---

---

---

---

---

---

Background: Permanent pacemakers are applied to treat some 2nd and 3rd degree AV blocks. Previous studies have shown the hemodynamic changes that may occur after pacemaker implantation. In this study, we have evaluated these hemodynamic changes from a different view point, with measurement of urinary sodium and blood pressure. Materials and Methods: This is a before and after clinical trial study in which 30 patients, who were hospitalized for permanent pacemaker implantation for the first time in Tehran heart center during 3 years, including 12 women (mean age 62.92 years) and 18 men (mean age 60.07 years), were tested for urinary specific gravity and sodium, blood pressure, blood sodium and potassium, before and after pacemaker implantation. Paired sample T test and Chi Square test were used for statistical analysis. Results: Systolic blood pressure was 136.5 mmHg and 120.6 mmHg before and after pacemaker implantation, (P<0.001). Also, after pacemaker implantation, urinary sodium rose from 83.45 meq/L to 106.61 meq/L (p=0.018). Conclusion: This study is consistent with previous studies, which showed hemodynamic changes after permanent pacemaker implantation including decrease in blood pressure and elevation of serum neuropeptides.

---

Introduction:The membranes used in haemodialysis may be manufactured from cellulose, modified cellulose or synthetic polymers. Such membranes, when in contact with blood will activate the complement system, which entails changes in leukocyte and platelet counts. Polysulfone is a synthetic membrane of high biocompatibility standards, whereas haemophane membranes are modified cellulose-based membranes. The biocompatible profiles of these membranes, has been studied by clinical reactions (i.e. hypotension, nausea, pruritis, …) during dialysis sessions. Both kinds of these membranes are used in Iran. The number and severity of these reactions define the degree of dialysis biocompatibility. Materials and Methods: In a clinical trial study which was carried out in Imam Khomeini hospital in Tehran, 100 hemodialysis patients were enrolled to this investigation. Their clinical reactions were compared during 3 sessions of hemodialysis with polysulfone and 3 sessions of hemodialysis with hemophan membrane. Each patient was the control of him/herself. Data was analyzed using Chi square test. Results:Mean age of patients was 48.85±17.56 years and 39% of them were female. The most common complications were hypotension and muscle cramps (each 21.5%). Hypotension was higher in sessions of polysulfon versus hemophane (18% versus 25%) but was not significantly different. Also other complications such as muscle cramp, nausea, vomiting, dyspnea, headache, chills and fever had no significant difference. Seizure did not occur in any patient. Conclusion: According to our findings the membrane’s type has no role in acute clinical complications during hemodialysis and in most patients, membranes can be used according to their availability. It seems their biocompatibility has no considerable clinical difference.

---

Introduction: Radiotherapy after breast cancer surgery will increase local control of the disease and also increase overall survival. Radiation have some side effects on lung function. In different radiotherapy techniques, these side effects are different. Pulmonary function tests and oxygen saturation are methods for evaluation of these complications. In this study we decide to campare pulmonary complications in two radiotherapy methods. Materials and Methods: In this clinical trial study fifty one patients with breast cancer in stage II and III according to TNM staging system, which were under modified radical mastectomy in Imam Hosein hospital and refered for adjuvant radiotherapy, randomly divided in two groups. In one group patients were treated with three field technique and in others with four field technique. All patients received total dose of 48-50 Gy. For patients, pulmonary function test and pulse oxymetery were done once before initiation of radiotherapy and then one and three months after radiotherapy. Results: Measurement of FEV1 , FVC and show that no significant statistical difference was present between the two groups one month and three months after radiotherapy, also in each of the two groups the amount of FEV1 , FVC and one month after radiotherapy had no significant statistical difference in comparison to baseline tests but FEV1 and FVC after three months was decreased and had significant statistical difference respectively (p<0.001, p<0.006). SO2 had no significant defference between the two groups and also in each group after one and three month of radiotherapy. Conclusion: Locoregional radiotherapy of breast and lymph nodes areas causes a decrease in some parameter of pulmonary function tests but no difference was present between three field and four field techniques.

---

Introduction:Final examinations are important stressors in schools and universities that result in different psychoneuroimmunological outcomes but the study of these effects on children has not been paid enough attention to. The aim of this study is to investigate the effect of final examinations on salivary immunoglubulin A in children. Materials and Methods: In this clinical trial a total of 100 children (50 boys, 50 girls) in 5th grade, aged less than 12 years from two primary schools of 5th educational district in Tehran were choosen randomly. The subjects completed Test Anxiety Scales of Sarason & Abolghasemi. After making sure of their physical and mental health by reviewing their medical history, clinical examinations and after controlling sleep, food, drug and sport variables, based on time series design, salivary IgA samples were taken five times as followed: one week before and then three times through mathematics, history and science exams and at last one week after passing the exams at, 9 to 10 am. IgA samples were analyzed by nephlometry method. Data was analyzed using ANOVA. Results: Findings indicated that IgA level was decreased significantly during examinations comparing to IgA levels before and after examinations (p=0.01). The relations of sex and anxiety scores were not statistically significant. It means that decreased IgA levels are the same in all children. Conclusion: Final examinations as a stress resource, diminishes IgA and this change is not related to sex and test anxiety score.

---

Introduction:Hyperlipidemia is one of the major risk factors of cardiovascular diseases. This study was done to assess lipid profiles according to sex and place of residence in the urban and rural area of Arak for controlling cardiovascular diseases. Materials and Methods:This descriptive study is the first phase of healthy heart program which was done in Arak. Sampling was randomized cluster. A questionnaire was used to collect demographic data and paraclinical test results (total cholesterol, LDL-c, HDL-c ,and Triglyceride). Data was analyzed using T-student, Kolmogorov-Smirnov, Mann-Whitney and Chi-square tests. Results: Of 4303 individuals over 30 years, 51.6% were female. Total cholesterol, LDL-c and HDL-c disturbances were more in female (p<0.05) but there was not a sigmifiant difference between male and female in triglyceride disturbance. The increase in serum lipids was signfiantly different in urban and rural areas, in which total cholesterol and LDL-c disturbances were more in rural and triglyceride disturbance was more in urban areas (p<0.0001). Conclusion: High prevalence of dyslipidemia in the studied region can be related to unhealthy life style, nutrition and inadequate physical activity, so dyslipidemia and cadiovascular diseases could be decreased by changing lifestyle.

---

Introduction: Children with reflux who fail prophylaxis management or reflux which do not resolve spontaneously are candidates for sugery. Delay in surgery increases the development of new renal scars. Finding a modal factor for prediction of reflux resolution likelihood can decrease complications of treatments. Regarding that sacral bone anomalies have a direct influence on the final function of urinary and bowel systems, this study is done to investigate the relationship between sacral ratio and reflux. Materials and Methods: This is a case-control study. The case group included 76 children less than 9 years old refered to Vali-e-Asr and Amir Kabir hospital clinics with urinary tract infection and according to voiding cystouretrograply (VCUG) results, children with III, IV and V grade vesicoureteral reflux (VUR) entered the study. The control group included 76 children with previous urinary tract infection and normal VCUG. Sacral ratio in the two groups was measured and was compared by student t, Chi square and Mann Whitney tests. Results: The case group included 24 males and 52 females with average age of 2.7 years old and the control group included 23 males and 53 females with the average age of 3 years. The percent of sacral ratio abnormality were 40% and 23.7% in the case and control groups respectively, which was significantly different (p=0.001). The difference between the mean sacral ratio in case group with the value of 80% and the control group with the value of 84% was not different. The ratio distribution pattern in the two groups was not different. Conclusion: The percent of sacral ratio abnormality in children with vesicoureteral reflux were more than children without reflux.

---

Introduction: Pollen grains are male gametophytes of flowering plants that with self interference in fertilization have an important role in plant fertilization, increasing fertilization and improving quality of products. Pollen grains are of important allergenic plants and 80-90% of allergens have plant origin. Achillea plant has medical usage and grows in different regions of the country. This research is done in order to acquire scientific information pertaining to pollen grains allergenicity in their development stages and comparing mature and immature pollen grains allergenicity. Materials and Methods: In this experimental study Achillea plant pollen grains in different developmental stages were collected around Isfahan city and samples were studied using light and electronic microscopy (SEM). Pollen extracts were prepared by incubating pollen grains in phosphate buffered saline, PH: 7.4. The allergenicity experiment was done on male Guinea pigs (Hartley strain, 350-500g weight, 4-6 week-old, Pausteur institute of Iran) and electrophoresis of proteins was done on 12% SDS- polyacrylamide gel. Data were analyzed using one way ANOVA and Duncan test. Results: Images of light and electronic microscopy showed pollens from ellipse-spherical type, with two colpate and echinate exine. The skin tests in Guinea pigs treated with pollen extracts indicated wheal with diameter larger than control group. In clinical tests, the numbers of eosinophils, neutrophils and IgE were increased in animals treated with pollen extract comparing control group. In SDS- PAGE protein profiles, 6 richly colored protein bands were seen in mature pollens in 14.4 to 66 KD and 5 slightly colored protein bands in immature pollens in 14.4 to 45 KD. Conclusion: This research shows changes of immature pollens` ellipse morphology to spherical form in mature pollens, partial increasing in accumulation and height of exine surface echins, changes in quality and quantity of immature and mature pollen grains and difference in their allergenic severity.

---

Introduction: Cataract is a type of tarnish observable opacity in different layers constituting the lens and will cause light occlusion or scattering. Necessity for treatment of Cataract via surgery and its close relation with corneal astigmatism, when we applied a new method in cutting and type of cataract surgery, led us to measure the post-operation corneal astigmatism changes in frown incision Phacosection. Materials and Methods: This interventional study has been done on 73 eyes(58 patients). These patients were gone under Cataract surgery via no stitch frown incision scleral tunnel phacosection method. In this study we have 7mm external scleral incision with no suture. They were Keratometerized in four separate periods including pre-operation, one week, one month and three months post- operation. Data was analyzed using independent and paired t-tests. Results: Age, sex and left or right eye had no influence on astigmatism. Mean pre- operation astigmatism was 0.84 ± 0.87D, mean astigmatism 1 week post- operation was 0.27 ± 0.88 D, 1 month post- operation 0.06 ± 0.82 D, and three months post-operation was -0.03 ± 0.85 D (P= 0.0001). Before operation, 80% of the patients did have an astigmatism rate less than 1D that increased to 94.5% in three months period after operation and in 89% of the cases, the ultimate change in astigmatism has been found lower than 1D. The obtained information revealed that there is a meaningful difference between pre-operation astigmatism and the same after one week, one month and three months post-operation(P= 0.0001). Independent sample t and paired t-test were used to analyse data. Conclusion: Our study indicated that the no stitch frown incision scleral tunnel phacosection surgery can reduce pre-op corneal astigmatism, and because of induction of the slight controlled astigmatism we can apply this technique for all cataractic patients

---

Introduction: Based on statistical and epidemiological studies, cancer is the third most common cause of death after heart diseases and accidents, therefore planning to control cancer is essential for public health. Cancer registration is an important part of cancer control, and the collected data could be useful in etiological studies, and health programming to prevent and treat the disease. In this study cancer incidence and cancer registration in Markazi province investigated. Materials and Methods: In this descriptive study, data related to cancer were collected from the health center of Markazi province, from 2001 to 2006. Then the prevalence and incidence of different kind of cancer were determined. Results: Results showed that the top ten cancers among women were: 1-Breast 2-Skin 3-Stomach 4-Colorectal 5-Lung 6-Uterus 7-Bladder 8-Lymphoma 9-Thyroid 10-Esophagus, and the ten most prevalent cancers among men were: 1-Skin 2-Bladder 3-Stomach 4-Lung 5-Prostate 6-Colon and Colorectal 7-Esophagus 8-Lymphoma 9-Testese 10-Gall bladder. Conclusion: In this investigation we also compared cancer incidence and distribution in Markazi province with national rates and our results showed that in some years, cancer statistics is different from national statistics which it may be due to different environmental and epidemiological factors.

---

Introduction: A pseudoaneurysm is a pulsetile hematoma secondary to bleeding into soft tissue, which involves peripheral vessels in the most cases. A femoral artery pseudoaneurysm that is a rare complication, mainly occurs following prior arterial catheterization but it may also be formed with trauma. In this article a superficial femoral artery is reported. Case: The patient is a 24 years old woman who was admitted with a wound in the posteroinferior region of right tight 10 days before her recent referral. The skin of the wound had been repaired. After 1 week pain, progressing swelling in inferior region of tight and knee, fever, shivering and limping were presented. In physical examination, 90 degree flexion of knee, edema, warmth and tenderness in inferior region of tight were observed. Any pulse of dorsalis-pedis and posterior-tibialis was not touched. In the next step blood laboratory test, simple X-ray, Doppler sonography and magnetic resonance imaging (MRI) of right lower limb were accomplished. Finally, with the diagnosis of femoral artery pseudoaneurysm, excision of the pseudoaneurysm with reverse saphenous vein grafting was performed. Conclusion: Pseudoaneurysm should be noticed in patients with history of penetrating trauma and symptoms due to infection. In these cases sonography is necessary to get the exact diagnosis. The size of aneurysm and patient’s symptoms, determine the method of treatment.

---

Background: Post operative nausea and vomiting (PONV) is a very common and distressing complication after surgeries which may result in more serious problems such as incisional hernia wound dehiscence and aspiration. Cataract surgery following increase in intraocular pressure is sensitive to POVN. This study was designed to evaluate the effect of capsicum ointment on Korean acupressure points in reducing PONV and the amont of anti- emetic medications was used. Methods and Materials: This study is a double-blinded clinical trial which was done on 200 patients who were referred to Amir Kabir hospital for cataract surgery. The patients were randomized assigned to two groups, one who received capsicum ointment and the other placebo (vaseline ointment) at the pressure points (K-K9 and K-KD2). After applying the ointments and during the first 12 hours after the operation the patients were assessed for the incidence and intensity of PONV. Results: The incidence of nausea and vomiting during the first 6 and 12 hours was higher in the placebo group in compare to the capsicum group (p=0.001). Nausea scores were also higher in the 6 and 12 hours in the placebo group (p=0.0005). Uses of metoclopramide was significant higher in the placebo group in compare to the capsicum group (p=0.001). There was no significant difference between the two groups for vomiting during first 12 hours ofter opration. Conclusion: Stimulating of both K-D2 & K-K9 Korean acupressure points simultaneously is a simple, noninvasive, cheap and effective method for reducing PONV.

---

Background: Hospital readmission rate as a global health problem has increased over the last few decades. Congestive heart failure (CHF) is one of the most common causes of hospital readmission. Little is known about barriers of readmission rate control. The aim of this study was used for data exploring the barriers of readmission rate control. Methods and Materials: A qualitative study was designed with grounded theory approach. Data were gathered with interview. This study was started with proposly sampling and continues with theoretical sampling during 6 months. A convenience sample of 42 people was recruited from two public educational hospitals in Tehran during 6 month. The data were analyzed using constant comparative analysis. Results: Data analysis demonstrated lake of sensitivity on barriers of readmission incorrect patient’s health believes and expectations insufficient patient education, drug and diet adherence, and incorrect life style lack of active medical system , distrust on physicians and lack of communication psychological issues and patient - family challenges, were as the barriers of readmission control. Conclusion: This research had shown that the barriers of readmission control recognized by applying Qualitative research method with source triangulation better than the biomedical approach with single source. On the other hand, lack of sensitivity of partcipants on barriers of readmission control is a new finding. So, for controlling the barriers of readmission despite of exploring the barriers, making sensitive of involved people to readmission, is also proposed

---

Background: Diabetic patients face many challenges related to their illness and treatment in their life. So they need to use coping strategies for adjustment. The purpose of this study was determined the coping styles among diabetic Iranian patients. Methods and Materials: In a case-control study, 100 consecutive diabetic patients admitted to Amin and Sedigheh Taherah Medical Centers, Isfahan, were selected based on the inclusive and exclusive criteria and compared with one hundred normal people who selected from general population. Data collected by using demographic questionnaire, the Jalowiec Coping Scale, then MANCOVA and co-variance were used to analyze the data. Results: Difference between two groups in coping styles were significant (F=2.835, p=0.005). Significant differences was in supportant coping style (F=11.204, p=0.001). There was no significant difference in other coping styles between two groups. Conclusion: It seems that the diabetic patients likely differ from normal people only in supportant coping style when deal with daily stress. But they are similar to normal people in other coping styles. In addition, both groups use problem solving styles when deal with daily stress. The findings emphasis the role of illness representation to determine coping styles.

---

Background: Skin cancer is one of the most important cancers in the world. This cancer is more common in men than women. We survey chromosomal changes in DMBA-induced skin cancer in SD rat strains. Methods and Materials: In this fundamental study, 20 SD rat strains were randomly divided into case and contal group. DMBA (2.5 mg) was injected to SD rat strains subcutaneously therefore skin cancer model for studies was created. Tumors became subjects for cell culture and metaphase chromosomal were prepared. Finally G-banding were stained. We have also transmitted genomic information from rat to human using suitable databases and Gene were determined. Results: Data showed numerical and frequent structural changes in different number of chromosomes. For example gain in chromosomes number 1, 15, 17 and loss in 1, 7, 15, and also structural changes like deletion was seen in chromosomes number 1, 4, 8, 10, 15, 17, and addition in chromosome number 15. Discussion: It is predicted that CST6، PRKCDBP، PTCH1، DKK3، ، BRMS1، CDKN1C، CD81، DMP1، CDKN2B ، EEF1A1 ، HRAS، CASP2، KLF4 probably cause skin cancer.

---

Abstract Background: Prevalence of urolithiasis is increasing in children and maybe hematury is only sign. This study was conducted to investigate clinical manifestation and etiology of urolithiasis in children younger than 14 year-old. Materials and Methods: This descriptive and case-series study was carried out on 100 patients referring to Sahamie Pediatric hospital in Qom in 2007-8. Age, sex, family history, clinical manifestation (fever, dysuria and Pain) and laboratory tests (Na, K, Ca, P, urea, Cr, Albumin, Alkaline phosphates of serum ABG, urine sediment, urine culture Na, K, Ca, P, Cr, oxalate and citrate of urine/24h and cysteine in random sample of urine) were determined. Ceratenin correcting formula was used for adequacy controlling of urine collecting. Results: Hypocitraturia (56.8%), hypercalciuria (29.4%), hyperuricosuria (26.3%), hyperoxaluria (14.7%), phosphaturia (8.4%) and cystinuria (6.3%) were detected. Also, 54% patients had urinary tract infection. Pain (27.7%), fever (33.3%), irritability and dysuria (62.2%) and hematuria (77.7%) were seen. Positive family history was reported in 23% of patients. Conclusion: Most common clinical manifestations in children with stone were hematuria, dysuria, fever and pain. The common etiology of urolithiasis respectively was hypocitraturia, hypercalciuria, hyperuricosuria, hyperoxaluria, phosphaturia and cystinuria.