---

Introduction: Quality of life (QOL) has become an important concept in medical research. Some research has shown a curvilinear relationship between QOL and glycemic control, but some did not so. The aim of this study is to investigate different aspects of QOL and also assess the hypothesis in diabetic patients. Materials and Methods: In a cross-sectional study, a random sample of adult diabetic outpatients (n=110) were selected and completed the WHO-QOL assessment instruments. In addition HbA1c was measured in these patients by calorimetric method. Patients were divided in to 3 groups: 1-good control (HbA1c<7), 2-fair control (7≥HbA1c<9) and 3-poor control (HbA1c≥9). QOL was assessed by measuring physical, psychological, social and environmental domains. Data were analyzed with one way ANOVA (Tukey as post hoc), Chi2 and Mann-Whitney, and correlation tests. Results: A significant correlation was seen between BMI and glycemic control, physical and social aspects, physical and environmental aspects, psychological and environmental aspects, and social and psychological aspects. No significant difference was seen between mean score of different dimensions of QOL in relation to HbA1c changes. The mean score of each dimension in relation to glycemic control showed that, better score of psychological, environmental and social dimensions is seen in patients with fair glycemic control. But regarding the overall score of QOL this is completely reverse. The mean score of physical dimension is decreased with increasing HbA1c. There was no correlation between other domains of QOL and glycemic control. Conclusion: In this survey higher quality of life was seen in fair glycemic control in social, environmental and psychological dimensions, but physical dimension in patients was decreased when HbA1c was increased. Regarding the overall score of QOL it can be seen that the lowest score of QOL is in patients with fair glycemic control which is in contrast with curvilinear hypothesis.

---

Background: There has been an increase in the number of women willing to have a caesarean birth because of their fear of childbirth. It seems the childbirth preparation educational class is a good way to remove or alleviate fears associated with pregnancy and childbirth.This research designed to identify the effect of childbirth preparation classes on childbirth fear on the primiparous women. Methods and Materials: The present study is a clinical trial which was carried out in 2007 at Milad Hospital, with 100 nulliparous pregnant women. Childbirth fear was measured by childbirth attitudes questionnaire. Normal pregnant women in the second trimester with childbirth fear score was 28 or more were randomly selected and dirided into experimental and control group with 50 subject in each qroup. The experimental group attended nine childbirth preparation class sessions and control group received routine antennal care. Results: The mean scored fear of childbirth in case and control group were 39.35±6.96 and 40.71±6.23 respectively. There was not significant difference between two groups. After the sessions, comparing childbirth fear score between two groups in third trimester showed the mean score of childbirth fear among experimental group was lower than control group (29.82+/- 7.18 compare to 38.03+/-9.27), and the differences statistically was significant (p<0.001). Mode of delivery was significantly different between the two groups. Conclusion: Primiparous women attended childbirth preparation classes acquired lower score of childbirth fear in compare to women received routine prenatal care. The results of this research showed relaxation training decreased childbirth fear and increased normal vaginal delivery.

---

Background: Self-medication is one of the existing problems in the treatment cycle of patients that with aging and increased drug use, its side effects increase. The purpose of this study was to assess the factors influencing self-medication among elderly urban centers in Zarandieh based on Health Belief Model Materials and Methods: This descriptive cross-sectional study was conducted on 180 elderly individuals (95 females and 85 males) over 60 in Zarandieh. Data collection tools were a questionnaire designed based on HBM model (perceived susceptibility/ severity, and perceived benefits/barriers) and self-medication checklist. Results: The prevalence of self- medication in the elderly was 31% (33% women and 29% men). The most common reasons for self-medication were previous experience of the disease and its recognition (61%), availability of drugs (60.5%), and good result of their previous treatment (56.7%). There was a significant difference in awareness, sensitivity, severity, perceived benefits and barriers among people with or without self-medication history (P< 001). Conclusion: Noticing the side effects of drugs and the high prevalence of self-medication among elderly, designing educational programs for changing the awareness and beliefs of elderly regarding self-medication is recommended.

---

Background: Postpartum women are a population at risk for sedentary life. Previous studies have shown that self-efficacy is an important determinant of stage of change and exercise adherence. This study evaluates the relationship between self-efficacy and stage of change and physical activity (PA) behavior in Iranian mothers. Materials and Methods: In this cross-sectional study, 300 postpartum mothers were selected randomly from all health centers in Arak. The instruments used in this study included the 7-day PA recall, stages of exercise adoption tool, and self-efficacy for exercise scale. Data analysis was performed using SPSS software. Results: Ninety-one percent of the participants were in the pre-contemplation, contemplation, and preparation stages of change. Mean score for moderate PA was 38.94±40.5 minutes a week. Significant relationships were found between the stages of PA behavior change and METs of weekly energy expenditure from moderate activities (r=0.60, P<0.001). Also, statistically significant relationships were found between self-efficacy and the stages of PA behavior change (r=0.50, P<0.001) weekly energy expenditure from moderate activities (r=0.40, P<0.001), and pre-pregnancy PA behavior (r=0.39, P<0.001). Conclusion: The level of PA of the participants was less than the recommended minimum level for regular PA behavior (150 minutes of moderately intense PA per week). In this population, self-efficacy plays an important role in PA behavior and it should be taken into consideration in designing interventions for improving PA behavior.

---

Background: Shigella dysenteriae one of the main causes of diarrhea in humans, but there is no vaccine against it. IpaD protein is one of the most important virulence factors in pathogenic shigella. The cloning N-terminal ipaD genes with ctB genes that have a role in adjuvant and carrier as recombinant vaccine can caused enhance the mucosal immune response.

Materials and Methods: Designing primers for genes ctB and ipaD were carried out based on the construction of gene cassettes, respectively. PCR reactions were performed to amplify the fragments and amplified fragments were cloned into pGEM-Teasy vector. Both the vector cut by restriction enzymes HindIII and XhoI and ipaD gene to gene ctB finally were Fusion. The ctB-ipaD gene cassette and expression vector pET28a(+) cuted by SalI and HindIII restriction enzymes. The cloning ctB-ipaD cassette was performed in the expression vector and expression of gene cassettes.

Results: In this study, the N-terminal ipaD as vaccine candidate antigen was genetically linked to the C terminal of ctB which has a carrier and adjuvant role. Fusing ctB-ipaD in the expression vector pET28a(+) is confirmed by sequencing, PCR and digested with restriction enzymes. The recombinant proteins produced is confirmed by SDS-PAGE and Western blot.

Conclusion: According to previous and similar studies, product cassette ctB-ipaD and expression its was expected. Is hoped to protein expression of this gene cassette and the production of antibodies could be achieved the candidate vaccine against Shigella.