---

The treatment of supraventricular arrhythmia include wide range of medical intervention, but ideal drug for treatment of this kind of arrhythmia is yet to be developed. Pharmacological interventions due to their adverse side effects and the possibility of proarrhythmic effects are usually ineffective in treating these conditions. Herbal remedies are suitable alternatives for synthetic drugs, due to their availability, minimal side effects and lower price. Pharmacological studies and traditional medical literature point to the cardiovascular effects of the Achillea Santolina in many instances. In present study, we used isolated heart of langandrof rats as an experimental model to determine the effect of various concentrations of the methanol extract of Achillea santolina (2×10^-7, 2×10^-9, 2×10^-10 W/V) on the electrophysiological properties of the isolated heart. Results of this study show a significant depression of WBCL, AVCT and ERP and non-significant increased in time constant of recovery (trec). It may be therefore be considered a potential role for anti-arrhythmic effect of Achillea Santolina in suppression or treating supraventricular tachyarrhythmia.

---

Liver is an important organ with major role in carbohydrates, proteins and lipids metabolism. In addition, secretion and excretion of toxic materials occur in this organ. Exposure to a variety of infectious agents such as parasitic, viral, bacterial or toxic materials may lead to liver damage. Today, one of the best way for investigation and diagnosis of liver damage is measurement of some liver enzyme such as Alanine Aminotransferase (GPT or ALT), Aspartate Aminotransferase (GOT or AST). Since, these enzymes exist in other tissues, measurement of other specific enzyme is required. In this study activity of Ornithine Carbamyltransferase (OCT), the second enzyme in urea cycle, in 56 patients with liver problem (Cirrhosis and viral hepatitis) was determined. SGPT, SGOT, Alb, Bil, ?GT and ALP tests were performed. To assess the health and unhealthy liver in both control and sample groups. Our data shows a correlation between activity of OCT with SGOT (R=0.782, P<0.001) and with SGPT (R=0.857, P<0.001). Since OCT enzyme is specific for liver, further investigation of activity of this enzyme in assessment of other liver problems is required.

---

Background and Objective: From 1942 when Griffith & Johnson suggested that muscle relaxants are safe drugs for better laryngoscopy & intubation and good for skeletal muscle relaxation during surgery, many of muscle relaxants discovered with different effect, side effect and potency. Some of the muscle relaxants properties include rapid onset, short-acting, fast recovery, stability of hemodynamic, lock of histamine release and etc. Hemodynamic stability is one of the important properties of this drug. In this research we wanted to see effect of Rocuronium, which is an intermediate muscle relaxant on systolic, diastolic BP and HR of patients who is candidate for elective surgery. Patients and Methods: This research is an experimental study. We wanted to see the effects of Rocuronium that is an intermediate muscle relaxant on mean avierial pressure and heart rate of the patient who is coming to the hospital of Iran medical university hospitals for elective orthopedic surgery. The sample size calculated 30 patients. We choose our patients with simple randomized method. All of them were ASA1 and in the age of 20 to 50 years old. The patients didn’t receive any pre-medication until coming to operating room. In the OR they received 7 cc/kg ringer solution and then 70 µg/kg thalamonal was administered intravenously. 5 minute latter their BP and PR was checked, which considered baseline measurement. Induction of anesthesia was with Thiopental 5 mg/kg and Rocuronium 0.9 mg/kg. After 60 sec patients were intubated with direct laryngoscopy. The maintenance of anesthesia for first 10 minutes was with O2 50% and N2O 50% and for continue of anesthesia MR and Opioid depend on need. Results: We analyzed our data with paired to T-test and green house test. Systolic and diastolic blood pressure and heart rate changes was 5% lowest than baseline hemodynamic parameter. Conclusion: With attention to previous studies and observation of hemodynamic changes with muscle relaxants which uses in Iran, this drug (Rocuronium) have good effect on stability of hemodynamic parameters. Beside other properties of Rocuronium include: Rapid onset, lack of histamine release, intermediate acting and etc. We can said this drug is a good and safe muscle relaxant for use during anesthesia and surgery.

---

Background and Objective: Heart failure is the end stage of cardiac disease after that myocardium has used all its reserve and compensatory mechanism. This is a descriptive survey for determine underlying and precipitating etiology of congestive heart failure among patients who admitted on CCU and cardiac department of 5th Azar Hospital of Gorgan. Materials and Methods: In this study 145 patients aged between 19-87 years have participated by data collection using questionnaire and analysis by SPSS-10. Results: The results indicated. The most common underlying causes are myocardial ischemia (57.3%) and the most common precipitating factors is inappropriate drug therapy (75.8%). Orthopnea (86.2%) and ralls (82.8%) are the most symptoms and physical exam findings. AF rhythm with 24.1% is the most common arrhythmia and cardiothoracic ratio more than 0.5 is the most abnormal finding in CXR-PA. The average ejection fraction (EF) in male patients was 32.3% and in women it was 35.7%. There was meaningful relationship between male sex and EF (P<0.05). Conclusion: This study indicated that good control of HTN and preventing of (CAD) incidence are the most important factor to avoid from CHF and appropriating drug therapy has the essential role to maintain compensated state in heart failure.

---

Background & Objective: Cardiovascular disease is among important factors of mortality in hemodialysis patients. There are some reports that indicate the Carnitine concentration reduction in the tissues accelerate cardiovascular abnormalities in those patients whom regularly are hemodialysed. This research has been set up to study the effect of oral Carnitine on the heart function of hemodialysis patients from Sari and Vali-Asr Hospital in Ghaem-Shahr Fatemeh Alzahra, Imam Khomeini in during 2003. Materials & Methods: In this study 20 patients with at least 3 month duration and 3 times interval hemodialysis in each month were chosen. The sample hemogenously devided in case and control group. One Carnitine tablet with 1 gr dose was given to the case group daily. The placebo was prescribed to the control group EF and LVEDD of patients were determined by echocardiography. The ratio diameter of heart to the chest was determined by chest radiography. The plasma level of hemoglobin, Cholesterol and Triglyceride were determined simultaneously. Results: There was not any meaningful recovery in EF and LVEDD and serum Lipids, between the case and control group 6 months after treatment with 1 gr/day Carnitine. There was only a meaningful difference in EF after 6 months duration of this study. In spite of this, there was a meaningful recovery with these patients anemia (P?0.05). Conclusion: Carnitine does not have a meaningful effect of heart function and serum Lipid level, but it has an efficacy on anemia recovery of such patients.

---

Background&Objective: The main cause of the cardiovascular disease is atherosclerosis of coronary artery. One of theraputic methods of the disease is coronary artery bypass graft (CABG). One of the main complicatons of CABG is bleeding after grafting. Different methods and proposed for preventing or reducting the bleeding. The aim of this study is to evaluate the effects of tranexamic acid (TA) on reduction of bleeding after grafting.

Materials&Methods: This study was a randomized clinical trial. 100 patients conditated to CBG divided into 2 groups randomizely (50 for control and 50 for subject). TA was injected to subject group twice with the same dosage of 15 mg/kg: first during the operation and second after ending the cardiopulmunary pomp and neutralizing the theraputic effect of heparin by protamin. The same method was used for the control group, except normal saline was used instead of TA variations such as bleeding rate, PT, aPTT were tested after CABG. The extracted data was analysed by SPSS software.

Results: The range of ages was 28 to 75 years and the control and subject groups were distributed normally from age viewpoint. Bleeding rate after grafting in subject group was 335±45 ml and in control group was 490±81 ml. in case and control platelet count and hematocrit groups, were significant differences (P<0.05).

Conclusion: Using TA during and after CABG is suggested to control bleeding.

---

Background&Objective: Considering the high prevalence of Tricomonas vaginalis (TV) in women and the known side effects of metronidazol, herbal drug therapy in order to reduce drug side effects has been considered increasingly in recent decades. This study was done to determine the effect of Artemisia aucheri Boiss, Zataria multiflora Boiss and Myrtus communis L. on Trichomonas vaginalis. Materials&Methods: This study was done on samples extracted from 100 patients with vaginitis due to Trichomona. The parasite was isolated from vagina and determined directly. Identification was done through direct smear preparation. Parasite was added to the 5 test tubes containing Dorse medium, metronidazole. dimethyl sulfoxaide (DMSO), Artemisia, Zataria and Myrtus extraction with concentration of 0.1, 0.01 ml in order to determine the effect of these concentrations within 72 hour. Results: Trichomonas could be alived in Dorse medium for 72 hours, in presence of metronidazole for one hour and in Dorse medium for 6 hours. Also, methonolic extracts of Artemisia are effective at concentration of 0.1 after one hour and 0,01 after 4 hours of the inoculation. Methanolic extracts of Zataria at concentrations of 0.1 and 0.01 and the Myrtus extract at concentration of 0.1 are effective at beginning of inoculation but the Myrtus extract at concentration of 0.01 is effective after one hour. Conclusion: Considering the acceptable effect of metanolic extracts of these plants on trichomonas in in-vitro conditions, it is recommended that , the therapeutic effects of the substances from these plants to be studied in in vivo conditions and in case of having positive effect to be used as a drug.

---

Background&Objective: Dyspnoea and fatigue caused considerable impairment in the functional performance and quality of life in HF patients. The purpose of this study were to determine efficacy of home walking exercise program on functional performance and quality of life in patients with heart failure. Materials&Methods: This study was qusiexperimental trial that assessed efficacy of home-based exercise program on the functional performance and quality of life in patients with HF in the Ahvaz city (2005). In this study 60 patients with New York Heart Association (NYHA) class II and III heart failure divided two groups training (n=30) and control (n=30). Material or measurements was demographic characteristics form, Minnesota quality of life check list and timed exercise program form. Exercise training in the patients would be performed tree day per week for 8 weeks. Determination quality of life measures by Minnesota check list would be performed in both the training and control groups at entry and after 8 weeks. Also 6 minute walking tests for determination functional performance would be performed in both groups at entry and after 8 weeks. Ultimately data analysis by SPSS softward. Results: results showed that significant difference existed between mean walking distance on the 6MWT at entry and after 8 weeks in the training group (373.86 to 412.30 m, P<0.05), that no significance was seen between control group (376.79 to 377.63 m). Also significant difference exists between mean quality of life scores at entry and after 8 weeks in the training group (52.32 to 43.80), that no significance was seen between control group (52.43 to 52.50). Conclusion: This study showed that home-based exercise program affected on functional performance and quality of life in HF patients. Its accepted. Therefore exercise training can be used as a therapeutic approach in these patients, because not only promotes quality of life but also improve the functional performance.

---

Background&Objective: To assess the effect of a lateral – wedge insole with subtalar supporting on the femorotibial angle in patients with varus defomrity of the knee. Materials&Methods: The efficacy of a wedged insole with subtalar supporting and that of traditional wedge insole shoe insert were compared. 20 outpatient with knee osteoarthritist were randomized to be treated with either the supported or traditional inserted insole. In both group , the baseline and 2 month koos scores for subjective knee pain and ADL and quality of live and symptoms were compared. Results: At the baseline , there were no significant difference in the femorotibial angle and pain and ADL, quality of life and symptoms, the 10 subjects wearing the subtalar supporting demonstrated a significatly increase femoretibial angle and koos scores without pain compared with insole group, there were no significant difference between twe group in pain after treatment. Conclusion: These results suggest that an insole with a subtalar supporting maintained the valgus correction of the, femoretibial angle in patgle in patients with varus knee OA for 2 months.

---

Background & Objective: Congenital spinal deformities usually present in infancy and make parents  worry about their child future. Because of congenital nature of these deformities, cord anomalies and other organ abnormalities must be evaluated. This study was done to determine Congenital spinal deformity and associated anomalies.

 

Materials & Methods: This cross sectional study was done on 97 patients who referred to Shafa hospital in Tehran- Iran with congenital back deformities from October 2005 to January 2007. All patients were assessed with physical examination, spinal radiography, MRI, urinary system sonography and echocardiography.

 

Results: Mean age of patients at presentation was 81 month. 81 patients had congenital scoliosis and 16 patients had congenital kyphosis. Mean cobb angle was 52 degrees for congenital scoliosis and 70 degrees for congenital kyphosis. 22 patients had neurologic or skin signs that 81% of them had cord abnormalities (p<0.05). Cord anomalies were seen in 36 scoliosis (46.5%) and 2 kyphosis (15%) (p<0.05). Most common cord anomalies were syingomyelia,diastematomyelia and tethered cord. Congenital heart anomalies was seen in 3 patients (4%) and valvular heart disease in 10 patients (13.5%) and kidney anomalies in 7 patients (12%). Only one patient with congenital heart disease and one patient with kidney anomaly had kyphosis.

 

Conclusion: Regarding to prevalence of congenital spinial deformity (CSD) in scoliosis and kyphosis patients, all of patients with CSD should screued for determiation of conganital anomalies by MRI, Eco cardiography and kidny sonography.

---

Background & Objective: The atherosclerosis of left anterior descending (LAD) coronary artery because of subtending more than 50% of left ventricular myocardial mass, has long been the focus of concern regarding appropriate treatment. This study aimed to evaluate efficacy of Percutaneous Transluminal Coronary Angioplasty (PTCA) with stenting for treatment of proximal LAD disease. Materials & Methods: In this descriptive study, 75 patients with isolated proximal LAD atherosclerotic lesion treated with PTCA and stenting were followed up for 9 months. The stenosis of all patients was documented by coronary angiography prior to enrollment. Exercise tolerance testing (ETT) by Bruce protocol was performed before angioplasty and at the end of follow up period as well. Results: There were 44 (58.7%) males, and 31 (41.3%) females. The mean age of patients was 59.4 (range, 39 to 83 yrs). Clinical outcomes of 73 (97.3%) patients were satisfactory. Only two patients developed re-stenosis during the follow up period. The first patient developed myocardial infarction at the 3rd day of her admission, and the second one had an abnormal ETT after 9 months. Percutaneous coronary revascularization with stenting was performed, and both of them were discharged without any problem. Conclusion: This study demostrated that the nine months prognosis of patients with isolated stenosis of proximal LAD coronary artery that treated by PTCA and stenting was acceptable. This treatment improves clinical status and results in lower hospital adverse event rates and in appropriate clinical outcome.

---

Background & Objective: Chest pain is one of the most important and prevalent symptom in coroner artery diseases , in which the nurse has the key role in its management. This study was done to achieve the objective of assessment of the nurse's role in pain management in patients involved in coronery artery diseases. Materials & Methods: This descriptive study was done by the use of convenience sampling method in Vassaii hospital in Sabzevar city. 95 instances of chest pain were assessed by the nursed participated. In the research project. The tools used was a researcher – made check list and the nurse's role in different aspects, including the assessment of pain, relieve measures and reevaluating of the pain was studied. All the observations was recheck by third person. The Khowledge and perception of the nurses involved this research was studied by another technique prepared. Results: The most of the nurses put priority assessement on the location of pain and the assessment of other features of the pain did not get much attention, for assessing the verbal pain, the use of verbal descriptive was the main method and no one used the visual analog scale in pain intensity. In 92.6% of the instances the nurses practiced to relieve the pain and in most instances (96.8%) medication was used. The findings showed that in 41.1% instances, no specific reassessment was practiced. Conclusion: This study showed that altough the most nurses are aware of their part in relieving the patients pain but they do not fulfill this role in pain mamagement specially in assessing and reevaluating the pain.

---

Background and Objective: Electromagnutic field of cell Phones may affect the biological systems. This study was done to evaluate the effect of electromagnutic field of mobile phones on blood pressure, heart rate and arytmia on students of Kurdistan University of Medical Science, in West of Iran. Materials and Methods: In a randomized, double-blind clinical Trial, 56 young healthy volunteers with 20-30 years age were divided in two groups: expousure (n=27) and control (n=29). Cell phone was kept in front of the heart. Non functional cell phone was used in the control group. Systolic and diastolic blood pressure, heart rate and basic ECG were recorded. The Parameters were recorded in stage one (before set on cell phone), stage two (the first 5minutes), stage three (6minutes,with silent ringing), stage four (after 17min conection) and stage five (after 35 min conection). In all Stages, it was evaluated by cardiac monitoring (Lead2) for the presence of (sinus arryhthmia, sinus bradycardia, SA block, AV block, PAC and PVC). Results: Systolic and diastolic blood pressure and heart rate did not show to have any significant differences between two groups in any stages. Rate of sinus arryhthmia was higher in expousure group at stages four and five, but only in stage four, this difference was shown to be significant (P<0.05). Conclusion: The findings of this study showed that, electromagnetic of cellular phone cause sinus arryhthmia after 17 minute connection, to prevent the side effect of cell phone, we suggest that, cell phone set distant away from heart and reduce the connection time.

---

Background and Objective: Success rate of IVF depends on infertility factors and its treatment cycle. Different methods of treatment and different centers have reported various rates of success. The aim of this study was to evaluate the fertility outcome after IVF and related factors. Materials and Methods: This descriptive analytic study was performed on 150 infertile couples following IVF in Montaserieh Infertility Center, Mashhad University of Medical Sciences, Mashhad, North – East of Iran during 2001-06. Data was collected by a questionnaire including woman's age, husband's age, infertility factor, spermogram, infertility period, the number of follicles caused by treatment, the number of oocytes, the number of produced and transferred fetus and treatment outcomes. Data was analyzed by SPSS software and Chi-square, t-studen test, One-way ANOVA and logistic regression. Results: The mean age of women was 29.7±5.4. The mean±SD follicles oocytes and transferred fetus were 11±6, 6±3.9 and 2.6±1.5 respectively. There was significant relation between the number of follicles (P<0.05), obtained oocytes (P<0.05) and transfered fetus (P<0.05) with the success rate of IVF. The fertility rate was 24.6%. There was no significant relation between the age groups and fertility rate. Conclusion: This study showed that ovarian response to ovulation stimulation and the number of transferred fetus are the important and effective factors for predicting the outcomes of IVF.

---

Background and Objective: Patent ductus arteriosus (PDA) is a common problem in preterm infants which can result in serious hemodynamic changes causing respiratory and cardiac morbidities if not treated in the first week of life. The treatment options available are pharmacological treatment with cyclo-oxygenase (COX) inhibitors and surgical ligation. The cyclo-oxygenase inhibitors approved for use are indomethacin and ibuprofen which have been used with different routes of administration and dosages. This study was conducted to evalute the lower and standard dose of oral ibuprofen in patent ductus arteriosus closure in preterm infants. Materials and Methods: In this clinical trial study, 44 preterm infants (<35 weeks gestational age) were randomly assigned to receive either a low dose (0.2mg/kg/dose for 3 doses, 24 hours apart) ibuprofen or a standard dose (10mg/kg/dose for the first dose, followed if needed, at 24hours interval by one or two additional doses of 5mg/kg each). These premature neonates either had clinical signs of patent ductus arteriosus or were diagnosed by echocardiography before stabilization of clinical signs. Patent ductus arteriosus closure was confirmed by echocardiography. They were under observe for drug's side effects (oliguria/anuria, GI bleeding, serum creatinin, intraventricular hemorrhage) and their clinical course was recorded. Results: The patent ductus arteriosus closure rates were the same with both doses (74% in case group vs.76% in control), 5 infants in the case group (22%) and 3 infants in the control group (14%) did not respond to the first course of therapy and needed a new course. There was a significant more rate of reducing renal output with the standard dose 33% vs. 4% (P<0.05), but the serum creatinin level was not different between two groups. One infant (4%) in the case group and 3 infants (14%) in the control group had GI bleeding. There was not any difference in intraventricular hemorrhage grading between two groups. Conclusion: This study showed that inspit of lower renal side effect, the low dose oral ibuprofen in comparison to standard dosage did not have any meaningful difference in closure of PDA in preterm infant.

---

Background and Objective: Cardiac arrest is responsible for half of the death cases, which is preventable in rapid and effective cardiopulmonary resuscitation (CPR). During the last years, a great amount of progress has occurred in this field, but there is still a lack of enough data for CPR. The aim of this study was to assess and compare the survival rate of patients undergoing CPR in two university hospitals in Tehran, Iran. Materials and Methods: In this retrospective analytical study, the survival rate of 178 patients undergoing CPR in the emergency department of two university hospitals (Taleghani and Shaheed Modarres) were assessed and compared during 2005. The related variables including the time delay for CPR, the time length for CPR and the outcome of CPR were analyzed. Results: 24 hours after the cardiac arrest, 7 cases of 54 (13%) survived in Taleghani hospital and 33 of 124 (26.6%) survived in Shaheed Modarres hospital (P<0.05). Conclusion: This study showed that the rate of short term survival of patients after CPR is similar to other parts of country but lower than the other parts of the world.

---

Background and Objective: Quality of medical articles is effective at improvement of medical science. This study was done for determining of published medical articles quality in approved Medical Journals. Materials and Methods: This cross- sectional study was done on 690 medial articles, which published between 1983-2005 in scientific journals, approved by special Medical Journal committee of Ministry of health and medical Education (MOHME) in Iran, during 2007. Source of data was indexed medical journal in the Iranmedex database. Results: Type of study in 52% of articles was descriptive, 21.2% was interventional and 5.8% of them were analytical. In recent years the number of analytic and interventional articles have been increased significantly in comparison to other types (P<0.05). There was no qualitative type article in published papers. The percentages of original, case report and review articles were 44.9%, 36.9% and 14.1%, respectively. In recent years the rate of original articles has increased in comparison to case report and review articles (P<0.05). In 80% of articles, at least one statistical test was applied. 60% of articles were clinical and 82% of them have been written in Persian language. Conclusion: Findings showed an increasing trend in quality indexes of published articles. It seems in recent years, the changes of MOHME policies in evaluation of the research deputy of medical science universities implementation of research and scientific writing workshops ratting protocol of approved medical journals and academic members promotion guidelines, resulted in improvement qualitative index of articles.

---

Buschke–Lowenstein Tumor (BLT) or Giant Condyloma Acuminatum (GCA) is a slow-growing, locally aggressive, cauliflower-like tumor of great size that usually arises in the perineal region. Buschke–Lowenstein Tumor is triggered by human papilloma virus (HPV), usually either genotype 6 or 11. Buschke–Lowenstein Tumor is usually preceded by condyloma acuminatum and occurs at any age after puberty, usually between the 4th and 6th decades. Invasive overgrowth and recurrence after treatment are its characteristics and malignant transformation is also possible. Here, we have reported a case of a 33 year-old man with penile Buschke–Lowenstein Tumor arising from common genital warts.

---

Background and Objective: Life saving with a high quality health care programs in the shortest duration is the mainstay of emergency department system. Frequent monitoring and quality control of this process and the satisfaction of patients are among the very important indices in hospital quality. This study was designed to evaluate the clients satisfaction in the hospitals affiliated to Golestan University of medical sciences. Materials and Methods: This descriptive cross-sectional study was done on 2400 referred patients in emergency departments of different hospitals in Golestan province, northern Iran during 2006. Data were gathered by questionnaire included demographic data and questions about satisfaction of outpatients and emergencies. The Data analyzed by SPSS-15 software and chi-square test. Results: Level of satisfaction in emergency department, was reported as follow: physician attention and behaviors (86%), nursing behaviors (85%) responsibility to patients (84.1%) status of the environmental temperature (83.9%) and cleaning (81.9%). The lowest satisfaction was related to behavior of guardsman (33.8%). In emergency ward, levels of patient's satisfaction were as following: Access to telephone (49.7%) quality of the meals (47.4%) quantity of meals (44.1%) and the lowest level of satisfaction of patient was neglecting the patient's right (8.2%). Conclusion: This study indicated that more educational programs, should be arranged for the emergency units employees to observe patients right.

---

Background and Objective: Osteoarthritis is the most common joint disease and associated with degeneration of the joint cartilage. Its high prevalence, particulary in the elderly, and the high rate of disability related to disease make it a leading cause of disability. The symptoms of osteoarthritis are pain, morning stiffness and joint limited motion. This study was carired out to compare the effects of physical modalities and home based exercise training on symptoms and function of knee osteoarthritis. Materials and Methods: In this randomized clinical trial study, fourty patients with knee osteoarthritis according to the American college of rheumatology (ACR) criteria randomly divided into two treatment groups. The physical modality group (A) received TENS, US and Hot pack at pain areas. The exercise group (B) received isometric exercise of the knee. Each group received 3 treatment sessions per week for 4 weeks. Evaluating measuring tools were pain intensity (based on Visual Analogue Scale: VAS) and function was measured with koos questionnare. Results: Improvement in pain, quality of life, symptoms, sports and reduction, in pain intensity on VAS in the physical modality group after treatment were seen (P<0.05). Also significant improvement in symptoms and quality of life observed in the exercise group. Improvement in activity of daily life found in the physical modality group in comparison with exercise group (P<0.05). Conclusion: This study showed that physical modality and exercise training reduce pain and improve quality of life, activity of daily life and sport in patients with the same rate. While activity of daily life improve more in physical modality method.