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Background:Breast cancer is one of the most common cancers in women worldwide and one of its most desirable treatments is tamoxifen. The reported side effect associated with tamoxifen is endometrial thickness and increased risk of endometrial cancer. The aim of this study was to assess the influence of tamoxifen on the endometrial thickness in amenorrhea breast cancer patients treated with tamoxifen. Materials and Methods: This descriptive-analytic, cross-sectional study was conducted in Radiotherapy Departments of Mashhad University of Medical Sciences over a period of seven years.162 patients treated with tamoxifen whose bleeding cycle had been disrupted were selected and the relationship between tamoxifen usage and endometrial thickness was investigated in them. In addition, the relationship between abnormal vaginal bleeding and the ultra sonographic findings was assessed. Data analysis was done by using t-test and Chi-square test. Results: There was a significant relationship between tamoxifen usage and abnormal endometrial thickness while the greatest relationship was observed in the first year of treatment. The relationship between abnormal vaginal bleeding and abnormal endometrial sonographic findings was significant (P=0.001). The incidence of endometrial cancer in tamoxifen users was more than general population (0.61% vs. 0.1%). Conclusion: Considering the findings of this study, in the presence of abnormal sonographic and clinical observations indicating abnormal vaginal bleeding, pathological evaluation of the endometrial biopsy should be carried out for patients who use tamoxifen.

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Background: Noticing the significant role of fertility in Iranian families, the incidence of infertility and its social and cultural dimensions, this study was carried out to compare general health status of infertile women with fertile women. Materials and Methods: This observational case-control study was done on 147 women as the control group and 147 infertile patients as the case group who were matched in terms of influential variables. Data collection was done through demographic questionnaire and general health questionnaire (GHQ) which were completed by both groups. The results were analyzed by logistic regression analysis, t test, and chi-square using STATA 10 software. Results: Means of general health score in fertile and infertile women were 19.249.72 and 28.06 10, respectively. Here the mean score of the infertile women was significantly higher in comparison with the fertile women (p<0.001). Physical symptoms, anxiety, social interaction, and depression scores of infertile women were significantly higher in comparison with the fertile women (p<0.001). There were no significant differences in the means of age and duration of marriage between the two groups and the distribution of educational level, occupation, and income levels were the same in the two groups. Conclusion: Average scores of general health and physical complaints, anxiety, impaired social interaction, and depression in infertile women were higher than those in fertile women. This indicates their involvement with some degrees of public health diseases.

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Background: Brucellosis is an endemic infectious disease in Iran. The neurological involvement of the central nervous system in brucellosis patients is about 3 to 5 %. Case: The case was a 25-year old Afghan man with weakness and arthralgia for one year as well as terrible headache, vertigo, vomiting, cough, sputum, and disequilibrium. Brain CT-Scan indicated communicating hydrocephalus in four ventricles. Since hydrocephalus was idiopathic and noticing the prevalence of tuberculosis among Afghan immigrants that can also cause hydrocephalus, ventriculo-peritoneal shunt was inserted for the patient. Pressure in CSF increased and had a turbid appearance. Glucose value of CSF decreased (35 mg/dl), whereas protein value increased (724 mg/dl). Leukocyte count was 10 mm3 with 80% neutrophils and 20% lymphocytes. The presence of brucella species in CSF culture confirmed that subacute meningitis had caused hydrocephalus due to delay in diagnosis and treatment. The patient was treated for brucellosis and discharged after 10 days with oral medications. Conclusion: Noticing this case and other studies, it is recommended that patients with neurological symptoms, such as hydrocephalus, be evaluated for neuro-brucellosis in endemic areas for brucellosis.

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Background: Brucellosis is a major zoonotic disease with worldwide distribution. The prevalence of this disease has decreased in developed countries however, in developing countries, it is still prevalent. The aim of study was to determine the effect of a health belief model (HBM) based educational program on the empowerment of rural women in Zarandieh in prevention of brucellosis. Materials and Methods: In a quasi-experimental study with a pre-test/post-test design, 141 rural women were randomly selected and assigned to experimental and control groups. The educational program was implemented for the experimental group. Data were gathered by a researcher-made questionnaire and analyzed by SPSS software version 16. Results: Demographic variables of the two groups were similar before education. In addition, there were no significant differences between the experimental and control groups with regard to mean knowledge, HBM constructs, and performance however, the post-test revealed significant differences in terms of the mean of variables between the two groups (P<0.001). Conclusion: The HBM based educational program is effective in women’s empowerment and also promoting women’s beliefs and performance regarding brucellosis therefore, the findings of this study may be used as a framework in designing zoonotic diseases prevention programs

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Background: Vasomotor disorders are one of the most painful menopausal complications that negatively affect the quality of life in menopausal women. This study investigated the effects of omega3 fatty acid on vasomotor disorders in menopausal women. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial study was done on 83 menopausal women aged 45-60 years that had met the inclusion criteria. The participants were randomly assigned to omega3 or placebo groups. Fish oil capsules (containing 300 mg of omega3) or placebo capsules were prescribed to the participants one capsule a day for 8 weeks. Of the 83 patients enrolled, 68 completed the study (omega3 supplement, n=34 placebo n=34). Data collection was done through demographic questionnaire, daily self report, and food frequency questionnaire (FFQ). Data were analyzed by t-test, Chi square, Fiedman, and Mann-Whitney tests using SPSS software version 18. Results: After 8 weeks of intervention, there was a significant difference in HF frequency (p=0.003) and nightsweats frequency (p=0.001) between the two groups. There was no significant difference in HF intensity between the two groups (p=0.2) but reduction of nightsweats intensity was significant between the two groups (p=0.003). Conclusion: Omega3 affected the reduction of HF frequency and nightsweats frequency and intensity but it did not have a significant effect on the severity of HF.

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Background: A lot of research has been done on the post-traumatic stress, but few studies have investigated the effect of chronic stress disorders on physical and psychological health. This study investigated the combined interactive effects of chronic stress disorders and mental disorders on somatoform disorders reporting among employees at Isfahan Steel Company. Materials and Methods: In this correlational study, 189 employees in Isfahan Steel Company wwere selected according to the stratified random sampling method and completed demographic characteristics, chronic stress disorders of Cohen, Karmark, and Mermelstein, and mental disorders and somatoform disorders of Barling, Loughlin, and Kelloway questionnaires in 2011. Data were analyzed using Pearson correlation coefficient and hierarchical regression. Results: Results showed significant internal correlations among chronic stress disorders, mental disorders, and somatoform disorders (p<0.01). In addition, by controlling for demographic variables, the results of hierarchical regression analysis showed the interactive effect of chronic stress disorders and mental disorders on reporting somatoform disorders to be significant (p<0.05). Conclusion: This study showed that chronic stress disorders have a positive relationship with reporting somatoform disorders both in experiencing and not experiencing psychological disorders however, this relationship was stronger when employees in addition to chronic stress disorders experienced psychological disorders.

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Background: Previous studies in Iran and around the world have indicated the high rate of medicines use. In recent years, medicine use has continued to rise in spite of attempts made by the Ministry of Health and Medical Education in Iran. Therefore, it seems that in addition to the reasons considered in previous studies, there are other reasons for this problem in Iran. One of the parameters involved in this problem is the high medicine use among the clinical staff. Thus the aim of this study is to compare medicine use among clinical and non-clinical staff members. Materials and Methods: In this cross-sectional study, information about the monthly use of medicines was obtained by means of a questionnaire administered to eight groups of clinical and non-clinical members: first-year medical students, first-year non-medical students, interns of medicine, forth-year non-medical students, general physicians, specialists, academic members with M.Sc, and academic members with PhD degrees. Results: The results showed that medicine use decreased with increase in education level in both groups. In addition, the comparison of medicine use between clinical and non-clinical groups showed that there is not a significant difference for most medicines among the first- and second-year students but medicine use significantly increased among general physicians and specialists compared to the control groups. Conclusion: The results of this study showed that medicine use among clinical staff should be considered in controlling medicine use in Iran.

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Background: Several studies have demonstrated that the levels of inflammatory markers in healthy women are under the influence of menstrual cycle changes. The aim of this study was to compare blood levels of inflammatory markers in women with appendicitis in different phases of menstrual cycle. Materials and Methods: In this case-control study, 70 female and 12 male patients with appendicitis, and 61 healthy women were enrolled based on inclusion and exclusion criteria. Inflammatory markers, such as leukocyte count, CRP, ESR, and TNF-α were measured and compared using student t-test and one-way ANOVA based on different phases of menstrual cycle. Results: There were no significant changes in the ESR, CRP, and TNF-α concentrations and the number of peripheral blood leukocytes in different phases of the menstrual cycle in women with appendicitis. The mean number of leukocytes and CRP concentrations were significantly higher in patients with appendicitis compared with the control group. Conclusion: The findings show that there are not significant differences in the inflammatory markers in women with appendicitis during the different phases of menstrual cycles. It seems that day to day variation of sexual hormones in the menstrual cycle have led to very different conclusions about the change of inflammatory markers in different phases of menstrual cycle. Therefore, studies investigating inflammatory markers in women with acute appendicitis based on day of menstrual cycle, time of sampling in the day, and severity of appendicitis are suggested.

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Background: Menopause is associated with changes in body composition in postmenopausal women. The aim of this study was to compare the effects of tibolone and continuous combined hormone therapy (HT) on body composition in postmenopausal women. Materials and Methods: In this randomized clinical trial, 120 menopausal women were randomly selected and divided into three groups. Of these, 40 women received 2.5 mg tibolone plus one Cal+D tablet (500 mg carbonate calcium with 200 IU vitamin D) daily, 40 women received 0.625 mg conjugated estrogen combined with 2.5 mg medroxy progesterone acetate plus one Cal+D tablet daily and the rest 40 (the control group) only received one Cal+D tablet daily. All regimes continued for nine months. Body composition was evaluated with measurements of waist to hip ratio (WHR), fat mass (FM), fat-free mass (FFM), body mass index (BMI), and weight before and after intervention. Fat mass and fat free mass were assessed by measurement of skin-fold thickness. Data were analyzed by SPSS software. Results: In the tibolone group, FFM, BMI, and weight significantly increased compared to the baseline (p<0.05). In the HT group, only weight and BMI significantly increased (p<0.05). In the control group, however, BMI, FM, and weight did not significantly increase in comparison with the other groups. Overall, tibolone group showed a more significant increase in comparison with the other groups (p<0.01) Conclusion: From these results, it can be concluded that tibolone can be used in treating menopausal changes in menopausal women as an alternative to continuous combined hormone therapy.

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Background: Heavy menstrual bleeding is one of the leading causes of poor quality of life and iron deficiency anemia in women of reproductive age. This study was conducted to investigate the therapeutic effect of tranexamic acid (TA) on menorrhagia. Materials and Methods: In this before and after clinical trial, 46 women with menorrhagia were selected and, after a control cycle for evaluation of the volume and duration of primary bleeding, were subjected to tranexamic acid treatment (500mg every 6 hours from day 1 to 5 of bleeding) for 3 consecutive cycles. Data on the duration of bleeding, amount of bleeding (PBAC chart), quality of life (SF-36 and MQ questionnaires), and hemoglobin and ferritin values were checked and compared before and after treatment using SPSS software. Results: Tranexamic acid reduced mean PBAC score from 242.86 (160.47) in control cycle to 101.50 (72.67) after the third cycle (p<0.001). Hemoglobin increased from 11.85 (0.84) to 13.08 (0.97) g/dl and ferritin increased from 15.9 (20.39) to 22.13 (2.03) ng/dl (p<0.001). Duration of menstrual bleeding decreased from 7.6 (1.23) days to 6.86 (0.84) days (p=0.001). Tranexamic acid reduced mean MQ score from 70.26 (17.64) to 11.64 (6.49) (p<0.0001). Quality of life scores increased in all aspects (except for bodily pain scale) (p<0.001). Conclusion: TA due to its short course of prescription, fewer side effects, especially on the pattern of bleeding and menstrual cycle, and not having hormonal effects, seems to be an effective drug for menorrhagia in women of reproductive age.

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Background: Primary dysmenorrheal is one of the most common gynecologic diseases. This study was carried out to compare the effects of omega-3 and vitamin E on the treatment of primary dysmenorrheal. Materials and Methods: In a randomized double-blind clinical trial, 80 female students from high schools in Arak, Iran, were selected by simple sampling and randomly divided into two identical groups in 2010. Omega-3 group received one omega-3 capsule (500 mg) per day while the vitamin E group received one vitamin E capsule (400IU) every other day for 60 days. Intensity of pain, duration of pain, and the number of painkillers taken before and after intervention were measured in both groups. Intensity of pain was assessed by VAS scale of pain. Data were analyzed by SPSS software. Results: After intervention, the mean of pain intensity in the omega-3 group decreased to 3.5 which indicated a significant difference in comparison with the corresponding values before intervention (7.40) (p<0.05) and the values in the vitamin E group (5.25) (p<0.05). After intervention, the mean duration of pain in the omega-3 group reached 11.04 hours which showed a significant difference compared with the corresponding values before intervention (31.74) (p<0.05) and the values in the vitamin E group (34.81) (p<0.05). Conclusion: Omega-3 is more effective than vitamin E in the treatment of primary dysmenorrheal and its application as a new therapeutic method to the treatment of primary dysmenorrheal requires further studies.

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Background: Obtaining cells from the patient, expanding cell population on a scaffold, and, eventually, grafting the tissue to the patient is one of the tissue engineering techniques to create replacement tissue structures. Blastema tissue is one of the cellular sources in this regard. This study investigated the use of human gum tissue to prepare a scaffold and the interaction between the three-dimensional tissue scaffold and blastema tissue. Materials and Methods: In this experimental study, human gingiva was prepared and through snap freezing method and the use of sodium dodecyl sulfate (SDS) and Triton X-100, went through cell bleaching. Then the provided scaffoldings were placed in 2-day-old blastema rings and stored in culture media for 25 days. Sampling of the blastema and scaffolding tissues was done once every five days. Results: The results confirmed the removal of the cells from the prepared scaffolds. Also, histological studies in the fifth and tenth days indicated cell penetration into the blastema scaffolds. In the fifteenth day, in addition to penetration, blastema cells division and differentiation as well as epidermis genesis were observed. In the twentieth and twenty-fifth days, infiltration, cell division, and differentiation processes continued. Conclusion: The findings of this study indicated the possibility of creating a natural scaffold of human gingiva through this method. This scaffold can have an inductive effect on cell behaviors such as such as migration, adhesion, division, and probable differentiation. However, further studies for demonstrating the identity of the cells and other properties of such a scaffold as well as the possibility of using it in gingiva tissue engineering are recommended.

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Background: To date, researchers have paid extensive attention to happiness and its relationship with a wide variety of personality, socio-demographic, and health-related factors. However, there is still little research on the issue of happiness. This study was done to investigate happiness and mental health and the relationship between them in the students studying at Arak University of Medical Sciences, Arak, Iran, in 2010. Materials and Methods: This cross-sectional study was carried out on 315 students at Arak University of Medical Sciences who were randomly selected during 2010. The students' happiness was measured by Oxford questionnaire and their mental health was measured using GHQ28. Data were analyzed by t-test, ANOVA, Pearson correlation coefficient, Logistic regression, and Chi-square test using SPSS software. Results: The mean of happiness in the students was 40.72±14.14 with only 9.2% of them in the normal range of happiness. Their mental health score was 25.73±7.47 with 32.1% of them within the normal range. Pearson correlation coefficient showed a statistically significant relationship between happiness score and mental health score (r=-0.14, p=0.012). Conclusion: Happiness and mental health status in the students at Arak University of Medical Sciences necessitate the need for more serious attention to this issue in educational planning.

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

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Background: Urogenital atrophy is a common problem after menopause and quality of life in post-menopauseis seriously affected by the symptoms associated with vaginal atrophy. The aim of this study was to compare the effectiveness of the vaginal suppository of hyaluronic acid and vitamin E in atrophic vaginitis treatment. Materials and Methods: This randomized double-blind clinical trialwas carried out in Ahvaz (Iran) from August to December 2010. Forty postmenopausal women with symptoms of vaginal atrophy were randomly allocatedto two groups to take vaginal suppositories of either 5 mg hyaluronic acid sodium salt (n=20) or 1 mg vitamin E (n=20) for 8 weeks. The symptoms of vaginal atrophy were evaluated by a self-assessed 4-point scaleand the composite score was determined asnone, mild, moderate, and severe in four periods. Results: The results showed that the symptoms were relieved significantly in both groups (P<0.001).The relief of symptoms was significantly superior in the hyaluronic acid group compared with the vitamin E group (P<0.05). Conclusion: Although both hyaluronic acid and vitamin E relieved the vaginal symptoms, improvements were greater in the hyaluronic acid group. Therefore,hyaluronic acid vaginal suppository is suggested for women with vaginal atrophy who do not want to or cannot take local estrogen treatment.

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Background: In recent decades, with the increasing use of devices generating electromagnetic fields in modern industrial societies, the study of biological effect of these waves on the many organisms development has been considered by government and scientific organizations all over the world. Many people in all hours of their life are exposed to boarding electromagnetic fields of devices in their life and work places, with different intensities and frequencies. This presence of a significant relationship between the increase of some diseases and genetic aberrations and electromagnetic fields is one of the most important issues for researchers that has created many concerns regarding the adverse effects of electromagnetic fields. The findings of some studies indicate that this field does not have enough energy to damage biological molecules, while other researchers believe that electromagnetic fields by affecting cellular stress response and other protective mechanisms cause genetic cell damage. Some studies express that the electromagnetic field are safe alone, but they enhance the genotoxic function of physical and chemical environmental pollutants.

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Background: Inmedical practice, learning the correct method of CPR and its practice and continuous training are of great importance. The aim of this study was to determine the effects of mental practice on learning basic CPR operations in undergraduate anesthesiology students studying at Arak University of Medical Sciences. Materials and Methods: This educational trial was carried out on 46 anesthesiology students at Arak University of Medical Sciences that were divided into intervention (mental and practical training) and control (practice alone)groups. Then they were assessed through accuracy and speed checklist designed by two instructors blind to the presence of training. Data were analyzed by t-test and Chi-square using SPSS software. Results: The mean scores of speed in intervention and control groups were 2.50.26 and 3.160.33, respectively, which showed a significant difference (p=0.001). The mean scores of the accuracy of students’ performance in case and control groups were 4.330.7 and 3.40.62, respectively, which indicated asignificant difference between them (p=0.001). Theopinions of the students in the mental practice group (90%) suggested the positive effects of mental practice on their performance. Conclusion: This study showed that mental practice increases students’ performance. Hence, for achieving better results in clinical practice, the application of both physical and mental exercisesby the teachers is suggested.

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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: 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