---

Background and Objective: Tuberculosis caused by Mycobacterium tuberculosis is one of the deadliest infectious diseases in the world. The amount of the bacilli in tuberculosis will reduce rapidly by starting effective antibiotic treatment and the remained bacilli in the sputum will be an important scale to respond to treatment. This study was conducted to evaluate the examin factors associated with the conversion of positive smear to negative one in tubercular-pulmonary patients in Golestan province, in northern Iran.
Methods: This retrospective cohort study was carried out on 2093 patients with smear positive pulmonary tuberculosis registered in Golestan province, northern Iran from March 2009-14 referred to health centers. The outcome of this study was to determine the time of changing to negative of the first smear during the treatment and evaluating its relationship with demographic variables, the density of bacilli in the smear, culture, chest x-ray, diabetes and HIV.
Results: 67.5% of patients among 2093 smear-positive pulmonary tuberculosis patients were conversion rate of smear at the end of the second months. Results of Cox model showed relationship between gender, age, weight, density bacillus smear and culture results at the start of treatment and negative smears(P<0.05). Old age, low weight, high density of bacillus in primary smear in the beginning of treatment and increasing of the number of colonies in culture of positive smear patients were considered as predictor factors in changing positive smear to negative one.
Conclusion: This study revealed that Conversion rate and treatment success in Golestan province was less than what was expected.

---

Background and Objective: Patients experience full stress condition after open heart surgery. Foot reflexology massage has a potential impact on the comfort of patients with special care. This study was done to evaluate the effect of soles of feet reflexology massage on feeling of comfort in open heart surgery patients.
Methods: This clinical trial study was done on 70 patients who were divided into intervention and control groups using permutable blocking method. 35 patients in interventional group were received Soles of feet Reflexology Massage after mesearment of vital sigins for six days. 35 patients in the control group did not receive any intervention received routine care. Data gathering tools were demographic items and HCQ questionnaire, which was completed in two stages, 24 hours after surgery, before massage and the 6th day after massage.
Results: The mean total comfort score in the intervention group was 103.1±9.04 and 110.63±7.6 before and after the intervention, respectively. This differnce was not significant. The mean total comfort score in control group was 105.14±10.37 and 111.29±7.56 perior and the end of study, respectively, this difernce was not significant. Also, there was no significant difference between considering the mean scors of comfort between the tow in the intervention and control groups.
Conclusion: Reflexotherapy massage had no effect on feeling of comfort in open heart surgery patients.