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Introduction: Many patients because of ischemic heart diseases, cerbral or pulmonary diseases are not appropriate candidates for general anesthesia in upper limb surgeries. Intravenous regional anesthesia (IVRA) is one of the anesthetic procedures for these patients. The aim of this study was to compare the effects of adding Pancronium and Fentanly to Lidocaine during IVRA.
Materials and Methods: In a single-blind clinical trial investigation, 46 patients-who were candidated for hand surgeries-were studied. The subjects were randomly classified into two groups. The first group who used 38 cc Lidocaine 0.5% and 2 cc sterile water (control group) and the second group who used 38 cc Lidocaine 0.5% besides 50  mgr Fentanyl and 0.5 mgr Pancronium (trial group) for sensory and motor blacking. Data analysis was performed by t-test through SPPS 10 software.
Results: The average time for storing of sensory and motor block in trial group was significantly faster than control group. Additionaly, the average time for starting of sensory and motor block in control group was significantly lower than trial group.
Conclusion: This study revealed that adding of Fentanyl and Pancronium causes better motor and sensory block and provide better relaxation for muscles during surgery.

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Introduction: Celiac disease (CD) or gluten-sensitive enteropathy is a malabsoption of nutrients due to hyoersesitivity of gluten. Some etiologic facrors are environmental, immunologic and genetic factors. The frequancy of Celiac disease is not studied in western regions of Iran, therefore this study is done to determine the frequancy of Celiac disease in general population of rural regions of Arak. Materials and Methods: This is a descriptive, cross-sectional study in which 700 people between 20-56 years old in rural regions of Arak were selected by multistage random sampling (364 male and 336 female). After completing questionnaires, blood samples were collected and serum IgA levels (to rule out IgA deficiency), and serum t-TG Ab were assessed. All cases that had positive serologies and those who had high clinical probability of having Celiac disease underwent second duodenal segment biopsy. Data was presented using mean, standard deviation and frequency distribution. Results: Serum IgA levels were normal in all samples. 8 cases were positive for t-TG Ab, 38 cases had high normal levels of t-TG Ab and the others had less than 6 Au/ml t-TG Ab. Only in patients with high normal serology, histology was positive. 1% (10 in 1000 people) of all studied subjects demonstrated intestinal lesions due to Celiac disease. Most of them were asymptomatic. Conclusion: CD frequency in rural regions of Arak in people between 20-65 years old was 10 among 1000 cases. This frequency is the same as studies done in northern and southern regions of Iran but was higher comparing to the other parts of the word. This amplifiles the importance of screening of CD in Iran. Also the sensitivity and specificity of t-TG Ab was found high because all cases with high normal levels of t-TG Ab were approved by histology.

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Background: Helicobacter pylori is the most common bacteria causing chronic infections worldwide. An important virulence factor of H. pylori is a vacuolating cytotoxin (VacA) that induces the formation of acidic vacuoles in cytoplasm and damage to epithelial cells. The aim of this study was to examine the antigenic properties of the recombinant VacA of H. pylori in infected sera of mice and human.

Materials and Methods: In this experimental study, the highly antigenic region of VacA gene (1233 bp) was detected by bioinformatics methods, and it was amplified by PCR method and cloned into the pET32a expression vector. After expression and purification of the target protein, its antigenicity was studied by Western Blotting using human sera infected with H. pylori and sera from immunized mice infected with purified recombinant VacA.

Results: PCR and sequencing results showed that the target gene was correctly cloned into the recombinant vector. Antibodies used in Western Blotting indicated the production and expression of the recombinant protein (65kDa) with concentration of 2.1 mg/ml.

Conclusion: Recombinant VacA protein has antigenic and immunogenic properties thus, it is a proper candidate for designing H. pylori vaccine and diagnostic kits

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Background: Intrathecal morphine side effect is Nausea & Vomiting after surgery. The aim of the study was to evaluate the effect of intrathecal atropine on PONV in patients receiving intrathecal morphine in lower limb surgeries.

Materials and Methods: In this clinical trial , 120 patients undergoing lower limb surgery were randomly divided into 2 groups . Experimental group received 0.1 mg (1cc) Intrathecal atropine and control group received 1cc saline 0.9% . PONV during the first 24 hours and hemodynamic changes in minute 3, 5, 10 and 15 after surgery in both groups were measured. Data were analyzed using SPSS software (verision14). independent t-test, repeated measures manova,and chi-square were used to compare comparison of variables.

Results: Hemodynamic cheanges before injection and 3, 5, 10 and 15 after injection in two groups was not significant (P>0.05). None of the patients in the intervention group were PONV, but 17 patients in the control group had PONV that this difference was statistically significant (p =0.000 ). Pain in the control group was great than intervention group while 26 patients in the control group and 14 patients in the intervention group had vas greater than 3 that this difference was statistically significant( P = 0.04).

Conclusion: Intrathecal atropine without interfering Hemodynamic and pain relief prevent nausea and vomiting caused by Intrathecal morphine in patients undergoing surgery to the lower limbs..