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Introduction: Electric seizure therapy is one of the most important treatments in psychiatry that is used as the least effective treatment for mental disorders. Significant anesthetics commonly used in Iran for this purpose are sodium thiopental with a dose of 0.5-3.5 mg/kg and propofol with a dose of 2-3 mg/kg, each of which has the above effects. It focuses on different systems of the body and causes different autonomic responses in patients. Therefore, it is necessary to compare the therapeutic effects and side effects of these two drugs in patients undergoing treatment for seizures with electricity. 
method: In this study, which is a cross-sectional clinical trial study, 40 patients in the field of electronics seizure therapy were examined twice, one time with propofol and the next with sodium thiopental to induce anesthesia. Pre-, post-operative, and postoperative information were collected and analyzed by a questionnaire for seizure duration, blood pressure, heart rate, and level of awareness.
Results: The duration of seizures in propofol was less than in thiopental, which was statistically significant (P<0.001). Blood fluid in the case of thiopental increased significantly compared to propofol (P<0.001). The thiopental receptor group also showed a higher increase in heart rate, but this difference was not significant.
Conclusion: The use of propofol in seismic therapy with electricity has fewer side effects than thiopental and its use is recommended.

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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: Radiotherapy after breast cancer surgery will increase local control of the disease and also increase overall survival. Radiation have some side effects on lung function. In different radiotherapy techniques, these side effects are different. Pulmonary function tests and oxygen saturation are methods for evaluation of these complications. In this study we decide to campare pulmonary complications in two radiotherapy methods. Materials and Methods: In this clinical trial study fifty one patients with breast cancer in stage II and III according to TNM staging system, which were under modified radical mastectomy in Imam Hosein hospital and refered for adjuvant radiotherapy, randomly divided in two groups. In one group patients were treated with three field technique and in others with four field technique. All patients received total dose of 48-50 Gy. For patients, pulmonary function test and pulse oxymetery were done once before initiation of radiotherapy and then one and three months after radiotherapy. Results: Measurement of FEV1 , FVC and show that no significant statistical difference was present between the two groups one month and three months after radiotherapy, also in each of the two groups the amount of FEV1 , FVC and one month after radiotherapy had no significant statistical difference in comparison to baseline tests but FEV1 and FVC after three months was decreased and had significant statistical difference respectively (p<0.001, p<0.006). SO2 had no significant defference between the two groups and also in each group after one and three month of radiotherapy. Conclusion: Locoregional radiotherapy of breast and lymph nodes areas causes a decrease in some parameter of pulmonary function tests but no difference was present between three field and four field techniques.

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Introduction: Endocrinopathy is a known consequence of external beam radiotherapy to the brain tumors. The aim of this study was to find out the incidence of hyperprolactinemia in brain tumor patients treated with radiotherapy, when radiation portals included whole hypothalamus and pituitary glands. Materials and Methods: This descriptive study was conducted from December 2004 to February 2006 on about 42 patients with brain tumors. They were referred to radiation oncology center of Hamadan to be treated with external beam radiotherapy, whose radiation portals included whole hypothalamus and pituitary glands. Serum prolactin levels were measured at the beginning of treatment, and at one month, three months, six months and one year after completion of radiotherapy. Data was introduced using descriptive statistics. Results: Of 42 patients 6 were excluded one because of previous hypothalamus and pituitary radiotherapy, three because of nonadherence to follow up program and two because of previous endocrinopathy Of the patients attending the follow up clinic, 11% were found to have hyperprolactinemia at six months, and 22 at one year. This condition in women and men was 37% and 15% respectively. Conclusion: Abnormality in Prolactine secretion is a late complication of brain radiotherapy and a significant number of patients develop hyperprolactinoma following radiotherapy to the brain (hypothalamus and pituitary region). It seems this complication increases by increasing the radiation dose and is more prevalent in women.

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Introduction: Typhlitis is a complication in GI tract specially in ileum and cecum due to sever prolonged neutropenia. The syndrome usually occurs in patients with leukaemia who take aggressive chemotherapy or in solid tumor treated with taxane base regimen. The syndrome is accompanied with neutropenia, fever, generalized abdominal pain specially in right lower quadrant and probably a mass in this area. Case: The patient is a 44 year old man which was presented with enlargement of right testes since two months ago. In sonographic evaluation of testes a mass was defined and surgery was done for him, which pathologic result was seminoma. Staging workup was done and in CT Scan a lymph node with size of 35 mm was detected in paracaval area . According to this result the patient received chemotherapy with Cisplatin and Etoposide. One day after completion of chemotherapy he developed abdominal pain , fever and bloody diarrhea and referred to hospital and admitted with diagnosis of typhlitis. Conclusion: Typhlitis is not restricted to a complication of leukaemia treatment or taxane base chemotherapy and other cytotoxic drugs can induce this problem. On the other hand, neutropenia and typhlitis can occur immediately after chemotherapy in sensitive patient and so the time of nadir value of white blood cell is too short.

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Background: Marital conflicts have great impact on social, economic and cultural aspects of the couples and their children. New Psychological interventions like “Imago Relationship Therapy” (IRT) have been widely used for resolving these conflicts. This study examined the efficacy of couple dialogue technique on marital relationship and children`s behavior in Iranian society. Methods and Materials: In a Clinical Trial study eighty consecutive couples refered to general pediatric clinics due to their children’s diseases, randomly allocated to intervention group(couple dialogue technique) and control group (consult usual treatment method) in consultation center. They filled "Distance and Isolation Questionnaire" and "Gottmann Love and Respect Scale" at baseline, post treatment and three months after intervention as follow up all of them. General linear Model with Repeated Measurements was used to analyze the data. Results: In this study, scores of mutual love and respect in marital relationship (Gottmann scale) and scores in Flooding, Loneliness and Retreatment subscales of Distance and Isolation Questionnaire had a better condition in IRT group just after the trial (P<0.05) but after three months, the differences between two groups were only marginal significant (P<0.1). In Parallel lives` subscale, scores were decreased in two groups, but right after trial there was not significant scores of the groups did not difference between scores. Scores after three months in IRT group was significantly lower in compare to control group. Scores of CBCL have not statistically significant differences in both groups at any time (P>0.05). Conclusion: This study revealed couple dialogue technique was an effective intervention in solving marital conflicts in Iranian population but had not a significant effect on children’s behavioral profile. This may be due to other factors or insufficient duration of intervention and needs more investigation and needs more investigation.

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

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Background: Pyelonephrities is the urinary tract infection. Using supplemental dugs may decrease duration of treatment and hospitalization. We studied the effect of vitamin C on the recovery of symptoms due to pyelonephrities Methods and Materials: In this clinical trial, double blind, study, 64 patients with uncomplicated pyelonephrities were assessed in 2 groups randomly. Case group took vitamin C capsules, and control group took placebo capsules. In both groups, primary treatment was ceftriaxon capsules during hospitalization and they took ciprofloxacin capsules for 14 days after discharging. Symptoms and Urinary analysis were assessed in the first day of administration and then on the 7th and 14th days after discharging. Data were analyzed with Chi-Square test. Results: Mean of fever duration in vitamin C group (1.130.34 SD day) and placebo group (1.560.62 SD day) significantly decrease (p=0.001). There was a significant difference in dysuria duration in vitamin C group 2.191.06 SD day with placebo group (2.971.06 SD day) (p =0.007). In flank pain, nausea and vomiting duration difference was not significantly (p≥ 0.05). Conclusion: It seems vitamin C, as a supplemental drug improves some pyelonephrities symptoms, such as fever and dysuria, decreases of the hospitalization period

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Background: Researches showed that there is a relationship among alopecia areata, psychological factors and prevalence of psychological disorders. In addition alopecia areata has a great effect on the quality of life of these patients. The purpose of this study is to investigate the effectiveness of cognitive-behavioral stress management therapy on female patients`s the quality of life with alopecia areata. Methods and Materials: This is a case-control study with pre and post-test exam which is carried out in Isfahan Skin Disease and Leishmaniasis Research Centre. The participants consisted of 20 alopecia areata patients diagnosed by specialists. The questionnaire was Skindex-16 which was completed by patients before and after the intervention. Cognitive-behavioral stress management therapy was done on the case group in eight sessions over a period of two months. Data was analyzed with covariance (ANOVA). Results: The mean of quality of life scores in experimental group in v.s control group significantly decreased (P<0.05). Conclusion: It seems, cognitive-behavioral stress management therapy couses in quality of life improvement in patients with alopecia areata.

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Abstract Background: Prostate cancer is the most common cancer in American's men and is the most common malignancy after skin in men. The purpose of this research was comparison of demographic characteristic of patients with advanced prostate cancer treated with surgical and medical orchiectomy. Materials and Methods: This retrospective cross- sectional analytic study carried out on 53 patients with locally advanced and metastatic (stages III- IV) prostate cancer referring to oncology wards in Buali hospital in Hamadanand and Vali-e-Asr hospital in Arak for adjuvant therapy of chemotherapy or radiotherapy during 2003-7. Demographic characteristics such as age, disease stage, cultural status, habitancy, socioeconomic status and patients accepted treatment of advanced prostate cancer treated with surgical and medical orchiectomy (hormone therapy), were determined and compared. Results: There was a significant difference between age mean of patients treating by orchiectomy and hormone (p=0.007). Also socioeconomic status distribution in two groups was different (p= 0.025). Distribution of disease stage, cultural level, habitancy in two groups were similar (respectively p=0.207, p=0.617, p=0.272). Conclusion: People less tend to orchiectomy to hormone therapy. Also, in high socioeconomic status and in elder, tendency to surgical orchiectomy is more.

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Background: This study was designed to investigate on efficacy of metacognitive–behavioral therapy (MCBT) on panic beliefs of panic female patients. Materials and Methods: This is a clinical- trial study. The participants, who were 24 panic female patients diagnosed with panic disorder, were selected from 76 panic patients referring to psychiatric clinics. The participants were randomly assigned in to two experimental and control groups. The data were gathered using the panic belief questionnaire which was completed in pretest, posttest and follow-up stages by the participants. MCBT was conducted in 8 sessions on the experimental group while the control group, in addition to the reception of common medical treatments, was laid in waiting list for psychological therapy. Results: According to the results of covariance analysis, the mean of panic beliefs scores obtained in the experimental group were significantly lower than those of the control group (p< 0.05). Conclusion: Panic female patients who attended in MCBT acquired lower scores in panic belief than the control group. Therefore, the results demonstrate that MCBT approach causes to keduce panic beliefs in panic female patients.

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Background: Psychological interventions may improve the quality of life in females with temporal lobe epilepsy through affecting their bio-psycho-social dimensions. This aim of this study was to aim assess the efficacy of cognitive-behavioral stress management (CBSM) group education on improvement of quality of life in epileptic patients. Materials and Methods: This was a case-control study with pre-post-and follow-up tests. The sample population included 26 patients, already diagnosed with temporal lobe epilepsy by neurologist and through electro-encephalography, that were randomly selected and assigned to experimental and control groups. Data were collected through the Quality Of Life Questionnaire for Epileptic patients (QOLIE- 89) that was administered in the pre-test, post-test, and follow-up test. CBSM group education was given to the experimental group in ten sessions during two months. Results: The mean of QOLIE-89 score in the experimental group showed a significantly higher increase in comparison to that in the control group (p<0.05). Conclusion: The results demonstrated the effectiveness of CBSM group education on the improvement of quality of life in females with temporal lobe epilepsy.

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Background: Sex life is one of the most important aspects of quality of life which is affected by a multitude of factors which can disrupt it. This study compares the effects of two different hormonal therapeutic regimens on sexual performance of postmenopausal women. Materials and Methods: In this randomized clinical trial, a total of 111 healthy postmenopausal women with no absolute contraindication for hormone replacement therapy (HRT) were divided into two groups that received GI-Tibolone 2.5mg/day (N=57) and GII-continuous conjugated estrogen (CE) 0.625mg/day plus medroxyprogestrone acetate (MPA) 2.5mg/day (N=54) for six months. At baseline and after 6 months of treatment, blood samples were collected for determining sexual hormones level. Sexual function was assessed by Female Sexual Function Index (FSFI). Data were analyzed using Spss 16. Results: Of all the participants, 45 women in the tibolone group and 32 women in HRT completed the study. Compared with the baseline values, the tibolone group significantly improved on all the six FSFI domains however, in the HRT group, just two of the six domains, lubrication and pain, got improved. The increase in mean total score and the score of each domain of FSFI except for satisfaction domain in the tibolone group was significantly greater than the HRT group (p<0.05). In the tibolone group, testosterone (p=0.003), FTI (p=0.002), and FEI (p=0.021) increased in comparison to the baseline, whereas SHBG decreased (p<0.001). In GII group, SHBG (p=0.001) significantly increased and tibolone was tolerated better than HRT. Conclusion: In post menopausal women, tibolone is more effective than HRT in improving sexual function scores, especially the desire, arousal, and orgasm domains. Its side effects are also much more acceptable.

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Background: H. pylori infection is common worldwide involving 50% of the general population. The aim of this study was to compare the effect of two sequential regimen therapies on the eradication of H. pylori. Materials and Methods: In this clinical trial, 150 patients were allocated to two groups of 75 each: group A and group B. The eradication of H. pylori in groups A and B was based on azithromycin and ofloxacin sequential regimens, respectively, and the results were compared between the groups. The data were analyzed by t-test, Chi-square test, and Fisher’s exact test using SPSS software version 16. Results: Mean of the patients’ age was 39.3± 1.2 within the age range of 18 to 85 years. There were not significant differences between the two groups considering the type of peptic ulcer. In group A, Urea Breath Test (UBT) was negative in 67 (89.3%) patients while in group B, it was only positive in 8 (10.7%) patients. In group B, there were 64 (85.3%) negative and 11 (14.7%) positive UBT test results. There were no significant differences in H. pylori eradication rates between the two groups (P=0.31). Conclusion: Noticing the absence of a significant difference between the two groups in terms of H. pylori eradication, it can be concluded that ofloxacin-based drug regimens have no superiority over azithromycine-based regimens and each regimen can be prescribed considering drug complication rates in different patients.

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Background: Previous studies in Iran and around the world have indicated the high rate of medicines use. In recent years, medicine use has continued to rise in spite of attempts made by the Ministry of Health and Medical Education in Iran. Therefore, it seems that in addition to the reasons considered in previous studies, there are other reasons for this problem in Iran. One of the parameters involved in this problem is the high medicine use among the clinical staff. Thus the aim of this study is to compare medicine use among clinical and non-clinical staff members. Materials and Methods: In this cross-sectional study, information about the monthly use of medicines was obtained by means of a questionnaire administered to eight groups of clinical and non-clinical members: first-year medical students, first-year non-medical students, interns of medicine, forth-year non-medical students, general physicians, specialists, academic members with M.Sc, and academic members with PhD degrees. Results: The results showed that medicine use decreased with increase in education level in both groups. In addition, the comparison of medicine use between clinical and non-clinical groups showed that there is not a significant difference for most medicines among the first- and second-year students but medicine use significantly increased among general physicians and specialists compared to the control groups. Conclusion: The results of this study showed that medicine use among clinical staff should be considered in controlling medicine use in Iran.

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Background: Dysmenorrhea is a common problem in women of reproductive age and despite the current treatments, it still remains a common problem in women’s health. This study was done to determine the effect of aromatherapy on pain severity in primary dysmenorrhea. Materials and Methods: This randomized clinical trial was done on 108 students with primary dysmenorrhea with pain score of 2 and 3 based on the multidimensional spoken criteria. After random allocation, the participants received massage with almond oil, massage alone, and massage with a mixture of lavender and peppermint essential oil a week before menstrual period until the presence of pain in two continuous cycles. During cycles zero, one, and two, the participants recorded the highest level of pain during the first, second, and third days according to the visual analogue scale. Data were analyzed using SPSS software. Results: There was a significant difference in the total of the most pain in days 1, 2, and 3 among the groups(p=0.038). A reduction was observed in massage and aromatherapy groups(p=0.014). There were significant differences in within group comparisons (p=0.002) for zero and first cycles(p=0.016) and first and second cycles(p=0.002). Conclusion: Aromatherapy reduces menstrual pain and considering the prevalence of dysmenorrheal, the low price, and harmless nature of this essence, its application in relieving menstrual cramping and pain is recommended.

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Background: Attention Deficit/Hyperactivity Disorder (ADHD) is a behavioral disorder in children which is characterized by one or a combination of three factors including hyperactivity, inattentiveness and impulsiveness. The purpose of present study was to investigate the effectiveness of ball and non-ball games on improvement of attention deficit/hyperactivity disorder in the 9-11 year old male students in Arak. Materials and Methods: In this pre/post-test designed clinical trial 60 male students with ADHD disorder, were randomly divided into three equal groups including ball games, non-ball games and control group. Practice groups had 12 weeks games therapy (3 sessions per week and 30-45 min per session). The symptoms of ADHD and Hyperactivity were evaluated through Child Symptom Inventory-4 (CSI-4) questionnaire before and after the 12-week practice programs. Results: The results of the present study revealed that after 12 weeks play therapy, both experimental groups had a significant decrease in ADHD symptoms in comparison with pre-test situation (p<0.05), but no significant difference was seen between ball games and non-ball games groups (p>0.05). Conclusion: Based on the obtained findings of the study it can be concluded that ball/ non-ball games, have a positive effect in improving and reduction of symptoms of ADHD.

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  Background : Hand eczema (HE) is a common skin disease which often needs long term treatment.. There are several reports about the efficacy of topical doxepin in the treatment of pruritic dermal diseases. This study was undertaken to compare the efficacy and safety of 5% doxepin cream and clobetasol 0.05% versus clobetasol 0.05% alone in the treatment of hand eczema.

  Materials and Methods: a randomized double blind placebo-controlled, study was carried out during years of 2011-2012.In total 70 patients with moderate to severe hand dermatitis were selected randomly to be treated with either the doxepin 5% cream+ clobetasol or clobetasol+placebo twice daily for 8 days. Efficacy assessments were performed at baseline and 8days after termination of therapy, according to hand eczema severity index (HECSI) and visual analogue scale (VAS). Statistical analysis was done using SPSS software, version 18.0 and statistical tests including paired T-test and independent T-test.

  Results: Overall, 56 patients completed our study. Out of them 32 were male and 24 were female. The reduction of HECSI score and VAS was statistically significant in the treatment and placebo group (p&le0.05), but differences in HECSI and VAS reduction between treatment and control group were not significant.

Conclusion: Although there is some evidence that doxepin 5% cream is effective in reducing the signs and symptoms of eczematous dermatitis, few trials have been performed. We suggest that in a more extensive clinical trial, the efficacy of this treatment against chronic hand dermatitis be evaluated.

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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.