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Introduction: End stage renal disease (ESRD) is a major health problem and each year the number of patients is increasing. If the disease becomes irreversible, patients must always be hemodialyzed. Since mortality rate will increase due to inadequate dialysis, determining the efficacy of hemodialysis and improving its quality is very important. The main goal of this research is investigating the efficiency of hemodialysis. Materials and Methods: This is a cross-sectional analytical study which was conducted on 103 people who were under dialysis treatment in the Vali-e-Asr hospital of Arak in year 2003. Weight, blood pressure (before and after dialyze), time of dialysis, BUN and Cr before dialysis and 5 minutes after turning of the pump and before the second dialysis were measured. Data was analyzed by T test and Pearson correlation. Results: The mean of KT/V was 0.58 ± 0.1 normal protein catabolic rate (nPCR), 0.36 ± 0.11 g/kg per day and time average concentration of urea (TAC), 43.3 ± 14 mg/d which had a significant difference with standard measures (p<0.05). KT/V was 0.49 ± 0.18 and 0.47 ± 0.10 for men and women respectively which was significantly different (p<0.03). There was a positive and linear relationship between education level and TAC, KT/V and number of dialysis per week. Conclusion: Regarding the low efficiency of hemodialysis in 80% of patients and lower levels of hemodialysis efficacy indicators in comparison to standard measures, periodic assessment and also investigating the reasons of low efficacy of hemodialysis is recommended.

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Background: Backache is a common problem in pregnancy period . Scientists believe that some simple exercise can help to prevent the occurrence of backache during their pregnancy period. Thus, this research carried out in order to investigate the effect of some simple exercises and correct daily activity in prevention of backache in pregnancy period. Methods and Materials: This is a clinical trial study that was carried out on 138 of pregnant women .The first group including 66 women which considered as control group and treatment group including 72 women. The research had four stages: 1) stage of taking history. 2) Arrange a teaching program. 3) stage of performance( In case group samples were done 60 minutes aerobic exercises for 3 days a week for the 30 weeks undersupervision a physiotherapist). 4) Assessment the results. Data were analyzed by SPSS for statistical analysis. Results: According to the result 18.2% of woman that were under treatment and 36.6% of control group, suffered from backache. Chi-square test showed significant differences between two groups. In addition Odd ratio of treatment population was 2(CI%95 = 4/04-1/91 & p<0/05). Conclusion: The result showed simple exercises during pregnancy period can not eliminate backache, but it can decrease delay backach.

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Background: There are not appropriate research about use of saline lock for obtaining blood samples and intravenous drug or fluids. The purpose of this study was compared the biochemistry values obtained by venipuncture and saline lock after intermittent administration of solution and medication. Methods and Materials: This quasi-experimental prospective study was done on 63 patients who were admitted in Cardiac ward Amir-Kabir educational hospital. The sampling method was convenience. A tourniquet was tied above the saline lock, the first 0.5 ml of blood withdrawn was discarded, then 5 ml blood was obtained. Simultaneously, 5 ml sample was drawn from the opposite arm. The samples were analyzed for FBS, Chol, TG, HDL, LDL, BUN, Cr, Na, K, CPK & LDH. Results: 53.9% participants were male. Mean of age was 63.52±12.63 years. There were no significant differences in mean of biochemistry values in blood obtained by venipunctures saline locks (p>0.06). Conclusion: Nurses can use saline lock after intermittent intravenous drugs and fluids, in order to determine blood sample for evaluating blood biochemistry value. This method relieve pain, due to blood sampling.

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Background: Candida species are the most common yeasts that reside in oral cavity in 30 - 50% of people, and are capable to produce opportunistic infections within the oral cavity. This study was done to determine the effect of cigarette smoking on the type and degree of Candida oral carriage. Materials and Methods: In this case-control study, oral Candida flora in 34 smoker and 66 non-smoker men were compared. All of the samples were collected by swab and examined by direct microscopy and culture on CHOROM agar Candida and corn meal agar media. Isolated colonies were identified by carbohydrate assimilation method using RapID Yeast PLUS System. Results: Out of the 34 smoker individuals, 27(79.4%) had Candida colonization in their oral cavity while 30(45.5%) of the 66 non-smoker individuals had developed this kind of colonization. A significant difference was observed between the two groups (p<0.05). Additionally, there was a significant difference in the degree of colonisation and the type of candida species which were isolated from the oral cavity of the smoker and nonsmoker groups. Conclusion: Cigarette smoking can act as an important underlying factor in oral candidiasis.

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Background: Nowadays, the use of inflammatory biomarkers in the diagnosis of appendicitis is on the rise. On the other hand, the role of oxygen free radicals in various inflammatory states has been verified. Noticing the high prevalence of negative appendectomy (9.3-22.2%), the aim of this study was to investigate the level of blood total antioxidant capacity (TAC) as a biomarker for early diagnosis of acute appendicitis. Materials and Methods: In this prospective analytical trial, over a one-year period, 407 patients, with preoperative diagnosis of acute appendicitis who had undergone operation, were studied. After measuring the TAC level, data were analyzed through the analytic ROC curve and parametric mean comparison tests. Results: Of all the patients, 298 were identified with appendicitis. TAC levels in adult female and male groups were respectively 663.9±164.75 and 752.58±167.37 µm/L which revealed a significant difference (p<0.0001). Also, in children, the mean of TAC level in perforated appendicitis sub-group was significantly greater than those in gangrenous and suppurative groups. Conclusion: TAC level can be used as a predictive factor for the diagnosis of perforated appendicitis in children however, it cannot be used as a biomarker for the diagnosis of appendicitis. Because of the significant difference existing between the level of TAC in male and female patients, further studies are suggested to investigate the level of inflammatory biomarkers with respect to menstrual cycle in women.

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Background: Diagnosis of acute appendicitis is one of the challenges that surgeons face in the emergency ward. Although Alvarado score has been recommended in the diagnosis of acute appendicitis, this criterion has some limitations in terms of age, sex, and race. The aim of this study was to evaluate the effectiveness of Alvarado score in the diagnosis of acute appendicitis based on the age and gender. Materials and Methods: In this cross-sectional study, 407 patients who underwent operation with the preoperative diagnosis of acute appendicitis from June 2008 to August 2009 were included in the study. The patients’ data were recorded by the investigators. The data were compared by parametric tests. The sensitivity and specificity were determined by the optimal cut-off point on ROC curve using MedCalc software version 10.2.0.0. Results: The optimal cut-off point for women was lower than men (6 and 7, respectively). The rate of negative appendectomy in the group with Alvarado scores 9 and 10 was 11.8%, while the negative appendectomy rate in the other two groups with Alvarado scores 7 and 8 and 5 and 6 were 29.9% and 52.8%, respectively. Conclusion: The diagnostic value of Alvarado score of 8 and less in physical examination is lower than the abdominal tenderness exam alone. Also, the cut-off point for the diagnosis of acute appendicitis in women should be considered lower than that in men. On the other hand, the cut-off point in adolescents and children is higher than adults.

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Background: Brucella is a gram-negative intracellular bacterium. Since Brucella brings about health and socio-economic problems, its control is of primary importance. The common method of vaccination includes using live attenuated strains of this bacterium. This study was done to evaluate the immunogenicity of Brucella aburtus P39 gene in Balb/c mice. Materials and Methods: In this experimental study, P39 gene was amplified by polymerase chain reaction (PCR) method and after extraction, it was sub-cloned to eukaryotic expression vector pcDNA3. The intramuscular injection of the obtained plasmid to the Balb/c mice was done in three stages. After the last vaccination, immunologic tests, such as proliferative response in lymphocytes, IFN- assessment, IL-5, and determination of IgG2a and IgG1, were run. Results: The level of activation in splenic lymphocytes response was 3.6 and the measured IFN- was 3 ng/ml, whereas IL-5 was insignificant. IgG2a and IgG1 titers were 1.640 and 1.40, respectively. Conclusion: The findings of the immunological analysis show the appropriate immune response in Balb/c mice model after the injection of P39 gene containing plasmid. The immune system response was in Th1 form which decreased the number of bacteria in spleen. Therefore, P39 gene is of appropriate immunogenicity and DNA vaccination is efficient in the activation of cell immune response against this bacterium.

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Background: Insomnia has major negative effects on quality of life in postmenopausal women and can reduce their physical, psychological and social function. About 64.8 percent of women prefer to use herbal supplements for sleep problems. The present study aimed to evaluate the satisfaction of taking Valerian on the improvement of sleep quality and sleep score in postmenopausal women during six month. Materials and Methods: In this clinical trial, satisfaction of taking Valerian and sleep score of 100 postmenopausal eligible women who were referred to health care centers of Tehran University of Medical Sciences were evaluated. Research tools had three part of personal caharctristictic, Pittsburg sleep Quality Scale, and for satisfaction Visual Analogue Scale (VAS 0-10). Data gathering were in tree phase immediately after intervention, one and six month after valerian withdrawal. Results: The difference between intervention and control group in satisfaction and sleep scores was significant only immediately after taking Valerian (p=0.001) and there was no statistically significant difference within valerian or placebo group in one and six month later. Also there was statistically significant difference in three times of evaluation and satisfaction and improvement in sleep score were reduced within the time. Conclusion: Valerian can improve the sleep quality in postmenopausal women in intervention duration and after withdrawal there is no difference between placebo and valerian group so continued use of this supplement is necessary for improving of sleep quality.

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Background: Anthrax is a common disease among human and livestock which is caused by Bacillus anthracis. Bacillus anthracis has two strong immunogenic proteins: Protective antigen (PA) and lethal factor domain I (LFD1) that have always been considered as vaccine candidates against Bacillus anthracis. The aim of this study is to express and purify the lethal factor domain I (LFD1) in Escherichia coli and produce polyclonal antibody against it in mice. Materials and Methods: In this experimental study, LFD1 gene was amplified with BamH I and Xho I restriction site by PCR. After isolation, the gene was cloned to the expression vector pET28a (+). This vector was transformed to E. coli-BL21 (DE3) PLysSto to express LFD1 gene. The expression of LFD1 gene was induced by IPTG. After protein purification by affinity chromatography, the produced antigen was injected into mice for four times. Then the produced polyclonal antibody in mice serum was evaluated. Results: The cloned LFD1 gene in pET28a (+) vector was confirmed by PCR, enzymatic analysis, and sequencing. The expressed and purified recombinant protein was confirmed by SDS-PAGE and Western blotting. Finally, the isolated polyclonal antibody from mice serum was evaluated and confirmed by ELISA test. Conclusion: Noticing the appropriate expression, easy purification of LFD1, and the titer of produced polyclonal antibody against LFD1 in mice due to its immunogenicity, it can be considered as a good vaccine candidate against anthrax.

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Background: Multidrug resistance is the main reason for unsuccessful chemotherapy. The important reason of drug resistance is ATP dependent pumps shus as MDR1 that extrude drugs from the cell. MDR1 is high polymorphic. It seems that polymorphisms influent on gene expression and response to treatment. The aim of this study was investigation of C1236T polymorphism MDR1 gene and it’s association with response of treatment in childhood acute lymphoblastic leukemia.

Materials and Methods: In this descriptive study, C1236T polymorphism of MDR1 was investigated in 44 acute lymphoblastic leukemia childhood and 40 healthy individual by ARMS-PCR technique. Association of this polymorphism with response to treatment was also investigated. Data were analyzed using Chi-squre test and SPSS software. P values <0.05 were considered to be statistically significant.

Results: There was no significant difference in frequencies of C1236T polymorphism between patients and healthy group (p=0.876). Frequency of C1236T polymorphism of MDR1 between responder and non responder was not significant (p=0.304).

Conclusion: It seems that there is no correlation between C1236T polymorphism of MDR1 gene and response to treatment. So the role of C1236T polymorphism in gene expression MDR1 in childhood acute lymphoblastic leukemia and response to treatment is still controversial.

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Background:  Ferula assa-foetida is one of the common medicines that was used as antiseptic with a view to traditional uses, it can be used as a safe and effective drug to treat diseases particularly resistant bacterial infections. This study aims to product gelatin nano- capsules containing Ferula assa-foetida essential oil and investigate their antioxidant and antibacterial activities.

Materials and Methods: This experimental study was performed on gelatin nano-capsules containing Ferula assa-foetida essential oil (FAO) (2, 4, 6 and 8% w/w), glycerol (25% w/w) as plasticizer and glutaraldehyde as cross-linker. The morphology, antioxidant and antibacterial activities and operation of the nano-capsules were assessed according to American Standards by Scanning Electron Microscopy, ABTS, and microbiological tests.

Results: Gelatin nano-capsules exhibited low antioxidant and antibacterial activities while gelatin nano-capsules incorporated with FAO exhibited excellent antioxidant and antibacterial. The highest rates of these effects were seen merged with 8% of FAO.

Conclusion: Gelatin nano-capsules merged with FAO have excellent physical form, as well as they are an appropriate antioxidant and antibacterial that have been considered to produce antoxidant and antibacterial drugs.

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Background: Staphylococcus aureus is one of the important pathogens can cause infections in hospitals specially in intensive care units (ICU). It seems that nasal carriage is important risk factor for developing l infection at ICU units. This study was designed to investigate the frequency of S. aureus nasal carriage and its virulence in patients admitted to ICU units in Vali-Asr hospital at Arak university of medical sciences.

Materials and Methods: In this cross-sectional study, nasal swab samples were obtained from all the patients hospitalized in ICU unit of Vali-Asr hospital from July-December 2014 at admission. After identification, methicillin resistance and the frequency of pvl and acme genes determined by PCR. Demographic data were collected using questionnaire and were analysed using SPSS 20 software.

Results: Out of 390 patients, 81(20.8%) and 31(12.9) patients had been colonized with MSSA and MRSA, respectively. The result of culture was negative for 278 patients (71.3%). 77.4% of MRSA and 54.3% of MSSA isolates were positive for acme gene. Also, 11.11% of and 6.45% of MSSA MRSA isolates were positive for pvl gene.

Conclusion: The application of medical supportive devices like cv line, ventilator, history of surgery operation and antibiotic use significantly was associated with S. aureus nasal carriage. High prevalence of S.aureus shows that these bacteria settled in the hospital. Hence, infection control measures must be performed to reduce the risk of hospital infection.

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Background: Listeria monocytogenes is one of the most important causes of abortion and postpartum infection in newborns. Because of the importance of L . monocytogenes in the health of pregnant women and newborn babies, the aim of this study was to determine the prevalence of these bacteria in pregnant women and to compare the level of prevalence between women with a history of abortion and with no a history of abortion.

Materials and Methods: In this study, 540 samples of pregnant women were provided from Arak Taleghani hospital. The samples were cultured in enrichment media, then L .monocytogenesis was isolated in specific media.

Results: Of clinical samples, 14 cases had Listeria monocytogenes. Of these samples, 8 cases in women had a history of abortion, while women with no history of abortion were 6 Most cases of positive culture were related to the age of 25 to 34 years, including 7 cases, the lowest cases were 35 to 44 years old including 3 women and 4 women were between 17 and 24 years old.

Conclusion: The study showed that Listeria monocytogenes can cause infection in pregnant women. The use of Phenotypic methods and specific media can apparently isolate listeria monocytogenes from healthy pregnant women.

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Introduction: Quality of life is one of the most influential issues that can encourage a person to continue a happy and healthy life. On the other hand, spiritual health is one of the dimensions of health and a sense of harmonious connection between oneself, others, nature, and beyond, and leads to understanding the ultimate purpose and meaning in life. The purpose is to determine the relationship between spiritual health and quality of life in university students in Arak. The results of this study can be used to formulate strategic plans improve spiritual health and the quality of students' lives.
Methods: First, the population of each university in Arak city was measured, and taking into account their population and establishing a ratio between the sample size of the study and the population of each university, people who had the characteristics of entering the study were included in the study. The sample size was 400 people and was conducted on students who have been studying at the university for at least six months. After obtaining the consent of the participants, the researchers filled out the questionnaire through interviews with the students. The questionnaires included two instruments: a spiritual health questionnaire and a quality of life questionnaire with 36 questions.
Results: No significant relationship was observed between spiritual health and demographic variables. Likewise, spiritual health had no statistically significant relationship with demographic variables. The analysis of the study data showed that there is a positive correlation between the quality of life and spiritual health of students. (P < 0.05).
Conclusions: According to the horoscope results, there is a relationship between the quality of life and the spiritual health of the students of Arak universities. By improving the quality of students' lives, we can increase their spiritual health, and even by increasing their spiritual health, we can witness the improvement of students' quality of life.

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Introduction: The stress caused by COVID-19 had affected many people in society, especially individuals at risk. The present study was carried out to investigate, firstly, whether COVID-19-related stress plays a mediating role in the relationship between rumination and aggression in drug-dependent people undergoing treatment. Secondly, the study was conducted to know whether rumination has an indirect effect on the aggression of substance-dependent people under treatment through the mediation of COVID-19-related stress.
Methods: In this correlational analytical study, 136 patients undergoing maintenance treatment with methadone who were willing to enter the study were investigated by the available sampling method in two addiction treatment centers in the 1st and 2nd districts. The data collection tools in the present study included the Corona Disease Anxiety Questionnaire, Rumination Questionnaire, and Bass and Perry Aggression Questionnaire. After collecting the data, the anxiety score of each participant was measured from 0 to 54, the rumination score from 0 to 88, and the aggression score from 29 to 145. Then, the data was analyzed using Lisrel statistical software.
Results: Findings showed that the direct effect of rumination on aggression is 0.23, which is significant at the P < 0.01 level. Therefore, rumination has a positive and direct effect on aggression. Also, COVID-19-related stress plays a mediating role in the relationship between rumination and aggression in drug addicts under treatment. In addition, the indirect effect of rumination on aggression is 0.25, which is significant. Thus, rumination has an indirect effect on aggression through the mediation of COVID-19-related stress.
Conclusions: According to the high prevalence of psycho-social problems such as depression, anxiety, fear, addiction, job burnout, suicidal thoughts, violence, domestic and post-traumatic stress during the COVID-19 pandemic, in the post-corona era, we have witnessed a high amount of mental and social injuries in the world. For this reason, governments must screen psychologically vulnerable groups in advance.