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Introduction: The  rapid  increase  of  antibiotic  resistance  especially  among  gram  negative  bacteria, has  made  the  researchers  to  find  an  alternative  substitutions  for  uneffective  antibiotics  and  the  candidate  was  herbal  plants  which  their  antimicrobial  effects  were  understood  traditionaly  from  the  past. Since  Oak  seed  hull (Quercus  brantii) has  been  used  in  traditional  medicine  for  treatment  of  diarrheal  diseases, the  role  of  methanol  extract  of  the  plant  on  few  gram  negative  entric  bacilli  were  evaluated  and  compared  with  some  in-use  antibiotics.
Materials  and  Methods: The methanol  extract  of  the  active  constituents  of  the  plant  was  concentrated  with  distillation  apparatus  in  vaccume  and  was  then  diluted  with  methanol  to  yield  different  concentrations. The  antimicrobial  activity  of  the  extract  was  then  examined  by  standard  MIC  and  disc  diffusion  method  on  E.Coli, Proteus, Shigella  and  Salmonella  and  compared  with  those  of  gentamicin, nalidixic  acid  and  co-trimoxazole  in  the  next  step.
Results: The  results  showed  that  the  antibacterial  effect  of  the  methanol  extract  on  proteus  and  E.coli  wwas  significant  and  directly  related  to  its  concentration  but  was  not  the  same  for  shigella  or  salmonella.  Some  concentrations  of  the  extract  had  a  similar  or  better  effect  compared  to  nalidxic  acid  or  co-trimoxazole. While  the  effect  of  80%  was  not  significant  in  general, except  for  salmonella  that  its  effect  was  equivalent  to  25mg  co-trimoxazole.
Conclusion: The  pverall  results  showed  that  although  Oak  seed  hull  has  some  antibacterial  activity, but  it  seems  that  its  anti-diarrheal  effect  id  due  to  Tanins  which  cause  water  absorption  and  protein  precipitation  in  the  intestine  as  well.

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Introduction: Nausea and vomiting are among the prevalent complaints in pregnancy, but there is a controversy about their treatments. At present, because of the problems caused by these complaints for mothers and incompatibility with drug treatments physicians prefer to use non-drug interventions such as acupressure. In this study, we evaluated the effectiveness of acuptessure in treatment of nausea and vomiting in pregnancy.
Materials and Methods: This was a randomised clinical trial study. 120 pregnant women with nausea and vomiting complaints that submitted in prenatal clinics and referred to Alavi pain clinic in Arak were investingated.
After filling out of questionnaires, the participants were alternatively divided into case and control groups. In case and groups, wrist band (for 90 minutes) was fastened in appropriate and non-appropriate sites, respectively. The subjects were followed up at 24 hours in 3 times visit and their responses to treatment were evaluated.
Results: The incidence of nausea and vomiting in the case group was significantly lower than control group. The rate of improvement of patient symptoms in the case group was six times higher than control group. No serious side-effect was observed in studied population.
Conclusion: Our findings indicated that acupressure is a safe and appropriate method used for treatment of nausea and vomiting in pregnancy.

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Introduction: Preclampsia is a pregnancy-specific condition characterized by hypertention, proteinuria and generalized edema. The condition usually occurs in the third trimester and word wide is one of the most common causes of maternal mortality and morbidity. No study concerning the immunological etiology and pathogenesis of preclampsia has been done in Iran. The aim of this study was to evaluate the role of some immunological factors involved in the pathogenesis of preclampsia.
Materials and methods: This research was a clinical trial study. We measured C3, C4, IgG, IgA and IgM levels in 20 women with preclampsia, 20 normal pregnant women and 20 non-pregnant women matched for age, BMI, parity and gestational age. Seven patients had developed severe and thirteen mild preclampsia. After written informed consent was obtained, blood samples of subject group.
Collected serum collected was analyzed for immunological parameters by the single radial immunodiffusion (SRID) method of Mancini.
Results: C4 level was significantly decreased in women with severe preclampsia than in women with mild preclampsia and normal pregnancies, whereas C3 level did not differ between groups. IgG concentration was significantly higher in non-pregnant women than in women with preclampsia and normal pregnancies. There was a significant decrease in IgA concentration in normal pregnant women compared with non-pregnant women. There was a not significant difference between the IgM concentrations of both groups.
Conclusion: Our data show several changes in immunological factors in preclampsia which may contribute to the pathogenesis of the disorder in Iranian women.

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Introduction: Renal cell carcinoma can be presented with extension of thrombosis to renal vein and inferior vena cava. Management of these patients consists of radical nephrectomy and thrombectomy. In this study we reviewed approach to these patients. Materials & Methods: This is a case series report. During 1379 to 1384, 148 patients diagnosed with renal cell carcinoma (RCC) limited to Gerota’s fascia (stage T3 or less) were admitted to Hasheminejad hospital. Fourteen patients had inferior vena cava (IVC) involvement. Radical nephrectomy as well as thrombectomy was performed in 8 patients. This investigation is done on these 8 patients. Results: Patients' average age was 51.4 years. Six patients were male (75%) and 2 female (25%). The most common symptoms were flank pain (75%), gross hematuria (62.5%) and structural symptoms (50%). All patients had tumors limited to Gerota’s fascia without any distant metastasis. Infrahepatic involvement of IVC was seen in 6 patients and in 2 patients thrombosis extended above the hepatic vein (infrahepatic). No perioperative mortality was seen. Postoperative complications were atelectasia in 2 patients and deep vein thrombosis in one which was treated with conservative management. Conclusion:By skillful surgical approach in patients with RCC and IVC involvement, thrombosis can be completely excised without increasing the rate of complications and longterm survival could be expected.

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Introduction: Performing correct research in different aspects of community as well as medical sciences can be a way to resolve many problems. In order to create a systematic knowledge of research method in academic members of Arak University of medical sciences and enabling them in providing proposals and performing researches, a clinical research center was developed. This study is done to investigate the effect of this center on improving clinical researches in the University. Materials and methods: This is a HSR, before and after, interventional study in which, clinical academic members of Arak University of medical science were evaluated. First the information of the pre intervention period was gathered (jan2002-jan2004). Then the intervention was done in the form of developing a research center in Vali-Asr hospital, performing serial research workshops, research conferences, research consultations and planning data bases during a 2 years period. Again data was gathered and then compared to those of pre intervention period. Results: The comparison of pre and post intervention periods showed that in pre intervention period from 38 proposals 30 and in post intervention period from 89 proposals 76 were approved by research committee of the University. In the two pre and post intervention periods 14(46.6%) and 50(65.8%) of accepted proposals were clinical respectively. Also from the view point of quality, 11 and 15 proposals were HSR, 2 and 22 clinical trials and 8 and 8 descriptive, respectively. The number of published articles in first period was 45 and in second 84. Presented articles in internal and external congresses were 33 and 59 in the two periods overally, which 25 and 51 articles were presented in the country and 8 and 8 in abroad congresses, respectively. Conclusion: Regarding the results it seems developing research center in this University and other similar Universities can have a significant effect on the process of clinical researches.

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Introduction: Spinal anesthesia is a conventional way of anesthesia for cesarean section (CS), which nausea and vomiting is a common complication of it. Metoclopramide is the standard medication used for preventing intraoperative nausea and vomiting (IONV). Because of extrapyromidal side effects of Metoclopramide and known antiemetic effects of low-dose Propofol and Dexamethasone, this study was performed to compare the effectiveness of these drugs for preventing IONV. Materials and Methods: This study, is a randomized clinical trial which is done on 144 parturients who were admitted for emergency CS. Patients were divided randomly into four groups and received: Metoclopramide 0.1 mg/kg IV, Dexamethasone 150 g/kg IV, Propofol 0.1mg/kg every 5 minutes from clamping umbilical cord till the end of operation and the fourth group received 2 ml distilled water. During the operation parturients were monitored for IONV. Data was analyzed using Kruskal-Wallis and one way ANOVA. Results: The Number of patients having nausea was lowest in Propofol and highest in Dexamethasone group. There was no statistical significant difference between Dexamethasone and placebo groups. The lowest rate of vomiting was in Metoclopramide and Propofol groups and there was no significant difference between them. Also the lowest level of retching was in the Prepofol group. Conclusion: According to results, the antiemetic effects of Propofol and Metoclopramide are similar. Amount of retching in Propofol was slightly lower than Metoclopramide and administration of Propofol was simple, cheap and without serious complications, so we recommend it for emergency CS.

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Introduction: Sensory stimulation of comatos patients is an important nursing intervention for increasing their LOC and tactile stimulation especially massage is one of the most important stimulations. The nurse as a person, who is responsible for this, must know the effects of this intervention on patients. But there are some conflicts about this intervention's effects especially on vital signs (pulse, blood pressure and respiration). This study was done to determine the effect of massage on comatos patient's vital signs who were hospitalized in intensive care unit. Materials and Methods: This study is a clinical trial. Samples were consisted of 100 comatos patients, divided into two equal groups randomly. The two groups were matched in age, geneder and glascow coma scale. Samples in experimental group received 20 minutes massage on their back, feet and hands in three continuous days. Vital signs in experimental group were measured before and immediately after intervention and vital signs in control group were measured at the same time with experimental group. A check list used was used for collecting data. Data was analyzed using descriptive and analytic statistics (T, paired T and Chi-square tests). Results: Findings showed that massage decreased vital signs significantly as followed: pulse rate and diastolic blood pressure in each three days (p<0.05), systolic blood pressure in first and third days (p<0.05), respiration rate in second day (p<0.05). Conclusion: This study showed that massage can decrease comatos patients' vital signs which can be the indicator of their relaxation and decreasing stress.

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Introduction: Adenosarcoma is a rare uterine tumor composed of benign epithelial and malignant stromal elements. In 20% of cases stroma contains heterologous elements (usually from stratified muscle type). Association between Tamoxifen usage (exogenous strogen) or ovarian thecoma (endogenous strogen) and occurance of this tumor has been reported. This is a case report of a uterine Adenosarcoma. Case: The patient was a 45 years old woman with history of 16 years OCP use who was admitted with a uterine mass and undergone total hysterectomy. Microscopic assessment of slides, stained by H&A, was indicator of Adenosarcoma with cartilage heterologous elements. Conclusion: Uterine Adenosarcoma is a rare tumor. Although there is a few reports of cartilage heterologous elements in uterine Adenosarcoma, this case had multiple cartilage points in stroma. Also in this case, the coexistance of this tumor with long- term OCP use was considerable. 

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Introduction: Flexor tendon entrapment of the digits (FTED) is a disorder characterized by snapping or locking of the thumb or fingers (with or without pain) and called trigger finger. Corticosteroid injections are one of the most commonly used treatments for chronic tendon disorders. Despite their popularity, the systematic evidence for their benefits are largely lacking. This study tries to determine the efficacy of local corticosteroid injection in treatment of trigger finger. Materials and Methods: This is a clinical trial research. Variables including local tenderness, trigerring stage, pain during isometric flexion and passive stretching of the tendon (based on VAS) were evaluated before local injection of corticosteroid and then 3 weeks, 3 months and 6 months after the injection. Data was collected by special forms and analyzed using Chi square and ANOVA Tests. Results: The difference between persence of A1 pulley tenderness in 4 examinations was significant (p<0.0001). The difference between pain induced by isometric flexion and pain induced by stretching the tendon passively in extension was also significant (both p<0.0001). The difference between frequency distribution of triggering was significant (p<0.0001). Patients satisfaction was 90% . Conclusion: The rate of success in local corticosteroid injection was 90% (only with one injection). The high rate of success and low side effects, make this method a suitable treatment for trigger finger.

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Introduction: The objective of this study is to clarify the opinions of scientific board members of Sina university hospital about medical research and the ways of promoting these researches. Materials and Methods: This is a grounded theory study in which we used in-depth interviews and focus group discussions. Scientific board members and different authorities of the hospital such as the chief of hospital and the deputy of education were participated in the study. We used three different FGDs. Each group included about 5 people. We also interviewed the chief, the deputy of education and the head of clinical research center of the hospital. Results: Most of the participants in our FGDs believed that the most important factor for research promotion in the hospital was preparation of a data base of patients. They also mentioned that, different research workshops are important for empowering scientific board members in research. Conclusion: According to our study the most important strategies for research promotion in Sina hospital are data bank preparation, providing repeated research workshops, revising the bureaucratic process of proposal approvals, revising the manner of evaluation of scientific board members and more participation of the department of epidemiology in clinical researches

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Introduction: Dehydroepiandrostrone (DHEA) and its sulfate form is an adrenal hormone and is the most common steroidal hormone in body and despite of other adrenal hormones increases with age, so it is called youth fountain. Recently, DHEA is noticed increasingly because of its multiple effects. Its effect on insulin sensitivity is controversial. In this study the relation between Dehydroepiandrostrone (DHEA) level and Insulin sensitivity is investigated. Materials and Methods: In this cross-sectional analytical study, samples were selected among female relatives of diabetic patients referring to Isfahan Endocrine Research Center. They were divided into three groups including diabetic, impaired glucose tolerance and normal glucose tolerance, each 30 persons. In these groups blood sugar, lipid, CBC, Insulin and DHEA-S levels were evaluated and the rate of Insulin sensitivity was determined using Homeostatic Modle Assessment- Insulin Resistance (HOMA-IR) and the relation between insulin sensitivity rate and DHEA in the three groups was compared. Data was analyzed using one way analysis of variance and t-tests. Results: The mean of variables in the three groups of diabetic, impaired glucose tolerance and normal glucose tolerance for DHEA-S was 127, 113, 129 mcg/dl Insulin 7.7, 1.10, 8.3 mcg/ml HOMA-IR 1.6, 3.5, 1.8 and fasting blood sugar 86, 135, 89 mg/dl respectively. Comparison of mean of variables showed that the difference between DHEA-S in groups was not significant. Also there was no meaningful relationship between DHEA-S and blood sugar. In the group with normal glucose tolerance, DHEA-S with HOMA-IR and insulin had a partial meaningful relation (p<0.06). Conclusion: Overally DHEA has no meaningful relation with insulin sensitivity and HOMA-IR, but this relation is meaningful in the three groups and the relation between DHEA-S with HOMA-IR in the group with normal glucose tolerance is partially meaningful.

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Introduction: Extracts of leaves from Camellia sinensis L contains polyphenolic components with antimicrobial activity. In this investigation biofilm inhibitory effects of black and green tea extracts were defined for five members of enterobacteriacea family including: Enteropathogenic Escherichia coli, Shigella flexneri, Proteus mirabilis, Klebsiella pneumoniae and Salmonella enterica serovar Typhimurium. Because tea is the most widely drunk beverage in Iran, therefore investigation of its effects on enterobacterial biofilm formation and colonization is very important. Materials and Methods: In this experimental study after extraction of samples with Soxhlet extractor in water/ methanol solution, further extraction took place in Ethyl acetate phase. The extracts preserved in 4oC refrigerator after sterilization by 0.44 µ filters. Well diffusion (Kirby Bauer) and broth dilution methods were used for evaluation of minimum inhibitory concentration of biofilm formation in black and green tea extracts treated cultures. Evaluation of biofilm formation was assayed by observation of colony forming unit of cultured bacteria per milliliter by sampling from Erlenmeyer flask wall scratching onto Tripticase soy agar medium and comparing the results with controls. Analysis of data was done using analysis of variance. Results: Biofilm inhibitory effects of black tea were greater than green tea. The concentration of 4.5 mg/ml of black tea and 5mg/ml of green tea had bactericidal effects against examined bacteria. On Mueller Hinton agar, Proteus mirabilis was more sensitive to black tea EPEC was more sensitive to green tea and Klebsiella pneumoniae showed more resistance to both extracts. Conclusion: Due to the fact that gastrointestinal tract is directly affected with consumed beverage, the high concentration of tea entered in lumen can reduce the number of enterobacteriaceae and can reduce their carcinogenic amine products. Thus it plays an important role in inhibition of gastrointestinal lymphoma and colon carcinoma. Also application of tea polyphenols as a food preservative can be useful.

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Background: Metronidazole has antibacterial and antiparasitic action. Therefore it can use for treatment inflammatory diseases as Crohn. The effect of metronidazole on human’s blood lipids to reducing levels of LDL and VLDL and increasing level of HDL is under investigation. Target of this research is consideration effect of metronidazole on hyperlipidemia case of death such as coronary artry disrase. Methods and Materials: This study is a triple blind clinical trial was done on 100 voluntaries between 25-65 years old. with hyperlipidemia. Samples divided in two equal groups. The first group received metronidazol, 500mg, BID, for 10 days, and control group received placebo with the same dose. Lipids of serum were measured before and after using drugs, then data analyzed by SPSS software. Results: In metronidazol group amount of total cholesterol, LDL and Triglyceride were significantly less than placebo group. HDL’s amount in metronidazole group was significantly more than placebo group. Conclusion: Significant effect of metronidazole on reducing harmful blood lipids and increasing useful blood lipids. It can be suggested a probable candidate in treatment of hyperlipidemia. Maybe it can use with this application. Although it needs to more study by meta analysis to validate this effect.

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Background: The role of sex hormones in pain perception and the effect of stress on reproductive system have not been determined yet. The present study investigated the effects of acute and chronic restraint stress on nociception and sex hormones concentration in rats. Methods and Materials: This experimental study was carried out with 47 male and female rats which ranged in weight from 170-230 gr. In order to transmit stress to the rats, they were initially exposed to acute restraint stress (1h) and chronic stress (for two weeks-1h/day). Then they were submitted to tail flick test for nociception evaluation. Sex hormones serum level was measured by radioimmunoassay method. Results were analyzed with Mann-Whitney and Kruskal-Wallis tests. Results: In male and female rats, acute restraint stress had significant increment in latency in the tail flick test. Chronically stress in male rats, was not significant effect on latency time. Chronically stress in females responded to restraint stress with an increase in tail flick latency. Both acute and chronic restraint stress reduced testosterone level in the male rats. In the female rats, only acute restraint stress significantly decrease plasma estradiol level. Restraint stress did not effect on testosterone concentration level in the female and estradiol level in the male rats. Conclusion: Acute restrain stress decrease nociceptive and sex hormon levels in male and female rate but, chronic restraint stress causes sex dependent response.

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Background: Pyelonephrities is the urinary tract infection. Using supplemental dugs may decrease duration of treatment and hospitalization. We studied the effect of vitamin C on the recovery of symptoms due to pyelonephrities Methods and Materials: In this clinical trial, double blind, study, 64 patients with uncomplicated pyelonephrities were assessed in 2 groups randomly. Case group took vitamin C capsules, and control group took placebo capsules. In both groups, primary treatment was ceftriaxon capsules during hospitalization and they took ciprofloxacin capsules for 14 days after discharging. Symptoms and Urinary analysis were assessed in the first day of administration and then on the 7th and 14th days after discharging. Data were analyzed with Chi-Square test. Results: Mean of fever duration in vitamin C group (1.130.34 SD day) and placebo group (1.560.62 SD day) significantly decrease (p=0.001). There was a significant difference in dysuria duration in vitamin C group 2.191.06 SD day with placebo group (2.971.06 SD day) (p =0.007). In flank pain, nausea and vomiting duration difference was not significantly (p≥ 0.05). Conclusion: It seems vitamin C, as a supplemental drug improves some pyelonephrities symptoms, such as fever and dysuria, decreases of the hospitalization period

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Background: Clinical research suggest a relationship between epilepsy and hypogonadism. The aim of this study is to identify the impact of epilepsy induced by kindling with pentylenetetrazol (PTZ) on hormones and some reproductive parameters in male rats. Materials and Methods: Adult male rats (NMRI strain) were divided into control and kindling groups. Kindling was induced by 40 mg/kg PTZ with a 48 hour interval through intraperitoneal injection. Each animal received 13 doses. At the end of the thirteenth dose, animals were weighed and uthenaized with ether and blood samples, collected from their hearts, were used for testosterone, prolactin and FSH, LH assay. In order to examine motility and morphology of sperms, tissue samples from epidydimis were isolated and minced in DMEM/F12 culture medium and were incubated for 15 minutes. Then sperm morphology and motility were studied. Testis were also isolated and weighed. Results: Kindling with PTZ decreased serum levels of testosterone and LH, but it increased rolactin. However, there was no difference in serum level of FSH between the two groups. Sperm motility in kindling group decreased significantly. There were no significant differences in testis weight, but the amount of animal weight losses in the kindling group was more than that of the control group. Conclusion: By changing the serum level of sexual hormones and decreasing sperm motility, PTZ kindling induced epilepsy exerts diminishing negative effects on reproduction.