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Material and methods: This is a Double blind Randomized clinical trial study which was performed on 66 children of 2-7 years of age who had been referred for first time, for nonbrain non-liver elective surgery (class 1 Anesthesia). This study was designed to define the efficacy of oral ketamine on Anxiety and Agitation and crying of children after separation from these parents, toleration of Anesthesia mask and IV needle. Sleeping before Anesthesia and entry into the operating room samples were divided in to two groups, cases and control. 5mg/kg of ketamine plus 0.2cc/kg of fruit juice was given to the case group while only 0.2cc/kg of fruit was given to the control group 30 minutes before the operation.
Results: Our results showed that 78.8% of children in the case group did not cry when they were separated from their parents and 78.8% of them did not show any resistance. 34.4% of children in the case group showed no response and 59.4% also had low response. Only 6.1% of children in the control group had no response while 78.8% of them had responses such as intense body movements and pulling of hand. 69.7% of the case group were cooperative when putting on the anesthesia mask while 75.8% of the control group refused to wear the mask, 81.8% of the children in the case group were asleep before Anesthesia while all of the children in the control group were awake and uneasy.
Conclusion: These findings indicate that ketamine can be used as a preanesthetic drug to decrease the anxiety and fear of children and to calm them before their transfer to the operating room.

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Introduction: Androgenetic alopecia is a very common disease. According to some reports, up to 96% of people have some form of this disease. In this paper we compared the effect of an herbal drug composed of the urticadioica, chamomilla, thymus vulgaris, equisetum arvense and foeniculum vulgare with 2% Minoxidil solution in the treatment of androgenetic alopecia.
Materials and Methods: We evaluated 82 patients suffering from androgenetic alopecia in a double blind prospective study. We counted terminal and vellous hair in 1 square centimeter of the predetermined area of scalp before and after treatment. After 6 months of treatment, the results were evaluated
Results: According to our findings, herbal drug and Minoxidil were effective in regrowthing the hair (45% vs. 35% respectively) and there were no meaningful differences between efficiacies of these two drugs
Conclusion: Herbal drug can be used as an adjunct or as an alternative to Minoxidil for treatment of the androgenetic alopecia.

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Introduction: Dysmenorrhea is one of the most prevalent complaints of women which is due to Prostaglandin release and is treated by chemical drugs. Today regarding side effects of these drugs, scientists are increasingly moving toward using herbal drugs. This study is planned to comparison the effects of Thymus Vulgaris and Mefenamic acid on primary dysmenorrhea.
Materials and Methods: This is a clinical trial study. Target population was women suffering from primary dysmenorrhea and study population was women reffering to marriage consulting center. Based on α=0/5, β=0/20, sample size was calculated 214 which were divided into two groups randomly. Samples were asked to determine their pain severity before using the drug, by a visual scale (0-10cm). In the study group each sample cosumed 15 grams Thyme leaf brewed in a glass of water and in control group samples used 250mg Mefenamic acid capsules. Then pain severity was determined again 1, 2 and 3 hours after using drugs. Data was analysed by mean and standard deviation indexes and K-S, man-whitney and chi-square tests. Helsinki declaration was regarded at all stages of the research.
Results: Pain severity mean, before using the two drugs had no significant difference between groups. In each group, pain severity was significantly decreased before and after using the drug (p=0.05). But the rate of decreasing pain between the two groups showed no significant difference.
Conclusion: Regarding results, it seems both Mefenamic acid and Thymus Vulgaris decrease pain at the same level which seems to be due to Thyme,s antiprostaglandin and antispasmodic effects.

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Introduction: Sneddon syndrome is a combinaison of skin lesions (Livedo Reticularis) and acute cerebrovascular accident. The syndrome involves many organs such as kidney, heart, skin and brain. Some patients have a good prognosis when taking Aspirin and Diprydamol. In this article a case of this syndrome is reported. Case: The patient is a 40 years old woman with a history of 8 times intrauterine fetal deaths. She was admitted to the neurology ward with signs of weakness in left side of the body (hemiparesis), dysarthria, 7th central nerve paralysis, and skin lesions (Livedo Reticularis). All laboratory data such as serology and microbiology were normal. After skin biopsy from the lower limbs and rule out possible secondary etiologies, this patient was recognized with Sneddon syndrome and recieved antiplatelet treatment. Conclusion: Despite the fact that this syndrome is rare, it seems considering the probability of appearing this syndrome, especially in young patients who are suffering from acute cerebrovascular signs and skin lesions in the same time, early treatment can prevent the desease from developing to other organs.

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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: Leukemia is a malignant and progressive disease. Over-expression of inhibitors of apoptosis proteins (IAPs), such as survivin and its anti-apoptotic variants, including sur-ΔEx3, is the main cause of resistance to apoptotic effects of chemotherapy drugs. In the present study, the effects of CBX on apoptosis and expression level of survivin and sur-ΔEx3 and K562 cells (experimental model of chronic myeloid leukemia) were investigated. Materials and Methods: In this experimental study, human K562 cells were cultured and exposed to CBX. Trypan blue exclusion test was used to evaluate growth inhibitory and viability effects of the drug. Fluorescent microscopy (acridine orange/ ethidium bromide double staining) and DNA electrophoresis were applied to the study of apoptosis. The expression level of survivin and sur-ΔEx3 was studied by semiquantative RT- PCR. Results: The results showed that after the 48 h treatment of K562 cells with 150 µM CBX, significant growth inhibitory and apoptotic effects (up to 50%) were induced. In addition, after 2-4 h of treatment with CBX (150 µM), down-regulation of survivin and sur-∆Ex3 were observed. However, the expression level of survivin and sur-ΔEx3 increased to the level of control cells with longer treatment times (6-12 h). Conclusion: Noticing the apoptotic and down-regulatory effects of CBX on survivin and sur-∆Ex3 expression, this drug can be used as a potential candidate for further studies on CML treatment, especially for inhibition of drug resistance in leukemia cells.

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Background: Nowadays, one of the basic problems of tuberculosis treatment is drug resistance. This study was done to determine the drug resistance of mycobacterium strains isolated from patients with pulmonary tuberculosis to anti-tuberculosis drugs and determine the affecting factors. Materials and Methods: In a cross-sectional study, all patients with tuberculosis who were covered by Markazi Province Health Center (917 persons) during 2005 to 2010 were included in this study. For all patients with resistant pulmonary tuberculosis, culture and antibiogram by standard method (proportional) were done. Effective factors in drug resistance were identified by logistic regression model using SPSS software. Results: Overall, the rate of resistance in patients with smear-positive was 7.3% and the rate of MDR-TB was equivalent to 4.3%, and 0.5% of smear positive patients were resistant to all five drugs. The most resistant strains were isoniazid (68.8%), rifampin (62.5%), pyrazinamide (25%), ethambutol (21.9%), and streptomycin (21.9%), respectively. The highest rate of resistance was in the 15-45 years age group. The incidence of resistance was significantly associated with sex, grade of smear positivity, relapse of TB, and HIV infection. Conclusion: The study of drug resistant mycobacterium strains over six years showed a growing trend. Therefore, close attention to prevent the production and dissemination of resistant strains is very essential.

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background: Early detection and treatment are crucial to prevent mental retardation in congenital Hypothyroidism (CH). The aim of this study was to evaluating of screening program of CH in Markazi Province.

Materials and Methods: In cross sectional descriptive study we used recorded data in Markazi province health center. From 2006 to 2012,127112 newborns were screened by measurement of serum TSH level by heel prick. Neonates who had blood TSH&ge5MIU/L were recalled for more evaluation. Neonates with confirmed hypothyroidism underwent treatment.

Results: From127112 screened neonates, 414 were diagnosed as CH patients (both permanent and transient). The prevalence of CH was . Recall rate was 4.8%. In 94.4% of patients, treatment were begun before the 40th day of life. The coverage percent in the province was 100% from the second year of the program.

Conclusion: Recall rate and the incidence of CH were higher than those in other studies, both in Iran and other countries. The mean age of treatment initiation and coverage percent were in favorable range.

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Background: Multidrug resistance is the main reason for unsuccessful chemotherapy. The important reason of drug resistance is ATP dependent pumps shus as MDR1 that extrude drugs from the cell. MDR1 is high polymorphic. It seems that polymorphisms influent on gene expression and response to treatment. The aim of this study was investigation of C1236T polymorphism MDR1 gene and it’s association with response of treatment in childhood acute lymphoblastic leukemia.

Materials and Methods: In this descriptive study, C1236T polymorphism of MDR1 was investigated in 44 acute lymphoblastic leukemia childhood and 40 healthy individual by ARMS-PCR technique. Association of this polymorphism with response to treatment was also investigated. Data were analyzed using Chi-squre test and SPSS software. P values <0.05 were considered to be statistically significant.

Results: There was no significant difference in frequencies of C1236T polymorphism between patients and healthy group (p=0.876). Frequency of C1236T polymorphism of MDR1 between responder and non responder was not significant (p=0.304).

Conclusion: It seems that there is no correlation between C1236T polymorphism of MDR1 gene and response to treatment. So the role of C1236T polymorphism in gene expression MDR1 in childhood acute lymphoblastic leukemia and response to treatment is still controversial.

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Background: Use of inappropriate drugs in the elderly is a major health care concern. It is likely to increase adverse drug reactions and induce a substantial increase in health care costs. The aim of study was to evaluate inappropriate drug use in the elderly.

Materials and  Methods: In this cross-sectional study, collecting data were collected from patient’s file for 260 patients aged 60 years who were admitted to Rasoul-e-Akram Hospital in 2012. Potentially inappropriate medications were identified based on the 2012 Beers criteria.

Results: The mean age of the patients was 75±8.3 years. Overall, 58(22.3%) of the patients were treated with potentially inappropriate medications. The most common inappropriately prescribed medications were benzodiazepines, pethidine, and TCAs.

Conclusion: To improve prescription quality in elderly patients in Iran, preparing a scientific criterion or guideline is necessary.

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Background: The overuse of therapeutic antibiotics results in the drug resistance. The excessive use of antibiotics causes the mutations in the microorganisms and the emergence of new microorganisms which are resistant against the common antibiotics. With regard to limitations and known side effects of antibiotics, the exploring of antimicrobial compounds seems necessary. The purpose of this study is to evaluate the antimicrobial effects of aqueous and ethanolic extracts of Chevil against Staphylococcus epidermidis PTCC 1435, Yersinia enterocolitica PTCC 1221 and Enterobacter aeruginosa PTCC 1151 and to compare them with the common therapeutic antibiotics.

Materials and Methods: In this experimental study, after collecting plants from the highlands of Chaharmahal va Bakhtiari province, the extraction was carried out by the maceration method. To evaluate the antimicrobial activity, Disc diffusion test with Kirby-Bauer method was used. The Minimum Inhibitory Concentrations (MIC) and Minimum Bactericidal Concentration (MBC) were determined by using the dilution method.

Results: The highest inhibition zone diameter in 40 mg/ml was related to Staphylococcus epidermidis and the minimum diameter in this concentration was related to Gram-negative bacteria, Enterobacter aeruginosa. MIC of aqueous and ethanolic extracts for Enterobacter aeruginosa 64 and 32 mg/ml and MBC of ethanolic and aqueous extracts of Enterobacter aeruginosa were 128 and 64 mg/ml respectively.

Conclusion: The ethanolic extract of the Chevil compared with the common therapeutic antibiotics had more inhibitory effect on studied bacteria. Furthermore, Chevil extracts showed greater inhibitory effect on Gram-positive bacteria in comparison with Gram-negative bacteria.

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Abstract

Background: Acinetobacters are aerobic gram-negative bacteria which are distributed widespread in soil and water. The bacteria are isolated from cultured skin, mucous membranes, secretions and hospital environment. Acinetobacter baumannii, is a strain that more frequently isolated. Acinetobacter strains are often resistant against antimicrobial agents.

Materials and Methods: The method of this study was based on field, observation and test. On August and October 2015, samples were isolated from the soil and water of the Sadeghieh Square river in Tehran, respectively, and were transferred to the laboratory in the ice pack. 50 baumannii samples were isolated by biochemical methods (TSI, SIM, OF and gram test). November 1394, 100 clinical samples were isolated from Imam Khomeini hospital by biochemical method, and in the culture media Mueller Hinton agar plates were transferred to the laboratory. Antibiogram test for 150 baumannii samples was performed. Biofilms formation of Acinetobacter baumannii environmental and clinical samples was investigated by Congo red agar and culture plate methods.

Results: In all samples (clinical and soil), most of antibiotic resistance was 92% for imipenem and the resistance of water samples to imipenem was 99.9%. Biofilm formation by Congo red agar in water, soil, and clinical samles was resprctively 44%, 40% and 1%. All isolates were negative biofilm culture plate.

Conclusion: Considering Acinetobacter baumannii resistance to antibiotics and the lack of biofilm formation of in clinical and environmental isolates, it was concluded that there wasn’t any relationship between antibiotic resistance and biofilm formation.

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Background and Aim: Fungal infections are among the most critical and common issues for hospitalized patients, especially in intensive care units. This study aimed to determine the fungal contamination of indoor air and surfaces in sensitive wards of the Arak University of Medical Sciences educational hospitals and determine the drug susceptibility pattern of isolated species.
Methods & Materials: In this descriptive cross-sectional study, 63 air samples were taken from sensitive hospital wards using the one-stage Anderson method, and 63 surfaces samples were taken using wet cotton swabs and cultured in saprodextrose agar medium containing chloramphenicol. Identification of the genus and, as far as possible, the species of fungi was performed using the culture method on the slide. Drug susceptibility testing was performed on isolated species by broth microdilution method (CLSI-M38A2 standard). 
Ethical Considerations: This study was approved by the Research Ethics Committee at Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1395.315).
Results: From the total samples, 18 species of fungi were isolated. These included: Aspergillus niger (8), Aspergillus flavus (4), Aspergillus fumigatus (2), Rhizopus spp. (2), Mucor spp. (1) and Fusarium spp. (1). In the drug sensitivity assay, instances of resistance included: Partial sensitivity of Aspergillus fumigatus to Itraconazole (1), Partial sensitivity of Aspergillus niger to Ketoconazole (1), and Resistance of Aspergillus niger to Itraconazole (1).
Conclusion: The pattern of nosocomial fungal infection with pathogenic fungi and the drug susceptibility pattern of these organisms in other regions of Iran and the world is relatively consistent with the present study results. And drugs listed in global guidelines for treating these infections, such as voriconazole and caspofungin in the treatment of invasive aspergillosis and amphotericin B in the treatment of invasive mucormycosis and Fusarium wilt, are now effective drugs.

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Introduction: Considering the importance of urinary tract infections caused by uropathogenic Escherichia coli (UPEC) in the medical field, this study aimed to investigate serogroups O25 and O16 and the pattern of antibiotic resistance among UPEC isolates obtained from hospitalized patients with urinary tract infections (UTIs) in Rasht hospitals.
Methods: A total of 110 urine samples were collected from patients with UTIs referred to selected hospitals in Rasht. The disk diffusion method, as recommended by the CLSI, was used to determine the pattern of antibiotic susceptibility. Serogroups O25 and O16 were detected using specific primers.
Results: Among the studied samples, 36.4% (40/110) were men and 63.6% (70/110) were women. Based on the antibiotic susceptibility pattern, a high level of antibiotic resistance was observed against nalidixic acid (81.8%) and co-trimoxazole (78.2%), while the most effective antibiotics were amikacin (85.5%) and nitrofurantoin (83.6%). In addition, multi-drug resistant phenotype was found in 72.7% (110/80) of UPEC isolates. According to PCR results, the frequency of serogroups O25 and O16 was 36.4% and 17.3%, respectively. Both serogroups had the highest resistance to nalidixic acid and co-trimoxazole, while the lowest resistance in serogroup O25 to nitrofurantoin (20%) and amikacin (14.3%) and in serogroup O16 to imipenem (5.3%) and nitrofurantoin (10.5%).
Conclusions: This study showed that the high prevalence of MDR strains among UPEC strains is very worrying and professionals should be very careful in prescribing antibiotics for patients. Like most studies, the frequency of serogroup O25 was high, and probably, this serogroup can play a role in causing urinary tract infections and antibiotic resistance of UPEC strains.

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Introduction: Nowadays, plant-derived compound is widely used in medical treatment as complementary therapies. Rosemary is one of these plants that have anti-angiogenic and anti-tumor effects. However, low solubility and low bioavailability lead to limited use of this compound. To overcome this limitation, the use of liposomes is beneficial. So, this study aimed to prepare liposomes containing rosemary alcoholic extract to obtain the best formulation with best properties to use in the antitumor study.
Methods: Liposomes were prepared by Thin-Film-Hydration method in different ratios of rosemary extract, hydrogenated-soybean-phosphatidylcholine (HSPC), Cholesterol, and mPEG2000 (F1-F6). The characterization of nanoliposomes includes size, PDI (Poly dispersity index), zeta potential, encapsulation efficiency, and release rate was measured.
Results: The results showed that the average particle size and zeta potential were 113.4 nm and -10.8 mV, respectively. Encapsulation efficiency showed a range of 60- 90%. The average release rate of the extract was about 60%. Also, the results showed that the F1 formulation was transparent, had appropriate properties, and did not precipitate. F2 formulation was not transparent. F3-F4 formulations were precipitated, and F5-F6 formulations did not achieve the appropriate size.
Conclusions: This study proved that F1 formulation in a ratio of 55:30:5 HSPC/chol/mPEG2000 is the best formulation for the preparation of nanoliposomes containing rosemary alcoholic extract to achieve the best properties for use in cancer studies.