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Background: Influenza is an acute respiratory disease caused by influenza virus. Influenza epidemics are reported every year and worldwide pandemics occur with varying frequencies. The majority of mortalities are due to underlying diseases and complications associated with influenza. In this study, we evaluated ten fatal cases caused by the established type A influenza (H1N1) infection in the 2009-2010 pandemic. Materials and Methods: This mortality survey was compiled by a review of the deceased patients’ files. The assessed variables were demographic data, underlying diseases, secondary infections, delayed commencement of therapy, and non-medication. Collected data were analyzed by measures of central tendency and dispersion using SPSS software. Results: In the ten deaths due to the established H1N1 virus, the median of age was 30 years and 90% of the cases had underlying diseases. Ninety percent of the deaths occurred during October and November and the rest took place in December and February. Conclusion: The main cause of death was the delayed commencement of antiviral treatment. This emphasizes the importance of timely treatment in high risk patients. In flu pandemics, physicians should swiftly start specific therapy in at-risk groups to reduce the mortality rates.

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Background: Traditionally levels of cholesterol and triglyceride are used to identify individuals at risk of coronary artery disease (CAD). The aim of this study is examining the association of ApoA1 and ApoB with severity of coronary artery disease and whether these parameters are better predictor of CAD.

Materials and methods: This is a cross- sectional study. All patients that referred to ARAK amirallmomenin hospital and enrolled for coronary angiography was entered to study. Before angiography and after gathering informed consent, levels of apoA1 apoB, cholesterol, TG, LDL, VLDL, HDL and FBS were measured. The results of coronary angiography were reviewed by two experienced cardiologist separately. Severity of coronary artery disease involvement was determined by Gensini score (GS), the data were analyzed with statistical methods by SPSS software.

Results: There is a statistically significant correlation Between apoB and GS (r=0.127, p=0.047). Logistic regression model showed that among predictors for CAD entered model eg gender, age, cholesterol, TG, HDL, LDL , VLDL, ApoA1, ApoB and ApoB/Apo- A1 ratio, only ApoB and gender were proper predictors of coronary artery Disease( CAD) (p=0.002, , p=0.001). In comparison with angiography for diagnosis of CAD, ROC analysis represent that using ApoB can be useful test (p=0.047).

Conclusion: According to result of this study, using ApoB in addition to conventional parameters for assessing the patient at risk to having CAD would be reasonable and could be an independent risk factor for CAD.

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Background: Motivation is one of the most important tools to push faculty members to perform effectively and efficiently in the workplace is. This study is based on Herzberg's theory of motivating factors to consider requiring faculty at the University of Medical Sciences deals.

Materials and Methods: In this cross-sectional study, a total of 168 faculty members of Tehran University of Medical Sciences, 102 persons conducting a completely free and informed, a 40-question questionnaire based on Herzberg's two-factor theory, design, a questionnaire. Data using t-test and Mann-Whitney U and indicators of central tendency and dispersion were analyzed by SPSS 16 software.

Results: Response rate to the questionnaires, 7.60, respectively. 5.24% of the faculty in the basic sciences and 5.74% at the clinical level of activity. Of "communication" and "progress and development", the motivation faculty have the greatest impact. Factors "physical condition" and "salary" have been less effective. Between the ages of faculty motivating factors, "nature", "responsibility and career" and "supervision and monitoring", there was a significant correlation. The relationship between work experience and of "salary" and "job security" was also significant.

Conclusion: Communication is one of the most important factors in increasing the motivation of faculty members in the physical conditions of work and wages are minimal impact in this area. With an aging faculty, salary, supervision and monitoring, and job security are more important motivation. In other words, with increasing age and work experience, academic expectations of the management of change and the proper evaluation of the activities of the officials do not have the decision-making, and because the quality of activities, good participate Ndah encouraged do not motivate members to create good will.

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Background: Peripheral nerve injures are common in clinical practice that includes from compression injury to complete disruption of nerve trunk. After injury nerves can grow and repair spontaneously, early end to end anastomosis is first choice for repair but only 50% of nerve fiber would be physiologically accurate and effective, thus several techniques for repair of nerve injury are introduced including combination of nerve transplant with silicon tubes, use of biologic and synthetic tubes for nerve conduit.

Materials and Methods: In this Exprimental study, 20 rats with the same weight were selected and kept in the same condition .The left sciatic nerve of them was cut and were divided in two groups.In the first group the facial flap method for repair of nerve injury was used .In the second group vein conduit method was used as standard method. Histological nerve repair was assessed after 45 days and the intact right sciatic nerve was used as control.

Results: Repair of nerve injury in proximal, mid and distal portion of nerve in facial flap method was more effective than vein conduit (P<0.05). Repair of nerve injury in proximal, mid and distal portion had no difference compared with control group (p>0.05).

Conclusion: Repair of nerve injury with facial flap method is more effective than standard method and can be used as a new method for nerve repair.

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Background: Phacoemulsification is a modern cataract surgery that developed surgery from large incisions into smaller incision size and lead to faster wound heal and earlier visual rehabilitation. The purpose of this study was to compare the outcomes and complications of 3.2 and 2.65 mm main Incisions in phacoemulsification .

Materials and Methods: In this clinical study in Amir Kabir Hospital of Arak, 78 patients with senile cataract were divided into two groups. Half of them experienced 3.2 mm main incision (first group) and the others were under main incision with 2.65 mm (group 2). Immediately after operation if patients had a wound leak, the standard stromal hydration was used and a suture was placed. A day after operation, the patients were examined in the light of iris prolapse, if it existed, then a suture would be palced.

Results: The occurrence of anterior chamber wound leak was 7.7% and 2.6% in group 1 and group 2, respectively. Stromal hydration was needed 5.1% and 3.2% in group 1 and group 2 respectively. In fact, suture was needed 2.6% and 0.0% in group 1 and group 2, respectively. There was no iris prolapse in both groups.

Conclusion: There was no statistically significant difference between two groups from the point of view of wound leak and the need for suture and the rate of iris prolapse (p>0.05). Also, in low or intermediate nuclear density grade, the smaller and the more permanent incision with 2.65 mm is preferred.

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Background: Cervical cancer is the third most common genital malignancy in women. In majority of developing countries the prevalence of this malignancy is high. The aim of this study was to determine the prevalence of cervical cancer among married wemon in Arak.

Materials and Methods: This cross-sectional and analytical study was carried out on 1000 married women. Demographic variables involving age, literacy, history of hysterectomy, nutrition statute, marriage age, history of abortion, smoking habits, etc were filled by questioners. Then Pap smear was done in all subjects and specimens were sent to the pathobiology laboratory. The data were analyzed with SPSS statistical software.

Results: The mean age of studied subjects was 39.38±10.1, the most freqrency of marriage once was 459(45%), the mean age of marriage was17.9±10.3, the mean age of first sexual intercourse was 15.1 (9.2%), the most frequency of the numbers of peregnancy was 2.6±2.1, and the mean times of abortion once was 153(15.3%). In this study, the prevalence of cervical cancer was 0.004(4 per 1000). There was a significant correlation between age, hysterectomy the time of marriage and painful sextual intercourse and cervical cancer (p<0.005). There was no statistically significant relation between smoking, food diet, pregnancy prevention drugs and the other variables of the study of cervical cancer (p>0.005).

 Conclusion: With attention to high prevalence of cervical cancer, promoting education and knowledge about the importance and necessity of pap smear and risk factors of cervical cancer and encouraging marriaged women to take part in screening programs is necessary.

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Background: The renin-angiotensin system(RAS) has a major role in development of diabetic nephropathy and blocking of RAS by inhibitors and blocking of angiotesin receptors is standard treatment for preventing kidney disease and proteinuria. It is reported that VIT-D analogues are able to suppress renin exertion and improve proteinuria. The aim of this study is to evaluate the effect of VitD analogue (calitriol) on reducing proteinuria in patients with diabetic nephropathy.

Materials and Methods: In this clinical trial study, 132 eligible patients that had diabetic nephropathy and hadn’t vit D deficiency were selected. The patients were divided into two equal groups. First group received the combination of losartan 25mg twice daily and calcitriol 0.25mg and second group received losartan 25 mg twice daly alone for 3 months. The FBS, lipid profile, ESR-CRP BUN, Cr, HbA1c, Ca, P, and 24 hours urine protein were evaluated in all patients at beginning and end of study and the results were statistcally compared.

Results: The 24-hour urine protein in losartan and calitriol group was improved compared to losartan. This difference was statistically significant (p=0.003). As well as, in kidney function (BUN, Cr) in the losartan and calcitriol group compared to losartan alone was significantly improved(p<0.05).

Conclusion: Combination of calcitriol with angiotesin receptor blockers(ARBs) is more effective than ARBs alone in improvement of proteinuria and real function.

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Background and Aim: Ankle injuries are among the most common musculoskeletal injuries in sports, accounting for 10% to 15% of all injuries. Since controlling pain and inflammation in ankle sprains is one of the main goals of treatment, we decided to compare the therapeutic effects of Cheleh daghi Herbal ointment with a common therapeutic gel such as piroxicam.
Methods & Materials: This study was performed as a double-blinded clinical trial for 6 months from January 2019 to August 2019. After referral, all patients completed the consent form, and the patient's details and study variables were recorded by the evaluator in the research form. To measure joint inflammation, we measured the ankle with a meter tape in the ankle area (cm) and recorded. A goniometer was also used to measure the degree of ankle movements. The symptoms of ankle ecchymosis were also checked by physical examination and observation and recorded in the checklist. Statistical analysis was performed in SPSS V. 18 using statistical tests (the Mann-Whitney U test, the Chi-square, and the independent t-test).
Ethical Considerations: The Research Ethics Committee of Arak University of Medical Sciences approved the study (Code: IR.ARAKMU.REC.1396.55) and registered by the Clinical Trial (Code: IRCT2017071720258N53).
Results: The Mean±SD age in the control group was 34.2±8.6 years, and in the case group was 35.4±8.9 years. There was no statistically significant difference according to the Mann-Whitney U test (P<0.05). Also, the Mean±SD height in the control group was 1.7±0.12 m and in the case group was 1.72±0.11 m. The results also showed a statistically significant difference between the two groups studied before and after the intervention regarding the mean indicators of pain, swelling, and inflammation around the joints (P<0.05).
Conclusion: The results of our study showed that Cheleh daghi Herbal ointment for 3 weeks could be more effective in reducing local pain and inflammation than piroxicam gel treatment.