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Background: Preoperative anxiety is a common reaction in patients. Many techniques are used for alleviation of it, such as preoperative visit by the anesthetist, reassurance by a psychologist, and prescription of tranquilizer drugs. In this study we surveyed propofol compared to Midazolam on pre-operative anxiolysis. Methods and Materials: In randomized controlled double-blind clinical trial, 60 patient swith ASA class I candidates for elective abdominal operations were randomly allocated in 3 equal groups (propofol, midazolam and normal salin). Anxiety was measured with 2 different scales: visual analogue scale (VSA) and clinical global impression (CGI). Pulse rate (PR), blood pressure (BP), respiratory rate (RR), and saturation PO2 (SPO2) were measured before drug administration and 3 times after that in 2.5 min intervals. Results were analyzed with ANNOVA, repeated measures ANNOVA, TUKEY, and X2 tests. Results: There were no differences in demographic variables between groups. Both propofol and midazolam were more effective than placebo in anxiety reduction. Both drugs had equal effect (p>0.05). There was no significant difference in BP, PR, RR and SPO2 between two drugs. Conclusion: Both drugs were the same and more effective than placebo. Midazolam may be preferred for economical reasons.

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Background: The most important determinant factor in elder’s quality of life is healthy. Since health can be declined by aging, in health promotion consider an effective model of care can be vey important. We surveyed the effect of Orem Self Care Model on quality of life (QOL) of elderly in Masjed Solaiman. Methods and Materials: This is a pre and post quasi-experimental study was carried out on 349 elderly clients which were selected from 11 health care centers in Masjed Solaiman in 2007-2008. Orem Self Care program was performed during a 3 months in days that the clients came to health care centers. Data were gathered by a short form questionnaire (SF36) before and after the intervention and was analyzed by descriptive statistics and paired t-test. Results: Results showed a significant increase in mean scores of different dominations of QOL including health, physical performance, physical role- performance, emotional role- performance, social performance, body pain, power and energy, general health perception, and overall mean of QOL. Paired t-test showed a significant difference (p<0.001) between all of dominations of the quality of life. Conclusion: Performing Orem Self Care educational program had a positive influence on improving QOL of elderly.

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Background: REM sleep has a role in memory processing. The period of post-learning, that REM sleep is higher than normal level and deprivation of REM sleep impairs memory, is called paradoxical sleep windows (PSW). Methods and Materials: In this experimental study, male N.M.RI rats were trained in a two-way shuttle avoidance task (100 trials/one sessions) then memory retention was tested in next week. In electrophysiology section, different sleep-memory factors were recorded in basal level and 1-4 hours after training. In behavioral section, animals that reached 70% learning criterion (learner group) were deprived of PS in the two periods of 1-4 hours and 5-8 hours after learning by Maze water technique. Results: The amount of REM sleep in group which gained 70% learning after 1-4 hours training, and group without it. In v.s of basic level, significantly increase (p0.01). Other factors were showed no significant difference between two groups before of training. In behavioral section those animals were deprived in 1-4 hr post-learning show significant memory impairment (p0.05). Conclusion: Paradoxical increased REM sleep is effective in memory consolidation after 1-4 hours training. This period can be consider as paradoxical sleep window.

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Sleep is one of the basic needs of human and any disorder in its natural flow in addition to creating psychological problems can reduce the individual performance. There are descriptions and references about sleep and its features in Quran. In Naba Surش sleep has been referred to as a weakness that indicates a disease state. However, the conditions for the occurrence of sleep can be inferred from Kahf Sura, verse 11, which states: “a major quality of sleep is that one cannot estimate its duration”. In several other verses, sleep is said to be similar to temporary death. Substances such as endorphins, cortisol, and encephalin cause euphoria and have direct impacts on different parts of the body including skeletal muscles that lead to muscle comfort during the day. The amount of secretion of these materials into the body in the morning hours significantly increases. Therefore, waking up early in the morning can bring about euphoria and can have positive impacts which last till the end of the day. According to the findings released by the International Agency for Research on Cancer World Health Organization, men and women who work night shifts are at a greater risk of developing breast cancer and prostate cancer, respectively. Night sleep is a divine blessing that God has endowed people and God in verse 23 of Rome Sura refers to sleep as “one of the signs revealed to people” and asks people to search and investigate about it so as to realize to what extent night sleep can contribute to human perfection and success

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Background: Brucellosis is a zoonotic disease which is endemic in Iran. Infection with brucella species during pregnancy can have negative impacts on the outcome of pregnancy however, there is no consensus on its leading to abortion or other severe complications. The aim of the present study is to determine the role of brucellosis in pregnancy and to characterize the risk factors, clinical presentations, and immunology of brucellosis based on the existing reports. Materials and Methods: In this review article, we studied papers on Pubmed, Elsevier, Cohrane, SID, Ovid, ISC, and IranMedex through such keywords as brucellosis, abortion, intra-uterine fatal diseases, and preterm labor. Results: Among the original research papers, 51 were found to be related to the title of this study and dealt with the outcome of brucellosis on pregnant women and had discussed the complications of pregnant patients suffering from brucellosis. Conclusion: According to the investigations made in this study, brucellosis in pregnancy can manifest as normal delivery, increased incidence of spontaneous abortion, intra-uterine fatal diseases, and premature delivery. Therefore, in endemic areas, especially those with inhabitants of low socioeconomic class, educating girls and women of childbearing age about brucellosis and its dangers and risk factors and isolating pregnant women may help prevent the disease and its complications in pregnancy. Moreover, further immunological investigation on the role of immunological reactions following brucellosis infection in pregnant women is required.

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Background: The use of propofol alone for insertion of supraglottic devices can lead to undesirable events such as cough, gagging, and laryngeal spasm. Narcotic drugs are used to improve the insertion of these devices. In this study, the effect of two narcotics, remifentanyl and sufentanyl, on ease of insertion of two types of supraglottic airway devices were evaluated. Materials and Methods: In this clinical trial, 200 patients undergoing general anesthesia were divided into four groups through blocked randomization. Induction of anesthesia was performed using propofol 2.5 mg/kg. Then the first group received remifentanyl and laryngeal mask, the second group remifentanyl and SLIPA, the third group sufentanyl and laryngeal mask, and the fourth group sufentanyl and SLIPA. The amount of jaw opening, ease of insertion of supraglottic devices, cough, laryngospasm, gag reflex, heart rate, and arterial blood pressure were recorded one, three, and five minutes after insertion of supraglottic devices. Results: No significant differences were observed in the amount of jaw opening, ease of insertion of supraglottic devices, cough, laryngospasm, gag reflex, and hemodynamic parameters between the four groups. Conclusion: The results of our study indicated that for controlling airways using supraglottic devices, use of laryngeal mask or SLIPA in the presence of remifentanyl or sufentanyl have no priority over each other and do not lead to hemodynamicimpairement

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Background: Some clinical trials have revealed the effects of Matricaria chamomilla on premenstrual syndrome symptoms. This study was done to compare the effects of Matricaria chamomilla extract and mefenamic acid on the severity of premenstrual syndrome symptoms.

Materials and Methods: In a randomized double-blind clinical trial, 90 students completed daily rating form for the diagnosis of premenstrual syndrome symptoms and its severity for two consecutive cycles. After verification, they were randomly divided into two equal groups. The participants received one 100 mg capsule of Matricaria chamomillaor 250 mg mefenamic acid three times daily from day 21 of menstrual cycle till the beginning of the menstruation. They completed the daily symptom rating form at the same time.

Results: General severity reduction of symptoms was significantly greater among Matricaria chamomilla extract users (25±13.8 and 28±14.5%) than that among mefenamic acid users (14.8±18.5 and 16.2±18.2%) after the first and second cycles (p<0.05). Severity of emotional symptoms was significantly higher among Matricaria chamomilla extract users (30.1±26.6 and 33.4±25.3%) than that among mefenamic acid-users (11.6±25.7 and 10.7±26.8%) after two cycles intervention (p>0.05).Reduction of physical symptoms was not significantly different between the two groups (p>0.05).

Conclusion: Matricaria chamomilla reduces the severity of symptoms of premenstrual syndrome symptoms during treatment. Matricaria chamomilla effect on the severity of general and emotional symptoms of premenstrual syndrome symptoms is greater than that of mefenamic acid.

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Background: Nutritional status assessment is a method for nutritional care which aims to determine nutritional needs and to meet nutritional requirements. Pregnant and lactating mothers are considered vulnerable groups. The use of this method, especially for determination of calorie and protein intake has positive effects on growth of neonates. Thus, the purpose of this study is to assess the nutritional status of pregnant women.

Materials and Methods: In this cross-sectional study, 80 pregnant mothers were selected from private and public hospitals in Arak. Data were gathered through a questionnaire including general information concerning pregnant mothers and their nutritional diet. The analysis of dietary intake was done by nutritionist IV software. Data were analyzed using SPSS software.

Results: The average weight gain for pregnant mothers at the end of pregnancy was 10.1kg. The mean of body mass index for the mothers was 22.2 kg/m2, and the average weight for neonates was 2.5 kg. The average energy intakes in mothers were equal compared with RDA, and the average protein intake was greater compared with RDA. There was a significant positive correlation between weight gain during and total body weight at the end of pregnancy (r=0.93) (p<0.01). Also, there was a significant negative correlation between weight of pre pregnancy and percent of weight gain at the end of pregnancy (r=-0.39) (p<0. 01). A significant positive correlation was found between total body weight at the end of pregnancy and birth weight of neonates (r=0.34) (p<0. 01).

Conclusion: Adequate nutritional status of mothers influenced normal body weight in neonates.

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Background: In recent years, studies have been conducted on the role of coenzyme Q10 in improvement of sport performance and also cardiovascular health. The present study investigate effect of coenzyme Q10 supplementation combined with swimming aerobic exercises on Heart Rate Deflection Point (HRDP) and VO2max in active women.

Materials and Methods: A number of 32 trained women with the average age of 21/25 ± 0.86 years and Body Mass Index (BMI) of 20/127± 1.06 kg/square meter were selected randomly and were divided into eight -member each groups: Control, Supplement, Supplement – Exercise and Exercise. The subjects participated in four-week consumption of coenzyme Q10 and swimming exercises (three sessions in a week).The consumption rate of coenzyme Q10 100 mg/kg/d was in the form of capsule that subjects took it during lunchtime. Before and after a four-week period, the subjects performed an incremental exhaustive test on treadmill, using respiratory gas analyzer to determine HRDP and VO2max. It should be noted that data analysis was conducted using One-Way Variance Analysis Test (ANOVA) in P<0.05 significant level.

Results: Based on paired T-Test results, despite HRDP had increased in each four groups but the significant increase was observed only among groups in VO2max (P=0.008) based on ANOVA Test (P<0.05).

Conclusion: Although positive changes were observed inside the group after passage of four weeks, coenzyme Q10 supplementation combined with swimming aerobic exercise had not any significant effect on HRDP only increased VO2max.

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Background: The aim of this research was to determine the relationship between inflammatory markers (Fibrinogen, C-reactive protein (CRP) and Creatine kinase (CK)) and respiratory responses FEF25-75% (Forced expiratory flow in 25-75 percent) and FEV1 (Forced expiratory volume in one second) in 14-16 year’s Urmia city boys in response to an incremental physical activity.

Materials and Methods: The subjects were boys of 14-16 years among 24 healthy participants. These groups divided into two groups randomly, one group as trained one (n=12) and the othes as control group. Blood sample was taken in baseline and after Modified Balke Protocol in trained group, And the blood sampling was taken in baseline and 48 hours later in control group. respiratory responses were measured immediately after Modified Balke Protocol.

Results: CRP and Fibrinogen significantly increased in trained group (p<0.001) and this group had high level of these markers compared with control group (p<0.001). The association between CRP with FEF25-75% and fibrinogen with FEF %25-75 and CK with FEF 25-75% in trained group was significant (p&le0.05).

Conclusion: The results of this study show that incremental physical activity increased inflammatory factors in active children. Incremental exercise shows a strong relationship between some inflammatory markers and respiratory parameters in adolescents 14-16 years old.

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Background: Premenstrual Syndrome (PMS) consists of repetitious physical and psychological symptoms that occurs in luteal phase of menstrual period and will be over when menstrual period starts. The goal of this study is to investigate the effect of calcium therapy plus vitamin D and cognitive behavioral therapy (CBT) on the parameters of PMS symptoms in women suffering from PMS.

Materials and Methods: This study has an experimental plan of pretest and post-test of the control group. The statistical society is 250 female staff of Tehran Universities in academic year 2013-2014. Premenstrual syndrome screening tool (PSST) questionnaire was used as an evaluation tool. The collected data were analyzed using the indexes of the descriptive statistics and covariance analysis (p<0.05).

Results: The minimum age of the statistical society was 24, 52.5 % of them held a master's degree and 60% were single. Cognitive behavioral therapy method, calcium and vitamin D therapy were significant in improving the parameters of symptoms at p<0.05 level of significance.

Conclusion: Combining cognitive behavioral therapy and calcium supplementation and vitamin D is significantly effective in improving components of PMS sympotoms and applying these methods is recommended by the consultants and gynecologists.

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Background: Reducing the duration of the effect of sedatives and increasing their quality is one of the tasks of ICU staff. The aim of this study is to compare the sedative effects of these medications on neurosurgery patients under mechanical ventilation.

Materials and Methods: In this double-blind clinical trial, 70 patients requiring mechanical ventilation in neurosurgery ICU were enrolled. Patients were randomly assigned to one of remifentanil or fentanyl groups. The first group received 0.05 µg/kg/min remifentanil and the second group received 1 µg/kg/hr fentanyl infusion for sedation and analgesia in the first 24 hours. Sedation score, Minogue scale and hemodynamic parameters were evaluated throughout the study and at regular intervals. 

Results: There was no significant statistical difference in demographic variables such as age, sex, and body weight between two groups. The results of this study showed a significant difference in sedation score (p=0.0001) and Minogue scale (p=0.0001) and both variables were lower in remifentanil group. Also, heart rate (p=0.011) and mean arterial blood pressure (p=0.007) were significantly higher in fentanyl group.

Conclusion: Generally, sedative effect of remifentanil has several relative advantages over older medication of fentanyl and causes more effective sedation and better control of hemodynamic parameters in patients under mechanical ventilation.

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Abstract

Background: Family is the most important component of community and family health leads to spiritual excellence and intellectual growth. One of the debates in current society is to enhance the bases of marital life. More than half of the sexual problems which cause family life and marital relationships abolishment are due to insufficient knowledge or erroneous beliefs about sexual relationships. The aim of this study is to investigate the effect of acceptance commitment therapy (ACT)-based premarital counseling on the couples’ sexual function.

Materials and Methods: The study population of this clinical trial consisted of all couples referring to premarital counseling centers of Isfahan in 2015. Sixty couples were selected and then randomly divided into two groups, an experimental group(30 couples) and a control group(30 couples). Then they completed a questionnaire of sexual function. The data were analyzed by SPSS 21 using the Mann-Whitney test.

Conclusion: The results of this study with the aforementioned condition showed the lack of significant difference in the couple’s sexual function between premarital counseling and the approach based on acceptance and commitment. So, it seems that performing a research with more samples and a target group having 1-5 marital experience would be necessary.

Results: The results showed no significant difference between the effect of premarital counseling acceptance and commitment therapy – based approach on the couples’ sexual fanction in comparison with a premarital conventional approach(p>0.02).

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Abstract

Background: The aim of this study was to investigate the acute effect of supplementation Jadvar on aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes after exhaustive incremental exercise in men's handball.

Materials and Methods: In this semi-experimental double blinded study 12 handball players with at least 2 years record in league (with average age=21.42, height=186cm, weight=83.25, and body mass index=24.09kg/m2) divided into 2 groups (n=6) accidentally. Both groups performed maximum Bruce protocol until exhausting level. Before (fasting) and after performing protocol ,blood samples were taken from middle forearm vein and transferred to lab then supplementation group consumed three 500 mg jadvar capsules and control group consumed three 500 mg maltodextrin  for 7 days daily. 24 hours after eating last capsule ,they performed maximum Bruce protocol up to exhausting level and the samples were collected like primary protocol blood samples before (fasting)and after performing protocol and were transferred to the laboratory.

Results: The results of dependent and independent t-test showed that consuming jadvar supplements for 7days did not have significant effect on aspartate aminotransferase(AST) and alanine aminotransferase(ALT)(p≥0.05).But alanine aminotransferase in supplementation group (16.83 mg.dl^-1) decreased in comparison to placebo group (20.5 mg.dl^-1). Also, aspartate aminotransferase was increased from 28 mg.dl^-1 to 35.17 mg.dl^-1 , but neither decrease nor increase was not meaningful (p≥0.05).

Conclusion: It seems that acute consuming of jadvar supplement and one session incremental exercise does not have meaningful effect on AST and ALT in man handball players.

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Background and Aim: Recently, there is increasing concern about the declining of male reproductive health. Oxidative stress has been proposed as a possible mechanism contributed in reproductive system failure. Dorema aucheri that is being used in Persian folk medicine has been supposed to have male fertility-enhancing properties. Present study was done to evaluate the impacts of Dorema aucheri on oxidative status and reproductive parameters in male rats. Materials and Methods: In this experimental study, healthy adult male Wistar rats were treated with 100, 200 and 400 mg/kg of ethanolic D. aucheri leaves extract via gavage for 70 days. Blood samples were collected for analysis of testosterone, LH and FSH serum levels. Reproductive organs weight, density, motility and morphology of spermatozoa, seminiferous tubules diameter, germinal epithelium height and also testicular levels of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GPx) were evaluated. Findings: Significant (p<0.05) increases were seen in the testis and epididymis weights of male rats treated with 200 and 400 mg/kg D. aucheri extract. In rats treated with D. aucheri extract sperm density and percent of morphologically normal sperm were significantly (p<0.05) higher. No significant differences were seen in serum testosterone, FSH and LH levels between D. aucheri extract-treated groups and controls. D. aucheri significantly (p<0.05) reduced malondialdehyde (MDA) levels and also increased superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity in testicular tissue of rats. Conclusion: Present study indicates that D. aucheri leaves extract has beneficial effects on reproductive parameters in male rats which might be a consequence of its antioxidant properties.

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Background and Aim: For decades, using fluoride has been introduced to prevent the development and progression of primary carious lesions. Increased surface microhardness of primary caries is among the essential factors in preventing lesion progression and cavity formation. The present study aimed to compare the microhardness changes of primary caries treated with 3 products, containing fluoride (varnish, toothpaste, & mouthwash) in dental teeth.
Methods & Materials: In this study, 45 extracted human deciduous molars were used. Using a diamond-winning disc, enamel blocks with a dimension of 1 x 4 x 4 mm were prepared from the buccal surface of the teeth, i.e., healthy and without structural defects; they were mounted in acrylic self-adhesive. Initial microhardness test (Vicker’s test) with a force of 300 gr and Dwell time for 15 seconds was applied on samples. Next, artificial caries with the standard solution were created in all samples and the microhardness of samples was recorded at this stage. The study samples were randomly divided into 3 groups of 15, treated with fluoride varnish, mouthwash, and toothpaste. Then, the microhardness of samples was re-measured. The mean surface microhardness was compared between the study groups by Independent Samples t-test and Bonferroni test. All analyses were performed using SPSS at the significance level of P<0.05.
Ethical Considerations: This study was approved by the Ethics Committee of the Arak University of Medical Science (Code: IR.ARAKMU.REC.1397.264).
Results: Increase in surface microhardness of primary caries in fluoride varnish group was statistically significant; in GC MI paste plus toothpaste and Oral B mouthwash was non-significant. The research samples treated by fluoride varnish had a higher surface microhardness, compared to toothpaste and mouthwash.
Conclusion: According to the present research results, fluoride varnish was superior to fluoride mouthwash and toothpaste in improving the microhardness of primary dental caries.

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Introduction: One of the most common problems in newborns is apnea of prematurity. Given the importance of preventing apnea in very premature infants, the present study was designed and conducted to investigate the preventive effect of caffeine on reducing the frequency of apnea events in very premature infants.
Methods: This randomized, double-blind, controlled clinical trial was conducted on premature infants hospitalized in the neonatal intensive care unit of Shahid Motahari Hospital in Urmia. Infants were randomly divided into two intervention and control groups. The intervention group received intravenous caffeine at an initial dose of 20 mg/kg and a maintenance dose of 5 mg/kg for 14 days. In contrast, the control group received an equal volume of normal saline intravenously for the same period. Apnea events, cyanosis attacks, and bradycardia were recorded by the researchers in a standard checklist.
Results: Of the 50 infants in each group, 2% of the caffeine and 4% of the control group required prolonged oxygen therapy, respectively. Also, 6% of the caffeine group and 4% of the control group experienced intraventricular hemorrhage. In addition, 4% of the caffeine group and 2% of the control group required surgery to close the patent ductus arteriosus, and 14% of the caffeine group and 18% of the control group experienced apneic events. However, there was no statistically significant difference between the two groups regarding the incidence of apneic events (P = 0.58). Ultimately, 20% of the caffeine group and 14% of the control group died.
Conclusions: Although the findings of the present study were not statistically significant, they indicate a decrease in the frequency of apnea events in the group of premature infants receiving caffeine compared to the control group.

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Background: Some intracranial surgeries must be performed while the patient is awake. Awake craniotomy is an intracranial surgical procedure in which the patient is kept in a state of relative consciousness while the surgery is performed. The aim of this study was to present a case of intracranial surgery to remove a tumor in the right frontal cortex by awake craniotomy.
Case: In this report, anesthesia in craniotomy surgery with full wakefulness was investigated in a 22-year-old man. This patient, who was the first to perform a craniotomy with the fully awake method (from the beginning to the end of the operation) at Arak University of Medical Sciences and Valiasr Hospital in Arak, after preparing the patient and interviewing before the operation, Cranial nerve blocks related to the skin and head muscles (scalp block) were performed in the desired locations, and after providing mild sedation, surgical excision was given. The lesion was examined while awake and the surgery was performed while fully awake from the beginning to the end, and the patient's brain tumor was removed safely. A combination of local and regional anesthesia and light intravenous anesthesia was used in the patient. Two types of local anesthetics, lidocaine 1.5% and bupivacaine 2.5%, were used for anesthesia, as well as intravenous sedatives and anesthetics such as propofol, remifentanil, and dexmedetomidine were used to relieve the patients. Throughout the operation, the patient was awake and breathing spontaneously, and the function of the brain nerves during the operation could be evaluated. Finally, the patient's surgery was performed without any complications and in completely favorable conditions, and the patient was transferred to the intensive care unit in a good general condition, awake and fully alert.
Conclusion: Although maintaining analgesia and hemodynamic and ventilation stability in fully awake craniotomy conditions is considered a challenge, but due to the necessity of performing this procedure due to the need to check the function of cranial nerves during the operation and to prevent any neurological and functional damage, using By carefully performing the desired nerve block in the scalp and prescribing a small amount of sedative medicine(propofol,remifentanil,dexmedetomidine), we were able to create a condition where the operation can be successfully performed while fully awake. In this method, the possible complications of surgery are prevented and a satisfactory analgesia is achieved for the patient. In this recent experience, both surgical complications are prevented and the patient and surgeon are satisfied during the operation. Performing this technique was satisfactory for our patient.