In the present health care environment, cost-benefit analysis is extremely important. In this screening program, the minimal cost of screening dipstick urinalysis in 1601 asymptomatic school children was determined. The process of screening was similar to all the studies. The minimal cost utilizing 3 general physicians was calculated. Costs were determined by using current charge for supplies ordered to perform tests, charges for tests performed by a commercial laboratory, and the cost of a final evaluation by a pediatric nephrologist. Initial abnormal urinalysis was found in 4.7% (76/1601) of patients. Upon retesting 1.37% (22/1601) of patients were calculated to have a persistent abnormality. The calculated cost was 1/530/000 Rials (164.5 $) to initially screen all 1601 patients with a dipstick urinalysis or 850 Rials (0.09 $) per patient. The calculated cost to evaluate the 22 patients with any persistent abnormality on repeat dipstick urinalysis was 246/840 Rials (26.5 $) or 11.220 Rials (1.2 $) per patient. This is the calculated cost for a single screening of 1601 asymptomatic pediatric patients. Multiple screening dipstick urinalysis in asymptomatic pediatric are costly and should be discontinued. We purpose that a single screening dipstick urinalysis be obtained at school entry age, between 6 and 7 years old, in all asymptomatic children.

Background & Aim: Tonsillectomy is the most common head and neck surgery in Iran. Considering that any operation involves three specimens and this can cause a considerable waste of time and cost, we intended to conduct a survey. The aim of designing and performing this research was to evaluate the value of histopathology done on all obtained specimens of adenotonsilectomy.Patients & Method: This retrospective study included 313 patients who had undergone adenotonsilectomy in Rasoule- Akram Hospital between 2000 and 2003. Fisher test was applied to analyze the information.Results: The age of the subjects ranged from 1 to 78 with an average age of 10.8. Only 3 cases (0.9%) who were above 50 years old yielded positive results. Considering p<0.01, there is a meaningful relationship between age and positive histological result. Also, a significant relationship was seen between malignancy and a change of voice in 60 cases (P=0.4), dysphagia in 26 cases (P=0.2, R=20%), unexplained weight loss in 1 case, asymmetric tonsils in 29 cases, neck mass in 34 cases (P=0.8), and infected tonsils in 15 cases (P=0.12). Therefore, the above-mentioned signs and symptoms can be considered as malignancy factors.Conclusion: Regarding the results of the study, there is no need to send tonsilectomy specimens to laboratory for histopathological evaluation, especially in children and patients without risk factors and clinical suspicions.

Introduction: Patients with acute leukemia often experience symptoms of the disease itself and side effects of the treatment. Nurses play a major role in the interdisciplinary team that cares for these patients. Often it is the bedside nurse who recognizes the subtle changes that can lead to major complications. Fever, bruising, bleeding, infection, change in mental status, nausea, vomiting, and diarrhea are but a few of the problems patients with acute leukemia may develop. Differentiating disease-induced versus treatment-induced symptoms can be critical and requires a broad knowledge base, with an understanding of disease process, pharmacology, and symptom management. The complex nursing care of this population not only encompasses physical changes, but psychological as well and includes the patient and the patient’s identified support system.Main nursing problems:ThrombocytopeniaNeutrogenaAnemiaMucositisis/gastritisNausea/vomitingDiarrhea/constipationCNS alterationKnowledge deficitIneffective copingConclusion: It is projected that the incidence of acute leukemia will increase over the next few decades as the population of the United States ages. Age has been identified as a significant prognostic variable, and with more than 50% of acute myelogenous leukemia occurring in patients over the age of 60, clearly more research is needed. Great strides have been made in identifying genetic abnormalities associated with leukemia, and in developing novel therapies, with improvement in outcome data. Still, more research is needed. Ongoing and future clinical trials will study more novel therapies and new combinations of agents, as well as ways of minimizing graft versus host disease without compromising graft versus leukemia effect. Nurses must keep current of these trials and new agents to provide the essential patient care that is required.

Introduction: Instructional tools are among effective factors in learning. Learning about students' Viewpoints towards these tools could help teachers in choosing the most appropriate one. This study was performed to investigate and compare students' views towards three routine instructional tools including PowerPoint, overhead, and whiteboard.Methods: In this descriptive study in the year 2007, 68 nursing students in Saveh Nursing School were investigated. The sampling was done by convenient sampling method and data were gathered using a 36 item questionnaire. The reliability and validity of the questionnaire were verified using content validity and internal consistency of data, respectively. Data were analyzed by SPSS software using descriptive (mean, standard deviation, and frequency) and inferential (paired t-test and Pearson correlation coefficient) statistics.Results: The mean scores of positive responses (from 0 to 100) regarding PowerPoint, whiteboard and overhead were 53.65±28.8, 53.65±27.6, and 21.93±25.5, respectively. 57.9% of students preferred PowerPoint, 38.6% chose whiteboard as their most favorable tool, and 3.5% had the preference for overhead. A difference was observed between scores of PowerPoint and overhead (t = 7.26, p < 0.005) as well as scores of whiteboard and overhead (t = 8.16, p < 0.005).Conclusion: Since, there are variations in students' preferences for instructional tools; it is recommended that teachers use a combination of different instructional instruments in order to be more effective in promoting students’ motivation and satisfaction in the classroom.

Background: Routine paraclinic evaluation of preoperative patients tends to cause unnecessary costs, extra ri5k to the patients, inefficient operating room schedules and extra medicolegal risk. Furthermore, it seldom affects clinicians preoperative evaluation and decision making process for healthy patients. Numerous studies have shown that about 60% of these will not be performed if they are ordered according to recognizable indications based on history and physical examinations unfortunately the "indication based" method can not replace to "routine" method due to difficulty and complexity to performing. Materials and Methods: We reviewed records of 1700 patients on a retrospective descriptive study in Sina Hospital from September 2000 to the end of September 2001. These patients had undergone general surgical procedures. and were categorized as American society of anesthesiologists classification I or II. Results of complete blood count, fasting blood sugar, blood urea nitrogen, serum creatinin, sodium, potassium, chest X-ray, electrocardiogram and urinalysis were compared between patients under 40 years of age (n=894) and patients aged 40 and over (n=806). Results: Among 4935 tests performed in patients under 40 years of age, only 1004 (20.3%) were indicated, and treatment plan was not altered due to the results of routine tests in any case. In the other group, patients aged 40 and over, 6300 tests were performed, from which 3361 (53.3%) were indicated and treatment plans of 5 patients were influenced by the results of routine tests. Conclusion: Routine preoperative paraclinical tests is not cost effective method, otherwise the "indication based" also is difficult and complex method. We offer routine preoperative paraclinical tests only in patients over 40 years to combine ease of "routine" with a great reduction in medical costs and no adverse affect to patient care.