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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: Considering the increasing incidence of atherosclerosis and cardiovascular disorders in diabetes mellitus, this study was conducted to evaluate the beneficial effect of two-month administration of Plantago Psyllium (PP) seed on the contractile reactivity of isolated aorta in diabetic rats. Materials and Methods: In this experimental study, 32 male Wistar rats were randomly divided into four control, PP-treated control, diabetic and PP-treated diabetic groups. To induce diabetes, Streptozotcin (STZ) was intraperitoneally administered (60mg/Kg). PP-treated groups received PP mixed with standard pelleted food at a weight ratio of 6.25%. After 2 months, contractile reactivity of thoracic aortic rings to KCl and Noreadrenaline were determined using isolated tissue setup. Data was analyzed using ANOVA and Tukey tests. Results: Serum glucose level showed a significant increase in diabetic group after one and two months (p<0.001), but it,s decrease in PP-treated diabetic group was not significant in comparison to diabetic group. Also PP-treated diabetic group showed a lower contraction to KCl (p<0.05) and noreadrenaline (p<0.01) as compared to diabetic group. Meanwhile, there was no significant difference between control and PP-treated control groups regarding contractile reactivity. Conclusion: It can be concluded that oral administration of PP for 2 months can decrease the contractile responsiveness of vascular system and this may prevent the development of hypertension in diabetic rats.

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Introduction: There is little information about essence and combination of ductuli efferentes secretions. Glycoconjugates importance in sperm production and maturation has been confirmed in previous studies therefore this study is done in order to recognitize Glycoconjugates in ductuli efferentes epithelium and determination of their distribution pattern by means of lectin histochemistry. Materials and Methods: In this descriptive study tissue species were obtained from 30 adult male BALB/c mice. After fixation and routine laboratory processes, 5 μm sections were prepared from paraffin blocks. These slides were exposed to different lectins by means of lectin histochemistry. Reaction intensity in different cells was investigated by light microscope and graded according to the previous related studies. Then results were compared with each other by Kruskal-Wallis and Dunn statistical tests. Results: The mean of reaction intensity in ductuli efferentes epithelium in reply to different lectins, showed significant statistical difference (p<0.005). The most intense reaction was seen in response to WGA (Wheat Germ Agglutinin) lectin and after that to SBA (Soybean Agglutinin), VVA (Vicia Villosa Agglutinin) and PNA (Peanut Agglutinin) respectively. But the staining was negative with GSA-I (Griffonia Simplicifolia Agglutinin-I) lectin. Conclusion: Results indicate that the cells of ductuli efferentes epithelium in mouse are involved in synthesis and secretion of sperm maturation related glycoconjugates and produce a variety of these components in various amounts. There is a large amount of components, containing terminal sugars such as Sialic acid,Galactose-N-Acetylgalactosamine and N-Acetylgalactosamine in ductuli efferentes cells. The lack of Galactose in this epithelium shows that, it hasn’t a role in sperm maturation.

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Introduction: Hypertension is a common asymptomatic and usually easy to treat disease. Regarding the fact that genetic, social and nutritional factors responsible for inducing hypertension are not the same in different societies, it is necessary to performe a study to introduce a model of hypertention which includes laboratory measures as risk factors of hypertension at Arak city in 2004. Materials and Methods: This is a case-control study. Study samples were 1000 persons (263 patients with hypertension and 737 healthy people). Samples were selected using multi-stage method in which the population ratio in city and village in both groups was considered. Laboratory findings and ECG results were documented. Data was analyzed using descriptive statistics and logestic regression. Results: In this study hepertensive patients were compared to healthy people. Some risk factors in this study were LVH (p<0.0001), high triglyceride, hypercholesterolemia and hyperglycemia. Also a model was made based on ECG results and laboratory findings to predict the probability of hypertension. Conclusion: By educating physicians about the determined risk factors in this study, they can control them better and decrease hypertension complications in heart, brain, kidney and eye. On the other hand the obtained model can be used in determination of the propable hypertension in people with positive family history

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Introduction: Plantar fasciitis is one of the common complications in adults. It can be treated by surgical and nonsurgical interventions. Nonsurgical treatments (functional foot orthosis, heel pad, night splint and wedge) are emphasized as the main option in management of plantar fasciitis. Wedge can be used effectively because of its low weight, low price, easy making and availability to the patient. In this study the effect of medial heel wedge on managing pain in patients suffering from plantar fasciitis was examined. Materials and Methods: In this before and after clinical trial, 15 patients with plantar fasciitis including 6 male and 9 female with 18 involved extremities were selected by non probability sampling.Variables including pain, ADL, sport and recreational activity, quality of life, stride length and step length were measured in three stages: once before intervention and then two and four weeks after intervension. For evaluating the variables, FAOS questionnaire was used. Data was analyzed using ANOVA. Results: The improvement of variables such as pain, ADL, quality of life, sport and recreational activity, step length and stride length was significant (p=0.05). Conclusion: Medial heel wedge reduced pain by shifing the center of force into lateral border of heel in addition to reduce the tension of plantar fascia.

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Introduction: Regarding the fact that dissanitation in swimming pools can cause a lot of diseases such as Dermatophytosis in swimmers, this study is done with the aim of determination of Dermatophytic infections in covered public swiming pools of Qom city during 2004. Materials and Methods: In this descriptive study 480 samples were taken from six public swimming pools. Samples were carried to the laboratory where they were passed through milipore filters. Filters then were trasfered to mycosel agar medium and incubated for three weeks at 25 Co. Data was analyzed using fisher test. Results: Among 480 samples, eleven Dermatophytes (8/8 percent) were isolated and indentified as follow: Trichophyton Mentagrophytes (2/4%), Trichophyton Tonsuranse (1/6%), Trichophyton Equinum (1/6%), Trichophyton Verrucosum (0/8%) Trichophyton Rubrum (0/8%), Trichophyton Schoenlinii (0/8%) and Epidermophyton Floccosum(0/8%). There was a significant relationship between prevalence of Dermatophytes and disregarding of personal hygiene standards (p=0/0001) and no significant relationship between residual Chlorine of swimming pools and prevalence of Dermatophytes. Conclusion: Because the majority of isolated Dermatophytes were anthropophilic and had been transferred from swimmers to the swimming pools it is necessary to care personal hygiene standards and provide good sanitation conditions in water and environment of the swimming pools.

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Introduction: The reported 12 months prevalence of low back pain in nurses ranges from 43% to 76%. In most researches physical factors were only a part of high prevalence of low back pain in nurses. This study was conducted to determine the association between occupational stress and low back pain in nurses. Materials and Methods: In this case-control study, 80 nurses as case group and 80 nurses as control group were selected via convenience sampling. Case group were defined as those subjects who had experienced low back pain in the last 12 months. Control group were defined as those subjects who had not experienced low back pain in the last 12 months. A questionnaire was used for data collection which consistsed of 3 sections: demographic information, history of low back pain and occupational stress. Data was analyzed using paired T, Mann-Whitney, and Chi-square tests, correlation coefficient and one way ANOVA Results: Results indicated that, there was an association between low back pain and occupational stress (p<0/01).Also an association existed between low back pain and working hours per month (p<0/05). Statistical tests showed no significant difference between the two groups in terms of age, gender, marital status, number of childbirth, number of pregnancy, smoking, sport, work shift, number of years spent in the hospital (nursing experience). Conclusion: Results indicated that occupational stress in case group was more than control group. Since there was not any significant difference between other factors and low back pain, it can be concluded that there is an association between low back pain and occupational stress.

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Introduction: There is difference between susceptibility or resistance to infectious diseases such as cystic and alveolar Eclinococcosis in human and animals, that is due to the difference between individual host factors and immunologic responses. This study is done to investigate the resistance and susceptibility markers (HLA) in Hydatid patients and healthy persons. Materials and Methods: This analythical (case-control) study is carried out on 60 patients with confirmed cystic echinococcosis and 30 healthy individuals living in Arak. Blood samples were gathered and tested by microlymphocytotoxicity method. At first diagnostic kits with specific antiserusms for each antigen (28 antigens) were provided and then lymphocytes were separated. After dye and stabling with formalin and based on cells morphology, results were seen by invert microscope. Data was analyzed using Odds Ratio, Relative Risk, Preventive Fraction, Aetiologic Fraction and Chi square test. Results: Results showed that HLA-A1 was significantly higher in patients (p<0.05), and people having this antigen are more susceptible for the infection. In spite, HLA-A10 was higher is healthy individuals (p<0.05) and have a preventive effect in disease involvement. Other investigated antigens had no signigicant difference in the two groups. For more accurate results molecular investigation is needed. Conclusion: In individuals having HLA-A1 there is more chance for cyst growth in confronting hydatosis and this individuals are more susceptible to the disease. But in individuals having HLA- A10 there is less chance for cyst growth in confronting hydatosis and this antigen have a preventive effect against hydatid cyst.

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Introduction: One of the severe forms of affective disorders, defined in DSM-IV-TR, is bipolar disorder type1. This is a psychotic disease that coexists with structural and biochemical changes of CNS. It is probably under influence of environmental and/or genetic factors. Finger and hand prints are formed during the late first and second trimester of fetal development, and then remain unchanged. There are some suggestions that disturbance in dermatoglyphic patterns probably are in relation with appearance of bipolar disorder. It seems that this disturbance is appeared at the first and second trimester of fetal development, which is a critical period for CNS growth. This study is done to investigate the dermatoglyphic patterns in bipolar disorder. Materials and Methods: This is a case-control study in which we have studied the dermatoglyphic changes in 30 bipolar disorder patients and compared to those of 72 healthy controls. The χ2 test was used for quantitative and T-test for qualitative data analysis. Results: Results showed that TABRC in patients was decreased in comparison to healthy people but this decrease was not significant. Regarding the type of patients, fingerprints, Loop and Whorls forms were heterogenous and were significantly different in comparison to control group (p=0.001, p=0.003). Conclusion: It seems that dermatoglyphic patterns can be an interesting and probably suitable procedure in determining the prognosis of bipolar disorder type 1 and other psychiatric disorders.

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Introduction: Using one subcutaneous infiltration of Bopivacaine can cause a good pain relief in pediatric surgery, so the child may no longer need rectal Acetaminophen after surgery. In this study, we compared the efficacy of the two drugs. Materials and Methods: This was a clinical trial, performed on 141 pediatric patients between 6 months to 3 years old with unilateral or bilateral inguinal hernia or undescending testis. Patients were divided randomly into two groups. The first group received infiltration of Bopivacaine preoperatively and the second received the routine rectal Acetaminophen after surgery. In both groups pain score was measured with FPRS score 3,6,12 and 24 hours after surgery. After collecting data they were analyzed with T-student and Friedman tests. P<0/05 was considered significant. Results: Global FPRS pain score was lower in the group treated with Bupivacaine infiltration on 3 and 6 hours after surgery (p<0/05), but in 12 and 24 hours after surgery no significant difference was seen in the two groups. Conclusion: This study showed that, infiltration of Bupivacaine reduces pain better than Acetaminophen, especially during the first 6 hours after surgery. So because of better pain control and also single administration, we suggest using infiltralition of Bupivacaine preoperatively.

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Introduction: Adenosarcoma is a rare uterine tumor composed of benign epithelial and malignant stromal elements. In 20% of cases stroma contains heterologous elements (usually from stratified muscle type). Association between Tamoxifen usage (exogenous strogen) or ovarian thecoma (endogenous strogen) and occurance of this tumor has been reported. This is a case report of a uterine Adenosarcoma. Case: The patient was a 45 years old woman with history of 16 years OCP use who was admitted with a uterine mass and undergone total hysterectomy. Microscopic assessment of slides, stained by H&A, was indicator of Adenosarcoma with cartilage heterologous elements. Conclusion: Uterine Adenosarcoma is a rare tumor. Although there is a few reports of cartilage heterologous elements in uterine Adenosarcoma, this case had multiple cartilage points in stroma. Also in this case, the coexistance of this tumor with long- term OCP use was considerable. 

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Introduction: Oxidative stress may play a critical role in neurodegenerative disorders but the relation between oxidative stress and learning ability in normal rats is not investigated, so the aim of this study was to investigate the correlation between oxidative stress and two way active avoidance learning in Wistar rats. Materials and Methods: This is an experimental research. 14 Wistar rats were assigned for assessed learning ability in shuttle box. One day after shuttle box learning, cerebrospinal fluid (CSF) and blood samples were obtained. Concentration of Nitric Oxide and Ferric reduction/antioxidant power were assessed. Data was analyzed using Pearson correlation test. Results: The results of the present study demonstrate that there are positive correlation between shuttle box learning ability and Ferric reduction/antioxidant power (p<0.001, r =0.66 4) and Nitric Oxide concentration (p<0.001, r = 0.724) in serum, but not in CSF. Conclusion: The results of this study suggest that high concentration of antioxidant power and Nitric Oxide concentration in blood can improve shuttle box learning in rats

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Introduction: Irritable bowel syndrome (IBS) is the most common functional bowel disorder. Stress triggers or aggravates it's symptoms. This investigation is carried out to determine the effect of Benson relaxation therapy on anxiety level and severity of symptoms in patients with irritable bowel syndrome. Materials and Methods: In this clinical trial 30 patients with irritable bowel syndrom were randomly divided into case and control groups. The control group was treated by only usual medical therapy but the case group was treated by combined medical- relaxational therapy. The two groups continued therapy for three months. Anxiety level and gastrointestinal symptoms of case and control groups were compared at three different times (two weeks before intervention and one week and three months after intervention). Also, patients were asked to document 6 common gastrointestinal symptoms in their daily symptom diaries, 2 weeks before intervention to 3 months after intervention. At the end of each week, these symptoms were compared in the two groups. Data was analyzed using chi square , Man - Whitney U and Wilcoxon tests. Results: Mean state and trait anxiety of the case and control groups two weeks before and one week after intervention did not show significant difference. But the results after 3 months showed a significant difference (p<0.001).The mean severity of gastrointestinal symptoms, 2 weeks before intervention, was significantly higher in case group, but the comparison of gastrointestinal symptoms severity, 1 week after intervention, did not show any significant difference between the two groups, and 3 months after intervention a significant difference was observed in the two groups (the control group had more severe symptoms than the case group). The comparison of 6 common gastrointestinal symptoms based on weekly self-report showed that abdominal pain, eructation and distention were significantly lower in case group, but there was no significant difference between diarrhea and constipation. Conclusion: Three months Benson relaxation therapy significantly decreased the state and trait anxiety level and severity of symptoms in patients with irritable bowel syndrome.

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Introduction: Flexor tendon entrapment of the digits (FTED) is a disorder characterized by snapping or locking of the thumb or fingers (with or without pain) and called trigger finger. Corticosteroid injections are one of the most commonly used treatments for chronic tendon disorders. Despite their popularity, the systematic evidence for their benefits are largely lacking. This study tries to determine the efficacy of local corticosteroid injection in treatment of trigger finger. Materials and Methods: This is a clinical trial research. Variables including local tenderness, trigerring stage, pain during isometric flexion and passive stretching of the tendon (based on VAS) were evaluated before local injection of corticosteroid and then 3 weeks, 3 months and 6 months after the injection. Data was collected by special forms and analyzed using Chi square and ANOVA Tests. Results: The difference between persence of A1 pulley tenderness in 4 examinations was significant (p<0.0001). The difference between pain induced by isometric flexion and pain induced by stretching the tendon passively in extension was also significant (both p<0.0001). The difference between frequency distribution of triggering was significant (p<0.0001). Patients satisfaction was 90% . Conclusion: The rate of success in local corticosteroid injection was 90% (only with one injection). The high rate of success and low side effects, make this method a suitable treatment for trigger finger.

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Introduction:The membranes used in haemodialysis may be manufactured from cellulose, modified cellulose or synthetic polymers. Such membranes, when in contact with blood will activate the complement system, which entails changes in leukocyte and platelet counts. Polysulfone is a synthetic membrane of high biocompatibility standards, whereas haemophane membranes are modified cellulose-based membranes. The biocompatible profiles of these membranes, has been studied by clinical reactions (i.e. hypotension, nausea, pruritis, …) during dialysis sessions. Both kinds of these membranes are used in Iran. The number and severity of these reactions define the degree of dialysis biocompatibility. Materials and Methods: In a clinical trial study which was carried out in Imam Khomeini hospital in Tehran, 100 hemodialysis patients were enrolled to this investigation. Their clinical reactions were compared during 3 sessions of hemodialysis with polysulfone and 3 sessions of hemodialysis with hemophan membrane. Each patient was the control of him/herself. Data was analyzed using Chi square test. Results:Mean age of patients was 48.85±17.56 years and 39% of them were female. The most common complications were hypotension and muscle cramps (each 21.5%). Hypotension was higher in sessions of polysulfon versus hemophane (18% versus 25%) but was not significantly different. Also other complications such as muscle cramp, nausea, vomiting, dyspnea, headache, chills and fever had no significant difference. Seizure did not occur in any patient. Conclusion: According to our findings the membrane’s type has no role in acute clinical complications during hemodialysis and in most patients, membranes can be used according to their availability. It seems their biocompatibility has no considerable clinical difference.

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Introduction: Pain relief has been received the highest level of medical attempts continuously but still many patients suffer from it. Narcotics' side-effects have led investigators to apply other techniques for controling acute postoperative pain to reduce narcotics requirements. Recently, some concepts have been presented implying that Metoclopramide does have analgesic effects and this led us to conduct the present study in order to determine Metoclopramide's effect on alleviating pain after cesarean section. Materials and Methods: In this clinical trial, 80 patients who were candidates of elective cesarean section were studied in two groups. 10 minutes before the cesarean section's ending time, the control group was given 25 mg Pethidine accompanied by 10 mg Metoclopramide and control group 25 mg Pethidine and distilled water. Then when patients were conscious after cesarean section, for a period of 6 hours received after-care for their vital signs and side-effects of prescribed drugs. Their pain score (VAS) and nausea rate was measured and if necessary, Pethidine was injected with certain dose. Injection time for first dose of Pethidine and its required amount were recorded in a checklist within first 6 hours after cesarean section. Data was analyzed using ANOVA and T tests. Results: Prescription of Metoclopramide inhaunced analgesic effect of narcotics and a meaningful decrease was found in pain score (p=0.002) and nausea rate (p<0.005). Injection time for the first dose of Pethidine was also prolonged in the group who received Metoclopramide compared to control group (p=0.019) and an obvious decrease was occurred in received Pethidine's amount within the first hours after cesarean section (p<0.005). Drugs side-effects were not found in patients. Conclusion: The results indicate that use of Metoclopramide accompanied by Pethidine in ending time of cesarean section, does have considerable effects in controlling acute pain after surgery and increasing analgesic effect of narcotic drugs. Therefore, use of Metoclopramide as a proper supplement drug with low side-effects is recommended.

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Introduction: Radiotherapy after breast cancer surgery will increase local control of the disease and also increase overall survival. Radiation have some side effects on lung function. In different radiotherapy techniques, these side effects are different. Pulmonary function tests and oxygen saturation are methods for evaluation of these complications. In this study we decide to campare pulmonary complications in two radiotherapy methods. Materials and Methods: In this clinical trial study fifty one patients with breast cancer in stage II and III according to TNM staging system, which were under modified radical mastectomy in Imam Hosein hospital and refered for adjuvant radiotherapy, randomly divided in two groups. In one group patients were treated with three field technique and in others with four field technique. All patients received total dose of 48-50 Gy. For patients, pulmonary function test and pulse oxymetery were done once before initiation of radiotherapy and then one and three months after radiotherapy. Results: Measurement of FEV1 , FVC and show that no significant statistical difference was present between the two groups one month and three months after radiotherapy, also in each of the two groups the amount of FEV1 , FVC and one month after radiotherapy had no significant statistical difference in comparison to baseline tests but FEV1 and FVC after three months was decreased and had significant statistical difference respectively (p<0.001, p<0.006). SO2 had no significant defference between the two groups and also in each group after one and three month of radiotherapy. Conclusion: Locoregional radiotherapy of breast and lymph nodes areas causes a decrease in some parameter of pulmonary function tests but no difference was present between three field and four field techniques.

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Introduction: Kalleh-Pacheh is an Iranian food used in many part of Iran and many other countries such as Afghanistan, Pakistan and India. We found no information regarding the effect of this food on acute myocardial infarction. The aim of this study was to assess the effect of this food, together with diabetes and smoking on myocardial infarction in Arak district. Materials and Methods: This was a case-cohort study which was performed in Arak district. In this study the data of Arak sub-cohort was taken from Isfahan healthy heart project which was performed in 2001. Cases were myocardial infracted hospitalized patients who were resident in Arak at the time of study. We showed the effect of different exposure, on myocardial infarction by estimating relative risk and population attributable fraction and 95% confidence interval. Results: In this study 150 cases were compared with 6339 sub-cohorts. The population attributable fraction for Kalleh-Pacheh was 19% (95% CI, 6 to 30%). This measure for diabetes and smoking was 31% (95% CI, 23 to 39%) and 41% (95% CI, 31 to 49%) respectively. Conclusion: According to the results of our study smoking, diabetes and using Kalleh-Pacheh has significant effect on myocardial infarction

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Introduction:Final examinations are important stressors in schools and universities that result in different psychoneuroimmunological outcomes but the study of these effects on children has not been paid enough attention to. The aim of this study is to investigate the effect of final examinations on salivary immunoglubulin A in children. Materials and Methods: In this clinical trial a total of 100 children (50 boys, 50 girls) in 5th grade, aged less than 12 years from two primary schools of 5th educational district in Tehran were choosen randomly. The subjects completed Test Anxiety Scales of Sarason & Abolghasemi. After making sure of their physical and mental health by reviewing their medical history, clinical examinations and after controlling sleep, food, drug and sport variables, based on time series design, salivary IgA samples were taken five times as followed: one week before and then three times through mathematics, history and science exams and at last one week after passing the exams at, 9 to 10 am. IgA samples were analyzed by nephlometry method. Data was analyzed using ANOVA. Results: Findings indicated that IgA level was decreased significantly during examinations comparing to IgA levels before and after examinations (p=0.01). The relations of sex and anxiety scores were not statistically significant. It means that decreased IgA levels are the same in all children. Conclusion: Final examinations as a stress resource, diminishes IgA and this change is not related to sex and test anxiety score.

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Introduction: There are a few clinical trials on human that show the effect of topical vitamin E on keloid and hypertrophic scars. In this investigation we try to study this effect and also show the effect of the concentrations which have not been considered yet in improving hypertrophic scar and keloid healing. Materials and Methods: In a double-blind randomized clinical trial, 32 patients who had hypertrophic scar from 12 weeks ago were given three ointments including placebo and ointments contaning injectional vitamin E (d-α tocopheryl) with different concentrations (300Iu/mg and 600Iu/mg). The scars size, erythema and hardness were evaluated by patients and physicians after 1, 4 and 12 weeks. Data was analyzed using ANOVA and Kruskal Walis tests. Results: After 12 weeks there were no signs or symptoms of dermatitis and rash. Comparison of the scar size after 1 week showed difference between the high concentrated ointment with the others and in the 12th week all of the ointments were different (p<0.001). Evaluation of the scar erythema, in the 1th, 4th and 12th week showed significant difference between vitamin ointments and placebo (p<0.001), also scar hardness in the 12th week was significantly different between groups(p<0.001), but in the first and 4th week no difference was detected in hardness. Conclusion: This study shows that topical vitamin E has good effects on keloid and hypertropic scars. Their effect in decreasing size and erythema is more considerable than scar hardness.