---

Background: Noticing the fact that graft survival rate of kidney transplantation from live donors is more than deceased donors, this study was conducted to determine the relationship between the graft survival rate of renal transplantation and the donor source in patients transplanted from March 1999 to March 2009 in Namazi Hospital Transplantation Center of Shiraz. Materials and Methods: In this retrospective cohort study which was designed to determine the relationship between graft survival of kidney transplantation and the donor source (related live donor, unrelated live donor, and deceased donor) in 1356 patients who were transplanted in Shiraz Transplant Center, Namazi Hospital. Kaplan-Meier method was used to determine the survival rate, log-rank test was used to compare survival curves and Cox regression model was used for ruling out the intervening factors. Results: Five-year graft survival rates of renal transplantation from related, unrelated, and deceased donors were 92.4, 92.6 and 82.1%, respectively. Also, a significant relationship was seen between donor source and survival rate of the renal allograft (P>0.001). Conclusion: The findings of this study transplanted patients with kidneys from living donors (related or unrelated) have a higher graft survival rate compared with deceased donors.

---

Background: Hemorrhoidectomy is the basis of treatment for grades three and four hemorrhoid. One of the major post hemorrhoidectomy problems is pain that is usually due to the spasm of the internal sphincter. There are different methods for the management of postoperative hemorrhoidectomy pain. The aim of this study was to investigate the effect of sphincterotomy on post hemorrhoidectomy pain. Materials and Methods: This interventional clinical trial was conducted on 60 patients with 3rd and 4th grade hemorrhoid who had randomly been divided into hemorrhoidectomy and hemorrhoidectomy combined with sphincterotomy groups. The degree of pain was measured on visual analogue scale (VAS) and analyzed through Mann-Whitney, Friedman, and Chi square tests via SPSS version 14. Results: In terms of reduction in pain with sphincterotomy, there was a significant relationship between the two groups on the first, second, and fifth postoperative days (P=0.001). On the third and sixth postoperative days, a significant relationship was observed between the two groups (P=0.001). Days four and seven also indicated a significant relationship between the two groups (P=0.002). However, there were not any significant relationships between the two groups in terms of urinary and fecal incontinence and gas retention (P>0.05). A significant relationship existed between the two groups in terms of reduction in the need for sedation (P=0.006). Conclusion: Lateral internal sphincterotomy combined with hemorrhoidectomy can reduce the patients’ post hemorrhoidectomy pain and can reduce the use of analgesics, but it does not have any significant influences on the incidence of urinary retention and bleeding after the first defecation and does not increase the risk of fecal and gas incontinence in comparison with the hemorrhoidectomy group.

---

Background: Falcaria vulgaris has different properties and it used as dietary and medicinal herb in the west of Iran. Previously, we showed that this plant has protective and repairing effect on gastric ulcer were demonstrated .The aim of present work was to investigate the effects of F. vulgaris extract on female rat's fertility. Material and methods: In this Exprimental study Virgin female NMRI rats (160-190 gr) were used in three experiments. In each experiment, animal divided into two subgroups (n=8): control which received Distilled Water (DW) (2cc/kg) and case which received herb extract (150mg/kg) interaperitonealy. In first experiment, animals received single dose of extract or DW. In second experiment، female rat received extract or DW in perimplantation period (day 1 to 5 of pregnancy) and in third experiment ( day 5 to 7 of pergnancy). In both experiments implantation sites and neonates were counted in three experiments. Data were analyzed by T-Test test and p<0.05 were considered significant. Results: All three experiments showed significant differences between control and case groups in implantation sites and neonates number. This differences were more prominence in first and third experiment.

---

Background: Postoperative pain brings about undesirable effects such as medical complications, increased healthcare costs, and the need for opioids administration. The aim of this study was to determine the effect of low dose (0.15 mg/kg) ketamine in comparison with the placebo on postoperative pain and analgesics consumption after cesarean section. Materials and Methods: In a randomized clinical trial, 120 women undergoing elective cesarean section were randomly divided into case and control groups. Ketamine (0.15 mgkg-1) or an equal volume of normal saline were administered intravenously immediately after initiating spinal anesthesia to the case and control groups, respectively. The anesthesia and surgery techniques were the same for both groups. Data were analyzed using SPSS version 11. Results: Means of age in the case and control groups were 28.85±4.81 and 28.87 ±5.62 years, respectively. Analgesics consumption, pain scores, homodynamic signs, drowsiness of the mothers, and the neonates’ Apgar scores after cesarean section were similar in both groups and no significant differences were found between them (P>0.05). The mean of postoperative arterial pressure in the early hours in the ketamine group showed a significant decrease compared to the placebo group (P>0.03). The means of the first time of request for analgesics after surgery in the ketamine and placebo groups were 99.75±68.88 and 96.1±52.59 minutes, respectively (P>0.05). Conclusion: It seems that the administration of 0.15 mg/kg dose of ketamine (0.15mg/kg) does not have a significant impact on decreasing the postoperative pain in cesarean section. Therefore, in order to obtain the desirable analgesic effects of this drug, further studies should be conducted with greater doses of this drug and its use in combination with other opioids.

---

Alzheimer’s disease is one of the most common causes of loss of mental function broadly known as “Dementia”. Alzheimer’s disease affects approximately 2% (6.5 Million) of people in the developed countries and responsible for over 100,000 death per year in USA Alzheimer’s disease usually occurs between sixth to ninth decade and its progressive deterioration comprised of gradual destruction of memory, judgment, language, reasons in addition to behavioral alterations. Microscopic biopsy shows cortical atrophy along with ventricular enlargement of the brain. These clinical manifestations reflect the neurotic degeneration in cerebral cortex, especially, the temporo-parietal cortex and the hippocampus. Pathological abnormalities of Alzheimer’s disease include brain deposition of two fibrillary proteins. These two are known as Beta-amyloid proteins containing Apolipoprotein E and Tau proteins. Alzheimer’s disease affects primarily cholinergic neurons, therefore, treatment is followed by specific drugs that inhibit the degradation of acetylcholine within synapses. Current medications only treat the cognitive symptoms but not the underlying disorder. Several lines of ongoing research are showing promising scientific results. These include, uncovering the biological markers for early detection and developing new effective drugs. Also, new approaches have been employed to block the molecular processes that lead to this disease. Moreover, many clinicians are exploring alternative pathways for Alzheimer’s disease treatment, such as good diet along with mental and physical exercise as preventive methods.

---

Background: Research has shown that healthy individuals with no known cardiovascular risk factors who experience a stressful life are likely to develop cardiovascular diseases. Therefore, stress can be one of the most important risk factors involved in cardiovascular diseases. This study evaluated the possible effects of chronic stress induced by obligatory swimming and noise on coronary arteries histological changes. Materials and Methods: In this experimental trial, male Wistar rats were exposed to two different types of chronic stresses, including physical obligatory swim stress and psychological noise stress. After the last stress session, the rats were examined in terms of the ratio of the vessel lumen diameter to outer diameter, ratio of media diameter to outer diameter, ratio of adventitia diameter to outer diameter, and ratio of wall thickness to outer diameter of vessels. Results: Obligatory swimming stress and noise stress each significantly increased the ratio of media diameter to the outer diameter of vessels (P<0.001) and decreased the ratio of vessels lumen diameter to the outer diameter (P<0.05). Swimming stress and noise stress induced increases in the ratio of wall thickness to the outer diameter of vessels (P<0.01, P<0.05, respectively). In addition, swimming stress significantly increased the ratio of adventitia diameter to the outer diameter of vessels (P<0.05). Conclusion: These findings suggest that chronic stress can induce coronary vessel remodelling which results in atherosclerosis and cardiovascular diseases

---

Background: Polymerase chain reaction is the most common technique in the field of molecular biology that use for amplification of a specific nucleic acid sequence. Degenerate primers have ability to amplify related but distinct sequences. The aim of current study was to use, two sets of degenerate primers in combination with Hemi Nested PCR for detection V3-Loop sequence of envelope gene from wide spectrum of Human Immunodeficiency Virus (HIV) subtypes. Material and Methods: In this experimental study we designed and optimized, a degenerate primer pair in combination with Hemi Nested PCR, to detect HIV-1 V3 loop from Envelop gene that has wide variations among genotypes. The developed assay was used to check, 40 HIV infected, 10 negative controls as well as 5 samples from each HCV, HBV, HGV, and TTV were analyzed using developed method. Results: after optimization, 35 out of 40 positive controls were positive using our test. None of the negative human and viral control samples showed specific band. Also, in positive samples, non-specific bands were not detected. Conclusion: In this study moreover than standard PCR, we used two degenerate primers that could detect specific region of genome. In fact, first round of PCR product act as a template for second round inner primers and can produce smaller sequence with high sensitivity due to degeneracy. Based on the current investigation, the developed assay had advantages including product confirmation and hence more sensitivity.

---

Background: Physalis Alkekengi is a perennial plant with a creeping and ryzumy stem belonging to the solanaceae family. This study investigates the possible effects of Physalis Alkekengi on plasma concentrations of some biochemical factors. Materials and Methods: Fifty male Wistar rats weighing an average of 190 ± 5 g were divided into five groups of ten: Control group without receiving any substances, control group with 2.0 ml/dl administration of the solvent, and three experimental groups receiving 0.4 (maximum), 0.2 (medium), and 0.1 (minimum) g/kg intra-peritoneal (IP) injections of the drug. The intra-peritoneal (IP) injection of the drug was done for 14 days and after this period, for conducting lab tests, blood sampling was done and the results were analyzed through ANOVA and Tukey test. Results: According to the results, protein and albumin plasma concentrations showed a significant increase (P<0.05) while creatinine plasma concentration, bilirubin, and urea nitrogen (BUN) did not reveal any significant changes. Conclusion: This family of plants contains significant amounts of glucocorticoids, such compounds are likely to increase liver and plasma proteins. In addition, due to the presence of compounds, such as physaline, vitamin C, and albumin, this extract is likely to increase blood pressure and, eventually, increase glomerulic refinement and diuretic properties therefore, the absence of significant increases in plasma concentrations of the substances produced by metabolism in plasma seems reasonable

---

Background: Major depression is one of the most prevalent psychiatric diseases, whereas schizophrenia is one of the worst human diseases. Therefore, finding low-cost treatment methods with few side effects can be of great help to patients. The present study was done to compare the serum levels of vitamin D, parathyroid hormone, calcium, and phosphorous in individuals with major depression and schizophrenics with healthy subjects. Materials and Methods: In this cross-sectional study, serum levels of vitamin D, parathyroid hormone, calcium, and phosphorous were assessed in 100 major depressive, 100 schizophrenic, and 100 healthy subjects. Subjects with a history of renal failure, hepatic failure, parathyroid disease, and consumption of vitamin D, parathyroid hormone, calcium, and phosphorous supplements were excluded from the study. SPSS software version 15 was used for data analysis. Results: Depression was accompanied with decreased serum levels of vitamin D and increased serum levels of parathyroid hormone (p>0.001, p=0.01), but there was not a significant difference between depression and healthy subjects in calcium and phosphorous serum levels (p=0.69, p=0.15). Schizophrenia presented a significant correlation with decreased serum levels of vitamin D and phosphorous (p>0.001, p=0.01), but there was not a significant difference between schizophrenic and healthy subjects in calcium and parathyroid hormone serum levels (p=0.47, p=0.67). Conclusion: Since depression and schizophrenia are accompanied by decreased serum level of vitamin D, consumption of supplementary vitamin D can be helpful in the treatment of these patients.

---

Background: Localization of ectopic parathyroid glands is one of the most sophisticated challenges in endocrine surgery and there is considerable controversy regarding the suitable approach to localize ectopic parathyroid glands and indications for using different modalities. The failure of the first operation leads to pain, scar, and financial burden of the following operation. Case: The patient was a 39-year-old woman hospitalized with hematuria as the main complaint and noticing the presentation of hypercalcemia in the initial tests underwent more thorough examination. Ultrasonography and 99mTc sestamibi scan helped us to localize the ectopic parathyroid gland in an anterior mediastinum and treat the patient in a one stage operation. Conclusion: Paying careful attention to the symptoms and signs, considering all differential diagnoses, and using appropriate diagnostic methods can be helpful in the diagnosis of rare syndromes.

---

Background: Launaea acanthodes is used as a common medicinal plant in central regions of Iran. To investigate the probable hypoglycemic activity of hydro-alcoholic extract of L. acanthodes as well as its effects on serum level of insulin and biochemical factors in normal and hyperglycemic rats, the present study was carried out. Materials and Methods: In this experimental study 24 male albino Wistar rats, weighting 250-300 g were randomly allocated into four groups (n=6) control, type 1 diabetic rats (STZ 55 mg/kg), type 1 diabetic rats treated by subcutaneous injection of 5 IU/kg insulin (STZ+insulin) and type 1 diabetic rats treated by injection (i.p) of 150 mg/kg hydro-alcoholic extract of L. Acanthodes (STZ+extract). The injection of insulin and extract were done every day from day 1 to day 21 of experiment. After that, all animals were kept up to day 30. Blood serum were collected and analyzed for the levels of glucose and biochemical factors (cholesterol, triglyceride, LDL and HDL) measurements, in the 15th and 30th day of experiment. Results: The results showed significant decrease (p<0.001) in glucose level and significant increase (p<0.05) in insulin level in STZ+extract group, when compared with other hyperglycemic groups in 30th day of experiment. Conclusion: These results indicate that the hydro- alcoholic extract of L.acanthodes could be effective in the treatment of diabetes. It can be concluded that extract administration somehow induce insulin secretion probably through stimulation of remaining β cells or their hyperplasia in Langerhans islets. This effect can also be referred to flavonoides constituent and antioxidant property of extract, too.

---

Background: It has been indicated that there is a relationship between vitamin B12 status and cognitive functioning. Measurement of serum vitamin B12 is routinely performed in patients with memory loss during initial diagnosis. Noticing the role of cholinergic system and vitamin B12 on memory, the aim of this experimental study was to examine the effect of the interactions between vitamin B12 and nicotine on memory retention in passive avoidance learning in adult male rats. Materials and Methods: The present study was an experimental one. Drugs, including vitamin B12 (0.01, 0.02, 0.03, 0.05, 0.1, and 1 µg/rat) and nicotine (0.1, 0.5, and 1 µg/rat) were administrated after training session intracerebroventriculary (i.c.v.). The drugs were used (i.c.v.) in a volume of 1µl/rat immediately after the training session. The level of memory retention was evaluated by passive avoidance learning. Twenty-four hours after training, a retention test was performed to determine long-term memory. Statistical analysis was carried out using one-way ANOVA test. Results: The results showed that the administration of vitamin B12 and nicotine significantly increased memory retention in rats. Nicotine significantly increased the response to vitamin B12 in memory retention process. Conclusion: Vitamin B12 through interaction with cholinergic system acts in memory retention process.

---

Background: Since researchers were able to produce dendritic cells (DCs) from peripheral blood monocytes, many scientists have been in search of discovering the best way of producing dendritic cells and optimizing the DCs maturation processes in vitro to treat some diseases. The aim of this study was to investigate the maturation of DCs for tumor immunotherapy. Materials and Methods: In this experimental study, DCs were produced in two stages. In the first stage, monocyte cells were converted to immature DCs by GM-CSF and IL-4. In the second stage, immature DCs were made mature in the presence of human umbilical vein endothelial cells and PHA -activated T lymphocytes conditioned media and maturation factors. Results: The produced DCs with appropriate phenotype, phagocytosis ability, and proliferation of T lymphocytes stimulation traits could secrete high levels of cytokines. Conclusion: Endothelial cells and T lymphocytes conditioned media can produce Th1 and DC1 in vitro. Therefore, DCs produced through this method are suitable for immunotherapy treatment applications and cancer treatment through treatment cells.

---

Background: Sodium arsenite has adverse effects on the reproductive system and vitamin E is a strong antioxidant and reproductive factor in the reproductive system. The aim of this study was to investigate the effect of vitamin E on the structure and the number of ovarian follicles during its development in rats treated with sodium arsenite. Materials and Methods: Pregnant Wister rats (n=4) were divided into 4 equal groups, including control, vitamin E (100mg/kg/day), sodium arsenite (8mg/kg/day), and sodium arsenite+vitamin E. Oral treatment of the pregnant rats started from the 7th day of pregnancy till the end of the weaning and continued till the age of 120 days. After the treatment period, the right ovary was removed and fixed, and then the mean number of ovarian follicles and atretic follicles, mean thickness of zona pellucida, and volume of oocytes and its nuclei in different types of follicle were determined. Data were analysed using one-way ANOVA and the mean difference was considered significant at P<0.05. Results: In the vitamin E+sodium arsenite group, significant increase(P<0.05) in the total number of follicles, mean number of primordial, primary, secondary, antral, and graafian follicles, significant reduction (P<0.05) in atretic follicles, and significant increase(P<0.05) in the thickness of zona pllucida in secondary and antral follicles as well as oocyte volume in parimordial and primary follicles and its nuclei in primary, secondary, antral, and graffian follicles were observed in comparison with the other groups. Vitamin E in the sodium arsenite+vitamin E group increased the number of different types of follicles and the thickness of the zona pllucida (P<0.05), decreased the number of atretic follicles, and increased the volume of oocyte and its nuclei to the level of the control group. Conclusion: Vitamin E can be administered as a supplement to compensate for the adverse effects of sodium arsenite.

---

Background: Pain is a complex problem, which can affect patients' physical and psychological condition. Inadequate postoperative pain control has adverse effects on the patients' physiological, metabolic and mental condition. Adding new supplement will increase the duration of analgesia. This study aimed to comparison of intratechal neostigmine and midazolam in increasing the time of postoperative analgesia. Materials and Methods: In this randomized double blind clinical trial, 60 patients with ASA class Ι, II who were candidate for elective colporrhaphy surgery under spinal anesthesia were randomly divided into 3 groups of 20 patients. All patients received hyperbaric lidocaine 5% and groups I received 1 mg midazolam, groups II received 50 μg Neostigmine and groups III received 0.5 cc normal saline additionally. Then according VAS pain score, postoperative painless duration and pain score were compared between groups by running SPSS software. Results: Mean of painless duration in the Midazolam, Neostigmine and control groups were 98.4±18.2, 74.5±32.6 and 64.5±9.9 minutes respectively which was significantly longer than in Midazolam group (p<0.001). The mean dose of requested analgesia in first 24 hours after surgery was significantly lower in Midazolam group (p<0.001). Conclusion: Inthrathecal midazolam and Neostigmine as a complementary medication to lidocaine 5% can increase painless duration in colporrhaphy surgery and midazolam is more effective than Neostigmine. Key Words : midazolam & Neostygmine , Spinal anesthesia, painless time , colporrhaphy

---

Background: Age-related macular degeneration is the most common cause of irreversible central visual loss in individuals over 50 years old. The aim of this study was to assess visual loss due to age-related macular degeneration and some of its associated risk factors. Materials and Methods: This case-control study was conducted on 150 patients with age-related macular degeneration and 150 controls, both aged over 50. A questionnaire on demographic and medical information was completed for each participant and an ophthalmological examination was performed. The results were recorded andthe data were analyzed using SPSS software version 16. Results: Mean age of the subjects in the case and control groups was 78.38 and 79.28 years, respectively.In a multivariable model, hypertension(p=0.003), diabetes(p=0.006), light iris color(p=0.05), hypercholesterolemia (p=0.036), lens opacity (p=0.029), and previous cataract surgery(p=0.029) were significantly associated with age-related macular degeneration. There was not a significant relationship between body mass index (p=0.11) and refractory errors (p=0.94) andage-related macular degeneration. Conclusion: Age-related macular degeneration is associated with hypertension, diabetes, hypercholesterolemia, light iris color, lens opacity, and previous cataract surgery.

---

Background: Protein-energy malnutrition is regarded as one of the public health problems in developing countries as a result of poor feeding due to poverty. This study was conducted to compare protein quality of two samples of commercial weaning food, Cerelac (based on dry milk, wheat and banana containing probiotic Bifidobactriumlactis) and Ghoncheh (based on dry milk, wheat, and honey), in rats. Materials and Methods: This experimental study was conducted on 64 male rats aged 23 days in 8 groups under 8 diets, including 2 test diets (Cerelaccontaining probiotic Bifidobactriumlactis and Ghoncheh), 1 standard diet (casein), 1 basal diet (protein free) for true protein digestibility and apparent digestibility study, 2 test diets, 1 standard diet, and 1 basal diet for net protein ratio, protein efficiency ratio, and food efficiency ratio study. Results: The contents of true protein digestibility for casein, Cerelac, and Ghoncheh were 93.77, 84.23 and 89.82, respectively and the results were significant in all of the groups (p<0.001). The content of net protein ratio for casein, Cerelac, and Ghoncheh was 4.38, 4.1 and 3.17, respectively and the results were significantin all of the groups (p=0.009). The contents of protein efficiency ratio for casein, Cerelac, and Ghoncheh were 3.05, 2.59, and 2.01, respectively and the results were significant in all of the groups (p<0.001). Conclusion: The findings of this study indicated that the protein value of Cerelaccontaining Bifidobactriumlactis was higher than Ghoncheh.

---

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.

---

Background: Gastric perforation is a rare occurrence in newborns with unknown etiology and risk factors. This study reports a case of acute gastric perforation in a preterm neonate and its risk factors. Case: The patient was a preterm neonate (26 weeks) with NG tube feeding with GI bleeding. The patient underwent abdominal surgery and gastric perforation in the anterior wall was reported. The risk factors for gastric perforation in this neonate were probably prematurity, low birth-weight, N-CPAP, and frequent insertion of NG tube. Conclusion: It can be concluded from this study that identification of risk factors and reducing or eliminating them are vital to the prevention of this complication.

---

Background: The presence of nitrate in drinking water causes various health and environmental problems. The aim of this study was to evaluate the efficacy of nitrate reduction by Fe/H2O2 process and adsorption on activated carbon. Materials and Methods: This experimental study investigated nitrate oxidation by advanced oxidation process of Fe°/FeІІ/FeШ/H2O2 at pH 2-10, nitrate concentrations of 50-300 mg/L. After adjusting the pH, 0.5, 1, 2, 5, and 10 g/L values of GAC, PAC, H2O2/GAC, and Fe/H2O2/GAC together with H2O2 at retention times of 15, 30, 45, 60, and 90 minutes, respectively, were added and mixed. Results: At retention time of 10 minutes and 0.5 mL H2O2 and 1 g/L from Fe°, FeІІ, and FeІІІ, the removal efficacy was 88.5, 84 and 78%, respectively. At 50 mg/L nitrate and 0.5, 1, and 10 mg/L GAC concentrations, the removal efficacy was 56.5, 93.6, and 82.6%, respectively. The nitrate removal efficiency at pH=4 was approximately 50%, whereas at pH=3 with 30% efficacy, it increased to 80%. Conclusion: Modified Fe/H2O2 process with iron nano-particles and activated carbon adsorption can effectively reduce nitrate under optimal conditions. The use of activated carbon at a concentration of 1 g/L increased the removal efficiency of nitrate to 90%.