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Introduction: In the 1950s vancomycin was introduced as an effective antibiotic for curing infections caused by methicillin resistant Staphylococcus aureus. Three decade after using vancomycin, resistant coagulase negative staphylococcus to this antibiotic was reported. In this study, we evaluate the Staphylococcus aurous resistant to vancomycin.
Materials and methods: During this invesitigatin which lasted for 6 months, 50 Staphylococcus aurous samples were taken from burn wards of each of two Imam-Reza and Gaem hospitals, Mashhad. All selected samples were resistant to methicillin and their MIC to vancomycin was determined.
Results: Of 50 separated bacteria from Imam-Reza and Gaem hospitals subjects, 4 patients had MIC equal to 12.5 mg/ml. In isolated samples from Gaem hospital, one case has MIC equal to 12.5 mg/ml.
Conclusion: With respect to expanding the resistant toward vancomycin, thus it is recommended to inhibit the resistance of this organism in the wards.

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Introduction: Post operative pain, nausea and vomiting are common complications after hemorrhoidectomy and cause unpleasant expriences for patients. Today, scientists are increasingly moving forward to find new drugs with fewer side effects and costs to control these complications. So this study was planned to evaluate the effect of Dexamethasone on post operative pain, nausea and vomiting. Materials and Methods: This study was a double blind randomized controlled clinical trial that carried out on 112 patients scheduled for hemorrhoidectomy. Patients were diveded into two groups. Case group received 8mg Dexamethasone and control group received 2 ml normal saline intramuscularly 30 minutes before the operation. The method of surgery and general anesthesia were the same in all patients. Pain and nausea score were recorded using visual analog scale (VAS) and vomiting was recorded by asking of them at 0, 2, 4, 6 hours after operation. The patients were followed for 6 hours after the end of the operation and data was analyzed using t and chi square tests. Results: There was a significant difference between the two groups regarding prevention of post operative pain and nausea (p=0.00001). But there was no significant difference between the two groups regarding prevention of post operative vomiting. Conclusion: The result of this study suggested that injection of Dexamethasone before hemorrhoidectomy can decrease incidence of postoperative pain and nausea but dose not have any effects on postoperative vomiting. Therefore Dexamethasone is recommended before hemorrhoidectomy.

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Background: Localization of ectopic parathyroid glands is one of the most sophisticated challenges in endocrine surgery and there is considerable controversy regarding the suitable approach to localize ectopic parathyroid glands and indications for using different modalities. The failure of the first operation leads to pain, scar, and financial burden of the following operation. Case: The patient was a 39-year-old woman hospitalized with hematuria as the main complaint and noticing the presentation of hypercalcemia in the initial tests underwent more thorough examination. Ultrasonography and 99mTc sestamibi scan helped us to localize the ectopic parathyroid gland in an anterior mediastinum and treat the patient in a one stage operation. Conclusion: Paying careful attention to the symptoms and signs, considering all differential diagnoses, and using appropriate diagnostic methods can be helpful in the diagnosis of rare syndromes.

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Background: Because of high mortality and morbidity of severe acute pancreatitis (AP) and its increasing incidence in recent years, early detection of severity of AP is very important. Since interleukin (IL) rapidly responds to body temperature changes, this study was done to examine the relationship between blood levels of interleukin 15 and 17 and severity of acute pancreatitis. Materials and Methods: In this cross-sectional study, 52 patients with AP were studied. For all patients, paraclinical information, Ranson criteria, and APACHE-II were completed. Serum interleukin 15 and 17 levels were measured by ELISA method. Then the relationship between them and AP severity was determined based on Ranson criteria and APACHE-II. Results: In this study, 36.5% of the patients were male and 63.5% were female and the mean age was 61.06 years. The serum level of IL-17 was negatively correlated with the severity of AP based on Ranson criteria (p=0.021, r= -0.319). ROC curve showed significant values for blood level of IL-15 and CRP in AP diagnosis. Sensitivities were 92.3% and 78.8% and specificities were 40% and 48%, respectively. Conclusion: Based on Ranson criteria, the role of serum level of IL-17 as an unknown factor was seen significant in determining the severity of AP. However, the diagnostic value of serum IL-15 should also be verified with further studies.

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Background: Several studies have demonstrated that the levels of inflammatory markers in healthy women are under the influence of menstrual cycle changes. The aim of this study was to compare blood levels of inflammatory markers in women with appendicitis in different phases of menstrual cycle. Materials and Methods: In this case-control study, 70 female and 12 male patients with appendicitis, and 61 healthy women were enrolled based on inclusion and exclusion criteria. Inflammatory markers, such as leukocyte count, CRP, ESR, and TNF-α were measured and compared using student t-test and one-way ANOVA based on different phases of menstrual cycle. Results: There were no significant changes in the ESR, CRP, and TNF-α concentrations and the number of peripheral blood leukocytes in different phases of the menstrual cycle in women with appendicitis. The mean number of leukocytes and CRP concentrations were significantly higher in patients with appendicitis compared with the control group. Conclusion: The findings show that there are not significant differences in the inflammatory markers in women with appendicitis during the different phases of menstrual cycles. It seems that day to day variation of sexual hormones in the menstrual cycle have led to very different conclusions about the change of inflammatory markers in different phases of menstrual cycle. Therefore, studies investigating inflammatory markers in women with acute appendicitis based on day of menstrual cycle, time of sampling in the day, and severity of appendicitis are suggested.

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Background: Nausea and vomiting are prevalent after laparoscopic cholecystectomy surgery and physicians need to use drugs, such as ondansetron, propofol, metoclopramid, and ramostrogen, for controlling them. This study was done to evaluate the effect of gabapentin 300mg and 600mg administration on controlling nausea and vomiting after laparoscopic cholecystectomy surgery. Materials and Methods: In this clinical trial, 105 ASA patients (classes 1 and 2) were randomly divided into 3 equal groups including placebo group, 300 mg gabapentin group, and 600 mg gabapentin group. The same technique of anesthesia was used for all groups. The patients were controlled for nausea and vomiting each 2 to 6 hours and after that every 4 to 18 hours. Data were analyzed using SPSS software. Results: The mean degree of nausea in the control group was 2.8, in second group which took 300 mg gabapentin was 0.67, and in third group which took 600 mg of gabapentin was 0.55 (p<0.001). In addition, the severity of vomiting in the control group was 0.326, in second group was 0.126, and in third group was 0.053 (p<0.001). Conclusion: Administration of one dose of 300 mg gabapentin can reduce nausea and vomiting, and with increasing gabapentin dosage to 600 mg, these complications will decrease even more. Therefore, using gabapentin in laparoscopic cholecystectomy surgery is recommended

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Background: Thymus is essential in creating some of the disorders and diseases. Treatment of these disorders (particularly tumors and myasthenia gravis) is possible with complete removal of the thymus.

Materials and Methods: In this retrospective study over a period of eleven years, all case of thymectomy performed at the Department of Thoracic Surgery of shahid Beheshti University has investigated. Variables examined included age, sex, primary diagnosis, surgical technique, complications and results of surgery.

Results: The total number of patients was 50 (46% male and 54% female) with a mean age of 85.14 ± 46.41 years. Primary diagnosis was myasthenia gravis in 40% of patients and thymoma in 42% of them. Myasthenic symptom was the most common presenting symptom (50%). Radical thymectomy surgery was performed in 64% of patients. Fever and atelectasis (10%) and respiratory failure (12%) were the most common postoperative complication and mortality rate was 4%. Thymoma (64%) and thymus hyperplasia (20%) were the most frequent pathology. Clinical symptoms were gone or greatly reduced in 40% of patients. The majority of them had a primary diagnosis of myasthenia gravis (36%). 50% of patients have been followed up. The mean follow-up time in these patients is 32.20 ± 36.41 months.

Conclusion: Thymectomy surgery with low morbidity and mortality, provides the possibility of treatment of thymic lesions. Especially Thymoma and Myasthenia Gravis

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Background: Catamenial recurrent pneumothorax is spontaneous pneumothorax in women of reproductive age, which includes 1-30% of spontaneous pneumothoraces in women and is associated with the menstrual cycle.

 Case: A 39-year-old woman with sudden onset dyspnea, respiratory distress and decreased right side respiratory sounds with a history of spontaneous pneumothorax and chest tube placement one month ago. The patient's symptoms improved after chest tube placement and within less than 24 hours after onset, she began menstruating. Treatment was performed with chemical pleurodesis with tetracycline and oral danazol.

Conclusion: Catamenial pneumothorax and thoracic endometriosis should be considered in all women of childbearing age with spontaneous recurrent pneumothorax. Early detection of this syndrome can result in reduction of morbidity and mortality with recurrence episodes.

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Background: The speech disorders may produce irreparable damage to childs speech  and language development in the psychosocial view. The voice, speech sound production and fluency disorders are speech disorders, that  may result from delay or impairment in speech  motor control mechanism, central neuron system disorders, improper language stimulation or voice abuse.

Materials and Methods: This study examined the prevalence of speech disorders in 1393 Arakian students at 1 to 6th grades of primary school. After collecting continuous speech samples, picture description, passage reading and phonetic test, we recorded the pathological signs of stuttering, articulation disorder and voice disorders in a special sheet.

Results: The prevalence of articulation, voice and stuttering disorders was 8%, 3.5% and%1 and the prevalence of speech disorders was 11.9%. The prevalence of speech disorders was decreasing with increasing of student’s grade. 12.2% of boy students and 11.7% of girl students of primary school in Arak had speech disorders.

Conclusion: The prevalence of speech disorders of primary school students in Arak is similar to the prevalence of speech disorders in Kermanshah, but the prevalence of speech disorders in this research is smaller than many similar researches in Iran. It seems that racial and cultural diversity has some effect on increasing the prevalence of speech disorders in Arak city.

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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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Abstract

Background: One of the problems in children with cerebral palsy is impaired eating and drinking liquids. The purpose of this study is to compare the effect of oral motor stimulations on feeding function in the children with spastic cerebral palsy by two medical and family centered approaches.

Materials and Methods: This research was a descriptive-analytical cross sectional study that performed on 40 children 2-8 year olds with spastic Cerebral Palsy from the rehabilitation clinics in the city of Arak. They were selected by simple and purposeful sampling. Applied instruments were Gross Motor Measure Function Classification System Expanded & Revised (GMFCS E&R) and oral motor assessment scale(OMAS). Data were analyzed by statistical tests such as: Kolmogorov-Smirnov, reporting mean, standard deviation, data analysis frequncy distribution table, independent t-test, dependent t-test, chi-square and MANOVA.

Results: The difference of swallowing function assessed by OMAS in both groups managed by family centered and clinician centered approach prior and post management statistialy was meaningful (p=0.001(. The difference between swallowing function of both groups post intervention was not meaningful in view of first and second assessor, also it had no statistical significance(p=0.89 , p=0.07)

Conclusion: In general, we can conclude that oral motor stimulation is effective on swallowing function of cerebral palsy children in both treated groups. The effect of these stimulations on swallowing function in children with cerebral palsy between clinician centered and family centered approaches was equal.

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Abstract

Introduction: Echinococcosis or hydatid cyst disease is one of the most common infectious diseases between animals and humans (zoonosis) that is endemic in all the countries of the Mediterranean region, including Iran. Pelvic involvement is rare, and the involvement of the uterus is very rare.

Case Report: 26-year-old female patient complained of limb paresis, ataxia and progressive headaches diagnosed with hydatid cyst of the brain was undergone surgery. The pain and slight swelling in the area of the wrist occurred, one year later and with the same diagnosis, surgery was performed again. Abdominal ultrasound showed two cystic lesions in the suprapubic region with a diagnosis of hydatid cyst of the uterus, 3 years later, surgery was performed. In all cases, the diagnosis was confirmed by pathology.

Discussion: Follow-up of patients with radiologic and serologic methods is necessary.

Conclusion: In patients with any clinical manifestation of endemic areas, particularly if there is a previous history of hydatidosis, hydatid cyst should be considered in terms of risk.

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Background and Aim: Swallowing disorder is a common and constant problem in people with Down Syndrome. In experimental method electromyography can be used to evaluate Mastication . The aim of this study was to evaluate the electromyography of the masseter and temporal muscles during Mastication in 2 to 12 years old children with Down syndrome in Arak.
Material and methods: This is a descriptive-analytical and case-control study, that conducted with the purpose of electromyographic study of masseter and temporal muscles during Mastication  on 15 children from available 2 to 12 years old Down Syndrome and 15 children that were matched according the method of person-to-person matching in terms of age and gender with samples with Down syndrome
Ethical considerations: In this study, conscious consent was obtained from all parents and no physical harm was inflicted on individuals.
Findings: About the comparison of the mean of amplitude (intensity) of electrical signal of muscle between two groups except right temporal muscle during Mastication  and about the mean of the mean frequency when Mastication  except for left temporal muscle, in other cases the difference was significant. In the case of comparing the median frequency of the electrical signal of the muscle in most muscles the difference was not significant.
Conclusion: Mean amplitude (intensity) and frequency of the mean electrical signal of the muscle when chewing in most muscles was different between the two groups with Down syndrome and normal, but the differences in mean median frequency in most muscles were insignificant.

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Abstract


Introduction: stress is an important criterion affecting personality on a general and minor level.
Aim: The present study aimed to assess the mediating role of stress in two diagnostic criteria of personality disorder, personality functioning (criterion A) and pathological personality traits (criterion B).
Method: The research method was descriptive-correlational. The statistical population was students studying at the University of Kurdistan in the academic year 2020-2021. By the available sampling method, 313 (50.08% of women) completed online PID-5, LPFS and PSS-14 questionnaires. Data were analyzed by structural equation modelling and using AMOS software version 24 and SPSS.
Results: The result of the direct path shows the mediating role of stress on personality detachment (0.85) and antagonism (0.88) traits. However, psychoticism, negative affectivity and disinhibition traits do not play a mediating role. In general, there was a positive relationship between stress and personality functioning (0.45) and personality traits (0.27).
Conclusion: The undeniable impact of stress on both personality functioning and personality traits is apparent. Broadly speaking, stress influences the alternative model of personality disorders, encompassing criteria A and B.
Keywords: Stress, Personality traits, Level of personality functioning, AMPD, ICD-11