract Background: Psoriasis is a chronic skin disease which continually causes other systemic disorders such as, hypertension and diabetes for unknown reasons. The aim of this study was to determine the epidemiology of psoriasis and concomitant diseases among patients referred to the dermatology clinic of Imam Khomeini Hospital of Ahvaz during 2006-2011. Materials and Methods: This descriptive study was performed on 854 patients with skin psoriasis referred to Ahvaz’ Imam Khomeini Hospital during 2006 to 2011. Medical records pertaining to the patients were studied in terms of features such as age, gender, family history, disease onset, disease duration, clinical form, location of the lesion, and concomitant diseases, e.g. hypertension, diabetes, depression, hypothyroidism, lupus, vitiligo and arthritis. Data were analyzed by SPSS software and reported as percent, mean and standard deviation. Results: Of 854 patients in vestigated during 5 years, 489 (57%) were male and 365 (43%) were female. The mean age of patients was 31.2±15.6 years; the mean age of disease onset was 26.7±11.7 years. Mean duration of disease was 12.3±6.9 years in men and women; 254 (29.8%) of patients had a positive family history of the disease. Most parts in the body which affected were feet (42%) and hands (34%). The most common clinical form of psoriasis was vulgaris (71.4%). Furthermore, other disease which observed with psoriasis were including;hypertension (32.7%), diabetes type 2 (25.6%), depression (16.9%), arthritis (9.4%), hypothyroidism (6.2%), vitiligo (5.1%) and lupus (4.1%). Conclusion: Given the high percentage of diseases associated with psoriasis in the study, it is necessary to improve the patients' awareness about the concomitant diseases, how to deal with them and doing further screening for better and earlier identification of these problems.

Abstract Introduction & Objective: In addition to control of the disease, improvement of quality of life is important for treatment of the patients suffering from chronic diseases such as thalassemia. The aim of this study was to compare the children with thalassemia and their parents' point of view about the quality of life (QOL). Materials & Methods: In this descriptive study, A 90 thalassemia patients with mean age of 17.29 years (SD = 6.28) were selected. During the comprehensive visits the SF36 questionnaire were completed. Patients rated SF36 from excellent (100) to poor (0) on nine and eight dimensions of health status. These results were accomplished by a brief medical history and chart review. Data were analyzed using paired t-test, independent t-test and descriptive tests. Results: The mean quality rated by patients and their parents were 70.25±17.17 and 67/44±16/59 respectively. Only in social activity (p=0/012) aspect there was significant difference between the two points of view. Conclusion: This study suggests that all patients with thalassemia should undergo QOL assessment so that interventions focused on affected domains can be implemented to improved QOL.

Abstract Introduction: Diabetes is a chronic medical disease in which self- management through a social support network for good prognosis is necessary. Anxiety and depression in people with diabetes are much more common in the healthy population. Panic anxiety disorder is also more common in people with diabetes than in non-patient population. Panic attacks worsen diabetes for different reasons. Not paying attention to the presence of anxiety disorder can have a detrimental effect on the treatment trend. The following case report deals with optimal control on diabetes mellitus by a successful treatment for panic attacks. Case report: A 45-year-old woman who had a history of diabetes from eight years ago, and was treated with insulin since two years ago, and was hospitalized because of lack of blood sugar control despite taking insulin. In the psychiatric interview with patient, depressive symptoms were found. The patient also complained of dyspnea attacks, which happened at different times of day and night and had the characteristics of panic attacks and consequently and consequently, patient imagining low blood sugar, took sugary drinks and sweets. Given the age of the patient, organic matters were considered, and recommendations were to be treated with clonazepam and citalopram. The patient was released in on the 7th day with suitable general conditions and without any asthma, of course, she was recommended to take psychiatric medications and insulin as well as to visit the clinic of psychiatry and endocrinology. Conclusions: simultaneous signs of the weakness, appetite disturbance, and autonomic nervous system stimulation, even in the absence of the patient's complaints about psychiatric problems, the respectful internal and general practitioners must consider psychiatric counseling.