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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: The aim of this study was to investigate the prevalence of pneumococcal infections, to determine penicillin and ceftriaxone susceptibility pattern among Streprococcus pneumoniae and to evaluate the risk factors of acquisition of pneumococcal infections in patients of Sari hospitals.
Materials and Methods: In this prospective study during one year (2002-2003), all patients admitted with pneumococcal infections in teaching and non-teaching hospitals were included. Diagnosis of pneumococcal infection was performed based on positive microbiological and appropriate clinical and standard laboratory findings. MICs of penicillin and ceftriaxone were determined by Agar dilution method and interpreted by NCCLS methodology. For statistically analysis Chi-square and Fisher's exact tests were used and P<0.05 was defined statistically significant.
Results: Seventy five episodes of pneumococcal infections among 32 pediatric patients and 43 adults were identified. The pattern of Streprococcus pneumoniae infections were similar between children and adults, and the most common infections were pneumonia (65.3%) and bacteremia (24%). The rate of penicillin and ceftriaxone nonsusceptible Streprococcus pneumoniae isolated from pediatric patients was higher than that in adult patients (93.8% versus 53.4%, P<0.01). This finding was correlated to prior penicillin use that was more common in children (37.5%) than in adults (7%). P=0,001. The susceptibility pattern of Streprococcus pneumoniae to penicillin and ceftriaxone isolated form pediatric patients and adults was different (6.2% from children, 46.6% in adults, P=0.0009). Eighty four percent of adults and 6.2% of pediatric patients had major underlying diseases (P<0.0001). This findings explain why adult patients tended to run higher mortality (30.2%) than children (6.8%).
Conclusion: This survey emphasis on vaccination of young children and elderly with major underlying diseases to prevent pneumococcal infections.

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Introduction: The use of complementary and alternative therapy is increasing and touch is one of them but several studies have indicated that premature neonates hospitalized in neonatal intensive care unit receive very little touch. The purpose of this research was to determine the effect of touch on arterial blood oxygen saturation in neonates with respiratory distress syndrome. Materials and Methods: This is a clinical trial with repeated measures that was performed on 37 neonates with respiratory distress syndrome. An information record form was used for data collection. The information record form was consisted of two parts: demographic information and a table for recording oxygen saturations. Oxygen saturation was measured by Nelkor pulse oxy meter. Information was collected in 3 sequential days. Arterial blood oxygen saturation was controlled 5 minutes before touch, then samples undergone 5 minutes touch and then in 5 and 15 minute intervals arterial blood oxygen saturation was controlled again. Data was analyzed using repeated measure ANOVA. Results: Findings showed that in the first day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/67, 95/91, 96 respectively. In second day, arterial blood and oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/72, 96/05, 96/08 respectively. In third day, arterial blood oxygen saturation in 5 minutes before, and 5 and 15 minutes after touch were 95/75, 96/16, 96/13 respectively. Arterial blood oxygen saturation in 5 and 15 minutes after touch were more than 5 minutes before touch in each 3 day(p<0.01). But there was no significant difference between 5 and 15 minutes after touch. Data analysis also showed no significant difference comparing arterial blood oxygen saturation in the 3 days. Conclusion: Findings suggested that premature neonates physiologically responded to touch. Nurses working in NICUs must be educated about the importance of touch in providing care for these neonates. Findings showed that touch is useful for premature neonates and this fact can be a start point for other investigations.

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 Introduction: Experimental autoimmune encephalomyelitis (EAE) is an animal model of multiple sclerosis distinguished by infiltration of leukocytes into the central nervous system. Changes in composition and levels of unsaturated fatty acids, affect the integrity of blood-brain barrier. In this study, we evaluated the effect of Sesame oil on the leukocyte infiltration into the brain of MOG35-55 induced EAE male C57BL/6 mice. Materials and Methods: In this experimental study, male C57BL/6 mice were placed in two therapeutic groups (n=10 per group) with age and weight-matched as follow: 1.Sesame oil-treated EAE mice received 4ml/kg/day of Sesame oil given i.p. from day -3 until day +19 after disease induction, 2.Non-treated EAE mice (EAE control) received Phosphate buffer alone with same schedule. EAE was induced by immunization of mice with MOG35-55 peptide and complete Freund's adjuvant. Leukocytes infiltration into the brain was investigated 20 days after immunization. Data was analyzed using Mann-Whitney U test. Results: The results show that Sesame oil-treated mice had significantly less clinical score of EAE (2.6±0.4) than non-treated EAE induced mice (4.2±0.6), (p<0.001). Also, there was a significant difference at number of the infiltrating cells in brain between Sesame oiltreated (80±20) and non treated EAE-induced mice (150±30), (p<0.01). Conclusion: These results indicate that Sesame oil reduces infiltration of leukocytes into the brain of EAE mice, therefore lessening the histological changes and clinical signs and thus ameliorating the disease.

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Introduction: Children with reflux who fail prophylaxis management or reflux which do not resolve spontaneously are candidates for sugery. Delay in surgery increases the development of new renal scars. Finding a modal factor for prediction of reflux resolution likelihood can decrease complications of treatments. Regarding that sacral bone anomalies have a direct influence on the final function of urinary and bowel systems, this study is done to investigate the relationship between sacral ratio and reflux. Materials and Methods: This is a case-control study. The case group included 76 children less than 9 years old refered to Vali-e-Asr and Amir Kabir hospital clinics with urinary tract infection and according to voiding cystouretrograply (VCUG) results, children with III, IV and V grade vesicoureteral reflux (VUR) entered the study. The control group included 76 children with previous urinary tract infection and normal VCUG. Sacral ratio in the two groups was measured and was compared by student t, Chi square and Mann Whitney tests. Results: The case group included 24 males and 52 females with average age of 2.7 years old and the control group included 23 males and 53 females with the average age of 3 years. The percent of sacral ratio abnormality were 40% and 23.7% in the case and control groups respectively, which was significantly different (p=0.001). The difference between the mean sacral ratio in case group with the value of 80% and the control group with the value of 84% was not different. The ratio distribution pattern in the two groups was not different. Conclusion: The percent of sacral ratio abnormality in children with vesicoureteral reflux were more than children without reflux.

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Introduction: Based on statistical and epidemiological studies, cancer is the third most common cause of death after heart diseases and accidents, therefore planning to control cancer is essential for public health. Cancer registration is an important part of cancer control, and the collected data could be useful in etiological studies, and health programming to prevent and treat the disease. In this study cancer incidence and cancer registration in Markazi province investigated. Materials and Methods: In this descriptive study, data related to cancer were collected from the health center of Markazi province, from 2001 to 2006. Then the prevalence and incidence of different kind of cancer were determined. Results: Results showed that the top ten cancers among women were: 1-Breast 2-Skin 3-Stomach 4-Colorectal 5-Lung 6-Uterus 7-Bladder 8-Lymphoma 9-Thyroid 10-Esophagus, and the ten most prevalent cancers among men were: 1-Skin 2-Bladder 3-Stomach 4-Lung 5-Prostate 6-Colon and Colorectal 7-Esophagus 8-Lymphoma 9-Testese 10-Gall bladder. Conclusion: In this investigation we also compared cancer incidence and distribution in Markazi province with national rates and our results showed that in some years, cancer statistics is different from national statistics which it may be due to different environmental and epidemiological factors.

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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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Abstract Background: Fetal Cerebrospinal fluid (CSF) develops viability and proliferation of nerve cells. Also this fluid contains many valuable factors for protection of nervous system injury cells. In this research, the effect of cerebrospinal fluid intraperitoneal injection on alpha motor degeneration after sciatic nerve compression in rat was determined. Materials and Methods: In this experimental-laboratory study, 18 male Wistar rats divided randomly in 3 groups (control, compression, and experimental). In compression and experimental group, right sciatic nerves were highly compressed. CSF was injected in experimental group each three days. After 1 month care, all rats were cordially perused by 10% formaldehyde and their L4-L6 lumbar segments of spinal cord were sampled and with processed for histological examination, the paraffin blocks were serially cut (7mm). Slices were stained with toluidine blue and numerical densities of motoneurons in spinal ventral horn were estimated stereological (dissector) technique. Quantitative data were analyzed by T-test. Results: Significant reduce in motoneurons number of compression group (47026) in comparison with control group (173978) was seen. Also there was significant difference between compression and experimental groups (992±141) in neuron density. Conclusion: CSF intraperitoneal injection may have a beneficial effect in neural regeneration.

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Abstract Background: Approximately 15-20% of pregnancies terminate to abortion. More than 50% of spontaneous abortions in 8-15 weeks pregnant mothers are related to genetically abnormalities. So, approximately 95% of them are related to numerical and 5% structural chromosome aberrations. Until now, neither of known human chromosomal abnormalities are treatable, and only way against these diseases limit to prenatal diagnosis and abortion of affected fetuses. The purpose of this study was determined the chromosome aberrations with cytogenetically methods. Materials and Methods: In this cross-sectional analytic study, 56 aborted fetuses were studied to detection of abnormalities frequency. Amnion-chorine culture, placenta, fetal tissue and aborted products from metaphase cells for gathering metaphase cells were used. Results: After cell culture, chromosome typing and GTG-banding Technique, trisomy 21 with highest frequency (12.5%) and isochromosomy 21, X and monosomy X with lowest frequency (1.8% for each them) was resulted. Conclusion: Not only chromosomal aberrations have important role in recurrent miscarriages, but also frequency rates of chromosomal aberrations in our country are similarity with other countries. Also cytogenetically diagnostic methods such as GTG-banding are a powerful and reliable technique for investigation of parents with recurrent abortion.

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Abstract Background: Developmental anomalies in sacral bone have been recognized as one of the causes of urinary incontinence. Sacral ration was suggested as a valuable scale in determining the sacral bone health. According to insufficient studies in this field and variation in results, a determination of relationship between sacral ratio (SR) with primary enuresis were seemed imperative. Materials and Methods: In a cross sectional-analytic study, two groups (n=59) of 5-9 year-old children who admitted in pediatric and urology clinics of Amir Kabir hospital in one year were determined. Primary enuresis group with normal urine-analysis and ultrasonography, no history of dysuria, frequency, and urgency and control group without primary enuresis were selected. The mean ratio between the greatest widths of the sacral bone to its greatest length in the AP radiogram was compared between both groups. Results: In case group, 98.3% had normal SR. The mean ratio of greatest width to length was 0.89. There were not a significant relationship between gender and normal or abnormal SR. In control group, 88.1% had normal SR. The mean ratio of greatest width to length was 0.91. Girls more than boys had normal SR. Significant difference between mean ratio of SR and greatest width to length in both groups were not seen. Conclusion: Significant relationship between SR with primary enuresis in 5-9 year-old children was not seen.

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Background: Ischemia/reperfusion-induced acute renal failure causes excretory functional disorders of nephrones. Ischemia/reperfusion injury increases iNOS expression in the renal tissue. Inhibition of iNOS expression and its activity can ameliorate ischemia/reperfusion-induced renal injury. The aim of this study was to determine the role of iNOS on progression of renal functional disturbances over the immediate post-ischemic reperfusion period. Materials and Methods: In this experimental study, renal hemodynamic and excretory functions were evaluated in male Sprague-Dawley rats. First, a 30-min control clearance period was taken. Then following bilateral renal artery clamping for 30 minutes, four consecutive 30-min clearance periods were taken during reperfusion, while saline or L-NIL as a selective iNOS inhibitor was infused. In plasma and urine samples, Cr and sodium concentration levels were measured. Results: Renal ischemia for 30 minutes decreased glomerular filtration rate and urine osmolality during reperfusion and increased urine flow and sodium excretion. L-NIL did not change the glomerular filtration rate and urine osmolality prior to ischemia but it improved them during reperfusion and there were progressive increases in urine flow. Additionally, L-NIL lowered ischemia-induced rises in sodium excretion. Conclusion: iNOS had a considerable role in the development of disorders in hemodynamic and excretory renal functions during early hours after ischemia.

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Background: The effectivity of applying antiseptics in preparation of the operative site on the reduction of post-operative infections is not quite clear and controversies exist about the best method for doing this. The aim of this study is to compare the traditional two-stage method of first, washing the site with povidone iodine scrub and then painting with aqueous povidone iodine with the method of washing the site only with povidone iodine scrub. Materials and Methods: In this retrospective study, patients who had been under knee arthroscopy in 2 separate hospitals by the same surgeon were compared with regard to post operative infection. In one hospital, the operative site was only washed with povidone iodine scrub, while in the other hospital this same procedure was followed by painting with aqueous povidone iodine. The primary goal of this study was to identify the patients who had manifested clinical and laboratory signs of superficial or deep infection or septic arthritis one month postoperatively. Results: A total 300 patients were studied in two equal groups. All the patients had only been under diagnostic or curative non-bony operations. No superficial or deep infection or septic arthritis were seen in any of the patients in the two groups. Conclusion: Preoperative preparation of the knee with povidone iodine scrub is a safe method for prevention of infection and can be used instead of the common two-stage method of using povidone iodine scrub and then painting with aqueous povidone iodine since this can decrease the time and cost of surgery.

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Abstract Background: Misconceptions of mental models are phenomena that are variance with accepted scientific models. Purpose of this study was to investigate the prevalence of misconception about half life and concentration of insulin hormone in students of Arak university of medical sciences. Materials and Methods: In this descriptive study 153 undergraduates in medicine and nursing – midwifery faculties of Arak university of medical sciences in 2009, were asked to answer to two questions about half life and concentration of insulin hormone. Results: The prevalence of misconception about half life of insulin hormone in medical, nursing and midwifery students were 75%, 80% and 85%, respectively, and prevalence of misconception about insulin concentration in blood were 31%, 26% and 20%, respectively. Conclusion: Misconceptions about insulin half life and concentration exist in high percent of students and it is necessary to correct the teaching pattern.

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Background: Following the reduction of neurons due to peripheral nervous injuries, the number of neuroglial cells also decline because of not receiving vital factors. The aim of this study was to determine the protective effects of curcuma longa total extract on spinal cord neuroglia cell degeneration after sciatic nerve compression in rats. Materials and Methods: In this experimental clinical- trial, Wistar rats were categorized in five groups (control, compression, treatment1, treatment 2 and treatment 3), each including six rats. For inducing the injury in the compression and treatment groups, the right sciatic nerve in the upper thigh was compressed using clamp forceps. In the treatment groups, 100mg/kg doses of the extract were injected in group1(3 times a day), group 2 (6 times a day) and in group3 ( 9 times a day). After 28 days, following being anesthetized, the rats underwent perfusion and samples were taken out of the lumbar segments of their spinal cord. Then the samples, after going through tissue processes, were cut in 7 m serial sections and stained in blue toluidine. Through the stereological quantitative technique, neuroglial cells were counted. Results: A significant decrease was seen in the number of neuroglial cells in the compression group (6913±208) in comparison with the control group (10184±791). Also, through the comparison of the compression group with treatment group 1(7077±293), treatment group2 (9372±252) and treatment group 3 (8715±252) a significant difference among dnsity of neuroglial cells in groups and 3 with conppnessin group was seen. a remarkable increase in the numerical density of neuroglial cells was obtained (p<0.05). Conclusion: Due to its antioxidant effects, curcuma longa extract increased the numerical density of neuroglia cells following the compression of the sciatic nerve. The antioxidant effects of this extract probably inactivate the apoptosis channels which have been activated due to peripheral nerve injuries.

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Background: This investigation was designed to determine the effects of a selective A1-AR antagonist (DPCPX) on renal hemodynamic and excretory dysfunctions induced during the early hours of ischemia/reperfusion (I/R). Materials and Methods: In this experimental research, rats were anaesthetized by sodium pentobarbital, and their renal arteries were, then, occluded for 30 min, four hours after the reperfusion period. There was a clearance period during the last one hour of reperfusion period throughout which urine was collected under 30-mm of paraffin, and arterial blood samples were taken during its beginning and end. Animals were divided into four groups DPCPX (2 mg/kg) or normal saline were injected 30 min before renal ischemia to the two groups of I/R+DPCPX and I/R, respectively, and to DPCPX and Sham groups which were subjected to surgery without clamping of renal arteries, respectively. Results: I/R resulted in elevations of plasma osmolality, plasma concentrations of Na, K, creatinine, and urea, fractional excretions of Na, K, and bicarbonate, absolute bicarbonate excretion, and urinary pH, but it induced reductions in arterial bicarbonate concentration, pH and Pco2, creatinine clearance, absolute excretions of Na and urea, free-water re-absorption, and urinary osmolality in the I/R group in comparison to the Sham group. Comparison between I/R+DPCPX and I/R groups showed that applying DPCPX could improve I/R-induced alterations in most of these parameters. Conclusion: Activation of A1-AR during the early hours of reperfusion following renal ischemia definitely contributes to the development of disorders in hemodynamics, tubular Na re-absorption, as well as excretions of K, urea, and acid-base.

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Background: Salvia staminea, belonging to lamiaceae family, has positive effects on the nervous system and possesses anti-oxidant and anti-inflammatory effects. Hence, this study was conducted to determine the neuro-protective effects of salvia and its total ethanol extract on spinal cord motoneurons in Wistar rats. Materials and Methods:In an experimental trial, 54 male Wistar rats were divided into nine groups of six: Control, compression, treatment A (ethanol extract of root in 25, 50, and 75 mg/kg doses), treatment B (aqua extract of root in 25 and 50 mg/kg doses), treatment C (aqua extract of leaves in 50 mg/kg doses), and treatment D (ethanol extract of leaves in 75 mg/kg doses). In compression and treatment groups, 28 days after inducing impairment in α motoneurons, sampling of the left leg sciatic nerves was done in the rats. Following tissue passage, 7 micron cuts were obtained and painted with blue toluidine. Neuralgia motoneurons count was, then, carried out through steriology and dissector methods. Results: Neuron number density in the rats treated with 50 mg/kg doses of total aqua and ethanol extracts of leaves and 75 mg/kg dose of ethanol extract of root showed significant differences in comparison to that of the compression group (p<0.05). Conclusion: The results of this study prove the neuroprotective effects of these extracts on neuralgia motoneurons of spinal cord.

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Background: Hospital wastewater usually contains pathogenic micro-organisms, drugs, radio active materials, and toxic chemical elements that in case of being disposed without filtration, will result in pollution and spread of diseases. Therefore, evaluating the status of wastewater disposal in hospitals is necessary for proper planning. Materials and Methods: In a cross-sectional descriptive study in 2008, data collection was done by means of interviews, observations, and questionnaires in all hospitals of Markazi Province. Noticing the 33 items in the questionnaire, the overall conditions of the hospitals and the methods of using the sewage system were studied, and at the same time, filtration installations and wastewater disposal systems were inspected. Results: Of all the 19 hospitals, 10 used a conventional method of direct disposal of sewage to subterranean shafts, and of the 4 hospitals with filtration installations, three were practically out of order or were not efficient. Five of the hospitals were directly linked to the city sewage system without any pre-filtration. None of the hospitals had a specialized operator of sewage filtration and disposal system. Conclusion: Wastewater disposal in hospitals of Markazi Province is not desirable therefore, such acts as conducting more specific surveys, creating a positive attitude in planners, and providing sufficient funds for filtering wastewater in some of the hospitals are suggested.

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Alzheimer’s disease is one of the most common causes of loss of mental function broadly known as “Dementia”. Alzheimer’s disease affects approximately 2% (6.5 Million) of people in the developed countries and responsible for over 100,000 death per year in USA Alzheimer’s disease usually occurs between sixth to ninth decade and its progressive deterioration comprised of gradual destruction of memory, judgment, language, reasons in addition to behavioral alterations. Microscopic biopsy shows cortical atrophy along with ventricular enlargement of the brain. These clinical manifestations reflect the neurotic degeneration in cerebral cortex, especially, the temporo-parietal cortex and the hippocampus. Pathological abnormalities of Alzheimer’s disease include brain deposition of two fibrillary proteins. These two are known as Beta-amyloid proteins containing Apolipoprotein E and Tau proteins. Alzheimer’s disease affects primarily cholinergic neurons, therefore, treatment is followed by specific drugs that inhibit the degradation of acetylcholine within synapses. Current medications only treat the cognitive symptoms but not the underlying disorder. Several lines of ongoing research are showing promising scientific results. These include, uncovering the biological markers for early detection and developing new effective drugs. Also, new approaches have been employed to block the molecular processes that lead to this disease. Moreover, many clinicians are exploring alternative pathways for Alzheimer’s disease treatment, such as good diet along with mental and physical exercise as preventive methods.

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Background: Since researchers were able to produce dendritic cells (DCs) from peripheral blood monocytes, many scientists have been in search of discovering the best way of producing dendritic cells and optimizing the DCs maturation processes in vitro to treat some diseases. The aim of this study was to investigate the maturation of DCs for tumor immunotherapy. Materials and Methods: In this experimental study, DCs were produced in two stages. In the first stage, monocyte cells were converted to immature DCs by GM-CSF and IL-4. In the second stage, immature DCs were made mature in the presence of human umbilical vein endothelial cells and PHA -activated T lymphocytes conditioned media and maturation factors. Results: The produced DCs with appropriate phenotype, phagocytosis ability, and proliferation of T lymphocytes stimulation traits could secrete high levels of cytokines. Conclusion: Endothelial cells and T lymphocytes conditioned media can produce Th1 and DC1 in vitro. Therefore, DCs produced through this method are suitable for immunotherapy treatment applications and cancer treatment through treatment cells.

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Background: Pain is a complex problem, which can affect patients' physical and psychological condition. Inadequate postoperative pain control has adverse effects on the patients' physiological, metabolic and mental condition. Adding new supplement will increase the duration of analgesia. This study aimed to comparison of intratechal neostigmine and midazolam in increasing the time of postoperative analgesia. Materials and Methods: In this randomized double blind clinical trial, 60 patients with ASA class Ι, II who were candidate for elective colporrhaphy surgery under spinal anesthesia were randomly divided into 3 groups of 20 patients. All patients received hyperbaric lidocaine 5% and groups I received 1 mg midazolam, groups II received 50 μg Neostigmine and groups III received 0.5 cc normal saline additionally. Then according VAS pain score, postoperative painless duration and pain score were compared between groups by running SPSS software. Results: Mean of painless duration in the Midazolam, Neostigmine and control groups were 98.4±18.2, 74.5±32.6 and 64.5±9.9 minutes respectively which was significantly longer than in Midazolam group (p<0.001). The mean dose of requested analgesia in first 24 hours after surgery was significantly lower in Midazolam group (p<0.001). Conclusion: Inthrathecal midazolam and Neostigmine as a complementary medication to lidocaine 5% can increase painless duration in colporrhaphy surgery and midazolam is more effective than Neostigmine. Key Words : midazolam & Neostygmine , Spinal anesthesia, painless time , colporrhaphy