Introduction: Problems associated with the field of Anesthesiology include stress related causes pertaining to the characteristics of the profession, concerns about the education process, insufficient skill attained and lack of protection against professional liability. This study is aimed at construction of a testing instrument to quantify stresses specified to the anesthesiology residents. Based on theoretical discussions as and literature published well as about the sources of stress in this specially and other professions, we compiled a primary checklist of stressors. Then, we asked specialists, professors and residents to verify face validity. Using their comments, we revised the checklist and used it in this study. Next we evaluated the content validity and reliability of the test and used loop method to qualify the effect of each question on the reliability of the test. We performed factor analysis (exploratory method) to evaluate construction, validity and used preliminary form of confirmatory method to validate correctness of five assumed factors. Using factor analysis, five previously assumed factors were reduced to three principal factors and a number of additional (miscellaneous) questions. Obtained results show that the questionnaire is reliable and valid in face and content as well as construction. The results of a complementary study using this questionnaire among another group of residents in the end of year 2003, confirms the ability of questionnaire in measuring the above mentioned factors.

Objectives: To investigate the interrater reliability of the REEDCO postural score (RPS) between a physical therapist (PT) and a schoolteacher in healthy adolescents. Methods: This cross-sectional study evaluated the interrater reliability. The standing postures of 86 adolescents were assessed using the RPS. The schoolteacher and PT independently observed and scored 10 items of posture. Results: The Kappa coefficients of all items assessed were slight to fair. No significant agreement was observed between the assessors for seven items, including the head, shoulders, spine, and hip in the posterior view, and the upper back, abdomen, and lower back in the lateral view. Furthermore, significant differences were observed in the grading between the two assessors for seven items: the shoulders, hips, and ankles in the posterior view and the neck, upper back, trunk, and abdomen in the lateral view. The total RPS score was also significantly different between PT and schoolteachers (P<0.001). Discussion: This study’s results showed poor to fair agreement levels for posture screening by RPS among schoolteachers. This may be due to the two assessors’ different observation skills. The sequence of assessments may also influence the results. The posture school screening program should consider more comprehensive training sessions to improve reliability between assessors.

Background: In order to use International Prostate Symptom Score (IPSS) in the Iranian population, a valid and reliable Persian version of this questionnaire is required. To date, this version of IPSS with those characteristics is not available.Methods and Materials: For evaluation of the validity, the original version of IPSS (English version) was translated into Persian and after 3 weeks was re-translated from Persian to English. The new English form was then compared with the original English IPSS form. Internal consistency was calculated. For measurement of reliability, the Persian version of IPSS was used to interview 50 patients with Benign Prostatic Hyperplasia (BPH). The difference between results was analyzed with a 3 week interval.Results: There was no significant difference between English translations and internal consistency was 0.7 using Cronbach’s α test. Test-retest reliability was assessed and showed no significant difference between the scores before and after 3 weeks (P value=0.9).Conclusion: Persian version of IPSS was proved to be valid and reliable and can be used as a symptom-based questionnaire for BPH in Iranian population.

Background: The one-third middle cerebral artery (1/3 MCA) method and Alberta Stroke Program Early Computed Tomography Score (ASPECTS) were used to detect significant early ischemic changes on brain computed tomography (CT) of patients with acute stroke. We designed the Persian Early CT Score (PECTS) and compared it with the above systems. Methods: The tomograms were chosen from the stroke data bank of Ghaem Hospital, Mashhad, in 2008. The inclusion criteria were the presence of MCA territory infarction and performance of CT within 6 hours after stroke onset. Axial CTs were performed on a third-generation CT scanner (Siemens, ARTX, Germany). Section thickness above posterior fossa was 10 mm (130 kV, 150 mAs). Films were made at window level 35 HU. The brain CTs were scored by four independent radiologists based on the ASPECTS, 1/3 MCA method, and PECTS. The readers were blinded to the clinical information except the symptom side. Cochrane Q and Kappa tests were used for statistical analysis. Results: Twenty four CT scans with sufficient quality were available. The difference in distribution of dichotomized £7 and >7 ASPECT scores between the four raters was significant; Q=13.071, df=3, P=0.04. The difference in distribution of dichotomized >1/3 and £1/3 MCA territory involvement between 4 raters was also significant; Q=13.5, df=3, P=0.004. Distribution of dichotomized <6 and ³6 scores based on PECTS system between the four raters was not different; Q=6.349, df=3, P=0.096. Conclusion: PECTS method was more reliable than ASPECTS and 1/3 MCA methods in detecting major early ischemic changes in stroke patients who were candidated for thrombolysis therapy.

Introduction: Identification and promotion of diagnostic methods has been a continuous effort to reduce disease and its complications and reduce costs associated with treatment. Despite all these efforts and improving our knowledge of diseases and diagnostic tools, pediatric appendicitis remains part of the diagnostic challenge in the surgical field. The aim of this is to compare the two diagnostic criteria of appendicitis (Children's Appendicitis Score [PAS] Versus Pediatric Appendicitis Score [CAS]) and evaluation of the diagnostic features of them. Methods: A retrospective cohort study was conducted on all children admitted to the hospital's emergency center with a possible diagnosis of appendicitis (270 patients) during 2018 and 2019 at Tabriz Pediatric Hospital. Based on the clinical examinations and para-clinical findings some of the patients were underwent the surgical intervention (220 cases) and some discharged and followed up for a period of 2 and 4 weeks later (50 cases). The data were analyzed through SPSS ver. 16 software. Results: The results of the present study indicated that if CAS was associated with ultrasound, the specificity of these criteria would improve and could be more acceptable compared with the PAS. In addition, it was revealed that WBC≥ 11000, as well as PMN≥ 65% and guarding were very specific for diagnosis and complication of acute appendicitis. There was a significant relationship between US findings and pathology reports (P<0. 05). Conclusion: In conclusion, the CAS criteria were more sensitive and the PAS was more specific in diagnosing pediatric acute appendicitis.

Background: In spite of many advantages in Lenke classification of adolescent idiopathic scoliosis, the latest study of Richards et al showed that the King classification is better than had been reported recently and the Lenke classification system of adolescent idiopathic scoliosis is less reliable than previously reported.Methods: In this study, we performed a multi-surgeon comparison of these two classification systems. After teaching and discussing all available data of these classification systems with four spine surgeons, a pilot classification was performed. Then, they independently evaluated preoperative radiographs (standing posteroanterior, lateral, and two supine side-bending views) of 99 patients with adolescent idiopathic scoliosis. The results were determined by calculating the average percentage of intraobserver and interobserver agreement. Reliability was quantified using kappa statistics.Findings: The King classification demonstrated good intraobserver and interobserver reliability, with an intraobserver agreement of 85.8% (kappa coefficient, 0.80). Interobserver percentage of agreement averaged 80.8% (kappa coefficient, 0.74). The complete Lenke classification, combining curve type, lumbar modifier, and sagittal thoracic modifier, demonstrated good reliability for both intraobserver and interobserver measurements. The intraobserver percentage of agreement averaged 85.8% (kappa coefficient, 0.82). The interobserver percentage of agreement averaged 80.8% (kappa coefficient, 0.77).Conclusion: In this study, with each investigator performing the radiographic measurements, the King and Lenke classifications were almost similar (the Lenke classification had slightly better results). Such better results might be due to more training of this complex classification system. So, because of greater coverage of idiopathic scoliosis curve and usefulness of Lenke classification system, we prefer using this classification system in our center.