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ABSTRACT Introduction & Objective: Post-operative shivering is a common complication of general anesthesia with a reported incidence of 40ـ70 percent. It increases metabolic rate of oxygen demand, cardiac output, intracranial pressure, surgical incision retracture and post-operative pain. Various drugs such as NSAIDS have been used to treat or prevent post-anesthetic shivering. The aim of this study was to determine the effect of Diclofenac Na suppository on post-anesthetic shivering. Materials & Methods: This is a doubleـblind randomized clinical trial performed on 120 primiparous women undergone elective Caesarian delivery. They were randomly divided into two case and control groups. Vital signs of all the patients were measured before anesthesia and recorded. Drugs used for premedication, induction and maintenance of anesthesia were the same in both groups. Just before the induction of general anesthesia, patients in case group received one suppository (100 mg) of diclofenac Na. Shivering was evaluated during 60 minutes after extubation and vital signs were measured as well. The data were analyzed by SPSS software. Results: Post anesthetic shivering was observed in 61/7% of control group and 5% of case group (p< 0. 0001). Post anesthetic hypothernia was much more frequent in control group in comparison with Diclofenac Na group (p<0. 0001). In comparison with control group, case group had more stability in body temperature. Conclusion: Results of this study indicate that a single dose of suppository Diclofenac Na (100 mg) prevents post-anesthetic shivering without significant effect on body temperature. Accordingly, it can be suggested that suppository Diclofenac Na can be used for the management of post operative shivering.

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Introduction & Objective: Sore-throat and hoarseness are the most common complication after endotracheal intubation which take place 12-24 hr after operation. Different studies have reported the incidence of these complications between 24-90%. Increase of heat on the trachea will raise the blood pressure in the local capillaries and therefore induce better blood supplementation to the local tissues. This study aimed to evaluate the effect of local heat on the incidence of sore- throat and hoarseness after endotracheal intubations. Materials & Methods: One hundred and sixty patients aging 15 -50 years old, candidate for elective surgeries under general anesthesia, were randomly divided into two groups. Patients for head and neck surgeries were excluded from the study. Methods of intubation, type, size, cuff pressure of ETT, method of anesthesia and time of operation were the same for all patients. During the operation time, local heat was applied on the external surface of trachea (up to 40 0C) by using electrical blanket for the patients in the study group. 24 hr after operation all the patients were visited by anesthesiologist for evaluating the sore– throat and hoarseness. Results: The incidence of sore-throat in the control group was 65% versus 40% in the study group (p<0.05). Moreover the incidence of hoarseness was 66.2% in the control group versus 10% in the case group. Conclusion: Application of local heat (40 0C) on the external surface of trachea can effectively decreases the incidence of postoperative sore – throat and hoarseness.

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ABSTRACT: Introduction & Objective: Job stress is a harmful physical and mental response which is due to the interaction between the individual and his environment and lack of agreement between job requirements and the individual's abilities and desires. In addition to damaging the individual, job stress imposes overwhelming expenses on the related organizations. Nursing is one of the occupations in which people are exposed to stress and thus it adversely affects the quality of the services which they offer. So recognition of stress – making factors among nurses can serve as an effective step in determining and reducing stress. The present study was carried out in order to determine the stress- making factors and their degrees of stressfulness from the viewpoint of the nurses working in the hospitals of the university of medical sciences in the province. Materials & Methods: This cross sectional, descriptive, analytical study included 142 nurses who were at work when the study was carried out. A questionnaire was designed for data collection. After coding, the data were analyzed using SPSS software. Results: The most severe stressful factors in nurses proved to be lack of consent with the rate of income (72%), high work- load (61.3), working on holidays (25.9), unacceptability of the profession in the society (51.4), and disturbance of sleep and relaxation (14.1). Presence of new unfamiliar equipment in the environment and the nurses' lack of skill in working with the equipment (2.4) and lack of skill in the field (14.1) turned out to be the least stress making factors. A comparison between the mean score of stress making factors and the township and the hospital in which they work proved to be statistically significant (p<.004 and p<0.0001). Spearman correlation coefficient indicated a significant relationship between the number of children and stress (p.01) and between age and stress (p< 0.007). This study, however, showed no significant relationship between stress and factors such as sex, ward, record of service, type of employment, status of marriage, income, and being local to the area where they work. Conclusion: Since stress among nurses is potentially harmful and influences their physical and mental abilities and reduces the effectiveness of the service they offer, officials should manage to reduce stress– making factors such as lack of consent with income, work load, etc.

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ABSTRACT: Introduction & Objective: Factor V Leiden and prothrombin mutation are not common but they are involved in pediatric thrombosis. The aim of this study was to evaluate the frequency of factor V Leiden & prohtrombin mutation in healthy population of Shiraz, south of Iran. Materials & Methods: In this cross-sectional study 195 healthy people (97 female and 98 male) were randomly selected. Peripheral white blood cells obtained from 5 ml blood contained 1-2 mg/ml K2- EDTA. Genomic DNA extraction was performed following the protocol described by Miller et al. PCR amplification was carried out in 25μl reaction volume containing 0.5 units Taq polymerase, 200μM dNTP, 500 μM of each of the previously described primers. After initial denaturation, 35 cycles at 95◦c for 30s, and 72◦c for 20s and followed extention by 72 for 10 min were performed. About 10μl of PDR product was digested with MNI I or Mbo restriction enzymes. Results: In this study we determined factor V Leiden in 8 (4.1%) and prothrombin mutation in 6 individual (3.07%) of 198 cases in heterozygous form. No homozygous was seen for any of the mutations. Only one case presented a double heterozygous for factor V and prothrombin in this cohort. Conclusion: Several studies of factor V leiden and prothrombin mutations in the East of Asia showed the higher frequency of these mutations in Iran.

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Introduction & Objective: Diabetes mellitus is the most common endocrine disorder and causes gastrointestinal complications .The aim of this study was to investigate the effects of ginger on the small intestine of diabetic rats. Materials & Methods: This experimental study was done in the anatomy department of Uremia Medical University in 1385. 24 adult male rats, weighing 250±20 gr were randomly selected and divided into 3 following groups: control, diabetic (induced by 60mg/kg STZ) and treatment groups. The treatment group was given ginger powder (5% of their consumed food weight during day/night period). After 8 weeks, all rats were anaesthetized and their small intestines were removed and measured for their weight and length. For histological assessment, samples from each part of duodenum, jejunum and ileum was fixed in 10% formalin and slides with hematoxilin & eosin staining were prepared. Villi length, crypt depth and muscular layer thickness were assessed by graticule eye piece of light microscope. Statistical analysis, one- way analysis of variance and Tukey’s SPSS software was used for data analysis. Results: The results showed that mean of intestinal length and weight, villi length and muscular layer thickness in all three parts and crypts depth in duodenum and jejunum in diabetic group increased significantly in comparison with control and treatment groups, but there was no significant difference between control and treatment groups. Conclusion: The results of this study demonstrate that ginger as an antioxidant, through decreasing oxidative stress, can prevent pathologic alterations induced by diabetes in small intestine.

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Introduction & Objective: The Ministry of Health and Medical Education of Iran established maternity facilities in order to provide a safe delivery and reduce deliveries at home in rural areas. However, a few of deliveries in Kohgilouyeh and Boyerahmad province took place in these centers. Therefore, the aim of this study was to determine the delivery status and factors influencing the pregnant women’s tendency to choose the place of delivery. Materials & Methods: This descriptive study was carried out on 747 participants in the rural areas that were covered by maternity facilities in the first three months of 1384. Data were collected by a self-structured questionnaire whose validity and reliability had been determined previously. Data of age, education level, parietal status, antenatal cares, decision-maker for the place of delivery, geographical access to maternity facility centers and the cause of avoidance of referring to the centers were determined asking the women. Data were analyzed by SPSS software and using X2 statistical test. Results: The results showed that overall 31% (230 cases) of deliveries took place at home and 51% (384 cases) at hospital, but only 18% (133 cases) of deliveries took place at maternity facility centers. There was a significant difference in antenatal education by midwives between women who delivered at home and those that delivered at maternity facility centers, showing that more educated women have managed to deliver at the maternity facility centers (p < 0.001). 58% of mothers had selected their delivery place by themselves, but in others the delivery place was selected by their mothers, mothers-in-law, their husbands, etc. Almost 79% (181cases) of mothers who delivered at home announced that geographical access (long distance) to the maternity facility was major problem. In addition, there was a significant association between literacy, living place and the number of previous pregnancies with selection of delivery place (p< 0.005). Conclusion: Findings showed that the most important cause of avoidance of referring to maternity facility centers, from women’s point view, was geographical access to maternity facility centers as well as antenatal education by midwives.

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ABSTRACT: Introduction & Objective: Nowadays the extensive changes in lifestyle resulted in an increase in consumption of fast food. This type of food, because of using deep–fat frying, may contain some toxic or unfavorable substances which have adverse effects on consumers’ health. The aim of this study was to determine the peroxide value of edible oils which are used in restaurants and sandwich shops in Yasouj city. Materials & Methods: This descriptive study was carried out on all sandwich shops (n=36) and restaurants (n=12) in Yasuj city in 2006. All samples and questionnaire data in restaurants and sandwich shops were collected at 11:30am and 12:30pm respectively based on a national standard protocol, number 493, by a food expert. The peroxide value was determined based on national standard procedure, number 4179, in a food laboratory and the acceptable limit was defined as 7 meq/kg. Results: Findings of this study showed that in terms of health rules and regulations, at least 50% of oils used in restaurants and 70% in sandwich shops were unfavorable. Peroxide value of 58.3% of oils in restaurants and 97.3% in sandwich shops was greater than the acceptable limit. Conclusion: These findings have shown that the health rules and regulations for the oils are not exercised in Yasouj restaurants and sandwich shops and this can have adverse effects on consumers’ health.

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ABSTRACT: Introduction & Objective: It is well established that adrenal hormone cortisol has long been used in human psychobiological studies as a biological marker of circadian rhythm, stress, and anxiety. There is little information, however, about the interrelationships of night work, plasma cortisol levels in females’ nurses of the developing countries. The aim of the present study was to compare circadian cortisol profile between two groups of nurses with shift and permanent work in a Hospital affiliated to Shiraz University of Medical Sciences, Iran, between January 2006 to September 2008. Materials & Methods: In this experimental study, we examined the reproducibility of plasma cortisol levels during one month period in 34 shift work nurses and 10 permanent day shift works. We evaluated potential associations between night work and hormone levels, using current and shift work information for the health care shift workers. Results: The results clearly revealed that shift work significantly increased nighttime cortisol levels (34.93 μg/dl) during night shift and decreased the peak levels of cortisol in the morning (39.03 μg/dl). During the work shift the plasma cortisol presented a decreased concentration in the morning and increasing levels (44.93 μg/dl) by the end of the evening. In contrast , the permanent day work nurses, who had never worked at night shifts, showed a lowest secretion of cortisol during the first half of night time sleep (10.02 μg/dl ), and a peak value of the cortisol after awakening at 07:00 h ( 59.75 μg/ml). We also observed a significant association between night work and increased levels of cortisol over the remaining of the day. Conclusion: It can be concluded that nurses with night shift work have an abnormal cortisol secretion profile. Shift work nurses on rotating night shifts seem to experience changes in hormones levels that may be associated with increased of circadian disorders risk observed among night – shift workers.

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& Objectives: In the recent years, following the increase of drug resistant strain of viruses, there has been an increasing interest in the use of natural substances with antiviral activity with fewer side effects. One of these herbal medicines, Quercqus persica L, has shown some therapeutic effects, such as anti-bacterial and anti-viral activities. Therefore, this study was aimed to determine the minimum inhibitory concentration of hydroalcoholic extract of this plant on Herpes simplex virus-1 (HSV-1). Materials & Methods: In this interventional study conducted at Shahrekord University of Medical Sciences in 2010, the hydro- alcoholic extract of Quercqus persica L. was prepared using 70% ethanol by the maceration method. Baby Hamster Kidney (BHK) cells were grown in monolayer culture with Dulbecco's modified Eagle's medium (DMEM) supplemented with 5% fetal calf serum and plated into 48-well culture plates. Fifty percent of cytotoxic concentration (CC50%) of the extract on BHK cells was determined and subsequently, 50% inhibitory concentrations (IC50%) of the herbal extract on replication of HSV-1 both in extracellular and interacellular cases were assessed. The statistical data was analyzed by the SPSS software using Probit analysis. Results: Based on Probit analysis, the extract had no cyto-toxicity up to concentration of 200 mg/ml. IC50s of the extract on the virus before cellular attachment and after entering the cells were 1.2 and 0.257 mg/ml, respectively. Based on the model, with the increasing of the extract concentration, the percentage of inhibition of cytopathic effect (CPE) in both of the stages were increased (p<0.05). Conclusion: In addition to low cytotoxicity, hydroalcoholic extract of Quercqus persica L. has promising inhibitory effects on HSV-1 replication in cell culture. Thus, it should be considered as a promising herbal medicine and should be thoroughly evaluated through a comprehensive study.

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& objectives: Today, different methods for maintaining reproductive capability in young women with cancer are being considered. One of the most prominent of these methods is ovarian tissue transplant. Despite the relative success of this method, the appropriate location and methods of transplantation is still a matter of discussion. The present study evaluated the histomorphology of fresh ovarian tissue transplantation by two methods, inter muscular and intra muscular, in Balb/C mice. Methods & Materials: The study was conducted at Hamedan University of Medical Sciences in 2009. Fresh ovarian tissues from 12-14 day old Balb/C mice were transplanted into back muscles of ovarectomized 6 week old Balb/C mice both intermuscularly and intramuscularly. All transplanted mice received intra-peritoneal injections of a unit of rFSH for 4 weeks, every other day. At the end of the tenth week, all transplant recipient mice were killed and the transplanted ovarian tissues were removed. All samples were assessed for the angiogenesis and viability of follicles. Data were analyzed using SPSS software, using independent t- test. Results: In intermuscular transplanted group, the transplanted tissues were rejected in two cases. In the sections prepared from the other cases, in spite of the presence of some small necrotic areas, the majority of ovarian tissues had a healthy appearance within the primordial, primary, secondary and antral follicles. Apart from a significant reduction in the number of follicles and smaller size of follicles in the transplanted tissue in comparison with control group, no other major differences in morphology, histology, and the process of maturation of ovarian follicles were observed between the transplanted and control groups. Conclusion: Fresh ovarian tissue transplantation into muscles of the back area without basic vascular pedicle has new angiogenesis capabilities, appropriate survival and development of primordial follicles and significant natural growth of maturing follicles. Degeneration of transplanted tissue in the intra muscular area indicates that it is an inappropriate site for transplantation.

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Introduction & Objective: Asthma is a chronic inflammatory airway disease. Asthma affects one in 13 school age children and is a leading cause of school absenteeism. It seems that prevalence of asthma is increasing wordwide. Many factors are identified and reported as factors related to asthma. This study was carried out to determine the prevalence of asthma and associated factors in 600 children under six years using logistic regression and probit. Materials & Methods: This cross-sectional study was conducted on 600 children under six years old. Questionnaire was constructed based on ISSAC questionnaire and its reliability was determined with a pilot study and calculated by the Cronbach's alpha equal to 69 percent. Cluster sampling based on household records as clusters was performed. Questionnaires were completed by trained staff under supervision of an expert person and by interviewing parents and children. Results: The prevalence of asthma was estimated to be 3.10 (7.89 to 12.78) percent. Based on fitting models to data, factors such as gender, maternal nutrition, exclusive breast feeding to 6 months, smoking at home by a family member and having a history of respiratory allergy in families were significantly associated with asthma prevalence (p-value ≤ 0.05). The results also demonstrated that the both models are almost identical in evaluating the data. Conclusion: This study showed that estimated asthma prevalence is equal to average prevalence reported in Iran. Protective factors, such as exclusive breast feeding as a strategy can be appropriated in children's health care programs and should be much more considered.

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Background & Aim: Listeriosis is mainly caused by consuming unpasteurized dairy products, especially soft cheese which is contaminated with listeria monocytogenes in people with a damaged immune system. The purpose of this study was to evaluate the possibility of using natural preservatives to control the growth of Listeria monocytogenes in dairy products. Methods: In the present experimental study, plants (Thymus denaensis, Jaft and green hull Pistacia atlantica) were collected from the mountains of Kohgiloyeh & Boyerahmad province and their hydroaloholic extract were prepared. Antibacterial activities, MIC and MBC, were determined by disc diffusion and microwell dilution methods. The Ampicilin disk (10µg) was used as positive control in disc diffusion. The data were analyzed by the SPSS software using One-way ANOVA. Results: The most anti-bacterial activities were found with hydroalcoholic extracts of Jaft and green hull Pistacia atlantica. Inhibition zone for the Jaft concentration was 32 mg/ml which was equal to the ampicillin disk. The minimum inhibitory concentration and minimum bactericidal concentration of Jaft extract were 125 and 250 μg/ml respectively. Conclusion: Based on the results of current study, hydroalcoholic extract of Jaft might be a suitable candidate to be used as a preservative in the food industry which is able to prevent the growth of Listeria monocytogenes.

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Background & aim: About 7% of patient referred to hospital are various forms of poisoning. This study was performed to determine the major causes of acute poisoning leading to Hospitalization at Shahid Beheshti Hospital of Yasuj, Iran. Methods: This descriptive study was performed from August 2007 to July 2008 on 470 cases of poisonings referred to Shahid Beheshti hospital of Yasuj. Demographic characteristics, time of poisoning, poisoning factor, history of previous poisoning, history of psychiatric disease, medication and other therapeutic intervention based on questionnaires and interviews with patients or companions of patients were recorded. Data were analyzed by Chi-Square Test. Results: Majority of poisoned patients were single females, in the age range of 21-30 years, unemployed, lived in urban areas, and had at least a diploma. The majority of cases were intentional poisoning with a history of depression, previous poisoning and attempted suicide. Significant relationship were seen between poisoning, age, sex, and job, (p<0.05), while relationship between the place of residency, marital status, and education, with poisoning was not significant (p>0.05). Conclusion: With respect to the results of this study, the majority of these poisonings occurred among young, single and unemployed females due to suicide and drug intoxication. Necessary actions should be done in drug usage and maintenance, taking action against non-prescription drugs and giving proper public education to families.

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Abstract Background & aim: Hepatitis B Virus is one of the most important viral hepatitis which includes eight genotypes based on genetic variations in the gene encoding virus RNA polymerase. Clinical picture, treatment response and prognosis of HBV infection is genotype dependent. Therefore, this study was aimed to determine the HBV genotypes in HBsAg-positive individuals. . Methods: This experimental study was conducted on one hundred and sixteen HBsAg-positiveindividuals referred to the health centers of Shahrekord, Iran, in 2011. Firstly, the viral nucleic acid was extracted from serum samples and subsequently, the samples were subjected to Polymerase Chain Reaction (PCR). Finally, genotyping was carried out on the positive samples, using Real-time PCR with type specific primers and probes. The data were analyzed using the chi-square test. Results: 23 out of 116 (19.8%) of the HBsAg-positive individuals were positive for HBV DNA. 17 out of 23 (73.9%) and 6 out of 23 (26.1%) of the patients were found to be infected with HBV genotypes of D and C, respectively. Conclusion: Same as other regions of Iran, genotype D, , is the dominate genotype of HBV in Shahrekord, Iran. However, genotype C may be one of the other common genotypes in this region. Key words: Genotyping, Hepatitis, Polymerase Chain Reaction

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Abstract Background & aim: Nowadays, most of gene therapy protocols are performed by lentiviral vectors. One of the most important factors which is involved in pancreas development and transcription of insulin gene is pancreatic & duodenal homeobox 1 (PDX-1) transcription factor. The goal of this study was to optimize a lentiviral construct, containing pdx-1 gene, to transfect stem cells towards gene therapy of type-1 diabetes. Methods: In this experimental study, first, the pdx-1 gene was multiplied by PCR from pcDNA3.1-pdx-1 and cloned into pTG19-T vector. Then, pdx-1 was subcloned on upstream of IRES-EGFP gene into IRES2-EGFP vector. At the next step, the cloned parts of IRES-EGFP and pdx-1 were isolated and cloned into the lentiviral expression vector pSINTREM in upstream of TRE-CMV gene. After sequencing, final construct was transfected into HEK 293 cells and gene expression of pdx-1 was evaluated using flow cytometry analysis and reverse fluorescent microscopy. Results: Flow cytometry results and inverted fluorescent microscopy observing showed that pdx-1 and GFP genes are expressed in cells transfected with final recombinant construct. Conclusion: Regarding the design of this construct, to ensure long time expression with higher in vivo and in vitro expression efficiency for stem cells and also use of Tet on induced optimized system, it seems that the current construct can be among the best ones to transfect stem cells. Key words: Gene therapy, Diabetes, Stem cells

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ABSTRACT Background & aim: Statins are inhibitors drugs of hydroxymethyl glotaryl coenzyme A. In addition to decreasing plasma cholesterol, low-density cholesterol they reduce the rate of triglycerides. The aim of this study was to investigate the effect of atorvastatin on rat pancreatic tissue.In addition to decreasing the rate of plasma cholesterol concentration they also decrease the rate of LDL and Triglyceride. The aim of this study was to investigate the effect of atorvastatin on rat pancreatic tissue. Methods: In this study, 32 adult male rats were divided into four groups, control and three test groups. To conduct the present study, 32 male adult rats were divided into 4 equal groups: one control group and three test groups. Then the test groups were treated by Atorvastatin for 45 days with 10mg (group1), 20mg (group2) and 30 mg (group3) doses respectively. At the end of the treatment period, all rats were killed by taking blood from their hearts. The pancreas tissue of each rat (N=32) was separated. After fixation, tissue preparation and slide staining, Longerhans diameter was measured and number of cells was counted. Data were analyzed by t test.After fixing and coloring the tissue, all slides were prepared and evaluated under the microscope the diameter of I's of Longerhans and the number of cells. The data was analyzed through t-test. Results: There was no significant difference in the diameter mean of Longerhans between the test groups and the control group. The mean number of islets cells were increased in compared to the control group (P>0.05).There was also a significant increase was shown in the number of Longerhans cells in the test groups in relation to the control group (p (05/0>.(p>0.05). Conclusion: The consumption of the atorvastatine causes an increase in the number of Longerhans cells. In addition, the increase in the number of cells also increases the insulin secretion. As a result, blood sugar is decreased. Key Words: Atorvastatin, Pancreas, Rat

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Abstract Background & aim: Attention deficit has significant effect on the life of patients suffering from schizophrenia and bipolar disorder. The aim of this study was to assess the attention deficit in patients with schizophrenia. Methods: In the present post-hoc study, 132 patients with schizophrenia and bipolar disorder were selected via non-randomized sampling at Shafa Hospital (Rasht, Iran) and then divided into four equal groups: chronic schizophrenia patients, first-episode patients, chronic bipolar patients, and first-episode bipolar patients. Thirty-three healthy individuals were selected as the control group. Subjects were evaluated by Stroop color-word test. The gathered Data were analyzed by one-way ANOVA. Results: Attention deficit among chronic schizophrenics and patients suffering from bipolar disease was higher than the control group (p <1). Chronic schizophrenic patients compared with schizophrenia bipolar disease and first round schizophrenia showed more attention deficit. There was no significant difference among the first bipolar disease and schizophrenia, bipolar disorder, as well as the first round schizophrenia (p<0.05). Conclusion: Attention deficit is more severe in schizophrenic patients than bipolar disorder, and chronicity is more effective in schizophrenic patients. Key words: Attention, Schizophrenia, Chronicity