---

Introduction: Performing correct research in different aspects of community as well as medical sciences can be a way to resolve many problems. In order to create a systematic knowledge of research method in academic members of Arak University of medical sciences and enabling them in providing proposals and performing researches, a clinical research center was developed. This study is done to investigate the effect of this center on improving clinical researches in the University. Materials and methods: This is a HSR, before and after, interventional study in which, clinical academic members of Arak University of medical science were evaluated. First the information of the pre intervention period was gathered (jan2002-jan2004). Then the intervention was done in the form of developing a research center in Vali-Asr hospital, performing serial research workshops, research conferences, research consultations and planning data bases during a 2 years period. Again data was gathered and then compared to those of pre intervention period. Results: The comparison of pre and post intervention periods showed that in pre intervention period from 38 proposals 30 and in post intervention period from 89 proposals 76 were approved by research committee of the University. In the two pre and post intervention periods 14(46.6%) and 50(65.8%) of accepted proposals were clinical respectively. Also from the view point of quality, 11 and 15 proposals were HSR, 2 and 22 clinical trials and 8 and 8 descriptive, respectively. The number of published articles in first period was 45 and in second 84. Presented articles in internal and external congresses were 33 and 59 in the two periods overally, which 25 and 51 articles were presented in the country and 8 and 8 in abroad congresses, respectively. Conclusion: Regarding the results it seems developing research center in this University and other similar Universities can have a significant effect on the process of clinical researches.

---

  Introduction: Patients` staying in recovery unit is associated with risks and complications and is expensive. Decreasing the duration of staying can both increase patients` safety and decrease hospital costs. Laryngeal mask airway (LMA) as a new instrument has been widely used for airway management and in this study, its effect on recovery time is investigated.

  Materials and methods: In a double blind randomized controlled clinical trial, 62 ASA Ι & Π patients were divided into two equal groups. In one group laryngeal mask and in the other, tracheal tube was used. The anesthetic drugs were similar in both groups. Patients with upper airway infections, as well as patients undergoing thoracic and upper abdominal surgeries were excluded. Those with more than one hour duration of anesthesia and more than 30 seconds need for intubations were also excluded. Duration of anesthesia was measured in minutes. Duration of recovery staying (in minutes) and complications were also recorded. Data was analyzed using Chi Square and Mann Whitney U tests.

  Results: There were no significant differences in age, sex and mean time of anesthesia between the two groups. But mean recovery time in LMA group with 10.65 minutes and tracheal tube group with 16.71 minutes was significantly different (P=0.007). Two patients (6.45%) in LMA and 11 patients (35.48%) in tracheal tube group developed complications during recovery period which was a statistically significant difference (P = 0.004).

  Conclusion: Laryngeal mask airway, decreased recovery time and the number and severity of respiratory complications. Complications such as cough, laryngospasm, bronchospasm, and arterial hypoxemia were significantly less in patients with laryngeal mask airway compared to patients with tracheal tube, so the use of LMA is recommended.

 

---

Introduction: Allium Sativum (garlic) is used widely in the world, especially in Iran. This plant is used in cooking foods as an odorant. In Iran it is believed that it is useful for gastrointestinal disorders. So in this study the effect of Allium Sativum extract on acid and pepsin secretion in rat is investigated. Materials and Methods: This experimental study is performed on two groups of rats (12 in each group: control group and allium sativum group). After anesthesia with nesdonal (50 mg/kg, ip), rats had gone under surgical tracheotomy, laparatomy and gasterodeodenostomy. In garlic group Allium Sativum extract (100mg/kg) was introduced into the stomach by gasterodeodenostomy canula. In order to stimulation of acid and pepsin secretion, Pentagastrin was used (25mcg/kg, ip). Stomach secretion was washed out and acid was measured using titerimetery and pepsin using Anson method. Data was analyzed using t-test. Results: Allium Sativum caused a meaningful increase in acid and pepsin secretion in garlic group comparing to control group (p<0.001). Pentagastrin also increased acid and pepsin secretion in control group (p<0.001). Conclusion: Using garlic in nutritional regimen causes an increase in acid and pepsin secretion in those using this plant.

---

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.

---

  Background: Considering some evidence on anti-diabetic potential of Allium ursinum (AU) , this study was conducted to evaluate the effect of oral administration of AU on contractile responsiveness of thoracic aorta in diabetic rats.

  Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, AU-treated control, diabetic, glibenclamide-treated, and AU-treated diabetic groups. For inducing diabetes, streptozotcin (STZ) was administered (60 mg/Kg). AU-treated group received AU mixed with standard pelleted food at a weight ratio of 1% for 2 months. Serum glucose level was measured at weeks 4 and 8. Eventually, contractile responsiveness of thoracic aortic rings to KCl and noradrenaline (NA) was evaluated .

  Results: Serum glucose level, at weeks 4 and 8, in the AU-treated diabetic group was significantly lower than that in the diabetics group (p<0.01 and p<0.005, respectively). In addition, the maximum thoracic aorta contractile responsiveness to NA in the AU-treated diabetic group was significantly less than the diabetic group (p<0.05) however, such a significant reduction was not observed for KCl.

Conclusion: Oral administration of AU for 2 months is of a moderate hypoglycemic effect and attenuates the contractile responsiveness of the vascular system in diabetic rats. Background: Considering some evidence on anti-diabetic potential of Allium ursinum (AU), this study was conducted to evaluate the effect of oral administration of AU on contractile responsiveness of thoracic aorta in diabetic rats. Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, AU-treated control, diabetic, glibenclamide-treated, and AU-treated diabetic groups. For inducing diabetes, streptozotcin (STZ) was administered (60 mg/Kg). AU-treated group received AU mixed with standard pelleted food at a weight ratio of 1% for 2 months. Serum glucose level was measured at weeks 4 and 8. Eventually, contractile responsiveness of thoracic aortic rings to KCl and noradrenaline (NA) was evaluated. Results: Serum glucose level, at weeks 4 and 8, in the AU-treated diabetic group was significantly lower than that in the diabetics group (p<0.01 and p<0.005, respectively). In addition, the maximum thoracic aorta contractile responsiveness to NA in the AU-treated diabetic group was significantly less than the diabetic group (p<0.05) however, such a significant reduction was not observed for KCl. Conclusion: Oral administration of AU for 2 months is of a moderate hypoglycemic effect and attenuates the contractile responsiveness of the vascular system in diabetic rats.

---

Background: Chronic diabetes mellitus is accompanied with disturbances in learning, memory, and cognitive skills. Noticing the existing evidence regarding the anti-diabetic potential of hesperetin, the effect of its chronic administration on learning and memory in diabetic rats was investigated. Materials and Methods: In this experimental study, 40 male Wistar rats were divided into control, hesperetin-treated control, diabetic, and hesperetin/glibenclamide-treated diabetic groups. For evaluation of learning and memory, initial (IL) and step-through latencies (STL) were determined at the end of the study using passive avoidance test, and the alternation behavior percentage was obtained using Y maze. Results: STL significantly decreased in the diabetic (p<0.01) and hesperetin-treated diabetic (p<0.05) groups in comparison to the control group however, the difference between these two groups was not significant. Alternation percentage in the diabetic group was significantly lower in comparison to the control group (p<0.05), but the hesperetin-treated diabetic group revealed a significant difference in comparison to the diabetic group (p<0.05). Conclusion: Although long-term treatment with hesperetin does not enhance the capability of retention and recall in diabetic animals on the passive avoidance test, it can improve the short-term spatial memory in diabetic animals.

---

Background: Laryngoscopes are one of the potential mediators of infection transmission due to their blades contact with oral mucous membranes. Using single-use plastic blades is a method of preventing infection transmission. The aim of this study is to compare the efficiency of single-use plastic and reusable metal laryngoscope blades in orotracheal intubation during the rapid- sequence induction of anesthesia Materials and Methods: In this clinical-trial, 310 patients, more than 10 years of age, who were candidates for elective surgery, were selected. After anesthesia induction, orotracheal intubation was done by either single-use plastic or reusable metal blades for patients. Duration of intubation and arterial oxygen saturation were recorded before and after intubation. Data analysis was done using SPSS software. Results: Orotracheal intubation was done successfully in all patients. Mean differences of intubation time from the standard upper limit were 1.42±8.19 and 13.1±4.22 seconds in the plastic and metal blades groups, respectively. Also, the mean of difference in oxygen saturation of the low 90% after intubation were 6.07±2.71 and 7.16±1.21 in plastic and metal blades groups, respectively. Both parameters indicated statistically significant differences. Conclusion: In rapid-sequence induction of anesthesia, by using single-use blades, both intubation time and arterial oxygen saturation drop will increase in comparison with metal blades. This will cause complications such as aspiration in the patients.

---

Background: Differentiation of M. tuberculosis complex organisms were assigned to one of three genotypic groups based on the combinations of polymorphisms at katG codon 463 and gyrA codon 95. Early identification of strains belonging to any particular group is very important. This study was planned to identify major genetic groups of clinically isolated Mycobacterium tuberculosis. Materials and Methods: In this cross sectional study 33 sputum samples were collected from tuberculosis patients of the Markazi province. DNA purification from isolated samples was performed by Chelex 100. Identification of isolates was confirmed by detection of katG gene and the mutation in KatG463 by using PCR method and RFLP respectively. Finally 620-bp of katG gene and 194-bp of gyrA gene purified from PCR product were sequenced. Results: Amplification of 620-bp fragment of katG gene was a good way to confirm the detection of bacteria as a molecular approach. Results of sequencing codon GyrA95 in combination by results of PCR-RFLP determined type of the major genetic group (MGG). Therefore it showed that among the 33 Mycobacterium tuberculosis isolates 12 samples were MGG 1, 15 Samples were MGG2 and 6 samples were MGG 3. Results revealed that MGG 2 was dominant form of M. tuberculosis strains of Markazi province by frequency of 45.5%. Conclusion: Based on the results of this study MGG2 occurrence was more frequent among clinical strains in Markazi province that its accordance with susceptibility of these strains to conventional antibiotics is notable. In this study, three applicable benefits from the test as: MGG typing, molecular detection of M. tuberculosis and bacterial resistance to Isoniazid were proven.

---

Background: Metastasis or compress effect of adjacent tumors and thyroid neoplasms are the most common causes for airway obstruction which may lead to emergent intubation or tracheostomy due to respiratory distress. Case: A 61 year-old, female patient with history of papillary cell carcinoma with metastasis to lung, trachea and vocal cords was referred to our hospital with complaint of dyspnea. In the early hours of hospital admission the patient suffered from attacks of apnea and gasping, and initial efforts to control the airway were performed immediately which were not successful. Then it was decided to perform broncoscopy and tracheostomy to provide a safe airway. Conclusion: In the absence of adequate equipment and emergency respiratory situation, it is better to provide a secure airway immediately. For this purpose, we can use low depth of anesthesia without use of muscle relaxants.

---

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

---

Background: Hydatid disease is a common infection caused by Echinococcus granulosus. Cerebral involvement is very rare and only occurs in 2% of all hydatidosis in endemic areas. We report a case of primary multiple cerebral hydatid cysts in a 23 years old patient. Case: A 23 years old female was admitted in our emergency ward with primary generalized tonic colonic seizure, left body and face hemiparesis and history of headache in last two months. Contrast enhanced CT and MRI showed a big well-defined, rounded, cystic lesion in the motor strip of right temporo-parietal region with mass effect causing midline shift which was diagnostic for brain hydatid cyst and several smaller cysts. There was no evidence of other organs involvement. The patient underwent the brain surgery. A big hydatid cyst (10cm in diameter) and some others adhering to brain parenchyma in different sizes were evacuated completely and without rupture using Dowling method. Patient received albendazole 400mg/two times a day for 2 months too. There was no cyst in patient’s MRI study in two years follow up.

Conclusion: Though low incidence, primary multiple cerebral hydatid cysts should be considered in endemic area using brain CT and MRI. Surgery is standard treatment of the disease.

---

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.

---

Background: Glaucoma is the second most common cause of blindness and it is one of the main causes of irreversible blindness. Multi-drug regimens usually recommended in reducing intraocular pressure (IOP) in patients with glaucoma. This study was aimed to compare the effect of combination therapy with Timolol and Latanoprost vs. Timolol and Dorzolamide in reducing IOP in patients with open-angle glaucoma.

Materials and Methods: In this blind randomized clinical trial study, 60 eyes with glaucoma were randomly assigned to two treatment groups including Timolol and Latanoprost vs. Timolol and Dorzolamide. Required variables were measured before and 6 weeks after the intervention. The data was analyzed by running the Stata software (version 12) at a significance level of 0.05.

Results: The mean age in groups of Timolol-Latanoprost and Timolol and Dorzolamide was 72.6 and 67.6 years old, respectively. Analysis of the data revealed that there was no significant difference between groups in terms of intraocular pressure (IOP), visual acuity and cup to disc ratio.

Conclusion: According to our findings, there were no statistical significant differences in the IOP lowering effect between both treatments in open angle glaucoma patients.

---

Abstract

Background: Uterine myomas are benign tumors of the uterus which are derived from smooth muscle cells of the myometrium. Genetic factors play a major role in the progression of the disease. One of the most important genes which have impression in the mechanism of formation of the myoma is epidermal growth factor receptor (EGFR) that plays a basic role in the process of cell growth, differentiation, proliferation and mitogenesis. The aim of this study is survey of EGFR gene common mutations in Iranian women with uterine myomas. In this test, the common mutations of the exon 21 and 19 in the EGFR gene were surveyed.

Materials and Methods: In this case-control study, 80 women with myoma and 80 healthy women were studied as control. For checking deletion mutation of the Exon 19 (rs121913438), the Tetra ARMS/PCR method has been used and also for checking point mutation of the exon 21(rs121434568), the ARMS/PCR method has been used and results of the experiments were analyzed via χ 2 test.

Results: The comparison of the genotypes frequency of exon 21 (TT, TG, GG) and exon 19 (WW, WD, DD) related to EGFR gene in two groups of patients and control with using statistical test respectively represents the significant difference (p=1.320e-16) and (p=3.053e-13) in the different genotypes frequency among the patients and control groups.

Conclusion: The results of research indicate a significant relationship between EGFR gene mutations in exon 19 and exon 21 and potential for myoma in the studied population.

---

---

Background and Aim: The widespread use of antibiotics has been led to increased emergence of antibiotic resistant bacteria and high mortality and morbidity rates due to infectious diseases. Pseudomonas aeruginosa is one of the most important causes of nosocomial infections, which shows high resistance to a wide range of antibiotics. So, finding new and effective antimicrobial compounds in order to overcome antibiotic resistant infectious diseases is so critical. Screening of native actinobacteria can be an effective strategy to find novel antimicrobial compounds. The aim of current study was isolation, screening and identification of rare actinobacteria to find the strains which produce antimicrobial compounds against P. aeruginosa. Material and Methods: Thirty samples of water and sediments were collected from Persian Gulf and Oman Sea and used for isolation of actinobacterial strains. After isolation of actinobacteria, their metabolites were extracted and their anti-P. aeruginosa activities were investigated. Minimum inhibitory concentration (MIC) of the most efficient extract was determined using broth microdilution method. Finally, the most efficient strain was identified. Ethical Considerations: In this study, all principles of biosafety and bioethics have been considered. Findngs: Fifty actinobacteria were isolated from water and sediments. Five isolates had considerable antimicrobial activity. MIC value of the most efficient extract against P. aeruginosa was 100 µg/ml. Molecular analysis of 16SrRNA showed that the most effective fermentation broth extract belongs to Micromonospora and has 99.8% similarity to M. chalcea. Conclusion: The current study revealed that the water of southern Iran and their sediments are promising sources of potent rare Actinobacteria in the production of antimicrobial compounds against P. aeruginosa.

---

---

---

---

Background and Objectives: The present study was conducted with the aim of investigating the effectiveness of problem solving training on life orientation, positive and negative emotions, and learned helplessness in incompatible couples in Qaemshahr city.
Materials and Methods: The method of the present research was an experiment and a quasi-experimental research design with a control group. The statistical population included all couples who referred to counseling centers in Qaemshahr city in 2023. 30 couples were selected as a sample using available sampling method and randomly assigned to two experimental and control groups (15 people in each group). Then, the subjects of the experimental group received problem solving training during 8 sessions of 60 minutes. In order to collect data from life orientation questionnaires (Shier and Carver, 1994), positive and negative affect (Watson et al., 1988) and learned helplessness (Quinless and Nilsson, 1988) in two stages before and after training in both groups (experiment and control) were used.
Results: The findings from the analysis of covariance test showed that problem solving training improved optimism in life orientation, increased positive emotion, and reduced learned helplessness in the tested group (p=0.05).
 Conclusion: According to the findings of the present research, in the field of therapy and counseling of incompatible couples, training in problem solving for the compatibility of couples and solving their conflicts; It looks very efficient and promising.