---

Introduction: Nowadays, depression is one of the most prevalent psychological disorders and is a prevalent mood disorder. Recently researches about depression etiology, show that in addition to different neurotransmitters and life events, internal stressors such as serum cholesterol, triglyceride and some coagulation factors can have an effect. This study was focused on the relationship between major depressive disorder and serum cholesterol level. Materials and Methods: This research is a case control study that was performed in the year 2006. Case group were 62 patients referred to Hashemi Senejani psychiatric medical center and control group were chosen from ENT ward patients of Amir-Kabir hospital. Both groups were paired match for age, gender and education. In order to determine serum cholesterol level, 5cc blood sample was taken of each person from both groups. Data was analyzed using K-S and Mann-Witheny U tests. Results: The mean age of samples was 35.5±9.9 years. 77% were female, 67.2% married, 25.8% single and 6.5% divorced. Average serum cholesterol level in case group (215.6 ± 47.6 mg/dl) in comparison to control group (183.1 ± 31.2 mg/dl) was significantly higher (p<0.05). Conclusion: Regarding the results, it seems that serum cholesterol is an internal stressor for depressive disorder so everyone with high serum cholesterol level must be evaluated for depressive disorder.

---

Introduction: Relationship between Multiple Sclerosis (MS) and primary headaches is not well recognized yet and the studies that have been done had different results. The aim of this study was to investigate the relation between primary headaches and multiple sclerosis. Materials and Methods: In this historical cohort study, 117 patients with actual MS were selected by convenience sampling as case group and 351 healthy subjects as control group. The incidence of primary headaches was assessed by a physician using a questannaire. Variables under investigation were age, sex, type of MS, Expanded Disability Status Score (EDSS), and characteristics of headache based on International Headache Society (IHS) classification. Data analysis was done using Chi-square, t-test, Fisher exact test, and logistic regression. Results: 53.8% of MS group and 27.4% of control group had chronic headaches (p=0.0001). Frequency of Migraine and tension type headaches among patients with headache in MS group were 73.1% and 26.98%, and in control group were 40.6% and 58.7% respectively. There was a statistically significant relation between Relapsing-Remitting MS and migraine headache (p<0.001).There was not any correlations between headache and using Interferone, MS duration, and EDSS. Conclusion: The results of this study indicate that primay headaches, especialy migraine without aura, are common in MS patients comparing to general population.

---

Background: In the recent years, oxidative stress was attended as one of the causal factors of ischemic stroke. In terms of the role of genetic, geographic and ethnic factors in the prevalence of stroke, This study was designed to compare the oxidative stress indexes of stroke patients with normal healthy subjects in this geographic area. Methods and Materials: In this case-control study, 36 patients older than 50 years with ischemic stroke and 45 healthy subjects with same age and sex, were enrolled. Five milliliter blood were drawn from all subjects. Samples were centrifuged and plasma was separated. Total antioxidant capacity, lipid peroxidation and thiol levels were measured respettively by FRAP, TBA and HU methods. Then the result was analyzed using t-test. Results: Results showed total antioxidant capacity and thiol plasma levels were lower in stroke patients in compare to healthy subjects, but only the thiol group had significant difference(P=0/001). Although lipid peroxidation showed a slight but non-significant difference in stroke patients in compare to control group. Conclusion: These findings suggest oxidative stress in patients with acute ischemic stroke may be conseaqence of an imbalance in oxidant/antioxidant homeostasis. Therefore it may be useful to recommend antioxidant medications or diet for these patients.

---

  Background: Stroke is one of the important causes of death. However the prognostic factors are not clearly defined. There are many evidences which show the role of inflammatory factors during the progression of stroke but the relation of CRP and stroke is still vague. This study was designed to determine the relation between CPR Level and WBS with severity of stroke (according to CNSS score) and volume of infarct in stroke patients.

  Methods and Materials : This is a cross sectional study performed during the winter and spring of 2007 on 49 patients with stroke hospitalized in Vali-e-Asr hospital of Arak.Clinical examination was done by using CNSS scoring. The CRP and WBC were measured in the first 72 hour of onset of the disease. The CT scanning together with infarct volume estimation was performed at the same time.

  Results : There was no correlation between the volume of infarct with CRP serum level (r=-0.14, p=0.39 ) and WBC (r=-0.17, p=0.92 . Also there was no correlation between CNSS score with CRP level (r=-0.04, p=0.81) and WBC (r=-0.124, p=0.40) too, but there was a significant correlation between CNSS score and stroke volum in brain CT scan (r=-0.43, p=0.006 ).

  Conclusion: According to data in this study there was no correlation between serum acute phase reactant, the volume and severity of infarction.

---

Background: Multiple sclerosis (MS) is a demyelinating disease of central nervous system which has different clinical manifestations. Noticing the role of vitamin B12 in synthesis of myelin tissue and the existence of different views about its pathogenesis and causes, we decided to evaluate B12 serum levels in MS patients. Materials and Methods: In a case-control study, 40 patients with definite clinical diagnosis of MS and 80 traumatic patients hospitalized in the emergency ward of Vali-asr Hospital of Arak (the control group) were chosen. The level of blood vitamin B12 was measured for all the subjects through the same type of kit and clinical checklist. Data were analyzed through t-test. Results: The mean vitamin B12 serum level in case and control groups were, respectively, 295±133.3 pg/dl and 257.73±91.3 pg/dl which did not indicate a significant difference(p> 0.05). However, in terms of the type of clinical manifestations, the mean vitamin B12 serum level in MS patients showed at least one sensory, motor, or sphinctery symptom lower than the control group. This difference turned out to be significant(p< 0.05). In terms of MRI findings, patients with brainstem and vertebra plucks respectively had the maximum and minimum vitamin B12 serum levels. Conclusion: Although a significant difference was not observed between the mean vitamin B12 serum levels, based on the significant decreases in the serum levels of this vitamin in some of the patients with subtypes of MS, further studies with larger sample sizes and over longer periods of time are suggested.

---

Background: Aflatoxins, especially aflatoxin B1, have lethal effects on human and animal health. This study is intended to present a specific, sensitive, and relatively fast method for measurement, detection, and isolation of aflatoxin-albumin (Af-Alb) adducts in serum. Materials and Methods: In this experimental-trial, three groups of rats were selected and used as positive control (treated with aflatoxin B1), negative control (without treatment) and standard (treated with radioactive aflatoxin B1). After drawing blood samples from the rats, blood serum and then, serum albumin were isolated. Albumin was hydrolyzed by pronase and eventually, was injected into HPLC system. The sample was then identified and measured by fluorescence detector. Results: Electrophoresis on PAGE revealed albumin isolated from serum to be perfectly pure. In HPLC method, detection limit for the measurement of Af-Alb adduct was determined to be 60 pg/ml. The mean of aflatoxin positive control rats serum was 19.2 ng/mg albumin. In inter- and intra-group experiments, a remarkable level of reproducibility was seen for this method. Conclusion: The amount of Af-Alb adduct is proportionate to the amount of aflatoxin received. This project was conducted with rat serum sample, but since albumin is hydrolyzed and can be isolated from aflatoxin, this method is applicable to the measurement of Af-Alb adducts in human serum samples.

---

Background: Vasomotor disorders are one of the most painful menopausal complications that negatively affect the quality of life in menopausal women. This study investigated the effects of omega3 fatty acid on vasomotor disorders in menopausal women. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial study was done on 83 menopausal women aged 45-60 years that had met the inclusion criteria. The participants were randomly assigned to omega3 or placebo groups. Fish oil capsules (containing 300 mg of omega3) or placebo capsules were prescribed to the participants one capsule a day for 8 weeks. Of the 83 patients enrolled, 68 completed the study (omega3 supplement, n=34 placebo n=34). Data collection was done through demographic questionnaire, daily self report, and food frequency questionnaire (FFQ). Data were analyzed by t-test, Chi square, Fiedman, and Mann-Whitney tests using SPSS software version 18. Results: After 8 weeks of intervention, there was a significant difference in HF frequency (p=0.003) and nightsweats frequency (p=0.001) between the two groups. There was no significant difference in HF intensity between the two groups (p=0.2) but reduction of nightsweats intensity was significant between the two groups (p=0.003). Conclusion: Omega3 affected the reduction of HF frequency and nightsweats frequency and intensity but it did not have a significant effect on the severity of HF.

---

Background: Cerebral venous sinus thrombosis is a rare form of brain stroke caused by thrombosis in venous sinuses of Dura. This study reports on a patient with venous sinus thrombosis and brucellosis who presented with uncontrolled seizure. Case: A 33-year-old woman with past history of controlled complex partial seizure who presented with headache, asthenia, and uncontrolled seizure for one month is described in this study. She was febrile and in brain CT scan hemorrhagic focus in left posterioparietal and temporal lobe was reported. MRI and MRV proved venous sinus thrombosis in left transverse sinus. In laboratory assessment, brucellosis was confirmed as well. The patient treated with anticoagulant, anti-brucellosis, and antiepileptic agents and discharged in good condition with medication orders. Conclusion: Clinical suspicion and accurate evaluation is the most important clue in the diagnosis and treatment of brucellosis and venous sinus thrombosis, especially in uncontrolled seizure in patients who had previously been under control.

---

Background: Several clinical studies suggest that melatonin is a neuroprotective molecule in neurodegenerative disorders and it showed to be reduced in Multiple Sclerosis (MS) patients. MS also results in blurred vision, papillitis and diplopia. The main objective of the study was to asses the influence of Melatonin supplimentation on visual characteristics in patients with MS.

Materials and Methods: In a Quasi Experimental plan, approved by AUMS ethical Committee, 34 (9 males and 25 females) patients with stable MS were asked to voluntearly participate in the study. All subjects (Mean EDSS 3.14) were taking their routine medications. Visual funtions were evaluated by Visual Functioning Questionnaire (VFO-25) and standard Pattern Reversal Visual Evoked Potentials (PR-VEP) records. Serum Melatonin levels were also measured using an ELISA assay. Recordings were performed after a single dose and after taking 1 tablet every night for 14 days, at the day 16th.

Results: In all subjects, Serum Melatonin levels were significantly enhanced. VFQ scores also showed significat improvement. Except the change in N75 latencies of left eyes, VEP latencies of P100, N145 of both eyes and N75 of right eyes were significantly (p<0.05) reduced.

Conclusion: Our findings suggest significat improvements of visual symptoms of MS after daily intake of 3 mg Melatonin. The results calls for further studies and clinical trails before asking all MS patients to take Melatonin suppliment every night.

---

Background: Wolfram syndrome is a rare neurodegenerative autosomal recessive disorder. That occurs in association with diabetes mellitus, diabetes insipidus, and optic nerve atrophy, hearing loss, urinary tract infection and nervous complication.

Case: The present report belong to a 24 years old girl who was effected by diabetes mellitus in 10 years old & has been effected by Diabetes insipidus, recurrent UTI, hearing loss and other type of disorders in 20 years old.

Conclusion: Strict control of blood glucose and regular fundoscopy, for early detection of optic atrophy are important. Step in management of this syndrome and quality of life is improved with hearing and vision aid tools.

---

Background: Multiple sclerosis (MS) is an autoimmune disorder with unknown etiology. Genetic and environmental factors associated with MS susceptibility. Genetic studies show an important role for human leukocyte antigens (HLA) and susceptibility to autoimmune diseases such as MS. There is controversy between the association of HLA alleles with MS susceptibility in various studies. However, with consider the high incidence of MS in Iranian population and limit information about association of HLA and MS, we analyzed HLA alleles in MS patients.

Materials and Methods: In this case-control study, 60 MS patients and 40 normal individuals with the same ethic background and geographic area were analyzed for HLA-DRB and DQB alleles by single specific primer-polymerase chain reaction (SSP-PCR) method.

Results: HLA-DRB1*03 and DQB1*02 alleles frequencies in MS patients were greater than healthy controls. There was no significant difference in frequency of other HLA-DR alleles between the MS patients and normal individuals.

Conclusion: DRB1*03 and DQB1*02 alleles confer increased susceptibility to MS in this population. However, to determine the role of HLA in Iranian MS patients, more studies are needed.

---

Background: Despite control, prevention and the availability of drugs to cure tuberculosis, TB remains an important cause of death from an infectious agent in Iran. Pulmonary tuberculosis is more than 80% of tuberculosis cases. Chest x-ray is sensitive, cheap and accessible instrument for the diagnosis of tuberculosis. The aim of this study was to determine the radiological changes in patients with pulmonary tuberculosis.

Materials and Methods: In this cross-sectional study, after consideration of inclusion and exclusion criteria, finally 477 radiographic patients referred to rural and urban clinics in recent decade were enrolled. The affected lobe or lobes of the left or right lung were recorded. The types of involvement were categorized based on patchy consolidation, cavitation, fibrosis, bronchiectasis, gohn lesion, bronchogenic spread and bronchopneumonia. Pearson correlation coefficient was used to measure the strength of association between continuous variables. For analysis of qualitative parameters, we use from Chi-square test. Data analysis was done in SPSS18 and p value below than 0.05 was significant.

Results: Out of 477 patients, mean age was 48.24±22 years old, male including 33.3%, Iranian and urban cases were 44% and 91.3% respectively. The most frequent involved site was the left upper lobe followed by the right upper lobe. The most frequent radiographic finding was patchy consolidation and then bronchogenic spread and pneumonic consolidation respectively. There was significant correlation between lung cavities in patients with nationality.

Conclusion: This study could  help to early diagnosis and treatment of suspect patients to pulmonary tuberculosis.

---

Abstract

Background: Self-talk is a psychological intervention that can affect the performance of an individulal, so the aim of this study was to investigate the effect of balance-training with educational and motivational self-talk on balance in women with MS in the city of Arak.

Materials and Methods: This study was a semi-experimental research with pre-test and post-test. The statistical population included women with MS in the city of Arak. 42 patients with the age range of 20-50 years old were chosen as samples and randomly were divided in 3 groups of individuls as control, educational self-talk and motivation self-talk and were experimented by Berg balance test.The experimental groups practiced the balance excercises for a month , 3 times a week and 45 minutes in each session. Then, post-test was performed for them. For data collecting, the demographic questionnaire, Berg balance test, one leg balance test and star test were used. Data analysis was done by using ANOVA and Tokey post-test by SPSS23 software at a significant level less than 0.05.

Results: The results of this study showed that the mean score of balance in educational self- talk group than motivational self-talk group (p = 0.045) a control group (p = 0.008) was significantly higher. Thus, the mean score balance performance test, motivational self-talk and control groups showed no significant difference (p = 0.689)

Conclusion: According the findings of this study, balance training with educational self-talk affects on balance in women with MS. Thus, balance training with educational self-talk can be a good approach to improve the balance in the women with MS. oxidative stress and DNA damage considerably. Thus, it is advisable for operating room personnel to consume green tea as a natural antioxidant supplement.

---

---

---

---

---

Background and Aim Sciatica is one of the most common diseases of the peripheral nervous system and may be caused by pressure on the sciatic nerve. Due to the fact that piriformis muscle located near the sciatic nerve, piriformis muscle spasm may put pressure on the nerve and cause sciatica and consequently piriformis syndrome. The present study aims to investigate the effect of core stability exercises on pain and inflammation of patients with piriformis syndrome.
Methods & Materials This is a randomized clinical trial. The study population consists of all patients with piriformis syndrome referred to medical centers in Arak, Iran from. Of these, 20 were purposefully selected and randomly divided into two groups of control (n=10) and exercise (n=10). The exercise group performed core stability exercises for 6 weeks, while the control group continued their normal life during this period. To examine the differences between the study groups, t-test, Chi-Square test, and McNemar’s test were used. The significance level was set at 0.05.
Ethical Considerations This study was approved by the Ethics Committee of Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1400.157) and was registered by Iranian Registry of Clinical Trials (ID: IRCT20211003052662N1). Informed consent was obtained from all participants.
Results The Mean pain score in the control group decreased from 95.2 to 90.7 after the exercise, which was not statistically significant (P=0.562). In the exercise group, the mean pain score decreased from 91.7 to 33.4, and this decrease was statistically significant (P=0.0); Therefore, at 95% confidence interval, we can say that core stability exercises had a significant effect on the pain of patients with piriformis syndrome (P<0.05). The number of patients with inflamed nerve in the control group decreased from 10 in the pre-test phase to 8 in the post-test phase, but this decrease was not statistically significant (P=0.5). In the exercise group, it was reduced from 10 to 2, and this decrease was statistically significant (P=0.008); Therefore, we can say that core stability exercises had a significant effect on the inflammation of patients with piriformis syndrome (P<0.05).
Conclusion Core stability exercises can reduce pain and inflammation in patients with piriformis syndrome. These exercises can be used in the treatment of these patients.