---

This article has no abstract.

---

---

Introduction: Wilms' tumor is the most common malignant and primary renal tumor in children. Studies, which have been done in some countries, have introduced numerous factors such as age of incidence, stage, lymphadenopathy, histopathology and etc. Effective in the survival rate of this tumor according to the importance of this tumor in children, we decided to perform a study about the survival rate of Wilms' tumor and the effective factors on it.
Materials and methods: This is an analytic study on 128 patients affected with Wilms' tumor whom referred to the oncology ward of Hazrat-e-Ali Asghar Hospital between 1977 and 2001. In addition to the current status of the patients, demographic characteristics, signs and symptoms, laboratory studies at the time of diagnosis and the stage of the disease were recorded and ultimately survival analysis was performed using the Kaplan-Meier procedure and life table. Cox Regression was used to determine the effective factors.
Results: The mean survival rate was 82.99 months. The number of patients was equal in both genders (64 patients in each gender) and the survival average did not have any significant statistical relationship with gender (power=%92.4). Most of the tumors were in stage 3 at the time of diagnosis. The survival of the patients was reducing significantly with the progression of the stage of tumor (P=0.002). The existence of metastasis (P=0.000, odds ratio=0.207), splenomegaly (P=0.018, odds ratio=0.336), and recurrent (P=0.037, odds ratio=0.184), were significantly reducing the survival of the patient. To determine the severity of effective factors on the survival rate of the patients Cox Regression Method was used in which, absence of metastasis and positive blood group were from well-prognosis predictive factors in these patients.
Conclusion: 5-year survival rate of the patients was 63.28% in this study. Which was lower in comparison with the results of other studies in other countries. This can be the result of delay in consulting with medical centers, the diagnosis method and or the Referral State of this center. Recent studies have shown that age and tumor size has minimal values in the prognosis of the patients due to improvement in the quality of treatment and our study support this idea. Genetic factors will probably be used in determining the survival of these patients and also in thcir treatment.

---

Introduction: In diabetes mellitus the increase of AgII (Angiotensin II), IGF-1(insulin like growth factor-1) and growth hormone induce kidney lesions especially changes in content and thickness of GBM and widening and fusion of podocyte pedicles. In this research for the first time the combination of Losartan (AT1 receptor blocker) and Octreotide (Somatostatin analogue) were used in order to prevent glomerular epithelial lesions.
Materials & Methods: In this experimental study 15 male rats (2 months age) were uninephrectomised from left flank and divided in 5 groups (3 per group). 7 days later diabetes was induced in 2th, 3th, 4th and 5th group by Alloxan (120mg/kg) subcutaneously. 5 days after diabetes induction, the third group received Losartan (5mg/kg/day) orally, 4th group Octretide (10 ŭg/day) subcutaneously and 5th group both two drugs with the mentioned doses for 8 weeks. The 2th group was served as diabetic non treatment group. Kidneys of all groups were fixed by perfusion technique. After second fixation of 1 mm3 cortex parts in Osmium Tetroxide, they were processed in TAAB812 resin for embedding. Thin sections (600 nm thickness) were prepared and investigated by transmission electron microscope qualitatively.
Results: Losartan inhibited fusion and thickening of podocyte pedicles but in some cases couldn,t maintain the 3 layer form of GBM. Octreotide had little effect on inhibition of fusion and thickening of podocyte pedicles and no effect in 3 layer form maintaining of GBM. Combined therapy inhibited fusion and thickening of podocyte pedicles and maintained 3 layer form of GBM but in some cases the lamina rara near endothelium was not seen.
Conclusion: Octreotide have little effect on prevention of glomerular epithelium lesions. However Losartan could prevent glomerular epithelium lesions well, but combined drug therapy showed better results comparing Losartan.

---

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: Hypomagnesemia hypercalciuria nephrocalcinosis (HHNC) is a rare syndrome due to mutation defect in CLDN-16 gene. Its product is paracellin, a protein in henle loop paracellur area which acts in magnesium and calaium reabsorption. In this article a case of HHNC is reported. Case: The patient is a 3 years old boy presented with tetany, polyuria and polydipsia. Imaging study revealed medullary nephrocalcinosis. Laboratory investigations showed hypomagnesemia, hypercalciuria, hypermagnesiuria and normal arterial blood gases. In 2 years follow up, no neurological diseases, growth failure, or rickets were seen. He was treated with Hydrochlorothiazide and Potassium polycitra for prevention of nephrocalcinosis and progressive renal failure. Conclusion: HHNC is a rare syndrome presenting with hypercalciuria, hypo- magnesemia nephrocalcalcinosis, tetany, polyuria and polydypsia which progresses to end stage renal failure in 2nd or 3rd decades. Early diagnosis and some treatment modalities like Hydrochlorothiazide or polycitra-k can delay this process.

---

Introduction: Endocrinopathy is a known consequence of external beam radiotherapy to the brain tumors. The aim of this study was to find out the incidence of hyperprolactinemia in brain tumor patients treated with radiotherapy, when radiation portals included whole hypothalamus and pituitary glands. Materials and Methods: This descriptive study was conducted from December 2004 to February 2006 on about 42 patients with brain tumors. They were referred to radiation oncology center of Hamadan to be treated with external beam radiotherapy, whose radiation portals included whole hypothalamus and pituitary glands. Serum prolactin levels were measured at the beginning of treatment, and at one month, three months, six months and one year after completion of radiotherapy. Data was introduced using descriptive statistics. Results: Of 42 patients 6 were excluded one because of previous hypothalamus and pituitary radiotherapy, three because of nonadherence to follow up program and two because of previous endocrinopathy Of the patients attending the follow up clinic, 11% were found to have hyperprolactinemia at six months, and 22 at one year. This condition in women and men was 37% and 15% respectively. Conclusion: Abnormality in Prolactine secretion is a late complication of brain radiotherapy and a significant number of patients develop hyperprolactinoma following radiotherapy to the brain (hypothalamus and pituitary region). It seems this complication increases by increasing the radiation dose and is more prevalent in women.

---

Introduction: Methicillin resistant staphylococcus aureus strains are the most important agents of nosocomial infections. The conventional antibiotic susceptibility methods such as disk diffusion are not suitable for detection of these strains due to their heteroresistancy. Therefore, in this study, agar screen and duplex-PCR were compared in determination of methicillin resistant Staphylococcus aureus (MRSA) strains isolated from nose of personnel in Hajar hospital of Shahre-kord, 2007. Materials and Methods: In this experimental study a total of 204 nasal swabs from personnel of Hajar hospital over a period of 6 months were collected. The specimens were cultured on mannitol salt agar for primary isolation and identification of Staphylococcus aureus strains and their susceptibility pattern to oxacillin was assessed using agar screen method. Finally, using duplex PCR, the isolates were tested for the presence of mecA gene. Results were compared and sensitivity and specificity of the method was determined. Results: In this study, 23 of the 52 (44%) Staphylococcus aureus isolates were resistant to oxacillin using agar screen method. However, mecA gene was detected in 27 of the 52 strains (52%). Our results showed that the sensitivity and specificity of agar screen method in determination of MRSA strains were 81.5% and 96%, respectively comparing with PCR. Conclusion: Oxacillin agar screen, comparing PCR, is an inexpensive, applied and phenotypical method with low false positive and suitable for screening of MRSA. However, due to its relatively high false negative results is not appropriate for screening of MRSA strains isolated from hospital-employed nasal carriers.

---

Background: According to the report of Iranian Center of Disease Control, in the summer of 2005 an outbreak of cholera (Inaba serotype) occurred in Iran. The outbreak lasted the mid of September. The aim of this study was to use the result of different studies performed during this period to determine source of infection. Methods and Materials: This is a meta-analysis study, which studies performed in Qum, Arak, Karaj, Golestan and Ghazvin were eligible. All of these studies were case control ones performed during the August 2005. The total of cases were 531. Pooled odds ratios was used to estimate by fixed and random method. All computations were performed by Stata 8 software. Results: The estimated pooled odds ratios resulted from 5 differemt studies were used in the meta-analysis as the following: travelling (1.64 95% CI: 0.98-1.88), non-pasteurized ice cream (0.88 95%CI: 0.48-1.61), post toilet hand washing (3.72 95% CI: 0.86-16.05), eating meal outside home (2.38 95% CI: 1.46-3.90), raw fruit eating (0.98 95% CI: 0.42-2.18) and raw vegetables use (5.36 95%CI: 2.4-12). Conclusion: According to the results of this study raw vegetable use and having meal outside home were significantly associated to the cholera in mentioned provinc

---

Abstract Background: Cartilaginous and movement diseases are the most prevalent problem in human. Various vitamins like A and C increase the process of regeneration and wound healing. In this research, the Alfalfa plant with scientific name Medicago sativa, that contains a lot amount of A, C, E and K vitamins, was used and effect of its extract on regeneration of pinna rabbit cartilage was studied. Materials and Methods: In this experimental laboratory study, 6 New Zealand male rabbits with 2.5-3 kg weight have been selected. After shaving hairs on ears with depilation cream, the ear were anesthetized by lidocaine 10% and 4 holes were punched with 4 mm diameter in medial situation of each ear. Test ears by extract of Medicago sativa and control ear were treated by normal saline every day. Holes era and the distance of two edges of cartilage were measured in various days of healing. Also, tissue sampling for microscopic observation by H&E color (day 0-50) was done. Results: Regeneration and healing of the treated holes with extract of Medicago sativa was faster than the control holes (p<0/004). Also, thickness of cartilage and cell density of chondrocytes and fibroblasts in the newly formed connective tissues in test were more than control. Conclusion: The extract of Medicago sativa because of A, C vitamins containing, probably increased the wound healing and regeneration of the rabbit ear cartilage and suggest the pharmacological usages.

---

Abstract Background: The important reality is that all of human developments and successes are due to learning. Knowing students learning styles will help to produce an educational plan in order to optimal and effective learning. The aim of this study was the comparison of learning styles and preferred teaching methods of different students of medical sciences. Materials and Methods: This study is a cross-sectional research. That was done on all students at Fasa Medical Sciences University in 2009. For data gathering, questionnaires of demographic variables and Kolb Learning Style Inventory (KLSI) was used and analyzed. Results: Majority of students learning style was convergent learning (38.3%) and then assimilator learning style (29.9%). More frequent preferred teaching method was group discussion. There was a significant difference between learning styles and course of students (P=0.011). Conclusion: Since, the majority of students had convergent and assimilator learning styles is recommended, considering the diversity of learning styles, educational methods related ro learning styles were using.

---

  Background: Considering some evidence on anti-diabetic potential of Allium ursinum (AU) , this study was conducted to evaluate the effect of oral administration of AU on contractile responsiveness of thoracic aorta in diabetic rats.

  Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, AU-treated control, diabetic, glibenclamide-treated, and AU-treated diabetic groups. For inducing diabetes, streptozotcin (STZ) was administered (60 mg/Kg). AU-treated group received AU mixed with standard pelleted food at a weight ratio of 1% for 2 months. Serum glucose level was measured at weeks 4 and 8. Eventually, contractile responsiveness of thoracic aortic rings to KCl and noradrenaline (NA) was evaluated .

  Results: Serum glucose level, at weeks 4 and 8, in the AU-treated diabetic group was significantly lower than that in the diabetics group (p<0.01 and p<0.005, respectively). In addition, the maximum thoracic aorta contractile responsiveness to NA in the AU-treated diabetic group was significantly less than the diabetic group (p<0.05) however, such a significant reduction was not observed for KCl.

Conclusion: Oral administration of AU for 2 months is of a moderate hypoglycemic effect and attenuates the contractile responsiveness of the vascular system in diabetic rats. Background: Considering some evidence on anti-diabetic potential of Allium ursinum (AU), this study was conducted to evaluate the effect of oral administration of AU on contractile responsiveness of thoracic aorta in diabetic rats. Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, AU-treated control, diabetic, glibenclamide-treated, and AU-treated diabetic groups. For inducing diabetes, streptozotcin (STZ) was administered (60 mg/Kg). AU-treated group received AU mixed with standard pelleted food at a weight ratio of 1% for 2 months. Serum glucose level was measured at weeks 4 and 8. Eventually, contractile responsiveness of thoracic aortic rings to KCl and noradrenaline (NA) was evaluated. Results: Serum glucose level, at weeks 4 and 8, in the AU-treated diabetic group was significantly lower than that in the diabetics group (p<0.01 and p<0.005, respectively). In addition, the maximum thoracic aorta contractile responsiveness to NA in the AU-treated diabetic group was significantly less than the diabetic group (p<0.05) however, such a significant reduction was not observed for KCl. Conclusion: Oral administration of AU for 2 months is of a moderate hypoglycemic effect and attenuates the contractile responsiveness of the vascular system in diabetic rats.

---

Background: Oxidative stress is one of the probable molecular mechanisms involved in lead (Pb) neurotoxicity. On the other hand, lemon balm (Melissa officinalis) which is widely used in traditional medicine, has a high antioxidant activity. In this study, the protective impacts of Melissa officinalis on the adverse effects of Pb toxicity on learning ability were investigated. Materials and Methods: In this experimental-clinical trial, 40 virgin Wistar rats were mated and divided into control, control positive (vitamin C+Pb), control negative (Pb), and 3 Pb and Mellisa experimental groups. Mellisa was orally administered in three doses including + 25, 50 and 100 mg/ kg of body weight daily. Treatment started from 7th day of gestation and continued through pregnancy and lactation periods. The three month- old offsprings in each group were assessed in terms of memory and learning ability by Morris water maze test and the results were compared between the groups. Results: Exposure to Pb during and after gestation leads to learning disorders. While concomitant administration of Pb and Melissa, as well as vitamin C can, to a large degree, reduce the adverse effects of Pb on learning abilities. Conclusion: Since no significant differences were obtained from the comparison of results in the control, Pb+M and vitamin C+Pb groups, it can be concluded that Melissa has antioxidant impacts equal to vitamin C. Therefore, similar to vitamin C, Mellisa can decrease the neurotoxic effects of Pb.

---

Background: Identifying the problems which exist in clinical education and setting to solve them will lead to the improvement of quality of medical care services. This study was conducted to fulfill this goal. Materials and Methods: In this descriptive–analytic research which was carried out in 2008, the views of the medical trainees and interns, who had at least gone through two major clinical courses at Arak University of Medical Sciences, about the obstacles of clinical education were evaluated. For achieving this purpose, a questionnaire containing 56 questions on 6 problem areas including clinical education spaces, educational facilities, cooperation of health and treatment personnel, clinical assessment and teaching methods, and clinical curriculum design methods was administered. Results: The quality of clinical education in the view of 41% of medical trainees and 48% of interns was seen to be at an average level. Assessment methods of clinical education, on the other hand, were rated as weak by 28.7% of trainees and 32% of interns. Also, 29.3% of trainees and 31.7% of interns evaluated the use of educational spaces to be at a weak level. Additionally, the quality of clinical teaching methods, educational facilities, cooperation of health and treatment personnel, and the design of clinical curriculum were seen at an average level. Conclusion: This study highlighted the importance of determining learning experiences, applying proper teaching methods, conducting continuous generative evaluations, using simulated environments and educational spaces congruent with graduates’ future employment opportunities, and enhancing students’ level of motivation, as effective strategies for the improvement of the quality of medical education.

---

Background: Brucellosis, a zoonotic disease with worldwide spread, is a common disease in Iran and is endemic in Markazi Province. Brucella osteomyelitis, on the other hand, is a rare disease. Here we reported a case of brucella osteomyelitis of the tibia following trauma. Case: The patient was a 22 year old man referring with chronic draining tibia ulcer. He had a history of trauma of the tibia, dating back to 3 years ago, for which local prosthesis had been prescribed. Later on, the prosthesis had been removed due to infection. Staining of the tissue samples indicated the presence of gram-negative coccobacill and brucella growth in the culture of excretions. Conclusion: This case was reported because of rare presentation of brucella and the educational implications of the patient with respect to the possibility of brucella development in chronic ulcers or prosthesis. Although uncommon, brucellosis should be regarded as a potential cause of osteomyelitis in patients with a record of physical contact with animals.

---

In the Holy Quran, it is stated that “eating honey has healing for people” “Fihe shefaho lenas”. The word “healing” in Quran has not been used about any other food but honey and one Sura in Quran is dedicated to Nahl (bee). This study investigates the importance of honey from the perspective of Quran and medicine. This review article investigated the therapeutic properties of honey from the perspective of Quran and medicine through text analysis and manual and online search. Medicine has proven that honey due to its low moisture, high osmosis, and high acidity inhibits the growth of infectious agents and creates a sterile coat on the wound. Prophet Mohammad said, “Lam yastashfeo almariz bemasale sharbato olasal”, meaning that nothing cures the sick person the way honey does. Studies have shown that honey is effective in strengthening child development and treatment, prevention, and improvement of skin, respiratory, liver, gallbladder, eyes, ears, and nose diseases and cancer. The application of natural honey to healing diabetic and cutaneous ulcers and the topical application of honey to open wounds can accelerate the healing process. Oral administration of dates honey syrup can enhance the natural progression of delivery and womb contractions which decrease the need for cesarean. It can be concluded from the review of the literature that emphasis of Quran on the use of honey in diet and its reference to the healing property of honey for people has not been without a cause. Modern medicine also verifies the curative properties of honey for many diseases.

---

Background: Molybdenum is an essential trace element for both animals and plants. Molybdenum (Mo), which functions as a cofactor for a limited number of enzymes including xanthine dehyrogenase, aldehyde oxidase, and sulfite oxidase in mammals, is believed to be an essential trace element in animal nutrition. The aim of this study is to evaluate the hepatoprotective potential of sodium molybdate against carbon tetrachloride (CCl4) induced liver damage. Materials and Methods: In an experimental study, adult male rats received daily oral administrations of different doses of sodium molybdate (0.05, 0.1, and 0.2 g/kg bw) along with intrapertioneal CCl4 (50% CCl4 in olive oil, 1 ml/kg bw) twice a week for 28 consecutive days. Results: Histopathological examinations in CCl4-treated rats showed extensive liver injuries characterized by extensive hepatocellular degeneration and necrosis, fat degeneration, and inflammatory cell infiltration while histopathological changes induced by CCl4 were significantly attenuated by sodium molybdate treatment. Conclusion: The results of this study suggest that sodium molybdate could protect liver against the CCl4-induced oxidative damage in rats, and this hepatoprotective effect might be contributed to the protection of liver by preventing the toxic chemical reactions which generate oxidative stress, lipid peroxidation, and molecular changes which ultimately lead to liver tissue necrosis.

---

Background: Hemorrhoidectomy is the basis of treatment for grades three and four hemorrhoid. One of the major post hemorrhoidectomy problems is pain that is usually due to the spasm of the internal sphincter. There are different methods for the management of postoperative hemorrhoidectomy pain. The aim of this study was to investigate the effect of sphincterotomy on post hemorrhoidectomy pain. Materials and Methods: This interventional clinical trial was conducted on 60 patients with 3rd and 4th grade hemorrhoid who had randomly been divided into hemorrhoidectomy and hemorrhoidectomy combined with sphincterotomy groups. The degree of pain was measured on visual analogue scale (VAS) and analyzed through Mann-Whitney, Friedman, and Chi square tests via SPSS version 14. Results: In terms of reduction in pain with sphincterotomy, there was a significant relationship between the two groups on the first, second, and fifth postoperative days (P=0.001). On the third and sixth postoperative days, a significant relationship was observed between the two groups (P=0.001). Days four and seven also indicated a significant relationship between the two groups (P=0.002). However, there were not any significant relationships between the two groups in terms of urinary and fecal incontinence and gas retention (P>0.05). A significant relationship existed between the two groups in terms of reduction in the need for sedation (P=0.006). Conclusion: Lateral internal sphincterotomy combined with hemorrhoidectomy can reduce the patients’ post hemorrhoidectomy pain and can reduce the use of analgesics, but it does not have any significant influences on the incidence of urinary retention and bleeding after the first defecation and does not increase the risk of fecal and gas incontinence in comparison with the hemorrhoidectomy group.

---

Background: Diabetic nephropathy is one of the most common causes of end stage renal diseases. The aim of this study was to evaluate the antioxidant, anti-diabetic, and anti-inflammatory roles of rosmarinic acid in inhibition of diabetic nephropathy. Materials and Methods:In this experimental study, 40 male rats were uninephrectomized from the left flank. The rats were randomly divided into four groups of ten: Group1 (control), group 2 (control) including untreated diabetic rats, and groups 3 and 4 (treatment groups) that received rosmarinic acid 100 and 200 mg/kg, respectively. Diabetes was induced in groups 2, 3, and 4 by subcutaneous injection of alloxan. After 8 weeks, serum malondialdehyde was measured. Kidney paraffin sections were prepared and stained by periodic acid Schiff method. Glomerular, intraglomerular mesangial, and glomerular capillary volumes were estimated by stereological methods. Data were analyzed by SPSS 13 software and Man-Whitney nonparametric test. Results: The level of serum malondialdehyde in treatment groups was maintained at the level of control group. Glomerular hypertrophy, mesangial expansion, and reduction of glomerular capillary volume in groups treated by rosmarinic acid were significantly inhibited compared with the untreated diabetic group, but the levels of these variables were significantly different from that of the control group. Conclusion: Rosmarinic acid significantly ameliorates glomerular hypertrophy, mesangial expansion, and glomerullar capillary volume in diabetic rats.

---

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.