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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: Previous studies indicated that children, who acquired conversation concept, produce adjectives better than other mental retarded.
Other studies showed that Down syndrome children have lower linguistic abilities than other mental retarded children. The main goal of this research was to study the effects of Down syndrome on production of semantic skills.
Materials and' Methods: This analytic cross-sectional study was conducted on girls who studied in exceptional primary schools of Semnan city.
Samples were chosen systenlaticaly. At first, 38 Down syndrome girls, who were monolingual and with no sign of sensory and motor deficits, were selected.
Then, 37 mental retarded girls (non-Down syndrome), that mental retardation had no specific ethiology, were matched on date of birth, educational level, failuer in previous classes, parent's job and education. These 75 pupils participated in operative tests and those who were able to comprehend the concept of conversation were examined by Raven Colourd Progressive Matrices. At final stage, 30 educable girls were participated in production test.
Results: Our findings showed that:
1. The production of nominal and superlative adjectives were equivalent between two groups, but Down syndromes had lower ability in production of comparatives;
2. The simplisity of adjectives were as fallow: nominal> comparative> superlative, and big-small> tall-short> thick-thief> wide-narrow.
3. There were few samples able to produce superlatives.
Conclusion: This investigation revealed that girls suffering from Down syndrome have lower ability on production of semantic skills.

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Introduction: Considering the importance of diagnosing fetal distress and knowing diagnostic methods with minimum cost and time and high diagnostic value, this study was performed to evaluate the vibroacoustic stimulation test ( VAST) value in predicting fetal distress in women in active phase of labor, reffering to Motazedi hospital, Kermanshah, 2004.
Materials and Methods: This clinical trial study was carried out on women in active phase of labor (dilatation >3-4), full term, single fetus, cephalic presentation, without previous diseases and also abnormal fetus. At first FHR was monitored for 15 minutes, then vibroacoustic stimulation was done for 3 seconds using an artificial larynx of Seimens Servox with high - pitch intensity equal to 105 dB. Results were recorded as non reactive and reactive FHR ( twice 15 beats acceleration for 15 seconds). Other variables such as type of delivery, 1 and 5 minutes Apgar, meconium passing and nuch cord were documented. Data was analyzed by descriptive statistics and diagnostic value test.
Results: Age of women was 25.2 ±5.8, number of pregnancy 1.94 ± 1.33 and 51.8% of them had one pregnancy. FHR before VAST was 61.1% reactive and 26.3% suspicious and after VAST 60.8% reactive and 5.3% suspicious. In VAST method sensitivity, specificity and diagnostic value were 88.3%, 70% and 75.5% respectively and in nonVAST method 68.3%, 66.5%, 23.6%.
Conclusion: This study showed that VAST can assist to reduce suspicious cases of FHR.The prognostic value of VAST in predicting fetal distress was high. It is recommended to carry out further researches about duration and intensity of sound and using periodic FHR

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Introduction: Estimation of fetal weight is very important in preventing delivery complications and also in selecting delivery method. This is specially important in potential macrosomia, IUGR and also preterm labor. The objective of this study is to compare the accuracy of ultrasonic, clinical and mother, fetal weight estimation in pregnant women in Kerman. Materials and Methods: In this cross sectional study 246 women with singleton, term pregnancies admitted for cesarean section within the following week, were studied. Estimation of fetal weight (EFW) was done using sonography and then by two obstetricians and one senior resident who were unaware of the other clinical and ultrasonic results. Mothers' estimation of their baby weight was also asked. Statistical analysis was done by paired T and Chi square tests. We also used ROC (Radar Operating Characteristics) curve to compare the accuracy of different tests. Results: Fetal birth weight was 3339±443 gr. In the 2500-4000 gr birth weight the sensitivity of predicting clinical birth weight was 11.8% with 99.6% specificity and for sonographic EFW was 12.6% with 92.1% specificity. Conclusion: Clinical estimation of birth weight in term pregnancies is as accurate as routine ultrasonic estimation obtained in the preceding week of delivery.

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Introduction: Using one subcutaneous infiltration of Bopivacaine can cause a good pain relief in pediatric surgery, so the child may no longer need rectal Acetaminophen after surgery. In this study, we compared the efficacy of the two drugs. Materials and Methods: This was a clinical trial, performed on 141 pediatric patients between 6 months to 3 years old with unilateral or bilateral inguinal hernia or undescending testis. Patients were divided randomly into two groups. The first group received infiltration of Bopivacaine preoperatively and the second received the routine rectal Acetaminophen after surgery. In both groups pain score was measured with FPRS score 3,6,12 and 24 hours after surgery. After collecting data they were analyzed with T-student and Friedman tests. P<0/05 was considered significant. Results: Global FPRS pain score was lower in the group treated with Bupivacaine infiltration on 3 and 6 hours after surgery (p<0/05), but in 12 and 24 hours after surgery no significant difference was seen in the two groups. Conclusion: This study showed that, infiltration of Bupivacaine reduces pain better than Acetaminophen, especially during the first 6 hours after surgery. So because of better pain control and also single administration, we suggest using infiltralition of Bupivacaine preoperatively.

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Introduction: Studies have shown that there is a relationship between metabolic syndrome and coronary heart disease. Hypertension is a common risk factor of both cardiovascular diseases and metabolic syndrome. The aim of this study is to determine the prevalence of metabolic syndrome phenotypes in patients with hypertension in Isfahan and Markazi provinces in center areas of Iran. Materials and Methods: This cross-sectional study was implemented in Isfahan and Markazi provinces in year 2001. Sampling method was random-clustering. 12514 people from both sexes who were above 19 years old were considered which based on ATP III, 1936 person of them had metabolic syndrome. Based on the definition, these people were those who at least had three of the following factors abnormally: HTN, FBS, TG, HDL and WC. Also hypertension was considered for all groups. Data was analyzed using Chi square test and Odds ratio. Results: The prevalence of metabolic syndrome was 0.6% to 7.5% in central areas of Iran. The most prevalent of metabolic syndrome was in hypertensive women with high TG and WC and the least prevalent was in hypertensive men with these two phenotypes: 1-high FBS and WC, and 2-high FBS and low HDL (p<0.05). Overall prevalence of metabolic syndrome in hypertensive people in the most of urban population was more than rural population. Conclusion: Results showed that hypertension is associated with different metabolic syndromes, especially in women with central obesity and dyslipidemia which necessitates more attention in preventing and treatment of the disease in this high risk group.

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Introduction: Many research demonstrate the effect of margarine trans fatty acids on many physiological mechanisms in both human and animals. The purpose of this research was to evaluate the effects of margarine oil on reproduction in Wistar rat. Materials and Methods: ‏This is an experimental study in which 46 Wistar female and male rats were divided into 4 groups. Male and female rats in group 1 were fed by 3% Margarine oil and standard food, in group 2 only female rats and in group 3 only male rats had Margarine oil with the standard food. Male and female rats in group 4 (as control group) had only standard food. Administration was started one month pre mating and continued during mating, gestation and lactation periods. After delivery, the pups were assessed for overall number, sex ratio, body weight, and mortality. One way analysis of variance was used for data avalysis. Results: ‏Results showed that weight and female ratio of pups were significantly increased in group 2 as compared to group 1 and control. Also the comparison of pups’ mortality in the four groups showed that pups mortality was increased in group 2 as compared to the other groups. On the other hand there was no significant difference in number of pups in the four groups. Conclusion: The results showed that dietary Margarine oil administration to female rats can significantly increase weight, ratio of female pups and mortality of pups.

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Introduction: Preeclampsia is one of the three major causes of death in pregnant women. Researcher believed that consuming proper nutrients can be a solution. In the last few years, the effect of type of fruits and vegetables on prevention of preeclampsia has been investigated, but there are still questions about the proper amount (unit) of fruits and vegetables. Materials and Methods: This case-control study was done on pregnant women referring to Thaleghani hospital in Arak. 35 pregnant women with preeclampsia were selected as case, and 70 healthy pregnant women as control group. The two groups were matched. Data were collected with a questionnaire consisting of two parts, first demographic information and second information about the amount of consumed fruits and vegetables. Each woman was questioned about food consumption 3 month before and during second trimester of her pregnancy. Portion of fruits and vegetables was calculated per week and then compared between the two groups. K-S, Leven, Mann-Whitney, and Chi2 tests were used for analyzing data. Results: In preeclampsia group, 3 month before pregnancy mean consumption of fruits and vegetables was 7.69±16 per week, and in healthy group was 12.43±1.87. There was a significant difference between the two groups (p=0/029). In the second trimester of pregnancy the mean was 11.03±1.6 and 13.95±0.98 in case and control group, respectively. Differences were significant (p=0.03). Incidence of preeclampsia was increased in group with less than 25% consumption of fruits and vegetables before pregnancy (less than 5unit per week) (P=0.05, OR:2.32, 95%CI:1/7, 7/24). This difference was also significant in the second trimester (P<0/03, OR:2.57, 95% CI:1/4, 54/29). Also in women who consume less than 8 units per week, the incidence of preeclampsia was increased. Conclusion: It was concluded that it seems there is relationship between consumption of fruits and vegetables with decreasing occurrence of preeclampsia. So researchers suggest that high risk groups of women be identified and educated to consume fruits and vegetables.

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Introduction: Oral Ketamine is used as a low side effect analgesic in comparison with opioids, in different pain syndromes. This study is designed to evaluate the effect of oral Ketamine in renal colic treatment. Materials and Methods: In this clinical trial study 104 patients with renal colic, hospitalized in emergency department, were divided in to two groups by Random block design. Group B received Pethidine (1 mg/kg up to 100 mg) and placebo, and group A received Pethidine with the same dose and Ketamine (0.5 mg/kg). All patients were assessed for pain by using VAS chart, for nausea by a 0-3 scale and for the number of vomiting at baseline and 1, 2 and 3 hours after taking drug. The results were analyzed by t-test. Results: Average pain score and vomiting in all times and nausea score in one and three hours after receiving drugs were reduced significantly in patients who took Pethidine and Ketamine comparing patients who took Pethidine and placcbo(p < 0.05). Conclusion: Regarding the significant effect of Ketamine in reduction of pain, nausea and vomiting without side effects, it is possible to use Ketamine as an adjuvant drug in treatment of renal colic and to reduce narcotic dosage.

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Background: According to the report of Iranian Center of Disease Control, in the summer of 2005 an outbreak of cholera (Inaba serotype) occurred in Iran. The outbreak lasted the mid of September. The aim of this study was to use the result of different studies performed during this period to determine source of infection. Methods and Materials: This is a meta-analysis study, which studies performed in Qum, Arak, Karaj, Golestan and Ghazvin were eligible. All of these studies were case control ones performed during the August 2005. The total of cases were 531. Pooled odds ratios was used to estimate by fixed and random method. All computations were performed by Stata 8 software. Results: The estimated pooled odds ratios resulted from 5 differemt studies were used in the meta-analysis as the following: travelling (1.64 95% CI: 0.98-1.88), non-pasteurized ice cream (0.88 95%CI: 0.48-1.61), post toilet hand washing (3.72 95% CI: 0.86-16.05), eating meal outside home (2.38 95% CI: 1.46-3.90), raw fruit eating (0.98 95% CI: 0.42-2.18) and raw vegetables use (5.36 95%CI: 2.4-12). Conclusion: According to the results of this study raw vegetable use and having meal outside home were significantly associated to the cholera in mentioned provinc

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Background: Pain following propofol injection was reported between 28- 90 %. Ketamine have lesser cardiovascular depression effect and also local anesthetic effect. In this study effect of ketamin were analyzed when it given before propofol injection. Methods and Materials: In a randomized double blind clinical trial selected 120 ASA I, II Ptients with 15-65 years old. They were candidated for elective surgery, in half of the patients 100 µg/kg ketamine in 2 ml volume and in another half, 2 ml distilled water were given before propofol injection. Severity of injection pain was evaluated according to 4 scale criteria (none, mild, moderate, or severe) fifteen seconds after injection of 25% of the calculated dose of propofol. Heart rate (HR) and noninvasive blood pressure were recorded before and after propofol injection, immediately and 3 minutes after intubation. The data were analysed by Mann Whitney U, Pooled t-Test and the Chi-squared test. Results: Pain was not sensed in 51.56% and 75% of control and case groups respectively. In cases group showed little decrease in systolic and diastolic pressures after anesthetic induction (p=0.012 and p=0.005). There were upper diastolic pressures after intubation (p=0.00) and 3 minutes after intubation (p=0.000). During intervention heart rate changes had not significant difference between two groups. Conclusion: Ketamine pre-treatment was an effective method in reducing pain and providing hemodynamic stability after propofol induction.

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Background: Dental plaque is composed of bacterial derived extracellular polysacharide known as glucan which is synthesized by Streptococcus mutans. Natural substances that could inhibit the plaque formation of the bacteria have a significant importance. This investigation has evaluated the honey beeswax extract effect on the Gft production, the key enzyme of S. mutans colonization factor for the first time. Methods and Materials: In this experimental study extraction of the sample conducted with ethyl acetate and methanol solutions in the Clevenger extractor. The ethyl acetate soluble fraction was separated in the first step and after the evaporation of the first solute, the 70% methanol as inactive solvent was added and the water mixture was used as a second solution, then materials were separated with dH2O. Minimum inhibitory concentration (MIC) of the honey beeswax extract was assessed by Broth diffusion method. Examination of cell adherence (Biofilm Inhibitory Concentration, BIC) was calculated by colony counts from surface scratching of glass slides in the bacterial media that supplied with 1% sucrose. Glucosyltransferase expression was detected by 15% SDS poly acrylamide gel electrophoresis. Results: Concentration of 1mg/ml of ethyl acetate honey beeswax extract was inhibited completely biofilm and it was prevented the production of glucosyltransferase enzyme. The concentration of formation 6 mg/ml of the extract had bacteriostatic effect and 30 mg/ml concentration of this extract had bactericidal for S. mutans (P<0.01). Conclusion: The sub- bacterial concentrotion honey beeswax extract was able to block the major enzyme that contributes to S. mutans biofilm formation.

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Background: Muscle mass is known to be a significant predictor of bone mineral density (BMD), and myostatin is a negative regulator of muscle growth. The aim of present study was investigate the effects of resistance training on bone mineral density and serum myostatin in healthy young men. Methods and Materials: In this clinical trial thirty young men were assigned to resistance training (n=15) and control (n=15) groups. The training group participated in 6 mounths of progressive whole-body resistance training. Total body fat, lean body mass, total body BMD, femoral neck BMD and L2-L4 spine BMD were determined by Dual-Energy X-ray Absorptiometry (DEXA) before and after 6 mounths of resistance training. Serum level myostatin measured by enzyme immnoassay. Results: Resistance training caused significant increases in chest press (52.36±6.36 vs 62.20±8.96 kg), leg press (135.24±13.77 vs 146.91±17.66 kg), lean body mass (61.00±0.96 vs 62.58±2.08 kg) and femoral neck BMD (1.115±0.078 vs 1.131±0.088 g/cm2), whereas myostatin were decreased (102.91±10.18 vs 94.03±13.93 ng/ml) (P<0.05). Total body BMD and L2-L4 spine BMD did not change with 6 months resistance training. Conclusion: A 6 month resistance training program increases muscle mass, power and improves BMD of the femoral neck in young men, and myostatin inhibition may play an important role in increasing BMD which is induced by resistance training.

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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.

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Background: Diabetes Mellitus is a heterogeneous group of different metabolic disorders that are characterized by chronic increase of blood glucose and proteins, lipids and carbohydrates metabolism disorder. The aim of this study was to investigate the effect of 8 weeks of aerobic exercise on metabolic factors, quality of life and mental health of women with type II diabetes. Materials and Methods: In this semi-experimental investigation, 18 women with type П diabetes referring to Arak Petroleum Company Clinic were selected and divided into two groups: aerobic (10 participants) and control (8 participants). Aerobic group performed selected exercises in 8 weeks (three 30-50 min sessions per week). In this investigation, we used metabolic factors (such as total cholesterol, triglycerides, HDL, VLDL, LDL, FBS, HbA1c and Insulin serum) and SF-36 quality of life (QOL) and GHQ mental health (MH) questionnaires. The level of significance was considered to be 95% (P<0/05). Results: There were significant differences between the means of pre-test and post-test measures of FBS, HbA1C, Insulin serum, QOL and MH in aerobic group. There were no significant differences between the means of pre-test and post-test measures of TC, HDL, LDL, VLDL and triglycerides in aerobic group and all factors in the control group (P<0/05). Conclusion: Aerobic exercise affects metabolic factors, QOL and MH in type П diabetic patients and it results in their improvement.

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Background: The purpose of this study was to determine the effect of L-carnitine supplementation on glucose and lactate concentrations, and aerobic capacity during sub-maximal exercise on ergometery cycle. Materials and Methods: In this double- blind clinical trail, 34 healthy noathlete male students at Saveh University were divided into experimental (L-carnitine usage) and placebo (lactose usage) groups and had one trial of cycling on ergometer (PWC170). This trial was done in two stages: 1) Exercise protocol without L-carnitine or placebo supplementation, 2) Exercise protocol with 3g L-carnitine (90 minute before exercise) and placebo supplementation in the experimental and placebo groups, respectively. Immediately after the physical exercise, blood sampling was taken for determining plasma glucose and lactate concentrations, and lactate dehydrogenase activity (LDH). Through polar telemetry rest and sub-maximal heart rate, and also, VO2max were measured. Results: L-carnitine supplementation had no influence on plasma glucose and lactate concentrations. Otherwise, rest and sub-maximal heart rate, VO2max and LDH activity were equal in pretest and posttests. All variables remained with no change in control group. Conclusion: Regarding the effect of L-carnitine usage on performance of endurance exercises, the findings are still vague and controversial. Our findings indicated that ingestion of 3g L-carnitine 90 minutes before exercise did not affect the dependent variables. Further investigation is required to determine the direct effect of such supplementations on substrate utilization, fat-carbohydrate metabolism and performance on exercise.

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Background: Green tea, which is the most common drink in the world, has antioxidant and detoxification properties. In this study, the protective effect of green tea extract on nephro-toxicity induced by acetaminophen was investigated. Materials and Methods: 32 male mice were randomly divided into 4 groups. Physiologic serum was administered to the control group for 30 days. Toxic (Acetaminophen) group received physiologic serum for 30 days and on day 30 in addition to physiologic serum, 500 mg/kg acetaminophen was administered orally. Green tea group, instead of water, was fed by 7g/l green tea extract for 30 days. Instead of water, the experiment green tea group was fed with green tea extract for 30 days and 500 mg/kg oral acetaminophen was administered on day 30. On day 31, blood samples were taken from jugular arteries for assaying BUN and Cr. The mice kidneys were cut off and placed in 10% formalin for histopathology assessments. Results: BUN and Cr reduced significantly in the experiment group in comparison with the toxic group. Also, in histopathology assessments, kidney necrosis reduced in experimental group. Conclusion: Green tea seems to have a protective role in acetaminophen induced nephro-toxicity.

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Background: Oxidative stress is one of the probable molecular mechanisms involved in lead (Pb) neurotoxicity. On the other hand, lemon balm (Melissa officinalis) which is widely used in traditional medicine, has a high antioxidant activity. In this study, the protective impacts of Melissa officinalis on the adverse effects of Pb toxicity on learning ability were investigated. Materials and Methods: In this experimental-clinical trial, 40 virgin Wistar rats were mated and divided into control, control positive (vitamin C+Pb), control negative (Pb), and 3 Pb and Mellisa experimental groups. Mellisa was orally administered in three doses including + 25, 50 and 100 mg/ kg of body weight daily. Treatment started from 7th day of gestation and continued through pregnancy and lactation periods. The three month- old offsprings in each group were assessed in terms of memory and learning ability by Morris water maze test and the results were compared between the groups. Results: Exposure to Pb during and after gestation leads to learning disorders. While concomitant administration of Pb and Melissa, as well as vitamin C can, to a large degree, reduce the adverse effects of Pb on learning abilities. Conclusion: Since no significant differences were obtained from the comparison of results in the control, Pb+M and vitamin C+Pb groups, it can be concluded that Melissa has antioxidant impacts equal to vitamin C. Therefore, similar to vitamin C, Mellisa can decrease the neurotoxic effects of Pb.

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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: Pain following tonsillectomy is common in children, and its elimination due to its subsequent complications is essential. Therefore, this study was conducted with the aim of obtaining the best method of administering ketamine for reducing pain following tonsillectomy with the greatest efficiency and the least side effects. Materials and Methods:This study was a double-blind clinical trial which was conducted on 92 children, aged 3-9, who had been admitted for tonsillectomy. The patients were randomly divided into oral ketamine and ketamine injection groups (each containing 46 patients). Thirty minutes before the operation, all the patients were given apple-juice ketamine injection group received normal apple juice without ketamine, whereas the oral ketamine group received 5mg/kg ketamine with the apple juice. Three minutes before tonsillectomy, 0.5 mg/kg ketamine was injected to the peritonsillar area in ketamine injection group while the same volume of saline was injected to the oral ketamine group. Data were registered, gathered, and, then, analyzed using Wilcoxon, Man Whitney, and t tests. Results: Demographic data and blood pressure before and after the operation did not have significant differences in the 2 groups. In terms of the duration of operation time, a significant difference was observed between the two groups the operation time in the ketamine injection group was shorter (p=0.006). Also, pain score in the ketamine injection group was less than the oral ketamine group. Conclusion: Ketamine is effective in reducing the pain after tonsillectomy operation. Peritonsillar injection of ketamine is more effective than its oral usage.