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Introduction: Coffee is a diuretic plant, cause vascular expansion and reduce free radical oxygen. There is evidence that show its effects on kidney. Low dose of coffee reduces blood urea and cratinine but its overdose may lead to glomeruloschelrosis. In this study, the effect of high dose of coffee on rat kidney was evaluated by stereological method.
Materials and Methods: In an experimental study, 48 Sprgue-Dawley rats 230-250 gr were selected and divided randomly into 4 groups. The control group was fed with only tap water and the experimental groups were fed with different doses of aqueous extracts of coffee (0.25, 0.5, 0.125 gr/kg) twice daily. After 48 hours, the animals were deeply anesthetized and right kidneys were removed. The Sum slides were prepared and stained with Hematoxyline. Eosin. From each kidney, 15-17 glomeruli were selected and means of glumerular volume were estimated, according to Cavalieri principle and point counting methods.
Results: Our findings revealed that low dose of coffee extraction were led to increase in glomerular volume, but higher doses decreased these volumes. These results were significantly different form control group (p<0.05).
Conclusion: It seems that decrease in glomerular volume leads glomeruloschlorosis and reduction of glomerular filtration rate. However, there should be more investigation such as urea and cratinine measurement to calrify the exact mechanisms.

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Introduction: Radius end fracture is one of the most common fractures of the upper limb, the treatment of which is controversial, and improper treatment can have significant side effects. In this study, we intend to examine the results of treatment with an external fixative method.
method: It was easy to study without control and sampling. The study was performed on 30 fractures (26 patients) for one year, based on radiographs of the fracture site of type 4 universal 5. Surgery with standard techniques was performed under general or regional anesthesia, and patients were followed up for up to one year after surgery and examined for shortness of breath, joint surface angle, range of motion, and pain.
Results: Twenty-four men and two women with a mean age of 5.28 years were examined. In all patients, clinical and radiographic effusion occurred. There were two cases of mild infection at the site of the pin, which were treated with medication. In one case, there was a slight sensation in the sensory branch of the radial nerve, which disappeared after a while, and in no case was there a tendon lesion. The mean deviation to the palm was 6.6.5.5 and the ulnar deviation was 4.5 to 12.5.
There were 4 cases of pain during strenuous activity, 2 cases of mild movement restriction and one case of severe movement restriction.
Conclusion: Compared to other studies, the results of this study are much better in many cases and it is recommended to use this treatment in the treatment of unstable fractures of the lower end of the radius and especially if it develops into the radiocarpal joint.

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Background: Researches showed that there is a relationship among alopecia areata, psychological factors and prevalence of psychological disorders. In addition alopecia areata has a great effect on the quality of life of these patients. The purpose of this study is to investigate the effectiveness of cognitive-behavioral stress management therapy on female patients`s the quality of life with alopecia areata. Methods and Materials: This is a case-control study with pre and post-test exam which is carried out in Isfahan Skin Disease and Leishmaniasis Research Centre. The participants consisted of 20 alopecia areata patients diagnosed by specialists. The questionnaire was Skindex-16 which was completed by patients before and after the intervention. Cognitive-behavioral stress management therapy was done on the case group in eight sessions over a period of two months. Data was analyzed with covariance (ANOVA). Results: The mean of quality of life scores in experimental group in v.s control group significantly decreased (P<0.05). Conclusion: It seems, cognitive-behavioral stress management therapy couses in quality of life improvement in patients with alopecia areata.

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Background: The UN report on the 41% increase of cesarean labor and its risks in Iran in recent years on the one hand and its association with cognitive and psychological factors on the other motivated us to identify the involving variables so as to control unnecessary cesarean sections. The aim of this study was to investigate the role of fear of pain and related psychological variables (pain catastrophizing, catastrophic cognition, childbirth attitude, depression-anxiety-stress, and experience of pre-menstruation (PMS) in prediction of cesarean labor. Materials and Methods: In this cross-sectional study, 300 pregnant women from Atieh private and Shahid Akbar Abadi public Hospitals (150 participants from each) were selected and matched by variables, such as age, level of education, month of pregnancy, previous experience of deliveries, tendency to cesarean, type of hospital, and having PMS. To collect data, a battery of questionnaires, including fear of pain, pain catastrophising, catastrophic cognition, childbirth attitude, and depression-anxiety-stress (DASS) were used. The results were analyzed through correlation coefficient and logistic regression. Results: Education, previous experience of deliveries, month of pregnancy were not significant but such variables as the tendency to cesarean, type of hospital, and age were significant (P<0.05). Such variables as pain catastrophizing, catastrophic cognition, and childbirth attitude were significant but other variables, including fear of pain , depression-anxiety-stress, experience of PMS were not significant (P>0.05). Conclusion: Such variables as the experience of cesarean, type of hospital, and age as well as pain catastrophizing, childbirth attitude, and catastrophic cognition are significant variable in prediction of cesarean labor in pregnant women.

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Background: Leukemia is the most common type of cancer in children which its relapse decreases the patients’ survival rate. The aim of this study was to determine the risk factors involved in leukemia relapse in patients in Shahid Faghihi Hospital, Shiraz, during 2004-2009 years. Materials and Methods: In this retrospective cohort study, 280 patients with acute lymphoblastic leukemia and acute myeloid leukemia were included. Patient characteristics were analyzed with respect to their association with recurrence through Chi-square test, Fisher’s exact test, and logistic regression model using SPSS software version 16 (P-value<0.05). Results: Logistic regression model revealed a statistically significance relationship between age and recurrence of the disease (odds ratio (OR) = 0.35, 95% confidence interval (CI) = 0.15-0.82), odds ratio of relapse in the 5-10 years old age group was 0.35 times more than the 0-5 years old age group (p=0.01). Conclusion: Noticing the greater likelihood of relapse in 0-5 years old age group compared with the 5-10 years old age group, more attention and better follow-up for decreasing the side effects of the disease and enhancing the survival rate of the 0-5 y/o age group are recommended.

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Background: Multiple sclerosis is a chronic and degenerative disease of the central nervous systemthat due to such reasons as its chronic nature, no prognosis, and absence of a definitive treatment causes stress in patients. Thus, this study was designed to examine the impact of peer educational program on stress in patients with multiple sclerosis in 2011. Materials and Methods: In this clinical trial, 110 patients with multiple sclerosis were randomly allocated to test and control groups (each group including 55 patients). After preparing 5 multiple sclerosis patients as the peer group, six training sessions forthe test group were held by the peer group over two months. Data collection tool was DASS 21 questionnaire that assessed patients’ stress before and after 4 months which was completed by both groups. In order to analyze the results, SPSS software 16 was used. Results: The results showed that before intervention, there was not astatistically significant difference between the two groups in stress score(p=0.24) while a statistically significant difference was seen between the two groups after intervention (p=0.001). Also, stress score in test group was statistically significant (p=0.001) but there was not a statistically significant difference between the stress scores of the patients in the control groups (p=0.39). Conclusion: Peer group educational program caused stress reduction in patients with multiple sclerosis. Hence, it is recommended that peer groups be used for education of multiple sclerosis.

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Background: Nowadays, international concern about the impact of antibiotic residues on the environment increased and their removal has received a lot of consideration. The aim of this study was to investigate the efficiency of Fenton’s advanced oxidation process (H2O2/Fe+2) in sulfadiazine antibiotic removal from aqueous solutions. Materials and Methods: An experimental-laboratory scale study was done on a synthetic wastewater containing sulfadiazine antibiotic with 0.079, 0.19, and 0.47 mM concentrations under Fenton’s process. Then optimal values of affecting parameters, such as initial antibiotic concentration, molar ratio of reagents, [Fe+2] and [H2O2] concentration, detention time, and pH, were determined. The discharged effluent analyzed by HPLC-UV to identify the antibiotic residues. Results: The results showed that the optimal parameters in the Fenton’s oxidation process to remove the sulfadiazine included antibiotics at pH 3.5, molar ratio of [H2O2] / [Fe +2] equal to 1.5, and contact time of 15 minutes, respectively. In these optimal conditions, the efficiency of removal of antibiotic in concentrations of 0.079, 0.19, and 0.47 mM were 99.82%, 97.97% and 78.23% and the wastewater COD removal degrees were 83.33%, 78.57%, and 78.57%, respectively. Conclusion: The experiments showed the efficient removal of sulfadiazine antibiotic in wastewater by Fenton’s oxidation process. The efficiency of this method can also be considered in eliminating other antibiotics resistant to biological treatment

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Background: Balance is one of the basic needs for daily activities. It has an important role in static and dynamic activities. The purpose of this study is to evaluate the balance of people with peripheral neuropathy after 4-weeks of functional and balance exercise program.

Materials and methods: In this quasi-experimental study, 22 diabetic patients with diabetic peripheral neuropathy (experimental group, n=11 control group, n=11) with the mean age of 53.79 years, mean height of 163.41cm, and mean weight of 71.49 kg, were randomly selected. Berg and T.G.U.G tests were used to evaluate the balance of patients. 12 sessions of combined training (balance and functional training) were used as intervention program. A paired t-test was used for the differences of pre-post test and independent t-tests were used to compare the experimental and control groups.

Results: The paired sample t-test showed that training program has significant effect on functional and dynamic balance. The comparison between the two groups showed no significant deference between pre-functional balance tests and significant post-functional balance test after training program.

Conclusion: Patients with diabetic neuropathy may have an impaired balance. The most important reason is the damage of proprioceptive receptors as combined training (balance and functional training) may improve balance and blood circulation in this organ also putting extra load on the visual system, vestibular and proprioceptive stimulation system and improves balance. Hence, it can be recommended as exercises to improve balance.

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  Background : Hand eczema (HE) is a common skin disease which often needs long term treatment.. There are several reports about the efficacy of topical doxepin in the treatment of pruritic dermal diseases. This study was undertaken to compare the efficacy and safety of 5% doxepin cream and clobetasol 0.05% versus clobetasol 0.05% alone in the treatment of hand eczema.

  Materials and Methods: a randomized double blind placebo-controlled, study was carried out during years of 2011-2012.In total 70 patients with moderate to severe hand dermatitis were selected randomly to be treated with either the doxepin 5% cream+ clobetasol or clobetasol+placebo twice daily for 8 days. Efficacy assessments were performed at baseline and 8days after termination of therapy, according to hand eczema severity index (HECSI) and visual analogue scale (VAS). Statistical analysis was done using SPSS software, version 18.0 and statistical tests including paired T-test and independent T-test.

  Results: Overall, 56 patients completed our study. Out of them 32 were male and 24 were female. The reduction of HECSI score and VAS was statistically significant in the treatment and placebo group (p&le0.05), but differences in HECSI and VAS reduction between treatment and control group were not significant.

Conclusion: Although there is some evidence that doxepin 5% cream is effective in reducing the signs and symptoms of eczematous dermatitis, few trials have been performed. We suggest that in a more extensive clinical trial, the efficacy of this treatment against chronic hand dermatitis be evaluated.

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Background: Considering the high prevalence of diabetes and developing cardiovascular diseases via dyslipidemia and inflammation in type 2 diabetic patients, the aim of the present study was to investigate the effects of Oligofructose-enriched inulin on serum lipid concentrations and inflammation in type2 diabetic patients.

Materials and Methods: In this clinical trial, 52 patients with type 2 diabetes were assigned to one of two groups. Experimental group (n=27) received 10g/d oligofructose-enriched inulin and control group (n=25) received 10 g/d maltodextrin for 8 weeks. Dietary intakes, anthropometric measurements, hs-CRP and serum lipids concentrations were measured at the baseline and at the end of the study. Data were analyzed using SPSS software (verision11.5). Paired, independent t-test and ANCOVA were used to compare comparison of quantitative variables.

Results: At the end of study, we observed significant decrease in total cholesterol (28.00 mg/dL, 14.10%), LDL-c (22.00 mg/dL, 21.7%), TC/HDL-c ratio (-0.73, 20.7%) and LDL-c/HDL-c ratio (-0.55, 27.5%) in oligofructose-enriched inulin compared with the maltodextrin group (p<0.05). Changes in concentrations of triglycerides and high-density lipoprotein were not significant in oligofructose-enriched inulin compared to maltodextrin group.

Conclusion: Oligofructose-enriched inulin supplementation with improving in inflammtion and lipid profile help in management of type 2 diabetes and its complications.

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 Background: Selenium is a unique trace element which is benefit on inflammatory underlining diseases. MAPK (Mitogen-activated protein kinase) pathways regulate several cellular functions including inflammation, cell differentiation, migration, and apoptosis. Objective: This study aimed to find out the pathway(s) by which Selenium modifies inflammatory events in oxidative or thrombotic induced stress in platelet.

Materials and Methods: This is a basic -experimental study on Human platelets obtained from 30 healthy individuals (age 35±12) .The phosphorylation rate of P38MAPK , c –JNK (c-Jun N-terminal Kinase), and ERK1/2(Extracellular signal-regulated kinases1/2) as three important proteins in MAPK family and P-selectin were measured in presence or absence of selenium by ELISA( solid phase sandwich Enzyme Linked-ImmunoSorbent Assay). Pharmacological inhibition is done by inhibitors of P38MAPK, ERK1/2 and c- JNK in order to compare with selenium effects. The percentage of ratio of phosphorylated to total protein was used for normalizing the phospho protein contents of platelets.

Results: Selenium significantly reduced P-selectin expression (p<0.05), P38MAPK (p<0.05) and c- JNK phosphorylation (p<0.05) induced by cu2+oxidized LDL in platelets but Se couldn’t significantly reduce Thrombin induced P-selectin despite of decreasing in mentioned phospho-proeins.

Conclusion: Our results indicated that Selenium can reduce inflammation via suppression of p38MAPK-dependent signaling pathway. These results may provide insights related to development of novel Selenium therapies in atherosclerosis.

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Background: Drugs residual discharge into the environment through municipal and hospital wastewaters is one of the emergent environmental problems. Imipenem as a professional hospital antibiotic is widely used against gram- positive and negative bacteria and with entrance to the aquatic environments could prompt a lot of risks such as bacteria resistance, allergies, spoiling alga and daphnia and interrupting in wastewater treatment processes. Therefore there is a command to develop a method for extraction and determination of Imipenem from hospital sewage.

Materials and Methods: Solid phase extraction (SPE) was used to extract Imipenem from samples. Recovery percentage calculated at different pH of 3 and 7. The extracted samples analyzed by High Performance Liquid Chromatography (HPLC) equipped with UV detector. HPLC operated using borate buffer/methanol as mobile phase at flow rate of 0.7 ml/min, column temperature of 20 °C, and UV wavelength of 280-300 nm.

Results: Maximum recovery percentage was obtained 68% at pH=7. The best condition for HPLC was 80:20 ratio of borate buffer/methanol with pH=7.5 and at UV wavelength of 300 nm. Linearity calculated 0.9829, primary and intermediate precision both were more than 95%. Limit of detection (LOD) and limit of quantification (LOQ) were 3 and 10 µg/l respectively.

Conclusion: The method could simply and with significant reliability be applied to extract and determinate Imipenem in complex hospital wastewater matrixes.

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Background: Delayed muscular soreness after resistance exercises or eccentric trainings is probably because of muscle damage and injury. Nutrition by playing a crucial role in both protein synthesize and catabolism can influence the extent of muscle injury. The objective of this study was to assess the effect of single portion of Glutamine supplement consumption on injury indices of muscle after a session eccentric resistance exercise.

 Materials and Methods: This study used a randomized, double blind design that consisted of 80 volvnteer non-athletic males (aged 22.2±2.2 years, height 175±5 cm, weight 71.64±9 kg, body mass index 23.2±2.2 kg/m2, and body fat 17.5±2.4%). A total of 40 participants were divided randomly into 2 groups, supplement group (receiving 0.1 g/kg Body weight/day Glutamine) and placebo group (receiving 0.1 g/kg Body weight/day Maltodextrin). Serum keratine kinase (CK) was determined by photometric method, muscle pain and knee joint range of motion were measured using, respectively, a standard scale of PAS and goniometer before, 24 and 48 hours after a resistance test involving knee flexion.

Results: Glutamine supplement consumption caused no significant differences in CK levels reduction in none of the measured times, but it reduced the muscle pain at the times of 24 and 48 hours in comparison with the placebo group. In addition, the knee joint range of motion was significantly improved at 24 hours after the test.

Conclusion: It seems that this dose of Glutamine supplementation can reduce the apparent signs apart from muscle injury indices reduction.

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Background: Understanding the real needs of children with cerebral palsy and their families  helps the therapists to provide adequate health care service for them. This study aimed to determine the needs  of  mothering handling training for family caregiving of children and youth with CP at home based on the level of gross motor function.

Materials and Methods: This research was a descriptive, analytical and cross sectional study that was performed on 186 children 4-12 year olds with CP from the rehabilitation clinics in the city of Arak. They were selected by simple and purposeful sampling. Clinical tests were Gross Motor Measure Function Classification System Expanded & Revised (GMFCS E&R) to assess the severity of gross motor function lesions and canadian Occupational performance measure (COPM) to determine the needs. Data were analyzed by descriptive tests such as: statistical test and two-way ANOVA.

Results:  The most important need of mothering handling training was self care training specially toileting, feeding, eating and functional mobility related to children with CP in the level of V of GMFCS E&R (transported in a manual wheelchair). There were no significant differences in needs of mothering handling training in areas of sex and severity of gross motor function lesions (p>0.05).

Conclusion: It seems that therapists should combine maternal handling trainings with other interventions in therapy programs, especially in the area of self- care.

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Abstract

Background: Candida albicans is still the main etiologic agent of candidiasis. However, infections of non-albicans Candida species are increasing. Candida dubliniensis is similar to C. albicans phenotypically and must be identified due to the better management of infection. The aim of the present study is to defferentiate and identify Candida species by Duplex PCR for getting an epidemiological data of Candida species among clinical specimens.

Materials and Methods: DNA was extracted using phenol-chloroform method from fresh colonies. Internal Transcribed Spacer region was amplified by polymerase chain reaction using specific primers. Based on differences of bands sizes on agarose gel electrophoresis, species were identified.

Results: Ninety four out of 100 patients (49 males and 51 females) had predisposing factors in the present study. Diabetes (73.4%), use of antibiotic (6.3%), vitamin deficiency (4.3%) were the main predisposing factors. The most specimens belonged to mouth (75%), vagina (5%), and blood (4%). All isolates were identified as C. albicans.

Conclusion: Duplex PCR is a rapid and precise method for the detection and differentiation of Candida species carefully, and in this method, phenotypic tests like germ-tube and chlamydoconidia production, as well as biochemical tests are not required for clinical laboratories that have limited resources and time for response to the patients, and it can replace with the traditional methods.

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Abstract

Background: With regards to importance of the role of parents in children's life, imbalance in the roles of parents can lead to serious mental, emotional and physical damages of the child. The purpose of this study was to determine how to do parenting role's tasks in parents of children with disability (physical- mental) younger than 7 years in the city of Arak in 2016.

Materials and Methods: In this study, the parenting role's tasks questionnaire for 120 parents of children with disability was completed. The effect of demographic characteristics on how to perform the role of parents was studied.

Results: Based on data collected and analyzed using Pearson correlation coefficient for the relationship between the parents and other factors, we have found no significant relationship between role of parents with the child's age. In disabled children, between parent's role and maternal age was significant difference which its correlation coefficient was -0.18, represented the inverse association between maternal age and the parent's role with disabled children. In comparison of parent's role based on child's gender, significant difference was not seen in any of cases. The impact of the seizure on performance of parenting role's tasks implied no relationship between history of seizure and performance of parenting role's tasks. Economic situation as well as on how to do tasks was ineffective.

Conclusion: Imbalance in performance of parenting role's tasks in primary care, education, leisure and cognition promotion showed that existence of a disabled child in the family had negative impact on the parenting role's tasks in different aspects, for example further focus on one of the domains lead to ignorance of other domains. Total score confirmed the negative impact of disabled children on efficient implementation of parenting role's tasks.

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Background and Aim: Musculoskeletal disorders are mainly prevalent among college students who experience direct contact with patients. This study aimed to determine the prevalence of musculoskeletal pains among Rehabilitation, Dentistry, and Nursing students at Arak University of Medical Sciences in 2017-2018.
Methods & Materials: In this cross-sectional descriptive study, 538 students of Arak University of Medical Sciences were recruited using the convenience sampling approach. Variables included age, sex, body mass index, study field, hours of using smartphone per day, and nine symptom sites being neck, shoulders, upper back, elbows, low back, wrist/hands, hips/thighs, knees, and ankles/feet. The researchers assessed the musculoskeletal pain by using the Nordic questionnaire and demographic questionnaire. Statistical analysis was performed using SPSS V. 18.
Ethical Considerations: The Research Ethics Committee of Arak University of Medical Sciences approved this study (Code: IR.ARAKMU.REC.1397.253).
Results:  In this study, 538 students (205 males and 333 females) were studied with Mean±SD age of 22.04±2.53 years old. The results showed that the prevalence of musculoskeletal pain in the spine (neck 29.4%, upper 24.3%, and lower back 37.2%) was higher than in upper and lower extremities. Musculoskeletal pain in the shoulder, upper, lower back, and thigh were significantly different based on sex. Also, musculoskeletal pain in the neck and ankle, and foot were significantly different based on age (P<0.05). There was a significant difference between musculoskeletal pain of back and ankle based on smartphone use hours per day.
Conclusion: This study suggested that rehabilitation, nursing, and dentistry students are at risk for musculoskeletal pain, especially in the lumbar, cervical, and upper back.