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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.

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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.

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Background: Cardiac rehabilitation is one of the essential components of caring in cardiac patients both in hospital and community. Therefore, this study was carried out to determine the effects of cardiac rehabilitation program on the quality of life in patients with myocardial infarction. Materials and Methods:This clinical trial was conducted on two groups (experimental and control). Thirty patients with myocardial infarction at Heart Center Hospital of Sari were randomly assigned to each group. The experimental group participated in the Home-based Cardiac Rehabilitation Program (3 visits at home in weeks 4, 8, and 12) however, the control group did not receive any intervention. Data were collected via demographic data and SF-36 quality of life questionnaires and patients’ home-based health behaviors checklist. Data analysis was done by Chi Square, ANOVA and Mann-Whitney tests using SPSS software version 16. Results: The two groups were homogenous in terms of demographic characteristics. The patients’ quality of life increased in the experimental group in physical and mental dimensions and in total before and after the intervention (P<0.001). In addition, the comparison of the quality of life showed a significant difference between experimental and control groups (P<0.001). Conclusion: Cardiac Rehabilitation Program at home can improve the quality of life in these patients therefore, its implementation is recommended.

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Background: Aquatic ecosystems pollution with heavy metals, especially mercury, has always been a major concern for aquatic organisms health. Hence this study not only described an innovative method for analyzing organic mercury compound, but also evaluated total and organic mercury concentrations in great cormorant and compared them with world health standards. Materials and Methods: In this cross-sectional study, 18 great cormorants were randomly captured in March, 2009. Total and organic mercury of muscle, kidney, and liver tissues were analyzed by an advanced mercury analyzer made in the United States (Model Leco, AMA 254), and statistical analysis was done by Mann-Whitney U, and Kolmogrove-Smirnov tests. Results: Mean accumulated total mercury in liver, kidney, and muscle tissues were 5.67, 3.59, and 2.26 mg kg -1 w.w., respectively and organic mercury formed 82, 79, and 58 % of the total mercury. Conclusion: The levels of accumulated mercury in all tissues of great cormorant were more than the established limits by WHO, FAO, and EPA. These results can be a serious warning for consumers of these birds, especially vulnerable people.

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Background: Male involvement in maternal health is one of the policies promoted by international reproductive health bodies. To better understand male involvement issues in maternal health, this study was done to explore midwives’ experiences toward the promotion of male involvement in maternal health and barriers to such programs. Materials and Methods: In this qualitative study, sampling was conducted by means of focus group discussions (FGDs) and in-depth interviews through a semi-constructed questionnaire. The experiences of all midwives at health centers were surveyed through 2 group interviews and the views of 8 midwives employed in Maternity Hospital of Sabzevar, Iran, were considered as well. Content analysis was applied to data analysis. Results: Results of this study can be divided into three categories: Arguments in favor of, obstacles to, and outcomes of male involvement in maternal health. Based on midwives’ experiences, the provision of couple-friendly health services would enhance the quality of care, better understanding of health information provided to pregnant women and easier acceptance of tasks like taking a sonogram. Midwives indicated some obstacles like manpower and work space deficiency and cultural barriers like husbands and midwives uneasiness while communicating and giving information. Disagreements between partners and higher likelihood of partner interventions in affairs were found to be possible negative outcomes of such programs. Conclusion: Midwives’ attitudes towards male involvement in maternal health were positive and indicate that the introduction of such programs would be accepted. However, attention should be paid to midwives’ concerns and cultural obstacles and they should be trained for such programs.

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Background: Olive oil as a mjor source of fat in diet, besides having a high level of unsaturated fatty acid contains biological components, such as the antioxidant phenolic compounds that can prevent the destructive effect of free radicals and their resulting mutation on cellular structures. The main goal of this study was to investigate the antioxidant and anticancer effects of olive oil through Salmonella typhimurium and microsome. Materials and Methods: In this study, 16 Iranian olive oil samples and one Spanish sample were used. The determination test of anti-mutagenic potential was based on the method proposed by Ames et al. using mutant strain of Salmonella typhimurium TA100 and a well-known carcinogenic material (sodium azide) which by adding microsome of rat liver (S9), its anticancer effect was examined. Positive and negative controls which respectively contained sodium azide and distilled water were studied. Each test was simultaneously done three times and the percentage of inhibition was determined according to (1-T/M) × 100. Results: The inhibitory percentage in its highest level in darkness was equal to 63.64% based on the variety of olive oil and in light was equal to 60.70%. Conclusion: The findings of this study show that the antioxidant and anticancer properties of olive oil decrease with exposure to light

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Background: Nucleos(t)ide analogues, such as lamivudine and adefovir, are effective drugs for treatment of hepatitis B patients. However, long-term treatment with these drugs leads to the emergence of the nucleos(t)ide analogue resistant strains. The impact of nucleos(t)ide analogues on the emergence of HBsAg escape mutations is not clarified. Hence, the aim of this study was to determine HBsAg escape mutations in chronic hepatitis B patients treated with nucleos(t)ide analogues. Materials and Methods:A cross-sectional study was performed on 50 patients with chronic hepatitis B under treatment with nucleos(t)ide analogues (lamivudine and/or adefovir) and 50 naive chronic hepatitis B patients. HBV DNA was extracted from plasma and S gene of virus was amplified by Nested-PCR followed by direct sequencing. HBsAg gene sequence of the samples was evaluated for detection of HBsAg escape mutations. Results: Among the 100 patients, the following HBsAg escape mutations were identified: sQ101H, sG119R, sP120S, sP127S, sA128V, sG130N, sG130R, sT131I, sM133I, and sY134N. The frequency of HBsAg escape mutations in patients under treatment of nucleos(t)ide analogues was 16% and in naïve patients was 6% (p=0.2, OR=2.98). Conclusion:According to the obtained results, there seems to be no association between using nucleos(t)ide analogues and emergence of HBsAg escape mutations.

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Background: Measurement of service quality is a basic prerequisite for improving quality. Studies show that consumers are in close contact with services quality better than any other group. This study was conducted with the aim of measuring service quality based on patients’ expectations and perceptions teaching hospitals in Arak, Iran. Materials and Methods: This cross-sectional study was done on 260 patients at under auspices of Arak University of Medical Sciences. For data collection SERVQUL questionnaire was employed to measure quality of services. The reliability and validity of this questionnaire had already been confirmed by studies both in Iran and other countries. Results: The results showed that there were significant differences between patients’ expectations and perceptions in all dimensions of quality. The accessibility dimension constituted the most serious problem at hospitals. Conclusion: The negative scores show that it is necessary to promote all quality services dimensions at hospitals. For reducing the qualitative gap among all dimensions, it is recommended that hospital managers take patients’ needs into account and provide desirable services for them.

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Background: Considering the importance of the presence of volunteer health care communicators and the reduction in their cooperation with health centers or their breaking off their communication in recent years, this study was done to explore the educational needs of health care communicators and their instructors. Materials and Methods: In a qualitative study, data were obtained through focus group discussions (FGDs) and individual depth interviews (IDIs) for need assessment from three groups of active volunteer health care workers, inactive volunteer health care workers and health instructors. In total, 14 FGD and 5 DII were held to cover the aims of research chosen by aimed sampling. The analysis was carried out by qualitative content analysis. Results: Three major themes emerged from data analysis, including the concepts of soft and hard tools (time, space, educational tools, and educational content), educator (teaching methods, awareness, and skills), and learner (application, literacy, experience learning level, and motivation). Conclusion: Many of the educational needs of the health care communicators and their educators had not been met which, in many cases, had led to the discontinuation of their cooperation with health centers. Hence, presenting the obtained feedback to officials for meeting their needs can be an effective measure in improving the activities of the communicators and their continuous presence in the health care system.

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Background: Prostate cancer is one of the most common cancers in men which its incidence rate and associated mortality and morbidity are on the rise. The aim of this study was to investigate the epidemiology of prostate cancer in Fars province between 2003 and 2008 years. Materials and Methods: In this epidemiological study, using Fars province cancer registry data, the incidence rates were calculated per 100,000 people and age standardized incidence rate (ASR) was measured by direct method using the world standard population. Data were analyzed by SPSS, version 16, and Microsoft Excel, version 2007. Cochrane Armitage Test for linear trend was used for evaluation of the incidence trend by running Winpepi software. Results: Over a 6-year period, 1212 cases were recorded in Fars province. The ASR of prostate cancer in these six years was 4.69, 7.16, 15.09, 14.04, 16.65 and 16.02, respectively, which revealed significantly increasing trends. The highest incidence rate was observed in 80 and upper age group. Conclusion: The ASR of prostate cancer in Fars province is significantly lower than other parts of the world, especially in more developed countries. This can be due to absence of screening programs and/or cancer registry.

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Background: ASSR is the latest threshold detection technology in pediatric audiology. The aim of this study is to investigate the degree to which ASSR thresholds correlate with click-ABR thresholds.

Materials and Methods: In this cross-sectional study, 32 children ranging in age from birth to 7 years were evaluated by ASSR and ABR in moderate to severe and severe to profound hearing loss groups.

Results: The correlation coefficients for frequencies of 500, 1000, 2000, and 4000, mean of 2-4 and mean of 1-4 kHz were between 0.68- 0.90 in moderate to severe hearing loss and 0.79-0.96 in severe to profound hearing loss.

Conclusion: Strong correlations were found between ASSR and click-ABR thresholds in all frequencies. This correlation was greater for higher degrees of hearing loss.

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Background: Nowadays, many patients with cardiovascular diseases require pacemaker implantation that is associated with few complications such as cardiac and valvular insufficiency. This study aims to compare the development of tricuspid and mitral regurgitation in right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing.

Materials and Methods: In this single-blind clinical trial, 164 candidates for permanent pacemaker (PPM) implantation due to sick sinus syndrome or atrioventricular block were randomly divided into 2 equal groups to receive either RVOT or RVA pacing. Patients with heart failure or valvular diseases were excluded from the study. Pre and post-procedural echocardiography after 6 months were performed and the results were compared for the development of mitral and tricuspid regurgitation and probable changes in the ejection fraction (EF).

Results: Age, gender, pacing mode, and baseline cardiac rhythm did not significantly differ between RVOT and RVA pacing groups. The incidence of mitral regurgitation was significantly higher in the RVA group (p=0.033), whereas the incidence of tricuspid regurgitation was similar in both groups (p>0.05). There was a trend toward less tricuspid regurgitation in the RVOT group however, it was not statistically significant. Ejection fraction was not significantly different between the study groups.

Conclusion: It seems that the incidence of mitral regurgitation in RVA pacing is significantly higher than RVOT although this needs further investigation in future studies.

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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: The purpose of the present study was to investigate the probable changes of HSP70 , liver enzymes & Cpk in professional athletes after a training season and participating in skating open world championship.

Materials and Methods: 10 elite female skaters were chosen. Eccentric exercise test were performed in three sections (24 hours before the beginning of the training, after six months of training (before participating in Skating World Championship) and 24 hours after the end of world championship). The training program consisted of 26 weeks of training, performed 5 times a week encompassing specialized skate trainings. Blood samples were taken before and after each eccentric exercise test.

Results: there was no significant change, in HSP70 concentration in response to eccentric exercise test, in pre exercise period (p>0.898). But, it illustrated a significant increase in after eccentric exercise test, in post exercise period (p<0.031). Moreover, in measuring down, it showed a significant increased in the amount of liver enzymes and Cpk after eccentric exercise test in second and third step compared to first step (p<0.05).

Conclusion: the results of the study illustrated that improving an athlete's physical fitness level during training season and matches leads to a significant increase in the protective level of the body (via the production of HSP70), depending also on the ability of the body of the individual in producing that protein. It can also be stated probably individual body fitness level, is an important factor in determining ALT, AST, ALP levels after performing eccentric exercise.

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Background: End stage renal disease or ESRD is a progressive and irreversible deterioration in renal function in which the body’s ability to maintain metabolic and fluid and electrolyte balance fails. Glutathione s-transfrase P1 is member of multigenic family which have essential role in cells as an antioxidant. In this study we investigated the polymorphism of GSTP1 genotypes and oxidative stress in ESRD patients and compare with control subjects to determine the possible relation between polymorphism of this enzyme and ESRD.

Materials and Methods: We select 136 ESRD patients and 137 control cases (without kidney disease). GST P1 polymorphism were determined with PCR-RFLP. Level of MDA was measured by HPLC apparatus.

Results: Genotypes distribution of GSTP1 A/G polymorphism to AA, AG and GG genotypes in control group were 70(51.1%), 56(40.9%) and 11(8%) and In diabetic group 74(55.6%), 50(37.6%) and 9(6.8%), respectively (p=0.744). MDA levels in ESRD patients was higher than control group (p<0.001).

Conclusion: GSTP1 A/G polymorphism between two groups and each groups was not statistically significant with ESRD, probably this enzyme has a protective role in the risk of ESRD.

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Background: Prostate cancer is one of the most prevalent type of cancer and the second cause of death among American men. Its prevalence has a direct relationship with increasing age. The present study was carried out to determine the level of prostate specific antigen (PSA) and calcium level in blood in men with prostate cancer and BPH in Arak.

Materials and Methods: In this prospective study, out of 400 Arak males, were selected from different inner-city areas through cluster sampling during a period of two years (august 2011-august 2012). After the population was approved to have the necessary criteria to be included in the study, their PSA and calcium level was measured and its mean in over 40 years. In order to determine mean difference among the seven groups T-test analysis and to determine "PSA", PSA Assay and Tandem-R kits were utilized and for measurement of serum calcium, pars azmoon kit was used.

Results: In this study, there was a markedly relationship between age and serum calcium and serum PSA in both groups.in this way that there was a negative relationship between age and serum calcium and a positive relationship between age and serum PSA.

Conclusion: With respect to the findings of the study, it could be confirmed that was a markedly relationship between serum PSA and serum calcium only in prostatic cancer patients,according to this study in future maybe we used serum calcium as a tumor-marker for screening for prostate cancer.

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Background: The Infections that are related to vascular access, are regarded as Important factor in mortality and morbidity in the patients with immune deficiency including hemodialysis patients. Staphylococcus aureus is the most common and most Important organism involved in this regard and it cause bacteremia and its complications in the patients is important. This organism can cause carriage states and its most frequent carriage source is in the nose. The aim of this study is determination of staphylococcal carriage states in the Zanjan hemodialysis patients and control group.

Materials and Methods: This cross sectional study is designed in the patients with chronic renal disease who were referred to the hemodialysis wards. Nasal samples were collected with sterile swabs. Then they were inoculated in the blood agar culture media and incubated at (35-37) degree for (24-48) hours. This method was taken for control group too. The collected data were analyzed with SPSS and Chi-Square statistically methods.

Results: Based on this study, 7.4 percent of patients and 11.1 percent of the control group were nasal carriers of staphylococcus aureus. The results did not show any meaningful statistically difference between the cases and control groups. But a meaningful statistically difference was observed in the Staphylococcus hemolyticus carriages and the nasal carriage of this organism was more common in the women of case group.

Conclusion: Based on our study, we don't find high prevalence rate of nasal staphylococcus aureus carriage among our case group, and It seems this organism isnot an important agent in our hemodialysis wards.

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Background: Occult hepatitis C virus (HCV) infection is defined as the presence of HCV-RNA in liver or peripheral blood mononuclear cells (PBMCs) in the absence of detectable hepatitis C antibody (anti-HCV) or HCV-RNA in the serum. Although occult HCV infection is less aggressive than classic chronic HCV infection, nevertheless it is important in management of hemodialysis (HD) patients. Occult HCV infection has been described in two different clinical settings: in patients with normal liver enzymes or in patients with abnormal values of liver enzymes. The aim of this study was to detect the occult HCV infection in hemodialysis patients with elevated liver enzymes.

Materials and Methods: This cross sectional study was performed in hemodialysis patients referring to 3 dialysis units in Tehran. In 30 anti-HCV negative HD patients with elevated liver enzymes, presence of HCV-RNA in plasma samples was tested by Reverse Transcriptase-Nested Polymerase Chain Reaction (RT-nested PCR). In cases with negative anti-HCV and plasma HCV-RNA, HCV-RNA was checked in PBMC specimens by RT-nested PCR.

Results: A total of 30 HD patients with mean age 54.4± 14.1years and mean dialysis duration 81.2 ±64.4 months were enrolled in the study. All HD subjects were negative for HCV-RNA in plasma and occult HCV infection with RT-nested PCR method.

Conclusion: Occult HCV infection was rare in HD patients with elevated levels of liver enzymes.

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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: One of the amendments made in Iran's Health System was family physician program were introduced in 2004 . This study aimed to describe the experiences of physician and other health team members about general interest of this program.

Materiasl and Methods: This study is a qualitative and data collection method was in-depth interviews (semi-structured). Groups participants including 15 physicians, 15 midwives and 25 healthworker declare their experiences about of general advantage in this program. In total, 55 interviews were carried out in population. Purposive sampling fand content analysis with comparative of the methods were used.

Results: In this study, after continuous analysis of data 376 initial codes were obtained. After integration of theses codes 30 the secondary cods come out which consist of public or general interest and economic benefit, respectively. Moreover 4 sub-categories (improve of index of public health and care, health folder, insurance for rural, low referral to expert of physican), were created.

Conclusion: Based on the results the use of electronic folders instead of traditional folder and accelerate to acsess of information patient for promotion of care and finally delivery some facilitate for health team worker recommended.