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Introduction: Irritable bowel syndrome (IBS) is the most common functional bowel disorder. Stress triggers or aggravates it's symptoms. This investigation is carried out to determine the effect of Benson relaxation therapy on anxiety level and severity of symptoms in patients with irritable bowel syndrome. Materials and Methods: In this clinical trial 30 patients with irritable bowel syndrom were randomly divided into case and control groups. The control group was treated by only usual medical therapy but the case group was treated by combined medical- relaxational therapy. The two groups continued therapy for three months. Anxiety level and gastrointestinal symptoms of case and control groups were compared at three different times (two weeks before intervention and one week and three months after intervention). Also, patients were asked to document 6 common gastrointestinal symptoms in their daily symptom diaries, 2 weeks before intervention to 3 months after intervention. At the end of each week, these symptoms were compared in the two groups. Data was analyzed using chi square , Man - Whitney U and Wilcoxon tests. Results: Mean state and trait anxiety of the case and control groups two weeks before and one week after intervention did not show significant difference. But the results after 3 months showed a significant difference (p<0.001).The mean severity of gastrointestinal symptoms, 2 weeks before intervention, was significantly higher in case group, but the comparison of gastrointestinal symptoms severity, 1 week after intervention, did not show any significant difference between the two groups, and 3 months after intervention a significant difference was observed in the two groups (the control group had more severe symptoms than the case group). The comparison of 6 common gastrointestinal symptoms based on weekly self-report showed that abdominal pain, eructation and distention were significantly lower in case group, but there was no significant difference between diarrhea and constipation. Conclusion: Three months Benson relaxation therapy significantly decreased the state and trait anxiety level and severity of symptoms in patients with irritable bowel syndrome.

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Background: Hysterectomy is one of the most common surgical procedures. Only after cesarian section, hysterectomys considered as second major surgical procedure. Problems such as severe pelvic pain, irregular or heavy bleeding and uterine cancer are cases that hysterectomy is used to care them. Abdominal pain after abdominal hysterectomy is one of the most common complaints of patients undergoing this type of surgery. This study aimed to compare the effects of bupivacaine into the subcutaneous tissue and skin ketamine to control pain after surgery in patients undergoing abdominal hysterectomy under general anesthesia.

Materials and Methods: This study is a randomized, double-blind clinical trial involving 99 women candidating for TAH referred to Taleghani center in Arak who were divided into three groups. The average duration of analgesia and pain and pain score were recorded.

Results: The average duration of analgesia in ketamine group, in the bupivacaine group and in the placebo group was 65.1±8.8, 65.4±8.7, and 57.6±5.5, respectively. According to p≤0.01, there was a significant difference between the three groups. The duration of analgesia in the placebo group was significantly lower than ketamine and bupivacaine groups, while that between ketamine and bupivacaine in terms of the average duration of analgesia, no significant difference was observed.

Conclusion: The results of our study indicate that the use of bupivacaine and cutaneous ketamine is effective in reducing postoperative pain in patients undergoing abdominal hysterectomy and further doses of ketamine and bupivacaine single dose resulted in a significant reduction of postoperative pain in patients compared to the placebo group.

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Abstract:
Background
CAP ( community acquired pneumonia ) is one of the most common infectious diseases that leads to hospitalization of patients. Also, the effects of vitamin D deficiency on the functioning of the immune system and its association with infectious diseases such as CAP have received much attention in recent years. Therefore, we decided to investigate the relationship between serum vitamin D levels and the incidence and severity of CAP pneumonia in this study.
Methods
In this case-control study, 75 patients with CAP  and 75 healthy individuals were evaluated and serum levels of vitamin D in these two groups were measured and compared.
Results
The present study shows that for each unit increase in serum vitamin D level, the need for hospitalization in the ICU according to the IDSA criterion is reduced by seven percent and according to the CURB65 criterion, the need for hospitalization in the ward and ICU is reduced by fifteen percent. Vitamin D deficiency also increases the chance of developing community-acquired pneumonia by 3.08 times. And for every unit increase in vitamin D, the chance of developing community-acquired pneumonia decreases by 4 percent. And in people with vitamin D deficiency, the chance of being admitted to the ICU according to IDSA is 2.05 times and according to CURB65 is 2.84 times.
Conclusions
Overall, based on the results of this study, it is concluded that vitamin D deficiency is associated with an increased incidence as well as a greater severity of community acquired pneumonia.