---

Introduction: Postoperative hypothermia is physiologically stressful by elevating blood pressure, heart rate and plasma catecholamine concentration. This study conducted to evaluate the effects of intravenous fluids temperature on perioperative hemodynamic situation. Materials and Methods: This was a randomized clinical trial study Perioperative pulse rate, blood pressure, intraoperative esophageal and skin temperature were measured in 60 volunteer patients undergoing orthopedic surgeries subjects randomly divided into two groups according to intraoperative IV fluids management. In 30 patients (hypothermia group) all IV fluids infused were at room temperature. In the other 30 patients (normothermia group) all IV fluids were warmed using and dry IV fluid warmer. Results: The core and skin temperature of hypothermia and normothermia group decreased significantly from induction of anesthesia toward end of surgery but its reduction was more in hypothermia group (P<0.005). Postoperative mean arterial blood pressure increased significantly more in hypothermia group versus normothermia group (P<0.005). Shivering was observed in 21 of 30 hypothermia and 11 of 30 normothermia group (p<0.005) and recovery time was significantly lower in normothermia group (36±5 vs. 26±3 min, P<0.005). Conclusion: Infusion of warm fluids helps to reduce the variation of postoperative mean arterial blood pressure, core and skin temperature, occurrence of shivering and recovery time.

---

Background: Postoperative shivering is a common problem with multiple complications. This study was compared effect of low doses of Ketamine with Pethidine for controlling postoperative shivering. Methods and Materials: This clinical trial was done on 189 elective cesarean section with ASA class I or II who had postoperative shivering. Patients with grade 2 or higher were divided in three groups and were injected 0.3mg/kg Ketamine and 0.5mg/kg Pethidine intravenously. In 5th and 10th minutes after injection, they were investigated for shivering intensity. Results: After 5 minute of injection drugs rate and intensity of shivering in Pethedine group was less than ketamine group. Ketamine with 0.5 mg/kg was more effective than 0.3mg/kg dose of it and Ketamine(p=0.041). In group with 0.5mg/kg dose of Ketamine, rate and intensity of postoperative shivering was more reduce than group with 0.3mg/kg of it in recovery(p=0/007). In Pethedine group rate and intersity of shivering was more reduce then 0.5mg/kg dose of Ketamine(p<0/001). This demonstrated that Pethedine is more effective than Ketamine. Conclusion: Although 0.5mg/kg dose of Ketamine has considerable effect on control of shivering but Pethedine is still a better choice for this side effect.

---

Background: Polymerase chain reaction is the most common technique in the field of molecular biology that use for amplification of a specific nucleic acid sequence. Degenerate primers have ability to amplify related but distinct sequences. The aim of current study was to use, two sets of degenerate primers in combination with Hemi Nested PCR for detection V3-Loop sequence of envelope gene from wide spectrum of Human Immunodeficiency Virus (HIV) subtypes. Material and Methods: In this experimental study we designed and optimized, a degenerate primer pair in combination with Hemi Nested PCR, to detect HIV-1 V3 loop from Envelop gene that has wide variations among genotypes. The developed assay was used to check, 40 HIV infected, 10 negative controls as well as 5 samples from each HCV, HBV, HGV, and TTV were analyzed using developed method. Results: after optimization, 35 out of 40 positive controls were positive using our test. None of the negative human and viral control samples showed specific band. Also, in positive samples, non-specific bands were not detected. Conclusion: In this study moreover than standard PCR, we used two degenerate primers that could detect specific region of genome. In fact, first round of PCR product act as a template for second round inner primers and can produce smaller sequence with high sensitivity due to degeneracy. Based on the current investigation, the developed assay had advantages including product confirmation and hence more sensitivity.

---

Background: HIV-1 and HCV are two of the most important blood-borne infectious agents. Hence, reliable, precise, and sensitive detection of these viruses in infected patients and donated blood units is highly important. Noticing the limitations of serological assays in detection of these infectious agents, this study was to use fast and sensitive molecular assays like real-time PCR. Materials and Methods: In this trial, a home-brewed SYBR green-based multiplex real time PCR, on the basis of melting curve analysis, was developed for the single or simultaneous detection of HCV and HIV-1 infections in plasma samples. Data were analyzed using SPSS software version 16. Results: The results obtained from different reactions on several clinical samples showed that the analytical sensitivities of the developed assay for HIV-1 and HCV were 200 and 100 copies/ml, respectively. It was also shown that the primers designed for each virus had no interaction with each other and other interfering agents. Conclusion: Noticing the good level of sensitivity and specificity, easy handling, relatively low cost, and rapid analysis of samples, this method can be a useful and rapid approach for simple and effective detection of HCV and HIV-1 in plasma samples.

---

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.

---

  Background: Due to the lack of efficient anti-HIV vaccine, anti-HIV pharmaceuticals play an important role in controlling HIV infection. Also significant rise in drug resistance and drug toxicity has caused increased interest in finding new anti-HIV agents. In this study, a nano-sized version of lamivudine based on PEGylated chitosan was synthesized.

  Materials and Methods: In this research, nanoparticles of chitosan were efficiently PEGylated for increasing their stability in water and then the anti-HIV drug, lamivudine, was loaded on these PEGylated nanoparticles. After purification and lyophilization of new synthesized nanoparticle, the raw materials and final product were sampled and FTIR, HNMR and CHN analyses were done.

  Results: Results of HNMR spectroscopy showed that chitosan nanoparticle was successfully PEGylated. HNMR data confirmed FTIR results and indicated that lamivudine was conjugated on chitosan nanoparticle. In addition, CHN analysis data also confirmed both HNMR and FTIR data, and demonstrated that a high yield of chitosan nanoparticle PEGylation (approximately 97%) was done and illustrated a high capacity of lamivudine conjugation on nano-sized PEGylated chitosan (30% _W/W chitosan).

  Conclusion: In this study, lamivudine drug was successfully synthesized, based on PEGylated chitosan nanoparticle.

 

---

Background: Because of the reported high ability of virulence and medicinal resistance of HIV-1 virus during the last decades, many investigations have been performed concerning discovery and the introduction of anti-HIV-1 drugs. The results of numerous researches have shown that drugs and protease inhibitory compounds mainly containing plant derivatives specially terpenoids may control HIV-1 infection very effectively. The aim of this research is the bioinformatical study of HIV-1 protease inhibition by standard drugs and triterpenoides from plant and mushroom.

Materials and Methods: This is a descriptive-analytic study. In the present study , the structure of drugs, triterpene comounds, and HIV-1 protease enzyme was received from the databases such as Chem Spider, PubChem, Human Metabolome Database (HMDB), and Protein Data Bank (PDB). After that, molecular docking was performed by iGRMDOCK 2.1 software

Results: The results confirmed that the interactions of the triterpene compounds like the standard drugs were in three safeguarded and catalytic areas including central domain, flap and carboxylic terminal domain specially amino acids Asp25, Asp27, Ala28, Asp29 and Asp30 in active sites of HIV-1 protease. Also, The study of the interactions of these areas showed that there is a direct correlation between the strength of the interactions and IC50 values of these compounds.

Conclusion: Finally, with due attention to the high effectiveness and the proprietary function of triterpenoids, we can conclude that these compounds may be considered as effectire HIV-1 antiprotease drugs.

---

Background: Nef is one of the HIV-1 critical proteins, because it is essential for viral replication and AIDS disease progression and induction of immune response against it can partially inhibit viral infection. Moreover, a domain of the HIV-1 Trans-Activator of Transcription (Tat, 48-60 aa) could act as a cell penetrating peptide (CPP). In current study, cloning and expression of Tat-Nef fusion protein was performed in E. coli for the first time. The protein expression was confirmed by western blot analysis and was purified using reverse staining method.

Materials and Methods: In this experimental study, primarily, cloning of Tat-Nef fusion gene was done in pGEX6p2 expression vector. Then, the expression of Tat-Nef recombinat protein in E.coli BL21 (DE3) strain was performed by using IPTG inducer. The protein expression was confirmed by SDS-PAGE and western blotting using anti-Nef monoclonal antibody. Then, the recombinant fusion protein was purified from gel using reverse staining method.

Results: The results of PCR analysis and enzyme digestion showed a clear band of ~ 726 bp in agarose gel indicating the correct Tat-Nef fusion cloning in pGEX6p2 prokaryotic expression vector. In addition, a 54 kDa band of Tat-Nef on SDS-PAGE revealed Tat-Nef protein expression that western blot analysis using anti-Nef monoclonal antibody confirmed it.

Conclusion: The purified Tat-Nef recombinant fusion protein will be used as an antigen for protein vaccine design against HIV infection.

---

---

---

Background and Aim: Acquired Immunodeficiency Syndrome (AIDS) caused by Human Immunodeficiency Virus (HIV), is a chronic and potentially life-threatening disease. Numerous factors affect its development and progression. Therefore, the present study attempted to identify characteristics impacting the prognosis and progression of AIDS using multistate models.
Methods & Materials: The present retrospective study consisted of 2185 patients affected with HIV referring to Behavioral Disease Counseling Centers in Tehran City, Iran, from 2004 to 2013. We considered multiple states of AIDS, tuberculosis, and tuberculosis/AIDS in the natural history of the disease (from the onset of HIV disease until death occurred). Then, we applied the multistate models, to examine the effect of contextual demographic and clinical variables on survival time; subsequently, the transition probabilities of HIV.
Ethical Considerations: This study was approved by the Research Ethics Committee of Hamadan University of Medical Sciences (Code: IR.UMSHA.REC.1396.117).
Results: HIV-Related deaths in individuals with an incarnation history were 2.40 times higher than in those without the prison history. Death risk was also 1.70 and 1.80 times higher in those aged 25-44 and 44 years, respectively, compared to the individuals aged less than 25 years. An inverse relationship was also found between CD4 levels and the risk of death in our participants.
Conclusion: Antiretroviral therapy, CD4 count, age, and history of imprisonment were the main factors in the progression of the disease and subsequent death in HIV patients. Thus, preventing the further spread of the disease to the community and controlling the disease in the patients requires targeted educational and therapeutic interventions; accordingly, the community will be familiarized with transmission routes and the preventing principle of disease. Furthermore, we can encourage patients to visit the healthcare centers early.

---

Background and Aim: The main objective of the current study was to compare the effectiveness of schema therapy and dialectical behavior therapy (DBT) on health-promoting lifestyle (HPL) and quality of life (QoL) of HIV/AIDS patients. 
Methods & Materials: The current study was an experimental study based on a pre-test-post-test design with a control group, and based on the objectives, it can be considered an applied study. The statistical population of the study included all HIV patients monitored by behavioral disorders clinics of the Healthcare Organization Centers in Hamedan County in Iran in 2019-2020. Using simple random sampling method, 45 patients were randomly selected from Shohada Clinic in Hamedan as the sample of the study, followed by randomly assigning them to three 15-member groups, i.e., two intervention groups and a control group. In order to measure the research variables, the Health-Promoting Lifestyle Profile (HPLP) (1987) and the Short Form (36) Health Survey (SF-36, 2001) were utilized. The obtained data were analyzed using ANCOVA in SPSS v. 12.
Ethical Considerations: The Ethics Committee of Hamedan University of Medical Sciences approved the study (Code: IR.UMSHA.REC.1398.1063). This study has been registered in the Iranian Registry of Clinical Trials (Code: IRCT20120215009014N348).
Results: The results of ANCOVA indicate that schema therapy and DBT affect HPL and quality of life, and there was a significant difference between the two groups (P‌<‌0.001). 
Conclusion: The results show that while both therapy methods affect the selected variables, schema therapy is more effective than DBT on HPL and Quality of Life (QoL). 

---

Background and Aim: AIDS (Acquired Immune Deficiency Syndrome) is a deadly disease that affects the human immune system. This study evaluated the Quality of Life (QoL) of Human Immunodeficiency Virus (HIV) patients in Markazi Province .
Methods & Materials: This cross-sectional study was conducted in 2020-2021 in Markazi Province . The World Health Organization (WHO) questionnaire was used to determine the QoL in HIV patients. This questionnaire includes the physical, psychological, level of independence, social relationship, environment, and spirit. Statistical analysis was performed in STATA software. 
Ethical Considerations: This study was approved by the ethics committee of Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1398.008).
Results: A total of 126 people with HIV were included in the study. The mean age of the subjects was 40.4±10.2 years. The mean score of each of the physical domains was 14.4±3.3, psychological 11.7±3.2, independence 13.3±3.8, social relationships 11.2±3.1, environment 0.8±0.3 10, spiritual was 13.2±3.3, and total QoL score was 12.1±2.6. In multivariate linear regression analysis, socioeconomic status and history of imprisonment significantly predicted higher scores of overall qualities of life.
Conclusion: The total score of QoL in people with HIV in Markazi Province is average. Among the factors affecting it are gender, socioeconomic status, and history of imprisonment. It is suggested that QoL assessment of these patients be added to their care protocols to take effective measures to improve it.