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Background: Allah descended the holy Quran to guide the human and for instructing him the principles of life. The holy Quran always guides the human in the best of ways. Accordingly, the aim of this study was to explore the manifestation of Quran reading in the life of faculty members, students, and clerks’ at Arak University of Medical Sciences (AUMS). Materials and Methods: This qualitative study was done through content analysis method, and the data were collected through interviews. The study was initiated with purposive sampling and continued by theoretical sampling 30 individuals were interviewed over a 2 month period at AUMS. The data were analyzed based on the content analysis method. Continuous-comparative analysis was utilized for data analysis. Results: Data analysis showed the manifestation of miracles in life, achieving internal peace, having humanistic communication, decision making based on Quran instructions, being patient and tolerant, behaving based on Quran instructions, and saving as secondary codes of the effect of Quran reading on participants’ life, and “the effect of holly Quran on the whole dimensions of life” as the main code or theme. Conclusion: In this qualitative study, using triangulation sources, the effects of Quran reading on the faculty members, students, and clerks’ life at AUMS were identified more profoundly than the quantitative methods. On the other hand, the effect of Quran reading on all dimensions of the participants’ life, as the theme of this study, is a very important finding which is completely in accordance with Allah’s words in Quran. Therefore, in order to achieve more divine benefits from Quran, reading the holy Quran is recommended to academians and all people, in general, so as to compete for using Quran more.

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Background: The main advantage of regional anesthesia is the elimination of post-operative pain without the need for narcotics, which leads to a more rapid outpatient recovery and faster return to consciousness in pediatric patients. The aim of this study was to compare caudal anesthesia with midazolam and neostigmin co-administered with bupivacain in reduction of post-operative pain in lower abdominal surgery in pediatrics (2- 8 years old). Materials and Methods: In a double-blind clinical trial, 45 pediatric patients were randomly allocated to midazolam, neostigmine, and placebo groups. Induction of anesthesia was done with inhalation of halothane and O2. Bupivacaine 0.25% in 0.5 ml/kg with midazolam in 50μ/kg was administered in caudal form to the first group, and bupivacaine 0.25% in 0.5 ml/kg with neostigmine in 2 μg/kg dose was administered to the second group. The third group received the placebo plus bupivacaine 0.25% in 0.5 ml/kg. Results: Mean durations of analgesia in neostigmin, midazolam, and placebo groups were 16.5± 0.25, 12.3±0.22, and 6±0.11 hours, respectively (P<0.001). Also, in the neostigmin group, mean score of pain in outpatient recovery 6 , 12 , 24 hours post operatively was less than that in the other two groups (P<0.001). Conclusion: Duration of analgesia period in neostigmin group was more than that in midazolam and placebo groups

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Background:Hypotension is one of the common complications of spinal anesthesia. Ephedrine with sympathomimetic effects is the selective vasopressor in obstetric. The aim of this study was to compare the effect of different doses of ephedrine on hypotension due to spinal anesthesia. Materials and Methods: This randomized double-blind clinical trial included 120 parturient patients with ASA Ι and П scheduled for cesarean section under spinal anesthesia at Fatemy Hospital of Hamedan in 2008.The patients were divided into three groups. Immediately after spinal anesthesia, the patients randomly received 10 mg ephedrine, 20 mg ephedrine, or placebo intravenously. Then vital signs were recorded every minute for 5 minutes and after delivery every 10 minutes till the end of the surgery. Results: Incidence of hypotension in 10 mg ephedrine, 20mg ephedrine, and placebo groups was 37.5,12.5, 85%, respectively (P<0.001 ). The difference in the prevalanceof hypotension was significant between the three groups (P<0.05).Based on Chi2 test, the prevalence of hypotension in 20 mg ephedrine group was less than 10 mg ephedrine group, and in the 10mg ephedrine group it was less than the placebo group (P<0.05). Conclusion: Intravenous injection of 10mg and 20mg ephedrine to parturient patients undergoing cesarean section reduces the incidence of hypotension, though thisdecrease is more significant with 20 mg ephedrine.

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Background: Noticing the sensitivity of measles virus to temperature and light, maintaining its stability is highly important in live vaccines. The aim of the study is to evaluate the stability of measles vaccine produced by AIK-C strain. Materials and Methods: In this experimental study, three lyophilized vaccine vials were incubated at 37˚C for one week and their stability was evaluated via accelerated test. In addition, reconstituted vaccines were incubated at 4˚C, 25˚C, and 37˚C for 0, 4, 8, 12, 16 hours after reconstitution and their remaining infectious virus titer was measured using CCID50 method. Half-life of the reconstituted measles vaccine was evaluated according to linear regression analysis. Results: When the reconstituted vaccine was incubated at 4˚C, 25˚C, and 37˚C, the titer loss per hour was equal to 0.05, 0.1 and 0.2 Log10 CCID50, respectively. Also, the half-life of this vaccine at these temperatures was 5.31, 2.26, and 1.36 hours, respectively. Conclusion: The loss of potency for measles vaccine produced by AIK-C strain is 0.33 Log after storage at 37°C for one week, while the reported amounts for commercial vaccines such as Mevilin-L, Attenuvax, Edmonston-Zagreb, and Rimevax are 0.7, 0.7, 1 and 0.78, respectively. Lyophilized and reconstituted vaccine containing AIK-C strain is more stable in comparison with Edmonston B, Schwartz, Biken-CAM, and Leningrad strains. The stability of the reconstituted AIK-C strain vaccine is similar to Moraten strain at 37˚C.

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Background: There is some evidence of antinociceptive effect of hydroalcoholic extract of Apium graveolens fruits in some recent studies. In present study, the possible mechanism of this effect of extract has been evaluated. Materials and Methods: In this experimental study, 48 male mice were examined. To evaluate the antinociceptive effect of extract, formalin test was used. The possible mechanism of extract was investigated with interaction of 3 drugs [Naloxone (2mg/kg), Dextromethorphan (20 mg/kg), L-NAME (20 mg/kg)] and Hydroalcoholic extract of apium graveolens fruits.(400 mg/kg) Results: Administration of Naloxone had no effect on antinociception of Hydroalcoholic extract of apium graveolens fruits. There was no significant difference between Dextromethorphan Plus extract and extract group in first phase. Pretreatment with L-NAME, decreased antinociceptive effect of extract in second phase of formalin test(p<0.05) Conclusion: Dextromethorphan has analgesic effect in acute phase and its interaction with hydroalcoholic extract of apium graveolens fruits shows at least, part of antinoceceptive effect of extract is via NMDA receptors in acute phase. On the other hand, it seems part of antinoceceptive effect of extract is via inhibition of NO syntheses in chronic phase. Extract of Apium graveolens may be effect via other neural pathways such as dopamine, noradrenalin or serotonin that need more research.

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Background: Pain is a complex problem, which can affect patients' physical and psychological condition. Inadequate postoperative pain control has adverse effects on the patients' physiological, metabolic and mental condition. Adding new supplement will increase the duration of analgesia. This study aimed to comparison of intratechal neostigmine and midazolam in increasing the time of postoperative analgesia. Materials and Methods: In this randomized double blind clinical trial, 60 patients with ASA class Ι, II who were candidate for elective colporrhaphy surgery under spinal anesthesia were randomly divided into 3 groups of 20 patients. All patients received hyperbaric lidocaine 5% and groups I received 1 mg midazolam, groups II received 50 μg Neostigmine and groups III received 0.5 cc normal saline additionally. Then according VAS pain score, postoperative painless duration and pain score were compared between groups by running SPSS software. Results: Mean of painless duration in the Midazolam, Neostigmine and control groups were 98.4±18.2, 74.5±32.6 and 64.5±9.9 minutes respectively which was significantly longer than in Midazolam group (p<0.001). The mean dose of requested analgesia in first 24 hours after surgery was significantly lower in Midazolam group (p<0.001). Conclusion: Inthrathecal midazolam and Neostigmine as a complementary medication to lidocaine 5% can increase painless duration in colporrhaphy surgery and midazolam is more effective than Neostigmine. Key Words : midazolam & Neostygmine , Spinal anesthesia, painless time , colporrhaphy

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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: The hypothesis that non-secretor status of individuals makes them more susceptible to certain bacterial infections and they might be at a greater risk of metabolic syndromes and autoimmune diseases motivated us to evaluate the relationship between secretor status and risk factors for duodenal ulcer in the present study.

Materials and Methods: This case-control study was done on 120 patients with duodenal ulcer, gastric ulcer, and gastric cancer undergoing endoscopy, and a control group including 120 healthy individuals. Secretor status was determined by saliva and the association of some risk factors with the prevalence of disease was determined by a questionnaire. The results were analyzed by SPSS software version 16.

Results: Overall, 27.5% of the patients were non-secretor and 72.5% were secretor, whereas 20.8 % of the controls were non-secretor and 79.2% were secretor. There was not a significant relationship between secretor status and the incidence of gastrointestinal diseases. However, some risk factors, such as gender, smoking, and physical activity, were significantly associated with gastric disease.

Conclusion: The statistical analysis showed that there was not a significant association between secretor status and prevalence of gastric disease. According to the results, gastrointestinal diseases are more common in men than women and in smokers more than nonsmokers. Furthermore, physical activities reduce the incidence of this disease.

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Background: Caesarean section is one of the most common gynecologic surgeries. Nausea and vomiting after pain is the most common side effect of surgeries, today, we most widely use of serotonin receptor antagonists, that are most effective antiemetic and have less side effect rather than other drug. Ondansetron is typical serotonin antagonists.

Materials and Methods: This is a randomized, double-blind clinical trial on 162 women undergoing cesarean section. 4mg intravenous ondansetron was given to first group and 8mg oral ondansetron was given to second group and thired group recived placebo. Blood pressure and heart rate were measured before and immediately after performing spinal and every 5 minute until 20 minute. Post operative nausea and vomiting and APGAR score were recorded after operation in recovery and 2, 4, and 6 houres after surgery.

Results: There was no significant difference among 3 groups according to age, gravidity, mean atrial pressure and heart rate before and during surgery. Nausea and vomiting in oral and intravenous groups at recovery, 2 and 4 hours after surgery were significantly less nausea and vomiting than placebo group (p<0.05). Whereas there was no significant difference between oral and intravenous groups.

Conclusion: It was concluded that using oral ondansetron with the same antiemetic effect is more convience to women undergoing cesarean section with spinal anesthesia.

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Background: There is abundant evidence indicating that inflammatory mechanisms within the central nervous system contribute to cognitive impairment via cytokine-mediated interactions between neurons and glial cells. BAT1, a member of the DEAD-box family of RNA helicases, appears to regulate the production of inflammatory cytokines associated with AD pathology. In the current study BAT1 -22 promoter polymorphism was analyzed in AD and control subjects.

Materials and Methods: In this case-control study, genomic DNA from peripheral blood samples of 153 Alzheimer’s patients and 153 healthy controls was extracted using salting-out method. DNA analysis was performed by PCR-RFLP method and p<0.05 was considered statistically significant.

Results: After genotyping and statistical analysis the results failed to show any association between BAT1 -22 promoter polymorphism and sporadic Alzheimer’s disease.

Conclusion: BAT1 -22 is not associated with Alzheimer’s disease in Iranian population and so has no effect on predisposition to sporadic Alzheimer’s disease.

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Background: Unpleasant side effect of awareness within general anesthesia is potentially an important concern in patients. The patient may sleep during anesthesia and feels the pain due to loss of pain suppression of sensory perception of pain during surgery. The aim of this study is to determine the effect of BIS monitoring on level of awareness during anesthesia in women undergoing elective caesarean section.

Materials and Methods: In this double-blind, randomized clinical trial, 214 ASAI–II patients, over 15 years of age, candidate for elective cesarean section were included in the study. Patients randomly divided to two groups of anesthesia with and without BIS monitoring. Patients were assessed for awareness within anesthesia immediately, 24 hours, and 3-6 days after operation.

Results: From 107 patients without BIS monitoring, 8 patients (7.4%) suffered from awareness during anesthesia and their awareness score was two and greater than two. While none of the patients in the BIS group experienced awareness during anesthesia. Level of awareness during anesthesia in the control group was significantly more than the BIS group (p<0.0000).

Conclusion: The incidence of awareness during anesthesia is significantly lower in BIS monitored group than the control group.

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Background: Atrial fibrillation (AF) is the most common complication after coronary artery bypass graft surgery (CABG). This complication causes an increase in morbidity and mortality after CABG and also increases the length of ICU stay and hospitalization. The aim of this study is to evaluate the prophylactic effect of amiodarone in reducing the incidence of post CABG atrial fibrillation.

Materials and Methods: In this clinical trial study, 204 patients, candidate for elective CABG, entered the study according to inclusion and exclusion criteria, and randomly divided into two equal groups. The case group received 300 mg of intravenous amiodarone before anesthesia induction and the control group received normal saline. Incidence of AF was recorded until 24 hours after CABG.

Results: The incidence of post CABG AF was 16 patients in the case group and 35 patients in the control group. Comparison of the frequency of AF between groups by Chi square analyses showed a significant difference (p=0.037) and the incidence of AF was significantly lower in the amiodarone group.

Conclusion: In total, amiodarone could significantly prevent the incidence of atrial fibrillation after coronary artery bypass surgery. In this study, patients took this medication only in the first 24 hours, while in some studies, this drug has been prescribed for even 14 days.

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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: 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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Background: The prediction models for infertility treatment success have presented since 25 years ago. There are scientific principles for designing and applying the prediction models that is also used to predict the success rate of infertility treatment. The purpose of this study is to provide basic principles for designing the model to predic infertility treatment success.

Materials and Methods: In this paper, the principles for developing predictive models are explained and then the design of such models in infertility treatments is described in more details by explaining one sample.

Results: The important principles for models that firstly are described are: identifying and defining the purpose, expected function of model, input data that will be used to develop a model: type of intervention or diagnostic procedures that can lead to changes in the samples and output definition or expected result of model function. Further, characteristics of predictive factors in final model, drawing the information flowchart, internal and external validation and attention to the analysis programme of results are the important subjects that have been described.

Conclusion: If predictive models are used properly, can help treatment team and patients to achive best treatment in ART.

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Background: Azoospermia is defined as the absence of sperm in the semen and is divided in two types; obstructive and non-obstructive azoospermia. Non-obstructive azoospermia include approximately 60% of azoospermia patients. Several genetic and environmental factors can be involved in the development of non-obstructive azoospermia. Until now, several genes have been introduced as the causing factor of the azoospermia that are involved in spermatogenesis and testicular development. These genes are located on Y and/or autosome chromosomes .The aim of the present study was to investigate Y chromosome microdeletions and STAG3 gene mutations in Iranian males with non-obstructive azoospermia.

Materials and Methods: In this study, peripheral blood samples were obtained from 122 men with idiopathic non-obstructive azoospermia and 100 Normo-sperm men who had at least one child and DNA was extracted. Samples were investigated for the presence of Y chromosome microdeletions by Multiplex PCR. Then, existence of probable mutations in exon 7 of STAG3 gene was investigated using MSSCP (multi-temperature single-strand conformational polymorphism) method.

Results: 13 patients (10.66%) had Y chromosome microdeletions, but none of the subjects showed mutation in exon 7 of STAG3 gene. The Y chromosome microdeletions were found in none of the control individuals.

Conclusion: The results showed that Y chromosome microdeletions are the most important cause of non-obstructive azoospermia and should be considered as the main candidate for male infertility diagnostic tests. Mutations in the STAG3 gene are not common among non-obstructive azoospermia patients.

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Background and Aim: Ankle injuries are among the most common musculoskeletal injuries in sports, accounting for 10% to 15% of all injuries. Since controlling pain and inflammation in ankle sprains is one of the main goals of treatment, we decided to compare the therapeutic effects of Cheleh daghi Herbal ointment with a common therapeutic gel such as piroxicam.
Methods & Materials: This study was performed as a double-blinded clinical trial for 6 months from January 2019 to August 2019. After referral, all patients completed the consent form, and the patient's details and study variables were recorded by the evaluator in the research form. To measure joint inflammation, we measured the ankle with a meter tape in the ankle area (cm) and recorded. A goniometer was also used to measure the degree of ankle movements. The symptoms of ankle ecchymosis were also checked by physical examination and observation and recorded in the checklist. Statistical analysis was performed in SPSS V. 18 using statistical tests (the Mann-Whitney U test, the Chi-square, and the independent t-test).
Ethical Considerations: The Research Ethics Committee of Arak University of Medical Sciences approved the study (Code: IR.ARAKMU.REC.1396.55) and registered by the Clinical Trial (Code: IRCT2017071720258N53).
Results: The Mean±SD age in the control group was 34.2±8.6 years, and in the case group was 35.4±8.9 years. There was no statistically significant difference according to the Mann-Whitney U test (P<0.05). Also, the Mean±SD height in the control group was 1.7±0.12 m and in the case group was 1.72±0.11 m. The results also showed a statistically significant difference between the two groups studied before and after the intervention regarding the mean indicators of pain, swelling, and inflammation around the joints (P<0.05).
Conclusion: The results of our study showed that Cheleh daghi Herbal ointment for 3 weeks could be more effective in reducing local pain and inflammation than piroxicam gel treatment.

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Background and Aim: The COVID-19 pandemic is capable of severely affecting the mental health of health care workers, who are at the forefront of this crisis; while the official staff of health organizations is facing the same danger. Therefore, monitoring awareness and other mental health issues to understand the mediating factors and awareness of appropriate interventions is a necessary priority. Therefore, the purpose of this study was to compare the level of knowledge, attitude, and practice of medical and administrative staff in facing the COVID-19 virus.
Methods & Materials: This cross-sectional descriptive study was performed on 160 medical and administrative staff of Jahrom hospitals in 2020. Demographic information questionnaire and researcher-made questionnaire of knowledge, attitude and practice of medical personnel about coronavirus (Covid 19) were used to collect information. Data were analyzed using SPSS software version 21 and descriptive and inferential statistical tests.
Results: 65% of subjects were women and the rest were men. In most of the answers given to each item in both groups, the medical and administrative staff’s answers were close to each other. In the case of the statement "I am more likely to get a corona", 54.4% of the medical staff chose the strongly agreed option, while this percentage is 16.5% for the administrative staff. This indicates that the medical staff is very afraid of getting COVID-19. According to the results, the mean knowledge scores of the medical staff (with an average of 94.35) were significantly higher than the administrative staff (with an average of 87.75) (t=5.96, p<0.001). But the performance of administrative staff (with an average of 93.14) is significantly higher than medical staff (with an average of 87.17) (t=-2.710, p=0.007). No significant difference was observed between the mean scores of the attitude scores of both groups (p=0.438).
Conclusion: The results of this study showed that the level of awareness in the face of corona virus in the administrative staff is significantly lower than the medical staff, but the administrative staff has a better performance in facing of the corona virus than the medical staff. It seems that educational measures are necessary to increase the awareness of these people.