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Background: The consumption of hydrogenated vegetable oils, rich sources of both saturated fatty acids and trans fatty acids, is one of the most important risk factors for cardio-vascular diseases(CVD). The aim of this randomized semi-experimental control study was to modify the consumption habits of vegetable oils among families under the cover of health centers of Khomeini city. Materials and Methods: 136 adult women living in Khomein and Mohallat were randomly allocated to case and control groups. Data gathering instrument was a questionnaire based on PRECEDE framework. The educational intervention was weekly conducted in three 60-90 minute sessions based on the PRECEDE framework constructs for two months. Results: Mean scores of predisposing (knowledge and attitude), reinforcing, and enabling factors showed a significant difference in the case group in comparison to the control group(p<0.05). Also, hydrogenated vegetable oils consumption in case group decreased from 72% to 63% , whereas liquid vegetable oils consumption increased from 28% to 37%(p<0.05). Conclusion: Planning and implementation of an educational intervention program based on PRECEDE framework can be effective in reduction of hydrogenated vegetable oils consumption.

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Background: Today, medicine regards brain death as absolute death a fact that its acceptance, especially by those who are emotionally connected with the patients with a beating heart and a normal face while he is breathing and seems to be fast asleep, is very difficult. Some religious leaders do not view this state as absolute death and do not relate it to death. Consideration of this issue is of great importance in legal, political, social, ethical, philosophical, and medical debates and several international conferences have been held on this controversial issue. There are different stances and viewpoints with regard to the nature of brain death. It goes without saying that if brain death is not regarded as absolute death, organ transplantation from patients with brain death who are a great source of organ provision will face major difficulties. By dividing life into such stages as complete physical life, constant vegetative life, singular organ life, and cellular life and elaborating on each stage, such conclusion can be reached that death occurs in three stages: 1) Cardiac and pulmonary death, 2)death of brain cells minutes after deoxygenation, and 3) death of body cells which differs from organ death. Such an order exists in natural death but in brain death, death starts from the second stage and eventually leads to the death of cells. There are, however, stages akin to deep coma. This study, in addition to explaining brain death and its differences with deep coma and other similar states, comes to the conclusion that brain death is equal to absolute death and can be treated as real death. This study investigates brain death in medicine by taking such concepts as sleep, coma, vegetable life, and cardiac death into consideration. Then it deals with the relationship between sleep and death as well as the reality of death so as to provide ample evidence for realization of death in the view of religion and compare it with the medical concept of death. According to this hypothesis, brain death is equal to absolute death. This study is a descriptive-analytical review of internet databases and library resources.

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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.

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Background: Mother and newborn's health is one of the important indexes in health services of every country and one of its main assessment indexes is the number of normal deliveries in each country. Identifying the effective factors in labor helps the right selection of patients the process of delivery. The main goal of this study was to assess the association between fetal sex and unsuccessful labor process which result in cesarean section. Materials and Methods: This observational cross-sectional study was conducted on 1537 pregnant women admitted for delivery to Taleghani Hospital of Arak during 6 months. Data were catch through a check list consisting of obstetric history, physical examination, labor process, and lab tests coupled with interview and observation. The results were analyzed through Chi2, chance ration analysis, and t-test. Results: Of the 1537 pregnant women, 74% had normal delivery and 26% underwent cesarean section. Of all infants, 35.1% of those delivered by normal vaginal delivery and 13.4% of those delivered by cesarean section were male sex while 38.9% of the infants in the normal delivery group and 12.6% of those in the cesarean group were female. These results did not show any association between fetal sex and type of delivery. Overall, 36.5% of the deliveries done through cesarean section were due to dystosia (18.1% male and 18.4% female) (P=0.934). Also,14.3% of the newborns delivered through cesarean sction due to fetal distress were male and 10.8% of them were female (P=0.162) while 10.5% of newborns delivered through cesarean section due to meconium were male and 8.5% of them were male (P=0.359). Conclusion: It appears there is no association between fetal sex and labor disorders which result in cesarean section.

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Background: TEM, PER, and VEB are extended-spectrum betalactamase (ESBL) enzymes that are capable of hydrolyzing penicillins, cephalosporins, and aztreonam. The aim of this study was to determine the prevalence of ESBL producing E.coli and molecular evaluation of TEM, PER, and VEB β-lactamases among E.coli strains. Materials and Methods: A total of 200 clinical strains of E.coli were isolated from clinical specimens and their antibiotic susceptibility was determined by disk diffusion method. ESBL production was determined using the combined disk method with CAZ and CTX with clavulanic acid and alone. Minimum concentration inhibition (MIC) for CAZ and CTX with clavulanic acid and alone was determined by agar dilution method. Finally, PCR with specific primers was used for determining the presence of blaTEM, blaPER, and blaVEB genes. Results: Combined disk method confirmed 94 strains (47%) to be ESBL producing E.coli. Of the 94 ESBL producing strains, 36 samples had MIC=16, 44 samples had MIC between 32-256, and 10 samples had MIC≥512 for ceftazidime, whereas 8 samples had MIC=16, 68 samples had MIC between 32-256, and 21 samples had MIC≥512 for cefotaxime. The frequency of TEM was 44% however, blaPER and blaVEB genes were not detected by PCR among ESBL producing isolates. Conclusion:The results indicated that the high percentage of ESBL producing E.coli is 47% and PCR method showed a high frequency of TEM enzyme, but PER and VEB betalactamase were not found among them.

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Background: There are various factors effective in the appearance of metastasis that have been surveyed and recognized in different studies. However, the appearance of metastasis by determination of these factors cannot be predicted. One of the models used for the analysis of recurrent data and consideration of heterogeneity between patients is frailty model. Materials and Methods: In this survival study, 133 women with breast cancer were treated in Fayazbakhsh Hospital, Tehran, during 2005-2007. All patients were followed until April 2011. Frailty model was employed for the analysis of data and gamma frailty distribution was assumed with the average one and Ө variance. All statistical methods were run in R software. Results: Disease-free survival rates for 3 and 5 years were 0.78 and 0.72, respectively. During the follow-up period, the risk of metastasis was estimated to be 43%. Two factors were identified as the prognostic factors in the appearance of metastasis: tumor malignancy grade and the number of positive lymph nodes. Frailty variance was 4.27 (P=0.001). Conclusion: The significant variance of frailty component in the model indicates that patients who have identical explanatory variables face different levels of risk experiencing metastasis. Also, specific characteristics of the patients are important in the incidence of metastasis.

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Background: Based on the association between beta (13-30 Hz) and attention and alertness and theta (4-8 Hz) and a hypnagogic state and less attention, the possibility of training attention deficit and hyperactivity disorder (ADHD) individuals in order to enhance their symptoms was investigated. Thus, the purpose of this study was to determine the effectiveness of neurofeedback training on students with ADHD symptoms.

Materials and Methods: This interventional study was conducted with an experimental group and a control group. A total of 34 female students with high scores on Conners adult questionnaire and theta/beta ratio in Mohaghege Ardebili University, Iran, were randomly selected and then assigned to neurofeedback training and control groups. Neurofeddback training (NF) was used with an experimental group in twenty sessions and the control group received no training. Data were gathered using the neurofeedback system (NFT), the continuous performance test (CPT), the short diagnostic hyperactivity disorder- Conners adult questionnaire. Multivariate analysis of covariance (MANCOVA) was used for analyzing the data.

Results: The results indicated that neurofeedback training affected all dimensions of CPT and short diagnostic hyperactivity disorder (P<0.001).

Conclusion: The findings suggest the positive effect of neurofeedback training on treating attention problems and reducing the symptoms of hyperactivity in female students with hyperactivity and attention deficit in comparison with the control group.

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Background: Post-anesthetic shivering is the most common cause of patient discomfort during recovery with a prevalence of 5 to 65%. Post-anesthetic shivering can increase pain, oxygen consumption, and cardiac output. The aim of this study was to compare the efficacy of various classes of drugs for preventing post-anesthetic shivering.

Materials and Methods: In this double-blind clinical trial, patients undergoing elective laparotomy were randomly divided into six groups, 40 each. The patients, respectively, received hydrocortisone, ketamine, tramadol, magnesium sulfate, pethidine, and normal saline. All patients were observed for body temperature and shivering for 20 minutes after arrival to recovery room.

Results: Seventy patients in the pethidine group did not have shivering upon arrival to recovery room which was significantly higher than other groups (&chi2=0.00002). Also, the patients in the pethidine group did not shiver 10 and 20 minutes after arrival to recovery room that was significantly lower than other groups.

Conclusion: According to the results, it can be concluded that pethidine is more effective than other drugs in prevention of post-anesthetic shivering.

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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: Menopause being the most critical period, the unfavorable changes in anthropometric and metabolic parameters associated with CVD risk. Metabolic syndrome is the key factor for cardiovascular disease and has become major problem in many countries. With the high prevalence of metabolic syndrome, especially in women after menopause, this study was performed to investigate the relationship between the menopausal age and metabolic syndrome in non-obese postmenopausal women.

Materials and Methods: This cross sectional study on 140 healthy non-obese postmenopausal women who had a BMI less than30 Kg/m2, at 2009 in Ahvaz the data were contained demographic information, menopausal age, BMI, values of HDL-C, FBS, TG serum after 12 houres fasting, blood pressure and waist circumference. We used the Pearson correlation and multiple regression analysis by SPSS15 software.

Results: Menopausal age with FBS (p=0.04) was negatively significant. But there was not any correlation between menopausal age with other Components of metabolic syndrome. [triglycerides (p=0.28), systolic blood pressure (p=0.80) diastolic blood pressure (p=0.48), waist circumference (p=0.08), HDL-C(p=0.65)].

Conclusion: Late menopause has favourable effect on fasting glucose.

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Background: Saffron (Crocus Sativus) petals consist of, glycosides, flavonoids, and anthocyanins. Due to the increasing use of medicinal plants in treatment of diseases and identifying their side effects on various organs, this study is to evaluate the effects of Crocus Sativus petals on biochemical blood parameters in male rats.

Materials and Methods: In this experimental study, 30 male Wistar rats with the mean body weight of 215±15 g were randomly assigned into five groups of 6 animals each. Control group received normal saline (10 ml/kg) and treatment groups received 75, 150, 220 and 450 mg/kg body weight of saffron petals extract, for 14 days. Body weight measured in days 0, 7, and 14. At the end of experiment, serum levels of liver function marker enzymes such as AST and ALT, total proteins, albumin, creatinine, cholesterol and triglyceride were assessed.

Results: Compared to control group, ethanol extract of saffron petals significantly increased serum albumin and also significantly decreased levels of serum cholesterol and AST (p<0.05). No significant changes were observed on serum total proteins, creatinine, ALT, triglyceride levels and body weight in control and saffron groups (p>0.05).

Conclusion: Increase in levels of albumin and decrease in liver enzymes may indicate the lack of liver damage. Reduction in cholesterol which is probably due to flavonoid extracts of saffron and no effect on body weight can be beneficial in the use of saffron petals.   

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Background: Load lifting is the most stressful activity of the Manual Material Handling and can trigger of work-related musculoskeletal disorders of workers. Purposes of this study are determining the prevalence of musculoskeletal disorders, assessment lifting tasks by NIOSH lifting equation method, ergonomic design and assessment of its effectiveness.

Materials and Methods: This analytical and interventional study was performed on 30 workers in a Porcelain Health Manufacturing industry in Hamadan. Assessment of lifting tasks by NIOSH lifting equation and determining the prevalence of musculoskeletal disorders by Nordic questionnaire was conducted. Then, construction steps and determination of the effectiveness of ergonomic design was conducted.

Results: The results showed that the most frequent musculoskeletal disorders related to back. Results of the lifting index (LI) showed that the risk of lifting load in before intervention is high (greater than 3). This value after the conducting of ergonomic intervention (load-carrying cart) decreased to moderate level (between 1 to 3). The relationship of risk average amount before and after interventions were significant (p<0.001).

Conclusion: Load-carrying cart designed with shelves capable of moving vertically up and down has considerable role in safe making of lifting tasks and probability of reduce the prevalence of musculoskeletal disorders and lumbar injuries will bring in the near future.

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  Background : Hand eczema (HE) is a common skin disease which often needs long term treatment.. There are several reports about the efficacy of topical doxepin in the treatment of pruritic dermal diseases. This study was undertaken to compare the efficacy and safety of 5% doxepin cream and clobetasol 0.05% versus clobetasol 0.05% alone in the treatment of hand eczema.

  Materials and Methods: a randomized double blind placebo-controlled, study was carried out during years of 2011-2012.In total 70 patients with moderate to severe hand dermatitis were selected randomly to be treated with either the doxepin 5% cream+ clobetasol or clobetasol+placebo twice daily for 8 days. Efficacy assessments were performed at baseline and 8days after termination of therapy, according to hand eczema severity index (HECSI) and visual analogue scale (VAS). Statistical analysis was done using SPSS software, version 18.0 and statistical tests including paired T-test and independent T-test.

  Results: Overall, 56 patients completed our study. Out of them 32 were male and 24 were female. The reduction of HECSI score and VAS was statistically significant in the treatment and placebo group (p&le0.05), but differences in HECSI and VAS reduction between treatment and control group were not significant.

Conclusion: Although there is some evidence that doxepin 5% cream is effective in reducing the signs and symptoms of eczematous dermatitis, few trials have been performed. We suggest that in a more extensive clinical trial, the efficacy of this treatment against chronic hand dermatitis be evaluated.

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Background: Today, ultrasonography has become the main tool used for the evaluation of fetal anomalies. The aim of this study was to evaluate fetal heart rate changes immediately after combined two- and 4-dimensional ultrasound.

Materials and Methods: This study was performed on 191 pregnant women aged 15 to 45 years old who were referred for 4-dimensional ultrasonography in summer 2013. Before the onset of 2-dimensional ultrasonography, baseline fetal heart rate was measured by ultrasound. At the same time, the maternal heart rate was recorded during one minute. Then, combined ultrasonography was performed and same parameters were recorded at the end.

Results: Maternal heart rate significantly decreased after combined ultrasonography (p=0.0001). Fetal heart rate did not differ before and after ultrasonography (p=0.693).

Conclusion: Four-dimensional ultrasonography has no effect on fetal heart as an indicator for evaluating the fetus temperature.

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Background: According to the studies, Iran’s per capita antibiotic consumption is remarkable. Since the emergence of Antibiotic Resistant Organisms (AROs) is considered a global problem in the community and hospitals, this study aimed to investigate the pattern of antibiotic resistance in Gram-negative bacteria isolated from patients in an academic and a non-academic hospital in Arak, Iran.

Materials and Methods: This descriptive cross-sectional study included all specimens referred to the microbiology laboratory at Amir Al-Momenin Hospital (academic hospital) and Imam Khomeini Hospital (non-academic hospital) in a one-year period from June 2012 to June 2013. The susceptibility of the isolated Gram-negative bacteria against the important antibiotics used in clinical practice was determined using the disk diffusion method.

Results: A total of 846 specimens were collected from patients in the two hospitals where 520 (61.5%) were Gram-negative bacteria, of which 63.3% were E. coli. The prevalence of Gram-negative organisms in the academic and the non-academic hospital was measured 79.8% and 20.2%, respectively (p=0.097). It was also determined that there is a significant difference between the two hospitals in the prevalence of ESBL (Extended-Spectrum Beta-Lactamase) Gram-negative bacteria (p=0.003).

Conclusion: There was a significant difference between the two hospitals in the prevalence of ESBL Gram-negative bacteria. Therefore, conducting regional surveillance programs to examine the patterns of antibiotic resistance is recommended.

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Background: Intraocular pressure (IOP) rise is the most common complication of Nd YAG laser posterior capsulotomy, and the aim of this study was to compare the effect of oral acetazolamide versus topical Co-biosopt in preventing IOP rise following Nd YAG laser posterior capsulotomy.

Materials and Methods: This clinical trial was done on 200 patients who underwent laser Nd: YAG capsulotomy. First group received oral acetazolamide 250 mg q 6h and placebo drops q 8h and second group received Co-biosopt) timolol 0/5% and dorzolamide 2%) drops q 8h and oral placebo capsule q 6h. IOP was measured before and 24 hours after laser capsulotomy.

Results: Mean IOP of right and left eye 24 hours after capsulotomy in the acetazolamide group was significantly decreased as compared to the previous (p=0.001) and in Co-Biosopt group the values 24 hours after capsulotomy was significantly decreased as compared with the previous in right and left eye (p=0.001).

Conclusion: According to oral acetazolamide side effects and desirable IOP reduction with Co-Biosopt that recently entered to Iran’s market and have typical domestic, this medication can be an option for preventing IOP rise after laser capsulotomy in a patient with posterior capsular opacification.

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Background: Pain is a complex medical problem creating which inadequate control pain results adverse effects on the patients physiological, metabolic and mental conditions.The aim of this study was comparison effect of Ketamin-propofol with Alfentanil-propofol on creating analgesia and sedation during cystoscopy and comparing the side effects of two drugs and patient and physician satissfaction.

Materials and Methods: In this double- blind clinical trial 140 person who were candidate for cystoscopy were randomly divided into two groups The first group received 1mcg/kg alfentanil with 1mg/kg propofol and the second group received 0.5 mg/kg ketamin with 1mg/kg propofol. Sedation score ,pain score, time of cystoscopy and hemodynamic changes determined and data were analyzed by SPSS.

Results: The mean of sedation in alfetanil group was significantly more than ketamin group(p=0.001) . The mean of pain score in alfetanil group was significantly less than ketamin group( p=0.001) .The time of cystoscopy in cystoscopy in alfetanil group was significantly less than ketamin group (p=0.001).

Conclusion: Results showed that alfentanil-propofol compare to ketamin-propofol reduced pain score and increased time of sedation with less side effects during cystoscopy .So this study supports the preference alfentanil compare to ketamin.

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Background: Pediatricians frequently confront with elevated body temperature in children and subsequent anxious parents. They practice several approaches in management of fever. A recently addressed issue is administration of alternating doses of acetaminophen and Ibuprofen. This method is relatively common , despite lack of sufficient evidence in this field.

Materials and Methods: This study is a randomized clinical trial. A total of 240 children, aged 6 months to 12 years suffering from gastroenteritis was recruited in this research. Children were classified in 3 groups. First group received Acetaminophen, second group received Ibuprofen and third group were treated with acetaminophen – Ibuprofen every other day alternately.

Results: 240 child were taken apart in this research . 112 ones were female (46.66%) and 128 were male (53.33%). The mean time of lowering fever in the first group was 2.07 days. This figure in the second and third groups were 1.82 and 1.87 respectively. Average doses in the first, second and third groups were (in order) 9, 8.17 and 7.13 doses. Medication in the first group minimum effectiveness rather than two other groups.

Conclusion: The alternating regimen of Acetaminophen – Ibuprofen is more effective than monotherapy in reduction of fever in infants and children between 6 months to 12 years.

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Background: Menopause is a critical period in the women life which is associated with different neurophysiological and cognitive changes. This study aimed to determine the relationship between menopausal symptoms with metabolic syndrome in postmenopausal women.

Materials and Methods: This descriptive - analytical study was conducted on 165 postmenopausal women referred to health centers in Ahvaz. Data collection tools were standardized questionnaire menopausal rating symptoms (MRS), questionnaire to record demographic information and the results of experiments and measurements (blood pressure, Waist circumference). The data were analyzed by Pearson correlation coefficients, Mann-Whitny in by SPSS version 19.

Results: The results showed that the overall mean of MRS in this study was 11.85±5.4. The mean of metabolic syndrome was 36±4.8 percent and we found significant association between blood pressure (p=0.04), blood sugar (p=0.02),HDL-C(p=0.02) and urogenital symptoms. But there werent significant relationship between other metabolic syndrome components and other menopausal symptoms (somatic and psychological Dimensions).

Conclusion: The relationship was observed between metabolic syndrome and urogenital symptoms, therefore, as a preventative health strategy women with urogenital complaints should examin for metabolic syndrome.

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Background: Maturation of oocytes and fertilization in vitro can be considered as one of the most important steps to treat infertility. In this study maturation medium was enriched with Platelet extraction (PL) which has high concentration of growth factors. Meiosis resumption and maturation was monitored after 18 hours of maturation.

Materials and Methods: In this experimental study, oocytes at germinal vesicle stage were obtained from mature NMRI female mice. Maturation medium was &alphaMEM and the control groups had 5-10% FBS and the medium in the experimental groups was enriched by 5, 10% PL and the combination of 5% PL and 5% FBS. Meiosis resumption and maturation were observed after 18 hours.

Results: The rate of matured oocytes in the experimental group 5% PL for both COC and DO group was significantly higher than the control groups (P<0.05). The maturation rate for 5% PL was 61% for the COC group and 72% for the DO group while this rate for 5% FBS control group was 53% and 50% respectively.

Conclusion: PL had a significant effect on meiosis resumption and maturation of oocyte at germinal vesicle stage. Based on these results, PL could be used as a maturation promoting factor.