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Introduction:  Oxydative  stress may  cause  preterm  labor.  Antioxidants  found  in  fruit  and  vegetable  prevent  the  oxidative  stress  reaction.  In  this  study  we  intend  to  answer  the  question: Is  any  correlation  between  preterm  delivery  and  use  of  fruit  and  vegetable  before  and  during  pregnancy?
Materials  and  Methods:  It  is  a  case  control  study  in  which  43  women  with  preterm  delivery  and  86  women  with  term  delivery  who  delivered  in  Arak  maternity  hospital  were  selected  randomly. (sample  size  was  calculated  with  α=5%, β=20%). The  two  groups  were  matched  for  socioeconomic  status, maternal  age , gravid  and  vitamin  supplement  consumption.  Data  was  collected  with  a  questionnaire  that  includes  demographic information, and  use  of  fruit  and  vegetable (proportion  in  week )  during  the  three  month before  and  second  trimester  in  pregnancy.  SPSS software  and  K-S, t (pooled), Mann-Whitney, Chi  square  and  logistic  regression  were  used  to  analyze  the  data.
Results: This  study  showed  that  the  mean  use  of  fruit  and  vegetable  consumption  calculated  during  the  three  month  time  before  pregnancy  was  20.64±2.48  in control  group  and  32.23±1.52  in  case  group  and  the  relationship  was  significant  (p<0.00001)  and  the mean.
Use  during  the  second  trimester  was  21.84±4.75  and  34.84±5.58  in  case  and  control  groups  respectively  that  was  significant  (p<0.00001). Accuracy, sensitivity  and  specificity  of  regression  model  were  90%, 87% and  91/9%  respectively.
Conclusion: This  study  showed  that  fruit  and  vegetable  consumption  is  related  to  the  decreased  incidence  of  preterm  labor. Based on  our  model, preterm  labor  can  be  prevented  and  predicted  with  enough  consumption  of  fruit  and  vegetables.
 

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Introduction: Tension  headache  is  the  most  common  type  of  headache. Tension  headache is  mostly  caused  by  stress, anxiety  and  depression.  Treatment  is  by  pharmacological  and  nonpharmacological  methods.  Nowdays  nonpharmacological  methods  are  used  increasingly. This  is  a  response  to  the  over  use  of  drugs, side  effects  and  cost.  The  purpose  of  chronic  tension  headache.
Materials  and  Methods: This  research  is  a  clinical  trial  study. 25  women  suffered  from  chronic  tension  headache  were  treated  by  massage  during  5  weeks. Samples  were  asked  to  record  headache  indexes  in  a  checklist  four  times  a  day  (before  breakfast, before launch , before  dinner  and  before  sleep)  through  these  5  weeks. Data  from  the  first  and  fifth  weeks  were  recorded  as  pre  and  post intervention  data and  data  from  the  second, third  and  fourth  weeks  of  investigations  were  recorded  as  the  data  during  intervention.  During  the  intervention  samples  were  treated  twice  a  week  for  20  minutes  each  time  with  the  friction  massage  on  posterior  parts  of  the  neck  and  shoulders.  Headache    indexes  included: intensity, frequency  and  duration  of  headache, headache  intensity  was  recorded  using  11  points  criteria. Headache  frequency  was  measured  by  calculating  the  days  of  headache  in  a  week  and  the  duration  of  the  headache  was  calculated  by  dividing  sum  of  headache  hours  in  a  week  to  the  frequency  of  attacks. Data  was  analyzed  by  analysis  of  variance  and  Tukey  test.
Results: Results  showed  the  positive  effect  of  massage  in  which  headache  indexes  showed  a  meaningful  difference  in  three  stages  of  pre, during  and  post  intervention (p<0.01).
The  recovery  rates for  each  index  were  52%, 28%  and  57%  respectively.
Conclusion: Massage  therapy  resulted  in  the  reduction  of  intensity, frequency  and  duration  of  tension  headache  and  can  be  useful  in  treatment  of  tension  headache .

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Introduction: Sex  ratio  is  referred  to  male, female  ration which  is  usually  1.06. This  ratio  is  decreased  during  the  last  few  years. One of  its  reasons  seems  to  be  poisons  and  environmental  pollutions  such  as  cigarette  smoke.  In  this  investigation  we  studied  the relationship  between  fathers  cigarette  smoking  and  sex  ratio  in  children.
Materials  and  Methods: This  is  a  historical  cohort  study.  Study  population  were  neonates  born  in  Arak  hospitals  during  summer  and  autumn  1383.  Sample  size  was  determined  710  neonates, based  on α=5%, β=10%. Sampling  method  was  census  in  which  all  newborns  with  inclusion  criteria  were  selected  and  questionnaires  were  filled. Samples  were  divided  into  three  groups. 1-newborns  with  nonsmoker  fathers  2- newborns  with  smoker  fathers (less  than  20 cigarette  a day) 3- newborns  with  smoker  fathers  (20  or  more cigarettes  a  day) (fathers  cigarette  smoking  at  least  3  months  before  conception  in  second  and third  group). Newborns  sex  ratio  was  determined  in  each  group  and  caparisoned. Data  analysis  was  done  by  frequency, ratio, mean  and  standard  deviation  indexes  and  k-s, leven, t, mann-whitney, chi  square  tests  and  relative  risk, using  SPSS  software. At  all  stages  study  Helsinki  declaration  was  regarded.
Results:  Overall  sex  ratio  was  1.04. This  ratio  was  1.272  for neonates  with  nonsmoker  fathers  and  0.77  for  neonates  with  smoker  fathers. Also  sex  ratio  in  newborns  with  smoker  fathers  using  less  than  20  cigarettes a  day  was  0.846  and  for  those  with  fathers  using 20  or  more  was  0.60. Based on  chi  square  there  was  a  meaningful  relationship  between  the  three  groups (p<0.00001). Relative  risk  in  low  cigarette  group  was  1.23  and  in  high  cigarette  group  1.42.
Conclusion: Based  on  findings  it  seems  that  fathers  cigarette  smoking  near  conception  results  in  decreasing  sex  ratio  and  the  increased  use  of  cigarettes  the  decreased  born of  male  neonates. 
 

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Introduction: Dysmenorrhea is one of the most prevalent complaints of women which is due to Prostaglandin release and is treated by chemical drugs. Today regarding side effects of these drugs, scientists are increasingly moving toward using herbal drugs. This study is planned to comparison the effects of Thymus Vulgaris and Mefenamic acid on primary dysmenorrhea.
Materials and Methods: This is a clinical trial study. Target population was women suffering from primary dysmenorrhea and study population was women reffering to marriage consulting center. Based on α=0/5, β=0/20, sample size was calculated 214 which were divided into two groups randomly. Samples were asked to determine their pain severity before using the drug, by a visual scale (0-10cm). In the study group each sample cosumed 15 grams Thyme leaf brewed in a glass of water and in control group samples used 250mg Mefenamic acid capsules. Then pain severity was determined again 1, 2 and 3 hours after using drugs. Data was analysed by mean and standard deviation indexes and K-S, man-whitney and chi-square tests. Helsinki declaration was regarded at all stages of the research.
Results: Pain severity mean, before using the two drugs had no significant difference between groups. In each group, pain severity was significantly decreased before and after using the drug (p=0.05). But the rate of decreasing pain between the two groups showed no significant difference.
Conclusion: Regarding results, it seems both Mefenamic acid and Thymus Vulgaris decrease pain at the same level which seems to be due to Thyme,s antiprostaglandin and antispasmodic effects.

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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: Hemorrhoid is a common disorder causing pain, and its standard treatment is Hemorrhoidetomy. Also, pain is a common problem after surgery and control of it prevents physiologic and psychiatric complications. Kegel exercise is one of the relaxing and none invasive methods for reduction of pain. In this study the effect of kegel exercise on pain relief post hemorrhoidetomy is investigated. Materials and Methods: This study is a single blind randomized clinical trial. Samples were patients admitted for hemorrhoidetomy to Shahid Sadooghi hospital of Yazd. They were randomly divided in two experiment and control groups (each group 30 persons). Before operation, Kegel exercise was educated to experiment group and after surgery pain range were recorded. Data was analyzed using descriptive and analythic statistics (t and Pearson correlaton tests). Results: Findings showed that the mean score of post surgery pain in the first 48 hours after operation in experimental group was 26.50±5.82 and in control group 31.26±5.94, that have meaningful difference (P=0.003). Regarding the amount of analgesics, the mean use of analgesics after surgery in experimental group was 18.9±14.83 and in control group 52.83±29.89 which has meaningful difference (P=0.00001). Type of analgesics in the two groups 18, 24 and 48 hours after surgery with p=0.04, p=0.04 and p=0.05, had significant difference. There were not any correlations between pain intensity and numbers of Kegel exercise. Conclusion: Based on results, Kegel exercise decreased post hemorrhoidetomy pain and using analgesic drugs was decreased in experimental group. Preoperative education of this method is useful in pain management postoperatively.

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Introduction: Preeclampsia is one of the three major causes of death in pregnant women. Researcher believed that consuming proper nutrients can be a solution. In the last few years, the effect of type of fruits and vegetables on prevention of preeclampsia has been investigated, but there are still questions about the proper amount (unit) of fruits and vegetables. Materials and Methods: This case-control study was done on pregnant women referring to Thaleghani hospital in Arak. 35 pregnant women with preeclampsia were selected as case, and 70 healthy pregnant women as control group. The two groups were matched. Data were collected with a questionnaire consisting of two parts, first demographic information and second information about the amount of consumed fruits and vegetables. Each woman was questioned about food consumption 3 month before and during second trimester of her pregnancy. Portion of fruits and vegetables was calculated per week and then compared between the two groups. K-S, Leven, Mann-Whitney, and Chi2 tests were used for analyzing data. Results: In preeclampsia group, 3 month before pregnancy mean consumption of fruits and vegetables was 7.69±16 per week, and in healthy group was 12.43±1.87. There was a significant difference between the two groups (p=0/029). In the second trimester of pregnancy the mean was 11.03±1.6 and 13.95±0.98 in case and control group, respectively. Differences were significant (p=0.03). Incidence of preeclampsia was increased in group with less than 25% consumption of fruits and vegetables before pregnancy (less than 5unit per week) (P=0.05, OR:2.32, 95%CI:1/7, 7/24). This difference was also significant in the second trimester (P<0/03, OR:2.57, 95% CI:1/4, 54/29). Also in women who consume less than 8 units per week, the incidence of preeclampsia was increased. Conclusion: It was concluded that it seems there is relationship between consumption of fruits and vegetables with decreasing occurrence of preeclampsia. So researchers suggest that high risk groups of women be identified and educated to consume fruits and vegetables.

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Abstract Background: This study was done to asses the educational barriers and problems, and improves the problems from the medicine students’ viewpoint in Arak, 2006-07. Materials and Methods: In this descriptive, cross-sectional study, a valid and reliable questionnaire concluding 71 questions about problems related to education, equipments, personnel, professors, motivation and evaluation methods was distributed among all interns (n=28) and externs (n=44). Results: Inappropriate duration of basic science education was 68%, too much general lesson was 86% did not provide a task description was 84.5% and lesson plan was 91.7% were considered at the start of course. Most of students were asked for learning clinical skill on mulage before practicum (84.5%) and internship (79.9%). Most of students believed that teaching pathology (86.1%) and pharmacology (97.3%) of each course may present by that course in clinic. Lake of sufficient diversity (71.8%), training equipment and inappropriate conference hall (54.9%) and library (76.1%) were considered. Inappropriate behavior 81.7% and corporation with students (58.6%) were reported. About professors, the mean was 16.8±5.1. The most of students worried about their unclear occupational future (87.1%) and 78.6% were believed that exams can not evaluate their knowledges. Conclusion: Asking for lesson plan present in start of course and clinical skills learning on the mulage before practicum and internship are including students demands that can easy to do. Umlaut of basic and clinical courses and teaching pathology and pharmacology courses in clinic can facilitate the basic and clinical courses learning.

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Abstract Background: Study of the nursing and midwifery instructors and students viewpoints, as two important groups in teaching proccess, can be effect on codifying and evaluating of educational program and effectiveness in this courses. The purpose of this study was to determine the effective educational and evaluation program on clinical learning from the nursing and midwifery instructors and students’ opinion in Arak University of Medical Sciences, 2008. Materials and Methods: In a descriptive study in 2008, all students and clinical lecturer (n=84) were studied. The data gathering tool was a questionnaire consisted of three parts, demographic information, clinical education and evaluation program. Results: The age mean of the teachers and students respectively were 38±3.14, 22.2±2.18 years and the mean of theoretical and clinical history teaching of instructors, respectively, were 6.04±2.48 and 10./95±2.9 years. The most percents of instructors (91.3%) emphasized on considering the communicating skills education in education program. The most percents of students (85.2%) emphasized on considering the critical thinking and moral students support. Also, the most percents of instructors (78.3%) emphasized on step by step evaluation. While, the most percents of students (90.2%) emphasized on the effect of teachers evaluation and reflected the results to them. Conclusion: Hope to, this study results can be helpful to effective nursing and midwifery students’ lesson planning and evaluating.

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Background: Mother and newborn's health is one of the important indexes in health services of every country and one of its main assessment indexes is the number of normal deliveries in each country. Identifying the effective factors in labor helps the right selection of patients the process of delivery. The main goal of this study was to assess the association between fetal sex and unsuccessful labor process which result in cesarean section. Materials and Methods: This observational cross-sectional study was conducted on 1537 pregnant women admitted for delivery to Taleghani Hospital of Arak during 6 months. Data were catch through a check list consisting of obstetric history, physical examination, labor process, and lab tests coupled with interview and observation. The results were analyzed through Chi2, chance ration analysis, and t-test. Results: Of the 1537 pregnant women, 74% had normal delivery and 26% underwent cesarean section. Of all infants, 35.1% of those delivered by normal vaginal delivery and 13.4% of those delivered by cesarean section were male sex while 38.9% of the infants in the normal delivery group and 12.6% of those in the cesarean group were female. These results did not show any association between fetal sex and type of delivery. Overall, 36.5% of the deliveries done through cesarean section were due to dystosia (18.1% male and 18.4% female) (P=0.934). Also,14.3% of the newborns delivered through cesarean sction due to fetal distress were male and 10.8% of them were female (P=0.162) while 10.5% of newborns delivered through cesarean section due to meconium were male and 8.5% of them were male (P=0.359). Conclusion: It appears there is no association between fetal sex and labor disorders which result in cesarean section.

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Background: Dysmenorrhea is a common problem in women of reproductive age and despite the current treatments, it still remains a common problem in women’s health. This study was done to determine the effect of aromatherapy on pain severity in primary dysmenorrhea. Materials and Methods: This randomized clinical trial was done on 108 students with primary dysmenorrhea with pain score of 2 and 3 based on the multidimensional spoken criteria. After random allocation, the participants received massage with almond oil, massage alone, and massage with a mixture of lavender and peppermint essential oil a week before menstrual period until the presence of pain in two continuous cycles. During cycles zero, one, and two, the participants recorded the highest level of pain during the first, second, and third days according to the visual analogue scale. Data were analyzed using SPSS software. Results: There was a significant difference in the total of the most pain in days 1, 2, and 3 among the groups(p=0.038). A reduction was observed in massage and aromatherapy groups(p=0.014). There were significant differences in within group comparisons (p=0.002) for zero and first cycles(p=0.016) and first and second cycles(p=0.002). Conclusion: Aromatherapy reduces menstrual pain and considering the prevalence of dysmenorrheal, the low price, and harmless nature of this essence, its application in relieving menstrual cramping and pain is recommended.

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Background: In addition to known environmental and acquired factors effective in cardiovascular diseases, polymorphisms of VKORC1 and CYP2C9 genes are identified as the main genetic factors involved in warfarin dosage requirement variations in these patients. With this approach, investigating the frequency of 1639 G>A in VKORC1 gene for determining the specific dosage required for each person was the main aim of this study. Materials and Methods: In this experimental study, peripheral blood samples were obtained from 200 patients with cardiovascular disorders in the northwestern areas of Iran (West and East Azarbayjan and Ardabil) and RFLP-PCR technique was used to determine the 1639G> A polymorphism of VKORC1. Results: Using Hardy-Weinberg law‏, polymorphism amounts of 1639G> A gene from VKORC1 in female and male patients with normal, heterozygote, and homozygote were determined 21.6%, 53.7%, 24.5% , and 22.3%, 60.6%, and 17.02% , respectively. Conclusion: VKORC1 genotyping is one of the important parameters that together with other confounding factors reduce the role of trial and error in patients with cardiovascular diseases. Genotypic variety and the high frequency of allele A in the studied population can justify varied responses to warfarin therapy and the importance of investigation before starting treatment with warfarin.

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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: 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.

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Background: Gastric ulcer treatment with chemical drugs is associated with a multitude of side effect. One of the most important groups of probiotics is lactic acid bacteria. The aim of this study was to investigate the healing effects of Lactobacillus pentosus on gastric ulcer induced by acetic acid.

Materials and Methods: In this experimental study, 45 male Wistar rats were divided into experimental, control 1, and control 2 groups. After one day of fasting, the rats were operated and gastric ulcer was induced by acetic acid. One day after surgery, the groups were treated with the 1010 cfu/day bacteria, dissolved in one ml of milk sterilizer, 1 ml of milk sterilizer, and 1 ml of normal saline, respectively, via gavage. On days 1, 4, 7, 10, and 14 after the induction of gastric ulcer, the animals were killed and the wound size (mm2) and the effect of the bacteria on the healing of wounds were measured for each rat.

Results: The treatment with Lactobacillus pentosus strains significantly decreased wound size in the experimental group compared with control groups. Significant increases in the number of neutrophils, macrophages, fibroblasts, significant decreases in the number of neutrophils, macrophages, and increased numbers of fibroblasts were observed in the experimental group compared to the control groups. Also, significant reductions in the number of neutrophils, macrophages, and fibroblasts were seen in the experimental group compared with the other two groups.

Conclusion: Lactobacillus pentosus has healing effects on gastric ulcer induced by acetic acid.

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Background: Depression is one of the most common problems in postmenopausal women. Diosgenin present in fenugreek seeds present study the effects of menopause on depression in menopausal women took the city in 1390.

Materials and Methods: In a randomized controlled trial enrolled 60 women with complaints of depression caused by menopause. Beck Depression Inventory on a sample of postmenopausal women and the inclusion criteria were enrolled. The samples were divided randomly into two groups, Diosgenin (6 g Fenugreek seed daily containing 25 mg Diosgenin) and sorbitol (25 mg daily) for 8 weeks were placed before and after 8 weeks of intervention questionnaire, Beck completed SPSS software was used to test the statistical Paired test scores before and after treatment were compared.

Results: Mean depression score decreased after 8 weeks took Fenugreek containing Diosgenin and sorbitol as compared with before of intervention of this study and it was significant.The comparison did not indicate a significant difference between the two groups.

Conclusion: According to the finding of this study, administration of 6 g Fenugreek seed containing Diosgenin for 8 weeks decreased menopausal depression . The need for further studies with longer duration and higher doses before any recommendations can be felt.

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Background: Hydatid disease is a zoonotic infestation by a tapeworm of the genus of Echinococcus that characterized by cystic lesions in the liver and lungs but rarely in other parts of the body.

Case: Known case of chronic Lymphocytic leukemia was a 56-years old man with several hydatid cysts of liver and lungs that was hospitalized because of ascites and abdominal pain. The patient received albendazol and surgical operation with diagnosis of peritonitis and complicated hydatid cyst in lungs and liver and Peritoneum. Patient expired with DIC and sepsis.

Conclusion: This case report provides evidence that complicated hydatid cysts in immunocopromised patients have a bad prognosis and can not be safely treated by medication and surgery.

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Background: Exclusive breastfeeding for the first six months after delivery plays a crucial role in preventing infants morbidity and mortality. Exclusive breastfeeding intention during pregnancy is one of predictors of this behavior. Determining the effective factors in exclusive breastfeeding intention helps plan for promoting breastfeeding intention and behavior. The aim of this study is to determine predictive factors of exclusive breastfeeding intention in pregnant women, based on the theory of planned behavior.

Materials and Methods: This analytical study was conducted in 2014 on 224 primigravide women referred to Health Centers of Kashan. The samples were randomly selected from 16 health centers. The mothers completed the questionnaires of demography, intention, attitude, subjective norms and the perceived behavior control. A linear regression analysis was used to identify independent predictors of the exclusive breastfeeding intention.

Results: In regression model, the perceived behavior control (&beta=0.42, p<0.001), attitude (&beta=0.27, p<0.01) and subjective norms (&beta=0.18, p=0.059) were predictors of the exclusive breastfeeding intention. This model could explain 63% of the variance of the exclusive breastfeeding intention. The knowledge and demographic factors were not predictors of the intention.

Conclusion: The results reveal the perceived behavior control, attitudes and subjective norms could predict exclusive breastfeeding intention, so they should be considered as general guidelines in designing educational interventions in order to improve exclusive breastfeeding in women.