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Introduction: The aim of this study was to investigate the prevalence of pneumococcal infections, to determine penicillin and ceftriaxone susceptibility pattern among Streprococcus pneumoniae and to evaluate the risk factors of acquisition of pneumococcal infections in patients of Sari hospitals.
Materials and Methods: In this prospective study during one year (2002-2003), all patients admitted with pneumococcal infections in teaching and non-teaching hospitals were included. Diagnosis of pneumococcal infection was performed based on positive microbiological and appropriate clinical and standard laboratory findings. MICs of penicillin and ceftriaxone were determined by Agar dilution method and interpreted by NCCLS methodology. For statistically analysis Chi-square and Fisher's exact tests were used and P<0.05 was defined statistically significant.
Results: Seventy five episodes of pneumococcal infections among 32 pediatric patients and 43 adults were identified. The pattern of Streprococcus pneumoniae infections were similar between children and adults, and the most common infections were pneumonia (65.3%) and bacteremia (24%). The rate of penicillin and ceftriaxone nonsusceptible Streprococcus pneumoniae isolated from pediatric patients was higher than that in adult patients (93.8% versus 53.4%, P<0.01). This finding was correlated to prior penicillin use that was more common in children (37.5%) than in adults (7%). P=0,001. The susceptibility pattern of Streprococcus pneumoniae to penicillin and ceftriaxone isolated form pediatric patients and adults was different (6.2% from children, 46.6% in adults, P=0.0009). Eighty four percent of adults and 6.2% of pediatric patients had major underlying diseases (P<0.0001). This findings explain why adult patients tended to run higher mortality (30.2%) than children (6.8%).
Conclusion: This survey emphasis on vaccination of young children and elderly with major underlying diseases to prevent pneumococcal infections.

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Introduction: Different strains of Echinococcus Granulosus have been found in endemic areas of Iran. This variation has a significant aspect in the field of medical parasitology and veterinary and also in epidemiology, pathology, control and prevention of Hydatid cyst infection. Morphology, epidemiology and biochemical studies can be carried out to determine Hydatid cyst strains in human and animal origins as host. This study was done to measure different biochemical compositions of liver Hydatid cyst fluids in human, sheep, goat, cattle and camel in 2004.
Materials and Methods: In a cross sectional-analytical study, 112 samples of Hydatid fluids were collected from the liver cysts of different hosts: 16 sheeps, 64 cattles, 12 goats and 10 camels in slaughter houses of Sari and Ghaemshahr and 10 human in Imam hospital. All cyst fluids were centrifuged at 4500 rpm at 4˚C for 45 minutes and the supernatants were analyzed for various biochemical parameters.
Results: Quantitative differences were observed in the levels of Sodium, Glucose, Urea, Alanin Aminotransferase (AST) in liver cystic fluids obtained from different hosts, although these differences were not statistically insignificant. However, differences in the levels of Potassium, Calcium, Triglycerides, Cholesterol, Uric acid, Creatinin, Albumin, Gamma Glutamyl Transferase, Aspartat Aminotransferase (AST) and Creatinine Phosphokinase (CPK) in different Hydatid cyst fluids were statistically significant (P<0.05).
Conclusion: Differences in biochemical composition of different Hydatid cyst fluids suggest the possible existence of more than one strain of Echinococcus Granulosus in human and other intermediate domestic animal hosts in Mazandaran.

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Background: Permanent pacemakers are applied to treat some 2nd and 3rd degree AV blocks. Previous studies have shown the hemodynamic changes that may occur after pacemaker implantation. In this study, we have evaluated these hemodynamic changes from a different view point, with measurement of urinary sodium and blood pressure. Materials and Methods: This is a before and after clinical trial study in which 30 patients, who were hospitalized for permanent pacemaker implantation for the first time in Tehran heart center during 3 years, including 12 women (mean age 62.92 years) and 18 men (mean age 60.07 years), were tested for urinary specific gravity and sodium, blood pressure, blood sodium and potassium, before and after pacemaker implantation. Paired sample T test and Chi Square test were used for statistical analysis. Results: Systolic blood pressure was 136.5 mmHg and 120.6 mmHg before and after pacemaker implantation, (P<0.001). Also, after pacemaker implantation, urinary sodium rose from 83.45 meq/L to 106.61 meq/L (p=0.018). Conclusion: This study is consistent with previous studies, which showed hemodynamic changes after permanent pacemaker implantation including decrease in blood pressure and elevation of serum neuropeptides.

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Introduction: World health organization has proclaimed the prevalence of smoking among 15 years old European region students, more than 24 percent. The cigarette smoking indicator in our country among over 15 years old individuals is 11.9 percent and in the province under survey is 15.6 percent. This research has been performed in order to study the effect of health education program based on health belief model (H.B.M) on preventive actions of smoking in middle school students. Materials and Methods: This is a quasi-experimental study, done on 248 students of grade one in middle schools of Boukan city (119 boys and 129 girls) that were randomly divided into experimental and control groups. Data collection tool was a questionnaire including 77 questions based on health belief model (perceived susceptibility, perceived severity, perceived benefits and perceived barriers to smoking, and cues to action) and preventive actions of smoking. After data collection in the first stage, action was taken with regard to educational intervention and then in the second stage (after the intervention), data was collected again. Data was analyzed using T test. Results: Results showed that the mean score of all parts of health belief model in experimental group(except for perceived barriers) after educational intervention compared to before intervention was increased significantly and also the mean score of all parts of HBM after intervention was significantly increased in experimental group compared to control group. Conclusion: The results of this survey show that by increasing the score of health belief model parts including, perceived susceptibility, perceived severity and perceived benefits, adopting preventive actions of smoking also increases. Therefore, the results of this survey confirm the efficiency of health belief model in adopting preventive actions of smoking.

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Abstract Background: Prevalence of urolithiasis is increasing in children and maybe hematury is only sign. This study was conducted to investigate clinical manifestation and etiology of urolithiasis in children younger than 14 year-old. Materials and Methods: This descriptive and case-series study was carried out on 100 patients referring to Sahamie Pediatric hospital in Qom in 2007-8. Age, sex, family history, clinical manifestation (fever, dysuria and Pain) and laboratory tests (Na, K, Ca, P, urea, Cr, Albumin, Alkaline phosphates of serum ABG, urine sediment, urine culture Na, K, Ca, P, Cr, oxalate and citrate of urine/24h and cysteine in random sample of urine) were determined. Ceratenin correcting formula was used for adequacy controlling of urine collecting. Results: Hypocitraturia (56.8%), hypercalciuria (29.4%), hyperuricosuria (26.3%), hyperoxaluria (14.7%), phosphaturia (8.4%) and cystinuria (6.3%) were detected. Also, 54% patients had urinary tract infection. Pain (27.7%), fever (33.3%), irritability and dysuria (62.2%) and hematuria (77.7%) were seen. Positive family history was reported in 23% of patients. Conclusion: Most common clinical manifestations in children with stone were hematuria, dysuria, fever and pain. The common etiology of urolithiasis respectively was hypocitraturia, hypercalciuria, hyperuricosuria, hyperoxaluria, phosphaturia and cystinuria.

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Abstract Background: Over 2 billion world people suffer from iron deficiency. Teenager girls are one of vulnerable groups in this area. Health education with various methods is a suitable tool for motivating and modifying incorrect function. The purpose of this research was determining the effect of health education program base on PRECEDE Model for controlling iron- deficiency anemia. Materials and Methods: This quasi-experimental and two-phase study was done on 72 students placed into case and control groups in 2007-8. Intervention was done in three sections with 45 minutes and 3 months after educational intervention was followed. Questionnaire base on PRECEDE Model parts and blood lab exams (Hb, Hct, Feritin) were data gathering tool. Data were analyzed by pair T- test, independent T- test, Mann- Whitney and Chi- square tests. Results: The mean score of knowledge (p<0.001) and attitude (p<0.001) (Predisposing factors), Using educational resources, taking place educational class and participating in educational programs (Enabling factors), encourage family and teachers (Reinforcing factors) and iron deficiency anemia preventive behaviors had a significant increase in the case group after the educational intervention. Conclusion: Above results indicate positive effect of educational intervention program base on PRECEDE Model and main components (Predisposing, Enabling, Reinforcing factors) in improving of iron deficiency anemia preventive behaviors in the study population.

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Background: Nowadays, mothers have ceased to breastfeed due to several factors and resort to bottle-feeding or other forms of complementary feeding for their children. This results in physical and emotional problems for children, and socio-economic harms in communities. The aim of this study is to assess the impact of BASNEF model based education on successful breastfeeding in pregnant mothers referring to health centers in Arak. Materials and Methods: This quasi-experimental study was carried out with the participation of 88 pregnant women. The participants were randomly allocated to interuention and control groups. Instructions were given in four sessions on the basis of BASNEF model and behavioral objectives. Eventually, the collected data were analyzed by using statistical tests. Results: Mean scores of knowledge, attitude, enabling factors and subjective norms in the inerurntion group before and after education showed a significant difference in comparison with control group (p<0.001). Conclusion: Model-based education has positive impacts on behavior improvements. Thus, in health programs instead of applying traditional instructions, appying planned education programs based on health education models that have measurable and reliable effects is suggested.

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Background: TTV is the first human circoviridae that was isolated from Japanese patients with unknown hepatitis in 1997. Since then, several studies have been done on different aspects of TTV pathogenesis. The aim of this study is to determine the prevalence of TTV in patients with chronic hepatitis using two different primer sets. Materials and Methods: In this descriptive study, blood samples from 240 patients with chronic hepatitis C at Professor Alborzi Clinical Microbiology Research Center were assessed in terms of the presence of TTV DNA in plasma through the nested polymerase chain reaction using two primer sets. Results: Of the 240 patients, TTV-DNA was detected in 220 (92%) patients with chronic hepatitis C using 5΄-UTR primer and in 12 (5%) patients using N22 primer. According to the demographic data, there was not a significant difference between male female patients in prevalence of TTV infection. Conclusion: The prevalence of TTV DNA in plasma samples from patients with chronic HCV by using 5΄-UTR primer was high and it was congruent with studies done in other countries however, N22 primer showed a lower prevalence of viral DNA in the samples. Overall, there was not a significant correlation between sex and the presence of viral DNA in patients. Controversial or high prevalence of this virus in HCV infected people necessitate further studies for determining the relationship between HCV and TTV infection.

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Background: Different studies have proposed the cognitive deficits as one of the main aspects of schizophrenia furthermore, the presence of psychosis in these patients can influence the degree of deficiency in executive functions .The purpose of this study is to compare the executive function in patients with schizophrenia, non-psychotic major depression and normal individuals. Materials and Methods: In this cross-sectional study, 28 patients with schizophrenia, 28 patients with non-psychotic major depression and 28 normal subjects were selected from hospitals in Tehran through available sampling method which were matched according to age, sex, and level of education. The executive functions of subjects were evaluated using Wisconsin Card Sorting Test, and data were analyzed using one-way ANOVA and Turkey post-hoc test. Results: Schizophrenic patients had poorer performance in comparison with non-psychotic depressives and normal individuals in all variables of Wisconsin test (P<0.001). Also, depressive patients showed more preservative error than normal subjects (P<0.001), but no significant difference was found between the two groups in the number of categories and specific error variables. Conclusion: Greater impairment in the executive functions in the Wisconsin card sorting test is mainly associated with psychosis which might be introduced as a special profile of schizophrenia. Noticing the amount of deficiency in executive functions in each group of patients, the positive or negative prognosis can be diagnosed initially.

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origanum vulgare l.spp viride was used in ancient medicine and it was medicated for digestive disease, diabetes, remedy of trauma. While antimicrobial, ant diabetic, anticancer and antioxidant effect of this plant was proved but there is done no study for its effect on reproductive system. Therefore the purpose of recent study is surveying eventual androgenic effect of this plant on hormonal level of pituitary - gonadal axis in mature male vistar rats. Materials and Methods: recent study was done on five groups of male rats of vistar race and every group includes nine rats. The control group received no drug. The sham group received physiological serum and experimental groups of A, B and C were received the ethanolic extract of origanum vulgare l. with concentration of 40, 20, 10 mg/kg body weight respectively with gavaj for 14 days. Then levels of FSH, LH and TSH hormones in blood sample was measured with RIA method and obtaining result was compared between control group and other groups. Data was analyzed with SPSS software and statistical method of ANOVA and Tukey test. In this research, significant level was p<0.05. Results: in control group, sham group and A, B and C groups, respectively mean and standard deviation from average of plasma concentration for LH hormone based on mlU /ml were: 0.18±0.006, 0.183±0.017, 0.187±0.026, 0.241±0.012 and 0.284±0.027 And for FSH Hormone were: 0.321±0.025, 0.342±0.071, 0.372±0.026, 0.383±0.031 and 0.372±0.026 And for TSH hormone were: 5.28±0.683, 6.07±0.5, 6.09±1.94, 6.66±1.48 and 8.1±1.66. Conclusion: ethanolic extract of origanum vulgare leaf in maximum dose have androgenic effects and it can affect the activity of different levels of hypothalamic – pituitary – gonadal axis and increase the secretion of testosterone and gonadotropic hormones.

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Background: Aging in men is characterized by a progressive, moderate decrease in plasma testosterone. However, the associations of partial androgen deficiency of the aging male with clinical symptoms are controversial. This study investigates the association between the androgen deficiency symptoms (based on ADAM questionnaire) and sex hormone levels in men over 40 years old. Materials and Methods: This cross-sectional study was carried out on 171 healthy men over 40 years old. Demographic data and ADAM questionnaire were completed by each patient. Also, serum levels of free testosterone, estradiol, LH, and FSH were determined using the ELISA method. The data was analyzed by Chi-squared, Mann-whitney U test and Logistic Regression Test. Results: Based on ADAM questionnaire, 85 patients (49.7%) had androgen deficiency symptoms, and there was a significant relationship between these symptoms and age. However there was no significant correlation between the total score of the questionnaire with sex hormones, and only sexual symptoms were significantly associated with low testosterone levels. Conclusion: It seems that the clinical symptoms of androgen deficiency cannot precisely predict the levels of sex hormones in elderly men. Nevertheless, hypogonadism diagnosis can be clinically suspected when symptoms of sexual dysfunction are present

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Background: Some clinical trials have revealed the effects of Matricaria chamomilla on premenstrual syndrome symptoms. This study was done to compare the effects of Matricaria chamomilla extract and mefenamic acid on the severity of premenstrual syndrome symptoms.

Materials and Methods: In a randomized double-blind clinical trial, 90 students completed daily rating form for the diagnosis of premenstrual syndrome symptoms and its severity for two consecutive cycles. After verification, they were randomly divided into two equal groups. The participants received one 100 mg capsule of Matricaria chamomillaor 250 mg mefenamic acid three times daily from day 21 of menstrual cycle till the beginning of the menstruation. They completed the daily symptom rating form at the same time.

Results: General severity reduction of symptoms was significantly greater among Matricaria chamomilla extract users (25±13.8 and 28±14.5%) than that among mefenamic acid users (14.8±18.5 and 16.2±18.2%) after the first and second cycles (p<0.05). Severity of emotional symptoms was significantly higher among Matricaria chamomilla extract users (30.1±26.6 and 33.4±25.3%) than that among mefenamic acid-users (11.6±25.7 and 10.7±26.8%) after two cycles intervention (p>0.05).Reduction of physical symptoms was not significantly different between the two groups (p>0.05).

Conclusion: Matricaria chamomilla reduces the severity of symptoms of premenstrual syndrome symptoms during treatment. Matricaria chamomilla effect on the severity of general and emotional symptoms of premenstrual syndrome symptoms is greater than that of mefenamic acid.

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Background: Considering the fact that more than one third of the world’s population is infected with Mycobacterium tuberculosis bacteria, identifying individuals with latent tuberculosis infection (LTBI) is vital for controlling TB. Tuberculin skin test (TST) and IFN-gamma release assays are practical methods used for screening people with LTBI. Due to the insufficiency of data on endemic tuberculosis region and the need for evaluation of these methods in a high-risk population, this study was performed in Zahedan.

Materials and Methods: This descriptive study was carried out on 75 individuals, including 21 health care workers (HCWs) as well as 54 family members of patients with active TB. IFN-&gamma release assay and TST were also carried out on the participants.

Results: Of the 75 participants, 26 had positive IFN-&gamma release assay results and 49 persons showed negative results. TST was also performed and 12 participants did not show up for taking the results. Among the remaining 63 participants, 60.31% had more than 10 mm indurations. The results in 32.25% of the participants were positive for both IFN-gamma release assay and skin test, whereas 34.92% of the participants presented negative tests results for both IFN-gamma release assay and skin test. The agreement between these two tests was 66.67 % (P=0.001, K=0.36, 95% Confidence Interval).

Conclusion: The results showed a weak agreement between the two tests.

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Background: Subclinical hypothyroidism is the compensatory stage before overt hypothyroidism. In overt hypothyroidism, risk of ischemic heart disease increases due to elevation of lipoprotein (a) as atherogenic agent, but evidence for subclinical hypothyroidism is one of the controversial issues in researches. According to the atherogenic lipoprotein (a) and other serum lipids, this study is conducted to compare the serum lipoprotein (a) and other serum lipids in patients with subclinical hypothyroidism and euthyroidism.

Materials and Methods: In this descriptive - analytic study, 90 persons (60 with subclinical hypothyroidism and 30 euthyroid state) are participated and these referred to Imam Reza and Taleghani Hospitals which are located in Kermanshah. The sampling method is selected with available sampling methods. After differentiating data by age, sex and underlying disease (liver, kidney, drugs), then they were subjected to determination lipoprotein (a) and other serum lipids profile tests.

Results: In both cases and controls, 16/7% were men and 83/3% were women. Based on results, there is no significant difference between serum lipoprotein (a), triglycerides, cholesterol, HDL and LDL in both statistical groups (p>0.05). Also there is no association between lipoprotein (a) and other serum lipids (p>0.05).

Conclusion: Serum levels of lipoprotein (a) and other serum lipids in young patients with normal weight with subclinical hypothyroidism is not increase, thus it can be concluded early treatment is not necessary for them.

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Background: Planning of educational programs to inform the people about the prevention of diseases such as cancers is necessary. This study was conducted to determine the effect of educational interference based on HBM on practices of women about gastric cancer.

Materials and Methods: In this semi-experimental study, 88 women participated from Arak. The subject were randomly divided in two groups, experimental group and control group (each group includes 44 women). Inclusion criteria were absence of cancer, Iranian nationality, age over 18 years, living in the city. Data collected with a questionnaire based on HBM and performance checklist about colorectal cancer prevention was used in order to evaluate the effectiveness of the educational program. Intervention was done in 1 month consist of 3 session each session 45 minutes. Three months later data were recollected and analyzed.

Results: In this study, the mean age in case and control group was 38.3±9.6 and 36.3±11.1 years respectively, with no significant differences (p=0.381). Average scores of knowledge and practice in experimental was 72.8±13.06 and 30.81±6.2 respectively group before the intervention, which was 88.05±12.2 and 65.3±8.9 respectively after the intervention (p<0.05). Moreover before of intervention susceptibility, severity and percieved benefit about practice of mothers was moderate but after intervention the entire items between experimental and control groups was significantly different (p<0.05).

Conclusion: Finding of this research confirms the effect of Health Belief Model on prevention from gastrointestinal cancer in women of Arak.

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Background: The average age of menarche varies from country to country due to regional variation and different factors, including genetic and environmental factors that affect the onset of menarch. This study performed to survey relationship between nutrition and physical activity with menarche age of girls in Ahvaz city.

Materials and Methods: This survey is a cross-sectional study that was conducted on 1249 female students 8-15 years in 2012- 2013 year. Participants were selected by random cluster sampling from 4areas and 16 elementry and middle and high schoolsin Ahvaz city. The data were collected based on interviews and questionnaire (food frequency and physical activity). After collecting the data, then they were encoded and analyzed by SPSS16 software  and descriptive and analytic statistics.

Results: The mean of age at menarche in girls in Ahvaz was 11.86±1.07 and age at menarche was not associated with nutrition and physical activity.

Conclusion: Based on these findings, significant association between nutrition and physical activity and age at menarche (p<0.001)was not observed.

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  Background: In spite of designing and applying an effective vaccine against Hepatitis B virus (HBV), chronic infection with this virus is still one of the most important health problems worldwide. Host genetic background including single nucleotide polymorphisms play a significant role in chronicity or clearance of the infection. The final product of programmed cell death 1 gene (PDCD1) is expressed frequently on T-cells and in chronic viral infections, prevent the virus-specific T-cell response against the virus. In this study, the association of a single nucleotide polymorphism (+7146A/G) in intron 4 of PD1 gene with chronic hepatitis B infection in Iranian population has been assessed.

  Materials and Methods: 212 chronic HBV patients and 208 healthy controls were analyzed in this case-control study. Genomic DNA of the studied individuals was extracted and after performing polymerase chain reaction (PCR), polymorphism of +7146 was determined via RFLP method.

  Results: Frequencies of GG, GA and AA genotypes on position 7146 of the intron 4 of PD1 gene were 77.4%, 20.7% and 1.9% in patient group and 80.8%, 15.4% and 3.8% in control group, respectively. After statistical analysis, No significant difference was observed between patient and control groups (p=0.198).

  Conclusion: Genotype frequencies in the studied population are in accordance with the results of previous studies. Results of the present study suggest that there is not any association between A/G single nucleotide polymorphism in intron 4 of PD1 gene and susceptibility to chronic hepatitis B in Iranian population.

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Background: Post ischemic myocardial reperfusion can impair CABG outcomes and cause increased mortality, hospital stay and costs. Then, increased oxygen free radicals lead to lipid peroxidation and sulfhydryl group oxidation. The aim of this study is to evaluate whether N-acetylcysteine and Vitamin C as antioxidants could effect postoperative outcomes of on-pump CABG.

Materials and Methods: In this clinical trial, patients who had undergone CABG were studied in 4 groups receiving Vitamin C, N-acetylcysteine, Vitamin C & N-acetylcysteine and traditional drugs. The study population consisted of 50 patients in each group. Data were recorded in a checklist and analyzed by using SPSS 20.

Results: Mean pump time, ICU stay, hospital stay, the distribution of troponin positive serum, arrhythmia and need for reoperation were significantly different between groups. Gender distribution, mean cross-clamp time, serum creatinine level before and after surgery, the need for inotropic drugs and required dose level of it, showed no significant differences between groups.

Conclusion: It seems that the combination of N-acetylcysteine and  Vitamin C had a stronger effect on the defference between the mean of pump time, hospital length stay and  length of ICU stay versus the administration of N-acetylcysteine or Vitamin C alone.

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Background: Endurance training can lead to tissue damage and destruction by creating oxidative stress. But, it seems that exhaustive and endurance swimming indicated different results with each other. The purpose of this research was to compare two kinds of endurance swimming training on levels of LDH, CK and MDA in male Wistar rats.

Materials and Methods: 18 male Wistar rats with 12 weeks old, weighting 250 to 300 g, were randomly divided into three groups (6 in each): 1) endurance swimming (EN), 2) exhaustive swimming (EX) and 3) Control (C). Both groups swam for 1 h/d and 5 d/w for 10 weeks. Swimming duration in EX groups was increased progressively by fiveth weeks, by 30 min/week, reaching 3 h/d by final 3 weeks of traninig protocol. In this duration, C group didn't receive any intervention. One day after the end of training protocol, blood samples of rats were obtained on vena cava. The activity of lactate dehydrogenase (LDH) and creatine kinase (CK) was measured with DGKC method and malondialdehyde (MDA) through reaction with TBA. Results were analyzed using the one- way ANOVA followed by a Tukey test. Significant level was 0.05.

Results: EN groups significantly increased the levels of CK compared with EX and C groups (p=0.001), when indicated significantly lesser levels of MDA than C group (p=0.011). But, no significantly difference observed in the levels of LDH.

Conclusion: It seems that endurance swimming creates more muscle damage, while were generates lesser lipid peroxidation.