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Introduction: Infection due to hepatitis B virus (HBV) could be due to wild or mutant viruses. The HBeAg negative chronic hepatitis B (HbeAg-CHB) is unable to produce hepatitis B, e antigen (HbeAg), so that patients with this varient do not present with HBV characterized by HbcAg in the serum. HbeAg-CHB usually proceeds to serious liver disease. The prevalence of different viral forms in patients with chronic liver disease in Iran has not been established.
Materials and Methods: Seventy-six Hamadanian patients with over 6 months HBSAg positivity were enrolled. Patients with co-infection of HIV, HCV, past history of alcoholism, fatty liver, using of hepatotoxic drugs, autoimmune hepatitis and other metabolic liver disease were excluded. All patients were screened for Hhe Ag. HbeAb. HBV DNA by PCR, AST, ALT, ALK. pH and bilirubin.
Results: Eleven (14.5%) patients had HheAg-CHB (HbsAg +ve, HbeAg-ve / ve/anti HbeAb + ve, HBV DNA + ve and elevated AST, ALT) and 6 (8%) had normal transminases (AST and ALT) accompanied by the remaining criteria of HbeAg-CHB. 59 patients (77.5%) were infected with wild type HBV, ie: HBSAg + ve, HbeAg-ve, HbeAb + ve, HBV DNA- ve, and normal AST, ALT.
Conclusion: Frequency of HbeAg.CHB in Hamadan is 14.5% knowing of this varient of chronic hepatitis B is important since the HbeAg-CHB have worse prognosis than wild type and more better response to lamivudine than interferon.

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Introduction: Hidden hepatitis B is a condition in which the surface antigen of hepatitis B in the patient's serum is negative but the DNA of the hepatitis B virus is detected in the serum or liver tissue. In this study, the prevalence of latent hepatitis B in chronic hepatitis C patients and their biochemical and histological changes were investigated.
method: In this descriptive study, target sampling was performed so that 27 chronic hepatitis C patients whose HBsAg was negative and during 2001 and 2002 to two hepatitis centers of Tehran and Research Center for Gastrointestinal and Liver Diseases of Shahid University of Medical Sciences Beheshti came in and underwent liver sampling. On the hepatic paraffinic block of these patients, polymerase chain reaction tests were performed for the presence of HBVDNA, as well as immunohistochemical tests for the presence and detection of HBsAg and central hepatitis B antigen.
Results: Of the 27 PCR samples examined, patients reported positive HBVDNA in 5 cases (19%). In all of these patients, IHC tests were reported to be negative for HBsAg and HBcAg. Histological changes of cirrhosis and irreversible cirrhosis symptoms were seen only in the HBVDNA group.
Conclusion: The prevalence of latent hepatitis B is relatively high in patients with hepatitis C. In these patients, latent hepatitis B can exacerbate liver damage and accelerate the progression of cirrhosis.

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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: Recent studies have demonstrated that hypothermia after hemorrhagic shock (HS) can decrease need of fluid therapy and increase arterial pressure that results in increase the survival rate. But it has not been determined how hypothermia causes these beneficial effects. This study reviews hypothermia effects in this area.
Materials and Methods: This is an experiential study in which 24 rats were divided into four groups. Rats were anesthetized by pentobarbital. In groups 1and3, bilateral renal sympathectomy was done and in the groups 2 and 4 renal nerves remained intact and only lateral incisions were done to preserve similar conditions. Then rats underwent HS phase (phase I) for 90 minutes, by withdrawing 4-6 ml of blood during 10 mines. After shock induction, only in groups 1 and 2, body temperature was lowered to 32oC. At the end of phase I, rats underwent resuscitation phase (phase II) by reinfusion of blood & additional Ringer Lactate to retain normal arterial pressure. Stage II lasted 60 minutes.
Results: In hypothermic groups (1 and 2) in comparison to normothermic groups (3 and 4) there was less blood or fluids needed for resuscitation (p<0.05). Arterial pressure before shock was the same in all groups but at the end of phaseII was higher in hypothermic ones (p<0.05).
Conclusion: It seems that mild hypothermia has beneficial effects on survival of animals with HS. Although it is obvious that intact kidneys have vital role in maintaining body fluid balance during HS, but it seems hypothermic rats requires lesser fluid therapy even without nerve of kidney. More studies could be probably required to confirm this.

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Introduction: One of the most important skills which should be learned and performed by physicians and nurses is the correct method of intubation. Therefore, more attention should be given to such trainings. The main purpose of the recent study is manufacturing and utilization of a detector device for correct intubation which can be used by inexpert staff who are not members of anesthesia team.
Materials and Methods: In a quasi experimental study a detector device was manufactured and utilized for correct intubation. In this research 400 patients undergone surgery, had been chosen for testing the device. Their ages varied from 5-75 years old and they had no chronic obstructive pulmonary disease (COPD), asthma and heart disease. These patients have been generally anesthetized. In all patients the tracheal tube has been placed in esophagus and then immediately in trachea, using the device. The sensitivity of device was evaluated. During the procedure patients, oxygenation was not disturbed.
Results: All 400 intubations were performed succesfuly using the device. In this study using air flow out of lungs, intubation was done successfuly. So the devices, sensitivity was 100%. By a professional the mean time for intubation using this device was 5 seconds, and it,s price was 1000 Rials.
Conclusion: Regarding the results, it seems the device is useful in emergencies and facilitates intubation. This device is cheap and portable and seems to be more useful than other reported devices in determining correctiveness of intratracheal intubation.

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Introduction: Diagnosing parturients in risk of cesarean section early in the beginning of active phase of labor, is very important. This may let take necessary action to accelernate labor (delivery) and prevent maternal mortality and morbidity due to late cesarean section. Materials and Methods: During a period of 8 months from July 2004 to March 2005, 216 primiparous women, with term pregnancy and cephalic single fetus, referred to Imam Reza hospital in (during) active phase of labor, were studied. Changes of cervical dilatation and descent of the conceptus were observed. Parturients were devided to two groups, vaginal delivery and cesurean section. Protraction or arrest disorders were the indications of cesarean deliveries. Findings were analysed through using T-Test, unilateral variance and Chi square test. Results: The more changes in cervical dilatation in the first 2 hours of active phase of labor, the less possibility of cesarean delivery (p<0.001). Also the more rate of the conceptus descent in the first 2 hours of active phase of labor, the less rate of cesarean section (p<0.001). There was no significant statistical relationship between condition of membranes at the onset of active labor and method of delivery, however there was a significant relationship between oxytocin augmentation and method of delivery (p<0.001). Conclusion: In primiparous women with term pregnancy, vaginal delivery would be fairly predictable by observing changes of cervical dilatation and conceptus descent during the first 2 hours of active phase of labor.

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  Introduction: The increasing use of EMF (electromagnetic field) generating apparatus (refrigerators, computers, TV, etc) caused an increasing interest in investigations of its adverse effects on human health. This study is done to investigate the effects of EFM on Balb/c mice.

  Materials and Methods: This is an experimental study in which at first a circuit generating low frequency electromagnetic field (50 Hz, 15G) was designed. Then adult virgin female mice were placed in coil and exposed to 15 gauss electromagnetic field for 4 day and 6 hour per day. Then their blood was examined to assay the level of hormones (FSH, LH, estradiol, progesterone). Also ovary and uterus sections were studied with light & electronic microscope.

  Results : Results showed that the weight and size of ovary was not significantly affected in females exposed to the low frequency electromagnetic field and their offspring. Our results also showed that the number of ovary follicles were significantly affected in exposed females (p<0.05). Also the study of micrographs showed hetrochromatinated oocytes and follicular cells and increasing polysomes, accumulation of mitochondria and cleft nucleus. Decreasing amount of FSH, LH and 50% decrease in couplation rate was also seen as compared with the control group.

  Conclusion: Results of this study is indicator of EFM effects on gonads^, structure and endocrine system and decreases fertility.

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Introduction: Sensory stimulation of comatos patients is an important nursing intervention for increasing their LOC and tactile stimulation especially massage is one of the most important stimulations. The nurse as a person, who is responsible for this, must know the effects of this intervention on patients. But there are some conflicts about this intervention's effects especially on vital signs (pulse, blood pressure and respiration). This study was done to determine the effect of massage on comatos patient's vital signs who were hospitalized in intensive care unit. Materials and Methods: This study is a clinical trial. Samples were consisted of 100 comatos patients, divided into two equal groups randomly. The two groups were matched in age, geneder and glascow coma scale. Samples in experimental group received 20 minutes massage on their back, feet and hands in three continuous days. Vital signs in experimental group were measured before and immediately after intervention and vital signs in control group were measured at the same time with experimental group. A check list used was used for collecting data. Data was analyzed using descriptive and analytic statistics (T, paired T and Chi-square tests). Results: Findings showed that massage decreased vital signs significantly as followed: pulse rate and diastolic blood pressure in each three days (p<0.05), systolic blood pressure in first and third days (p<0.05), respiration rate in second day (p<0.05). Conclusion: This study showed that massage can decrease comatos patients' vital signs which can be the indicator of their relaxation and decreasing stress.

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

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Introduction: End stage renal disease (ESRD) is a major health problem and each year the number of patients is increasing. If the disease becomes irreversible, patients must always be hemodialyzed. Since mortality rate will increase due to inadequate dialysis, determining the efficacy of hemodialysis and improving its quality is very important. The main goal of this research is investigating the efficiency of hemodialysis. Materials and Methods: This is a cross-sectional analytical study which was conducted on 103 people who were under dialysis treatment in the Vali-e-Asr hospital of Arak in year 2003. Weight, blood pressure (before and after dialyze), time of dialysis, BUN and Cr before dialysis and 5 minutes after turning of the pump and before the second dialysis were measured. Data was analyzed by T test and Pearson correlation. Results: The mean of KT/V was 0.58 ± 0.1 normal protein catabolic rate (nPCR), 0.36 ± 0.11 g/kg per day and time average concentration of urea (TAC), 43.3 ± 14 mg/d which had a significant difference with standard measures (p<0.05). KT/V was 0.49 ± 0.18 and 0.47 ± 0.10 for men and women respectively which was significantly different (p<0.03). There was a positive and linear relationship between education level and TAC, KT/V and number of dialysis per week. Conclusion: Regarding the low efficiency of hemodialysis in 80% of patients and lower levels of hemodialysis efficacy indicators in comparison to standard measures, periodic assessment and also investigating the reasons of low efficacy of hemodialysis is recommended.

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Introduction: Candidiasis is the second common cause of vulvovaginitis. We evaluate the frequency of species of Candida in vaginal candidiasis. Materials and Methods: In this cross-sectional anaiythical study, 220 patients with typic and nontypic signs and symptoms of vaginal Candidiasis were studied. Smear and culture were done. For positive culture, evaluation of germ tube, clamidospor production and carbohydrate assimilation and fermentation was done. Data was presented by descriptive statistics and analyzed using Chi square, Man-Whitney and Kolmogrov tests. Results: 40% of patients showed positive culture and smear. Frequancy of Candida Albicanse (42.03%), Dublininsis (29.5%), Glaberata (14.75%), Gilermondy (6.81%), Norvejensis (2.27%), Tropicalis (2.27%), and Kefayer (2.27%) were determined. There was no significant relationship between antibiotic and OCP consumption and type of identified Candida. Conclusion: Frequency of non Albicanse species is increasing. We suggest treatment based on culture and smear, because non Albicanse vaginitis usually is resistant to Azols.

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Introduction: Nowadays, the attention of researchers has been focused on natural medicine in order to avoid the detrimental side effects of chemical drugs. In this study we assessed the effect of root extract of Tagetes minuta against HSV-1 and HSV-2. Materials and Methods: This research is an experimental study. Root extract of Tagetes minuta was obtained with 70% ethanol by maceration. Vero cells were grown in DMEM containing 5% fetal bovine serum. Serial dilutions of extracted suspension (1/10, 1/20, 1/40, 1/80, 1/160) were incubated by the exact titer of viruses and monitored for antiviral activity of extract. Data was analyzed using Doncan test. Results: Root extract obtained from Tagetes minuta significantly has antiviral activity against HSV-1 and HSV-2. This extract has more effect on HSV-2 than HSV-1. This study indicates that antiviral activity of the extract varies between different concentrations and the optimum antiviral activity on both viruses was obtained using 1/10 concentration. Conclusion:The results of this investigation showed that root extract of Tagetes minuta have good antiviral potenoial against HSV-1 and HSV-2, a good source of drug for treatment of diseases due to HSV-1 and HSV-2.

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Introduction: In order to determine the importance and power of physical examination diagnosis, we decided to compare the results of physical examination in patients with distal forearm penetrating wound and whatever is observed during surgery as golden standard. Materials and Methods: This cross-sectional analythical study was performed on 91 patients with distal forearm sharp injury. Findings of physical examination were compared to what was found during surgery (definitive diagnosis) as golden standard. Results: Based on findings, physical examination value of diagnosis for FDP and FDS was determined. In FDS clinical examination value had 88% sensitivity, 40% specificity, 94% positive predictive value, 22% negative predictive value and 1.46 positive likelihood ratio, and 0.3 negative likelihood ratio and FDP clinical examination value had 97% sensitivity, 25% specificity, 93% positive predictive value, 50% negative predictive value, 1.29 positive likelihood ratio and 0.12 negative likelihood ratio. Conclusion: Physical examination view point of rule in of flexor tendon injury because of sharp and penetrating trauma is more valuable than rule out.

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Introduction: Abdominal pregnancy is 1 in 10000 live births and advanced abdominal pregnancy is rare. Abdominal pregnancy is associated with high morbidity and mortality with the risk for death 7 to 8 times greater than tubal ectopic pregnancy and 90 times greater than intrauterine pregnancy. In this article a case of advanced abdominal pregnancy is reported. Case: The patient was a 35 year’s old (G4P3) woman presented with undelivered pregnancy after two years. After diagnostic procedures laparatomy was done. During the operation, fetus adhesion to the omentum was released. A 9 kg calcified fetus was delivered. Then the placenta and left adnex was removed completely. Conclusion: Regarding the high mortality rate of abdominal pregnancy, in every pregnancy specially in the precence of it’s risk factors (such as PID, history of ectopic pregnancy, history of infertilitry and using drugs to induce ovulation, IVF, prior tubal surgery and …) and also suspicious symptoms, this probability and early intervention must be considered.

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Introduction: Menopause is a natural period of life. It means the permanent cessation of menstruation and the end of reproductive period which occurs between 45-52 years old. It also serves as an indicator of population health as the occurrence of menopause indicates the increased risk for the onset of several chronic diseases. In this study, the mean age of natural menopause among women in Arak (Central Iran) was investigated, considering their reproductive and socio-economic-demographic factors and their health behaviors. Materials and Methods: This study was an observational cross-sectional study on a population base, carried out in 2007 year. Interviews and questionnaires were used for gathering data from 458 women resident in Arak city, who had undergone a natural menopause. Sampling was multistaged using postal zones and selecting samples in each zone. Data was analyzed using variance analysis, multiple regression, T and correlation coefficient tests. Results: Findings showed that the mean age of menopause in our sample was 48.2±2.34 years (95% CI: 47.98- 48.41) and its median was 49 years. The mean age of menopause in women who were never married was less than married women (P= 0.015). Low income level (P= 0.003), having physical activity (P= 0.004), number of pregnancies (P<0.001), age of last pregnancy (P=0.026) and place of birth (P=0.003) were meaningfull factors in age of menopause. Conclusion: This phenomenon must be documented in Iran because of its strong link with mortality and morbidity of the growing number of women who are reaching advanced ages whose one forth of life is after menopause. Therefore health education as the best way for changing their lifestyle is suggested.

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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: Hypomagnesemia hypercalciuria nephrocalcinosis (HHNC) is a rare syndrome due to mutation defect in CLDN-16 gene. Its product is paracellin, a protein in henle loop paracellur area which acts in magnesium and calaium reabsorption. In this article a case of HHNC is reported. Case: The patient is a 3 years old boy presented with tetany, polyuria and polydipsia. Imaging study revealed medullary nephrocalcinosis. Laboratory investigations showed hypomagnesemia, hypercalciuria, hypermagnesiuria and normal arterial blood gases. In 2 years follow up, no neurological diseases, growth failure, or rickets were seen. He was treated with Hydrochlorothiazide and Potassium polycitra for prevention of nephrocalcinosis and progressive renal failure. Conclusion: HHNC is a rare syndrome presenting with hypercalciuria, hypo- magnesemia nephrocalcalcinosis, tetany, polyuria and polydypsia which progresses to end stage renal failure in 2nd or 3rd decades. Early diagnosis and some treatment modalities like Hydrochlorothiazide or polycitra-k can delay this process.

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Introduction: Prolonged labor is an important problem during labor which can have undesirable effects on both maternal and fetal health. Shortening the duration of labor has always been one of the aims of obstetricians. Hence, the purpose of this research was to investigate the effect of massage on the duration of labor in women attending to Bentolhoda Maternity Unit in the city of Bojnord, Northern Khorasan, Iran in 2005. Materials and Methods: In this clinical tial study, 62 primiparous women with normal pregnancy were participated. The indications of normal pregnancy included a gestational age of 37-42 weeks, single tone, and vertex presentation. Sampling was done by purposive method. Women were randomly allocated in two groups. The experimental group (n=32) received a 30-minute directional, reasonably firm and rhythmic effleurage massage in the back in each of the three phases of labor. The control group (n=30), did not receive any form of massage and received a routine 30-minutes nursing care in each of the three phases. Measurements were then made for strength, interval and frequency of contractions and the duration of each phase. Data were analyzed using student t, Chi-square and Mann-Whitney tests. Results: Findings showed a significant decrease in the duration of labor after massage sessions. The mean duration of labor for the massage group was 5.75 hourse and for the routine nursing care group 9.15 houres (p=0.001). Conclusion: According to the above results, there was a significant decrease in duration of the first phase of labor in pregnant women receiving massage sessions. Therefore, this method can be used to decrease the period of hospitalization.

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Introduction: In this study the effect of extracellular trans zinc and voltage sensitive calcium channels on different aspects of learning and memory has been investigated. Materials and Methods: This is an experimental study in which the effect of a calcium channel antagonist (Verapamil) and zinc chelator (Ca-EDTA), on passive avoidance learning (shuttle box apparatus) has been examined by intraperitoneal administration of defferent doses of these drugs. Data was analyzed using one way analysis of variance. Results: Result of intraperitoneal injection of 100 milimolar Ca-EDTA indicated that it has no effect on the acquisition, consolidation, and retrieval of passive avoidance learning. Verapamil (100 and 150 micrograms) as a L-type voltage gated calcium channel antagonist, decreased acquisition and consolidation but not retrieval of passive avoidance behaviour. These effects were dose dependent. The simltaneous effect of Ca-EDTA and verapamil was also studied. Ca-EDTA (100milimolar) and verapamil (100 micrograms) have negative effects on consolidation of passive avoidance learning. Conclusion: Probably, common mechanisms are involved in acquisition and consolidation of passive avoidance learning, and zinc and calium ions play interactive roles in this aspect.