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Introduction: The existence of acoustic trauma secondary to drill noise during chronic ear surgeries has not yet been clearly demonestrated. This investigation aims to document the hearing loss that occures in patients who underwent mastoidectomy.
Materials and Methods: Sixty-three (38 male and 25 female) consecutive patients (11-57 years) who underwent modified radical mastoidectomy were included. In a concurrent clinical trial design, we measured bone conduction thresholds before and after (1 week and 1 month) operation on both sides.
Bone conduction thresholds were assessed in 250, 500, 1000, 2000, 3000 and 4000 Hz frequencies.
Results: Paired-test results showed a satistically significant temporary (TTS) and permanent threshold shifts (PTS) were occured in the 2000-4000 Hz region for operated (on addition to 1000 Hz) and non-operated ears, but clinically PTSs were not remarkable and TTSs were important only for operated ear (P<0.05). The correlation between duration of noise exposure and magnitude of threshold shift was only significant in operated ear in 2000-4000 Hz region (P<0.05).
Conclusion: We could not demonestrate any permanent hearing loss caused by drill-generated noise, but resultant noise is able to produce TTS in the operated ear in 2000-4000 Hz region. We found poor relationship between duration of noise exposure and magnitude of threshold shifts.

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Introduction: Pain is one of the main complaints of many postoperative patients. Narcotic and NSAID drugs are used to control postoperative pain.
Recent studies suggest different results of pain relief by NSAID group. We compared analgesic effects of intramucular Pethedine to Didofenac Sodium and Indomethacin suppositories due to inguinal hernioplasty.
Materials and Methods: This study was a clinical trial study over 55 patients of 17-60 years old who underWent unilateral inguinal hernioplasty.
These patients divided into 3 groups. The first group included 17 patients who received 100 mg Indomethacin suppository every 8 hours to relief postoperative pain. The second group of 18 patients who received 100 mg Diclofenac Sodium suppository every 8 hours and the third group induded 20 patients who received 0.5 mg/kg body weight Pethedine intramuscularly every 8 hours. The first dose of each drug started 2 hours after termination of operation. Tue sevrity of pain was checked by visual analogue scale method every 2 hours for 24 hours. Mean pain severity recoded and compared in 6 hours intervals.
Results: The averages of pain severity in the first 24 hours were 23±12 for Indomethacin, 31±9 for Pthedine and 27±12 hours for Diclofenac Sodium groups. There was no significant difference in whole 24 hours.
Conclusion: We concluded that Indomethacin and Diclofenac Sodium suppositories are good substitutes for intramuscular Pethedine to relief postoperation pain during the first postoperation day.

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Introduction: Because tetraploid embryo is used as a base for growth and development of transgenic cells, one of the most important stages in animal biotechnology is to produce tetraploidy by electrofused 2-cell embryo. The aim of this study was to determine the effect of fusion duration on developmental rate of tetraploid embryos.
Materials and Methods: In this experimental study some of the bovine 2-cell embryos were obtained from in vitro matured and fertilized cumulus oocyte complexes 33-35 hr post fertilization as an unexposed control group (UCG). The remaining 2-cell embryos were exposed to 0.75 kilovolt per centimeter for 80 microsecond, and were transferred to SOF1 medium. Subsequently those embryos fused at 30 and 60 minute post electrofusion were categorized as fused groups (FG30 and FG60) and separated from unfused embryos as exposed control group (ECG). The developmental rate was compared between UCG, ECG, FG30, and FG60 groups and the relation between fusion duration and cleavage and developmental rate was surveyed. Results: The cleavage rate up to 8-cell stage in FG60 was increased significantly compared to FG30 (p<0.05) while the blastocyst rate has no significant difference between the two groups. The cleavage and developmental rate in UCG was significantly higher than ECG, FG60 and FG30. Chromosomal analysis showed that 76% of embryos were true tetraploid.
Conclusion: The fused embryos in FG60 had more ability to produce embryos up to 8-cell stage than FG30. The electrical pulse can decrease the cleavage and developmental ability of embryo

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Introduction: In diabetes mellitus the increase of AgII (Angiotensin II), IGF-1(insulin like growth factor-1) and growth hormone induce kidney lesions especially changes in content and thickness of GBM and widening and fusion of podocyte pedicles. In this research for the first time the combination of Losartan (AT1 receptor blocker) and Octreotide (Somatostatin analogue) were used in order to prevent glomerular epithelial lesions.
Materials & Methods: In this experimental study 15 male rats (2 months age) were uninephrectomised from left flank and divided in 5 groups (3 per group). 7 days later diabetes was induced in 2th, 3th, 4th and 5th group by Alloxan (120mg/kg) subcutaneously. 5 days after diabetes induction, the third group received Losartan (5mg/kg/day) orally, 4th group Octretide (10 ŭg/day) subcutaneously and 5th group both two drugs with the mentioned doses for 8 weeks. The 2th group was served as diabetic non treatment group. Kidneys of all groups were fixed by perfusion technique. After second fixation of 1 mm3 cortex parts in Osmium Tetroxide, they were processed in TAAB812 resin for embedding. Thin sections (600 nm thickness) were prepared and investigated by transmission electron microscope qualitatively.
Results: Losartan inhibited fusion and thickening of podocyte pedicles but in some cases couldn,t maintain the 3 layer form of GBM. Octreotide had little effect on inhibition of fusion and thickening of podocyte pedicles and no effect in 3 layer form maintaining of GBM. Combined therapy inhibited fusion and thickening of podocyte pedicles and maintained 3 layer form of GBM but in some cases the lamina rara near endothelium was not seen.
Conclusion: Octreotide have little effect on prevention of glomerular epithelium lesions. However Losartan could prevent glomerular epithelium lesions well, but combined drug therapy showed better results comparing Losartan.

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Introduction: Considering the importance of diagnosing fetal distress and knowing diagnostic methods with minimum cost and time and high diagnostic value, this study was performed to evaluate the vibroacoustic stimulation test ( VAST) value in predicting fetal distress in women in active phase of labor, reffering to Motazedi hospital, Kermanshah, 2004.
Materials and Methods: This clinical trial study was carried out on women in active phase of labor (dilatation >3-4), full term, single fetus, cephalic presentation, without previous diseases and also abnormal fetus. At first FHR was monitored for 15 minutes, then vibroacoustic stimulation was done for 3 seconds using an artificial larynx of Seimens Servox with high - pitch intensity equal to 105 dB. Results were recorded as non reactive and reactive FHR ( twice 15 beats acceleration for 15 seconds). Other variables such as type of delivery, 1 and 5 minutes Apgar, meconium passing and nuch cord were documented. Data was analyzed by descriptive statistics and diagnostic value test.
Results: Age of women was 25.2 ±5.8, number of pregnancy 1.94 ± 1.33 and 51.8% of them had one pregnancy. FHR before VAST was 61.1% reactive and 26.3% suspicious and after VAST 60.8% reactive and 5.3% suspicious. In VAST method sensitivity, specificity and diagnostic value were 88.3%, 70% and 75.5% respectively and in nonVAST method 68.3%, 66.5%, 23.6%.
Conclusion: This study showed that VAST can assist to reduce suspicious cases of FHR.The prognostic value of VAST in predicting fetal distress was high. It is recommended to carry out further researches about duration and intensity of sound and using periodic FHR

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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: Cataract is one of the most important and a major disease in human. The prevalence of cataract in age 65-74 get to 50%, and over 75 it arrives to 70%. Absolute cure for cataract is surgery that can be done by different techniques such as intracapsular, extracapsular, and phacoemulsification. Cataract surgery has different side effects such as hemorrhage, Glaucoma, posterior capsular opacification and astigmatism. This study decides to compare astigmatism after two techniques of cataract surgery phaco and extracapsular. Materials and Methods: This study is a double blind randomized clinical trial, which has been experienced on 112 patients. Patients were divided in two groups (A and B). In group A surgery was done by phaco technique which has a small incision of 3.2 mm and does not need suture. But in group B, (extracapsular group) the incision is bigger about 10 mm and needs suture. Then keratometry was done for each patient before surgery, one week and 2 months after surgery for determining astigmatism. Data was analyzed by independent and paired sample T tests. p< 0.05 was considered meaningful. Results: From 112 patients that had been studied, 56 patients underwent phaco technique and 56 patients underwent extracapsular technique. Mean of astigmatism before surgery in group phaco was 0.79±0.71 D and in extracapsular was 0.90.55 D (p>0.05). Mean of astigmatism 1 week after surgery in phaco group was 1.110.72 D and in extracapsular group was 3.991.46 D (p<0.05) and mean of astigmatism two months after surgery in phaco group was 1.00.71 D and in extracapsular group was 3.281.29 D (p<0.05). Conclusion: Induced astigmatism in phaco group was 0.21 D and in extracapsular was 2.38 D, that has meningful difference. Other criteria such as age, lens number, sex and left or right eye do not have any effect on induced astigmatism.

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

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Introduction: Familial adenomatous polyposis (FAP) is a rare disease with hundreds to thousands adenomatous polyps in large intestine which inherits in the form of autosomal dominant, but 25% of patients have no positive family history. Rectorrhagia and rectal prolapsus are the most prevalent symptoms. Diagnosis is based on clinical findings and results of colon investigation, and prompt colectomy prevents carcinoma in patient. In this article a case report of familial adenomatous polyposis is presented. Case: The patient is a 17 years old teenager, a known case of familial adenomatous polyposis, who was refered with severe obstruction signs of gastrointestinal tract. The disease was diagnosied when he was 5 years old. In 6 years old he was treated by partital colectomy and in 11 years old by total colectomy and ileorectal anastomosis. The patient was investigated by endoscopy and small bowel transit. Because of many polyps in stomach, duodenum and jejunum polypectomy, gastrectomy and duodenotomy were done. Diffuse carcinoma in situ was reported in pathology. Conclusion: Rectal and colonic polyps are rarely obsereved below 10 years old, but rectorrhagia and rectal prolapsus suspects the diagnosis of FAP in children. In the case of dysplasia and carcinoma abdominal pain, anemia and weight loss will be presented. In children with suspecting FAP, screening of extracolonic manifestation and dysplasia should be considerd and elective surgery should be done.

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Introduction: Due to the absence of frozen section in the majority of hospitals, malignant breast masses are being operated in two admissions first for biopsy and second for mastectomy. With simple and rapid technique of touch imprint (intraoperative cytology) both operations can be done in the same time. In this study the diagnostic accuracy of intraoperative cytology (touch imprint) in malignancy of breast masses is evaluated. Materials and Methods: During 2003 to 2006, reports of touch imprints of 70 patients with breast masses were compared to reports of their permanent section. Based on gathered data, positive and negative predictive value, sensitivity and specificity, and positive and negative likelihood ratio of the test were determined. Results: In 70 patients, 39 cases had malignant and 31 cases had benign masses. In 39 patients with malignant masses, 36 patients had malignant and 3 patients had benign cytologic reports. In 31 patients with benign masses 2 patients had malignant reports in cytology. Therefore sensitivity, specificity and accuracy of touch imprint in diagnosis of malignant breast masses were 92.3%, 93.5% and 92.9% respectively. Conclusion: Because of high specificity of touch imprint, it seems that this test can be done in centers that do not have frozen section for intraoperative diagnosis of malignant breast masses.

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Introduction: Cataract is a type of tarnish observable opacity in different layers constituting the lens and will cause light occlusion or scattering. Necessity for treatment of Cataract via surgery and its close relation with corneal astigmatism, when we applied a new method in cutting and type of cataract surgery, led us to measure the post-operation corneal astigmatism changes in frown incision Phacosection. Materials and Methods: This interventional study has been done on 73 eyes(58 patients). These patients were gone under Cataract surgery via no stitch frown incision scleral tunnel phacosection method. In this study we have 7mm external scleral incision with no suture. They were Keratometerized in four separate periods including pre-operation, one week, one month and three months post- operation. Data was analyzed using independent and paired t-tests. Results: Age, sex and left or right eye had no influence on astigmatism. Mean pre- operation astigmatism was 0.84 ± 0.87D, mean astigmatism 1 week post- operation was 0.27 ± 0.88 D, 1 month post- operation 0.06 ± 0.82 D, and three months post-operation was -0.03 ± 0.85 D (P= 0.0001). Before operation, 80% of the patients did have an astigmatism rate less than 1D that increased to 94.5% in three months period after operation and in 89% of the cases, the ultimate change in astigmatism has been found lower than 1D. The obtained information revealed that there is a meaningful difference between pre-operation astigmatism and the same after one week, one month and three months post-operation(P= 0.0001). Independent sample t and paired t-test were used to analyse data. Conclusion: Our study indicated that the no stitch frown incision scleral tunnel phacosection surgery can reduce pre-op corneal astigmatism, and because of induction of the slight controlled astigmatism we can apply this technique for all cataractic patients

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Background: Breast cancer is the most prevalent type of all cancer in women. In this study form various methods for treatment of depression due cancer. This study conducted for comparison drug therapy and drug-cognitive therapy on decreasing depression, effect of drug and cognitive theray on decreasing depression. Methods and Materials: This is a clinical trial study. Form patient refered to oncology clinic and ward of vali-e-Asr hospital 78 women were selected by simple sampling. Based on Beck depression test, 42 of them had depression. They randomly divided to case and control groups. Both groups received antideresant drug as usual. But case group had also cognitive- drug therapy. Afrer 6 Month treatment both group were tested again for depression. Data was analyzed by spss using independent and paired t tests. Results: The mean depression score hadnot signigiant difference between case and control grops beor and after treatment. The mean depression score in control group had no significant deference before and after treatment the mean depression score in the case group was significantly different after treatment (p<0.05). The mean score of depression in control group was more than case group after treatment. Conclusion: In the present study cognitive therapy cause a significant decrease in depression score of case group.

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Background: One of the best examples of epimorphic regeneration in the mammals is the formation of new tissues formed from blastema in holes punched in the ears of rabbits. The aim of this research is to investigate speed and percentage of regeneration in different geometrical shaped holes and different regions of rabbit's ear. Methods and Materials: In this experimental research different region of rabbit's ear (proximal, medial and distal) were punched as different geometrical shaped holes (circlc, quadrangle and triangle) with the same area (50 mm2) Ubyg a puncher which designed for this purpose. The regeneration of wounds was evaluated and the percentage of regeneration was calculated. After punching, each 3 days (36-40 days). Results: Results showed speed and percentage of regeneration in circular holes was significantly (P<0.05) more than quadrangular and triangular holes. In addition, regeneration speed of holes located in proximal regions of ear, was more than peripheral holes. Conclusion: Wound regeneration in rabbit's ear is related to the geometrical shape of holes. Speed and the percentage of regeneration in circular shapes is more than angular shapes.

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Background: Pain management is the challenging concepts in health workers. Since neonates have higher pain sensitivity in compare to childhood and adults. The objective of this study was to examine the pain relieving effect of breast feeding during immunization injections in healthy neonates. Methods and Materials: In this control randomized clinical trial, Samples were divided two groups (by age and sex) of 76 healthy 2- 4 months old term infants. In breast-fed group, 2 minutes before, during, and 15 seconds after the DPT immunization injection were in mother hug, and in control group as routine of clinic, were lied on the examining table during injection. Appearance of Neonates were observed and assessed by Modified Behavioral Pain Scale (MBPS) during 5 second before immunization to 15 second after it. Results: In breast fed and control group mean of age were 81.53±41.46 and 81.61±40.59 day and for weight were 6.65±1.17 and 6.70±1.14 kg for hight were 64.27±5.5 and 63.38±5.06 cm respectively. There were significant differences in Behavioral Pain Scores of two groups include: facial expression (4 items), cry (5 items), and movements (6 items). (P<0.0001). There is no statistically significant difference between the 2 groups for age, sex and the time of feeding prior to vaccination Conclusion: Regarding to significant difference in behavioral of pain responds in two groups, it is suggested, with simple and safe intervention method of straight breast feeding reduce pain during immunization and muscular injections too.

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Introduction: Stirility is a problem throughout the world. Decreasing the growth and developmental rate of embryo and arresting in certain step of development like two cell block, could be the reason of infertility in some couples. Previous study show that arrest and retardation in embryo development can produced by low temperature exposure. We aimed to evaluate the effect of Ethanol on growth and development of mouse two-cell arrested embryo. Material and methods: The 4-6 week old female mice were coupled with male mice following superovulation and positive vaginal plaque mice were killed 48 hour after HCG injection by cervical dislocation method. Two cell embryo were collected in RPMI medium and divided and cultured (in M16 medium) in three groups. The 2nd and 3rd groups were exposed to 4°C for 24 hour in order to delay and arrest for cleavage and developmental rate. The 2nd group (2nd control) were incubated immediately, while the 3rd group (experiment) were exposed to % 0.1 Ethanole for 5 minutes and the 1st group (1st control) without any exposure to low temperature group were incubated . Results: The data analysis by one-way ANOWA show that the developmental rate of embryos exposed to low temperature (4°C) significantly decreased (P=0.001), retardation and arrest being produced. The mean of cleavage rate between groups were not significantly affected, but the mean percent of degenerated embryos between groups have significant differences (P=0.045). On the other hand the mean percent of morulla is significantly different between groups (P=0.005) similarly the mean percent of blastocyst and hatched blastocyst have significant differences between groups (P=0.014) (P=0.001) after 120 hr evaluation. Conclusion: Effect of %0.1 Ethyl-alchol on arrested two cell embryos can significantly increase the mean percent of morulla and development up to blastocyst and hatching blastocyst stage related to control group, without any significant effect on cleavage rate

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Background: Breast Cancer is the most common malignancy and is the second largest cause of death among 35-55 years old women. The aim of this study is explore and to describe women's experiences with breast cancer for achieving a deeper comprehension of their individual experiences. Methods and Materials: This is a qualitative study with a phenomenological approach. Sampling method was purposive and continued till data saturation. Twenty two participants (patients,families and treatment team) attended in the study.Data were collected by using in-depth interviewing and were analyzed by “Parse”method. We tried to analyze qualitative data based on valid criteria. Results: The findings of this research were summarized into four core concepts:delay in diagnosis and treatment, treatment rejection, drowning in suffering (reaction to disease,facing with outcome of treatment,exposure to treatment system, ineffective care and disturbance in daily life of the family) and moving toward normal life. Conclusion: Knowledge of treatment team from the expriences of women suffering from breast cancer helps them to play a better role in their treatment. It seems, this is essential for make a shift from terminal treatment to early diagnosis. Also it emphasise to use of source for support of patients.

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Background: The use of proper contrast agents is very effective in improving the quality of medical imaging. In this study, we dealt with the effect of high PH blackberry juice accompanied with omeprozole in reducing the upper fluid artifact in MRCP images. Methods: This single blinded before-after clinical trial was done with the enrollment of 34 patients. After receiving official agreement from the patients and applying the enrollment criteria, they were ordered to take two 20mg omeprozole capsules the night before the exam. The next day, while they had been held NPO, they were exposed to the first MRCP. After this, they drank 300cc blackberry juice and were re-examined after 15 minutes. The related checklists were printed and three radiologists independently inspected the reduction of artifact checklists and the resolution of images. Eventually, the quality of images and the mean of artifact reductions in the images before and after black berry Juice consumption were compared. Results: Reduction of artifact scores due to gastrological secretions did not show any significant differences before and after black berry juice consumption (2.97±0.37 and 2.89±0/87, respectively). Additionally, no significant changes were observed in the visibility of gall bladder, water ampoula, common hepatic duct, intrahepatic ducts and head of pancreatic duct images. There was a decrease in the common bile duct visibility (p=0.01). In the case of pancreatic duct tail and body visibility, images showed improvements (p=0.04 and 0.03, respectively). Conclusion: Blackberry juice, as a contrast agent, does not seem to have enough paramagnetic metals and does not improve the quality of MRCP.

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Background: The existence of estrogen and progesterone receptors, p53, human epidermal receptor-2(HER-2) and cathepsin-D are among the prognostic markers for breast cancer. In this study, we investigated the relationship between these factors and lymph-node involvement. Materials and Methods: In this case-control analytic study, 105 patients with breast cancer were investigated. After detecting breast mass, surgical biopsy was done and the status of the estrogen and progesterone receptors, p53, HER-2, and cathepsin-D were studied. Collected data were registered in a checklist and were subjected to analysis. Results: There was no relationship between lymph-node involvement and estrogen and progesterone receptors, p53, cathepsin-D and HER-2. Conclusion: In order to get more precise results about hormonal receptors, p53, HER-2 and cathespin-D, a similar research with a larger sample size over a longer period of time is needed.

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Background: Two of the most common complaints of patients who refer red to ophthalmology clinic are headache and asthenopia which are induced or intensified by exodeviation. This study was conducted to determine the relationship between exodeviation and headache or asthenopia. Materials and Methods: In this cross-sectional study, the sampling method, was screening of patients who referred to ophthalmology clinic with headache and asthenopia in 2006. Inclusion criteria were age above three, rejection of other causes of headache and asthenopia. Also, patients with organic headaches such as tumor were eliminated from the study. A questionnaire was provided for the patients and Cover-uncover test was also conducted for determining the existence of exotropia. Results: Of 206 patients, participating in this study, 90.77% had exotropia and the majority of them were female. The most common symptom in these patients was headache. A direct relationship was observed between both headache and asthenopia with exodeviation. Exodeviation also had a direct relationship with gender. Conclusion: Noticing the direct relationship between headache and asthenopia with exodeviation in patients referring with such complaints, exodeviation examinations must be done in order to prescribe surgical or non surgical treatments asneeded.

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Background: Nowadays, mothers have ceased to breastfeed due to several factors and resort to bottle-feeding or other forms of complementary feeding for their children. This results in physical and emotional problems for children, and socio-economic harms in communities. The aim of this study is to assess the impact of BASNEF model based education on successful breastfeeding in pregnant mothers referring to health centers in Arak. Materials and Methods: This quasi-experimental study was carried out with the participation of 88 pregnant women. The participants were randomly allocated to interuention and control groups. Instructions were given in four sessions on the basis of BASNEF model and behavioral objectives. Eventually, the collected data were analyzed by using statistical tests. Results: Mean scores of knowledge, attitude, enabling factors and subjective norms in the inerurntion group before and after education showed a significant difference in comparison with control group (p<0.001). Conclusion: Model-based education has positive impacts on behavior improvements. Thus, in health programs instead of applying traditional instructions, appying planned education programs based on health education models that have measurable and reliable effects is suggested.