JOURNAL OF MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES
Year:2016 | Volume:26 | Issue:139|Papers Count:28

Background and purpose: Pain relief and reducing the interventions during labor is an essential aspect of obstetric care. Acupressure is one of the methods that is used to reduce pain and facilitate delivery. This study was designed to investigate the effect of acupressure before the onset of labor on the use of analgesics and oxytocin in term nulliparous women.Materials and methods: In this clinical trial, 162 pregnant women without any symptoms of labor were randomly divided into three groups: acupressure, sham acupressure and control group. The subjects were selected from Shahid Akbar Abadi Hospital in Tehran, 2015. Acupressure was performed in the Sp6, BL32, and BL60 at 39-40 weeks of gestation in low risk participants. They were then followed during labor. Statistical analysis was performed in SPSS 22.0 applying Chi-square, Kruskal-Wallis and ANOVA.Results: The use of analgesics during labor in the acupressure, sham acupressure, and control groups were 30%, 42%, and 50%, respectively and the Kruskal-Wallis test did not show a significant difference between the groups (P=0.122). The use of oxytocin was 54% in the acupressure group, 58% in sham acupressure, and 78% in those who received routine care indicating statistically significant differences between the three groups (P=0.028). The use of oxytocin was found to be lower in acupressure group compared with other groups.Conclusion: Acupressure before labor decreased the consumption of oxytocin during labor. So it could be beneficial in decreasing interventions during labor.

Background and purpose: Despite the proven effectiveness of propofol on reducing smooth muscle tone, the effect of this drug on ureteral spasm has not been investigated yet. This study was designed to investigate the effect of propofol on transurethral lithotripsy (TUL) and its influence on reducing acute ureteral spasm.Materials and methods: A double-blind clinical trial was conducted in 122 patients. Initially, all patients were given 0.02mg/kg midazolam and 2mg/kg fentanyl. The subjects were then randomly divided into two groups. The first group (n=65) received 2.5mg/kg propofol and for the second group (n=57) 5mg/kg thiopental was injected. TUL was performed using pneumatic method. Duration of TUL, hemodynamic condition, and success rate of lithotripsy, using ESWL, ureteral stent, Double J and any complications were recorded.Results: There were no significant differences in terms of gender, age, weight and stone size between the two groups (P>0.05). Duration of TUL (P=0.004) and the mean of SBP, DBP and HR in one and five minutes were significantly lower in the propofol group (P<0.01). The success rate of TUL was 96.9% and 89.5% in propofol and thiopental groups, respectively (P=0.097). Stent and double J replacement were observed in 17.5% and 22.8% of thiopental group and 20% and 16.9% of the propofol group, respectively (P=0.415).Conclusion: Propofol was associated with higher reduction in systolic and diastolic blood pressure, less changes in heart rate, reducing the duration of TUL, increasing the success rate of TUL, and less need to Double J and ESWL.

Background and purpose: Pain after amputation have several outcomes including disability, reduced quality of life and reduces the ability of communication with others. The aim of this study was to evaluate the effect of foot reflexology on pain in patients after lower limb amputation.Materials and methods: A clinical trial was conducted in patients undergoing amputation in Isfahan Al-Zahra Hospital who were divided into a control and an experimental group (n=25 per group). To assess the pain intensity the Numeric Rating Scale (NRS) was used. The patients in experimental group received 30 minutes foot reflexology while simple massage was done for the control group for 30 minutes. Both techniques were carried out 8 to 10 times. To analyze the data Chi-square test, T-test, and ANOVA were used.Results: Foot reflexology massage significantly reduced pain intensity in the experimental group compared with the control group (P=0.009). The T-test showed no significant difference in pain intensity between intervention group and controls before the operation (P=0.52). There was a significant difference between the two groups in mean pain intensity (P<0.001).Conclusion: Foot reflexology in patients undergoing amputation reduces post-operation pain and is suggested for pain relief.

Background and purpose: Appendectomy is the most common emergency surgery and diagnosis of this clinical problem is of great importance in decreasing the complications and treatment costs. In this study the diagnostic value of bilirubin level and WBC count in acute appendicitis were compared.Materials and methods: A cross-sectional study was performed in patients attending Emergency Department in Sari Imam Khomeini Hospital, 2014, with pain in abdomen and primary diagnosis of appendicitis. The diagnostic value of lab tests (bilirubin level and WBC count) was investigated. Also, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of two tests were compared.Results: The specificity, sensitivity, PPV, and NPV of hyperbilirubinemia for acute appendicitis was 66.7%, 75.8%, 95.8%, and 21.4%, respectively. The specificity and sensitivity of leukocytosis for appendicitis was 100% and 71.4%, respectively. The positive predictive value for an elevated WBC count was 100% and the negative predictive value was 25.7%.Conclusion: Bilirubin level and WBC count were found to have fairly similar predictive values for acute appendicitis. Therefore, measuring bilirubin levels might be useful when investigating a patient with symptoms of acute appendicitis.

Background and purpose: Gastrointestinal complications frequently occur in patients admitted to intensive care units (ICUs). Of these, ulceration and bleeding due to stress-related mucosal disease (SRMD) can lengthen hospitalization and increase mortality. The purpose of this study was to evaluate the risk factors of SRMD in patients and review the rational use of SUP drugs in ICU.Materials and methods: The study was conducted in Sari Imam Khomeini Hospital, 2013-2014. We investigated 100 patients in ICU. Demographic and clinical data was recorded and the appropriateness of SUP administration was determined according to American Society of Health-System Pharmacists (ASHP) protocol.Results: The patients were 51% male and 43% female. Overall 92% of the patients received prophylaxis. 34% of the patients who were administered parenteral drugs tolerated oral medications too. Among the patients, 31% who received prophylaxis did not have any indication for SUP. We found that 64% of the patients received SUP according to ASHP guidelines.Conclusion: Unnecessary prophylaxis could cause adverse drug reactions, increase the risk of hospital- acquired pneumonia, and increase the burden of treatment. The prophylactic regimen to prevent stress ulcer bleeding should be chosen based on risk factors and underlying diseases of patients in order to provide the best therapy. Health care professionals should evaluate the risks and assess the need for stress ulcer prophylaxis.

Background and purpose: Particulate matter less than 10 microns (PM10) is one of the main pollutants that cause irreparable damage to the environment and human health. The aim of this study was to estimate the health effects of PM10 on human health.Materials and methods: This analytic study was conducted in Bushehr, 2013. PM10 data were obtained from Bushehr Meteorological organization and Department of environment. PM10 concentration was measured by GRIMM. Raw data processing was done in Excel (instruction set correction of averaging and coding), then the impact of meterological parameters was considered and the data was converted into the Air Q model.Results: The results showed that the annual average concentrations of PM10 in Bushehr was 251.35 mg/m3. Total number of cardiovascular diseases attributed to PM10 was 130 cases. The total cumulative number of respiratory diseases in a year was 346. 52 of which 52% were attributed to PM10 concentration less than 150 mg/m3. In areas studied per 10 mg/m3 increased concentrations of PM10, the risks of cardiovascular death and respiratory deaths increased by1.8% and 2.1%, respectively.Conclusion: High rates of these two diseases could be due to higher average PM10 or continued days of high PM10 concentration in Bushehr.

Background and purpose: Headache is one of the pain syndromes in multiple sclerosis (MS). Migraine is one of most frequent types of headache among patients with MS. The aim of this study was to investigate the association between MS and migraines.Materials and methods: A cross-sectional study was conducted in 60 patients with definite MS. The brain MRI scans were obtained and the location of lesions and number of lesions and locations were recorded and compared.Results: The study population included 51 females and 9 males. Among the patients 82% were diagnosed with remitting-relapsing MS and 18% had secondary progressive MS. Patients with headache were found with higher number of lesion locations compared with those without headache (P=0.0001). Compared with MS patients without migraines, migraineurs with MS had larger sizes of lesions in midbrain, cerebellum, thalamus, frontal and temporal lobes (P<0.05) while migraine patients with aura had more significant involvement of the frontal lobe and less significant involvement of the occipital lobe than migraine patients without aura (P=0.035 and P=0.011, respectively). Same results were found for number of lesions in MS patients with and without headache. The difference in number of lesions in subjects with and without aura were observed only in occipital lobe. (P=0.031).Conclusion: The presence of MS plaques in the infratentorial region mainly midbrain and cerebellum and supratentorial region especially the frontal and temporal lobes, and thalamus may contribute to the increase in occurrence of headache with migraine characteristics.

Background and purpose: Some patients need to repeat certain tests. However, despite a peripheral vein catheter in the patients usually phlebotomy is done. This study examined the biochemical and hematological test results of the two methods of usual blood sampling and blood sampling through peripheral vein catheter.Materials and methods: A case-control study was carried out in 96 patients admitted to the intensive care unit in Sari Imam Khomeini Hospital, 2014. Each patient was considered as a control group. Blood samples were taken in the usual way (control) and peripheral venous catheter (case). To obtain a blood sample, peripheral venous catheters were washed by 2cc of normal saline. After 5 minutes, 0.5 CC blood was discarded and sampling was performed again. In all samples the levels of hemoglobin, hematocrit, sodium, potassium, BUN, Cr and FBS were investigated. Results were analyzed using Chi-square test, t-test, Wilcoxon, and Fisher’s exact test in SPSS V.18.Results: The patients were 56.2% male (n=54). Mean age of the participants was 47.58±17.83 years. The results showed no significant difference in the values of hemoglobin (P=0.452), hematocrit (P=0.718), potassium (P=0.282), BUN (P=0.239), Cr (P=0.247) and FBS (P=0.074) between the two methods. But a significant difference was found between the values determined for sodium levels (P= 0.034).Conclusion: Blood sampling through peripheral venous catheter while the patient is receiving liquid, is a reliable method for the analysis of hematocrit, hemoglobin, BUN and Cr.

Background and purpose: Proprioception is one of the somatic senses which is used by the nervous system for muscular control. Inappropriate posture or pain could result in impaired proprioception. One of these poor postures is forward head posture (FHP). The aim of this study was to investigate cervical repositioning error in FHP subjects with and without neck pain and normal individuals.Materials and methods: A case-control study was conducted consisting of people who had FHP without neck pain (n=31), individuals with FHP and neck pain (n=31), and healthy subjects (n=31). Cervical total range of motion (ROM) and then repositioning error in target angle (50% of full ROM in each movement( of flexion, extension, right and left lateral flexion, and right and left rotation were measured by cervical range of motion (CROM) device. Pain intensity was measured using the visual analog scale (VAS).Results: Cervical ROM in FHP subjects was significantly less than that of healthy subjects in most movement directions. The absolute repositioning error of the target angle in FHP subjects was found to be significantly more than that of healthy subjects in most movement directions (p<0.05). The mean VAS score in patients with neck pain was 4±0.68.Conclusion: FHP whether with or without pain may increase the cervical repositioning error. But presence of pain do not leads to higher rates of error.

Background and purpose: Pseudomonas aeruginosa is an opportunistic pathogen in patients with chronic respiratory disease or in immunocompromised hosts. This bacterium shows intrinsic and acquired resistance to diverse antimicrobial agents. An important mechanism of resistance to fluoroquinolones in P. aeruginosa is the mutation in gyrA, a subunit of topoisomerases II. The aim of this study was to investigate the gyrA mutations in ciprofloxacin resistant isolates in Guilan province.Materials and methods: In this cross-sectional study, 44 P. aeruginosa strains were isolated from different clinical samples such as burn, urine and respiratory secretions identified by biochemical tests. The antibiotic resistance and susceptibility of strains was determined by Kirby Bauer method. Chi-square test was carried out and P value of < 0.05 was considered statistically significant. PCR-sequencing was carried out to assess the gyrA mutations in drug resistant isolates. CLC main workbench v3.5 and BLAST softwares was used to compare gyrA sequence in resistant isolates with reference gene in PAO1.Results: The highest MIC of ciprofloxacin in some strains was >512 mg/ml. T83I and D87Y mutations were determined in gyrA gene in resistance isolates. Also, this study showed no relationship between MIC of ciprofloxacin in resistant isolates and mutation in gyrA.Conclusion: These results demonstrated that gyrA mutations are one of the most important mechanisms of resistance to ciprofloxacin in clinical strains of P. aeruginosa in Guilan. It is believed that mutations in gyrA alongside several genes that are involved in development of resistance have increased the resistance in different strains.

Background and purpose: Mannoprotein in the cell wall of Saccharomyces cerevisiae is a glycoprotein with antimicrobial and antitoxin effects. In this research antifungal properties of gelatin based edible coating containing Saccharomyces cerevisiae mannoprotein were tested against Aspergillus flavus growth and the inhibitory effect on pistachio kernel.Materials and methods: Antifungal properties of gelatin based edible coating containing Saccharomyces cerevisiae mannoprotein against Aspergillus flavus (PTCC 5004) were evaluated employing Serial Dilution (in plate and tube), Agar-well diffusion methods and inhibitory effects in coating of the pistachio kernels.Results: Gelatin-based coating containing mannoprotein showed to have inhibitory effects against Aspergillus flavus growth. MIC and MFC values for mannoprotein were 0.005 and 0.01 mg/ml, respectively.Conclusion: The application of gelatin based edible coating containing mannan delayed and reduced Aspergillus flavus growth. In this regard, this active coating could be applied in preservation and storing of foods such as pistachio to reduce Aspergillus flavus growth and eventually diminution of aflatoxin.

Background and purpose: Estrogen is a steroid hormone that enters water sources through urban and hospital waste water and is a serious threat to aquatic organisms, especially fish, and human health. The aim of this study was to evaluate the performance of municipal and hospital waste water treatment, especially biological treatment in removal of estrogenic compounds.Materials and methods: Estrogens in aqueous samples were determined by tracking. Fifty six samples were obtained from various locations in Ahwaz municipal wastewater treatment plant and hospital waste water treatment facilities within 8 months. The samples were analyzed using Electrochemiluminescence (ECL). The results were reported in units of ng/L.Results: The average influent and effluent hormone levels in municipal wastewater treatment plant were 58.8 ng/ L and 5.4 ng/L, respectively. In hospital treatment plant the average influent estrogen level was 61.8 ng/L and the average effluent level was 10.8 is ng/L. The results showed that biological treatment using activated sludge can remove significant amounts of estrogen and could reduce its level to a value lower than international standards.Conclusion: The removal mechanism of estrogen in biological treatment system, especially activated sludge are adsorption and biological degradation. Secondary treatment of wastewater is effective in reducing hormones that could be due to wastewater biological treatment.

Background and purpose: Natural organic matter in water resources (mainly caused by humic acid) leads to formation of THMs and HAAs. Removal of DBPs precursors from drinking water resources is the most important step to prevent from THMs formation. The aim of this study was to investigate the efficiency of modified nanoclay with EDTA and fresh nanoclay in adsorption of humic acid in aquatic solutions.Materials and methods: Characteristics and chemical structure of fresh and modified nanoclays were determined via scanning electronic microscope (SEM), BET, XRD, and FTIR techniques. HA concentration was determined by spectrophotometric method in 254 nm. Langmuir, Freundlich models and pseudo-first and pseudo second-order kinetics were used for adsorption isotherm and kinetics studies, respectively.Results: The XRD results showed that the distance between the layers increased after modification of nanoclay with EDTA. Also, BET analysis revealed that specific area of nanoclay increased from 13.02 to 28.36 m2/gr after modification. By decrease in pH the efficiency in removal of humic acid increased and in constant initial concentration of HA by increasing adsorbent dosage the adsorption capacity decreased. Adsorption of HA onto modified nanoclay and fresh nanoclay complies with Langmuir (R2=0.989) and Freundlich (R2=0.96), respectively. The pseudo-first order kinetic complies for both adsorptions.Conclusion: This study showed that in acidic condition the modified nanoclay has an appropriate efficiency on HA adsorption.

Background and purpose: Aniline is widely used as raw material in many chemical industries. The aim of this study was to survey the photocatalytic degradation of aniline using magnesium oxide nanoparticles from aqueous solutions.Materials and methods: An experimental study was carried out in a 2 L volume batch reactor. Various parameters such as pH (3-11), dose of nanoparticles (0.1-1), contact time (15-120 min), initial aniline concentration (5-250 mg/L) and irradiation source power (8, 15 and 30 W) were investigated. The concentration of residual aniline was measured by UV spectrophotometer at λmax of 198 nm.Results: The results showed that photocatalytic process of nMgO+UV could effectively remove aniline from effluent. The optimal solution pH and dose of nanoparticles for 8 W, 15 W and 30 W UVA lamp were 7.0 and 0.6 g/L, 7 and 0.4 g/L, and 7 and 0.4 g/L, respectively. In 30 min optimum contact time the photocatalytic degradation efficiency decreased when the concentration of aniline was increased. In optimum conditions (5 mg/L of aniline and 30 min reaction time) the aniline removal efficiency was 90.63 % and COD removal was 87.02%.Conclusion: The photocatalytic process of nMgO+UV can be used as a suitable technique for aniline removal from aqueous solutions.

Background and purpose: One of the important features of a successful and long-term marriage is marital commitment. Self-compassion could well predict improvements in marital relations. The aim of this study was to examine the relationship between original family health and self-compassion with marital commitment.Materials and methods: A descriptive correlational study was performed in 372 married individuals selected by multiple cluster sampling. Data was collected using the Family of Origin Scale (FOS) and Self-Compassion Scale. Data analysis was done applying Pearson’s correlation coefficient and multiple linear regressions.Results: The mean age of the participant was 37±7.42 years. The results showed a significant positive correlation between marital commitment and health of the original family, self–kindness, common humanity, and mindfulness subscales (P<0.01). We found a significant negative correlation between marital commitment and health of the original family, self-judgment, isolation, and over- identification subscales (P<0.01). Also health of the original family and subscales of self-kindness, common humanity, self-judgment and mindfulness could highly predict marital commitment.Conclusion: Health of the original family and self-compassion play important roles in improving marital relationships. Therefore, self-compassion focused therapies could increase mental health and create self-compassionate behavior and consequently enhance marriage durability.

Background and purpose: The rising rate of Iranian runaway girls indicates a need for conducting deep studies on this issue. This study aimed at investigating the phenomenon of running away from home by studying the lived experience of the girls in a juvenile correction and rehabilitation center in Tehran, Iran.Materials and methods: A qualitative phenomenological study was performed in which 12 female in correction and rehabilitation center were selected using purposive sampling. The lived experiences of the participants were studied by semi-structured interview. Then, the transcripts were analyzed applying interpretative phenomenology and Van Manen approach. Afterwards, the main themes, subthemes and semantic units were created.Results: The thematic analysis resulted in three subthemes for turmoil in the family including disturbed family, lack of parental support and affection, and family's antisocial behaviors. All subthemes included some semantic units.Conclusions: According to this study, deep attention is needed on lived experiences of runaway girls, psychotherapy sessions based on the main themes achieved in this research, and family therapy sessions based on improving the conflicts, especially in presence of key family members. Such actions in correction and rehabilitation centers helps the psychologists to rebuild the life of affected individuals after coming back home and prevent future problems.

Background and purpose: Social phobia is a prevalent psychiatric disorder that negatively influences different aspects of life. Developing a simple and effective tool is necessary in epidemiological studies and clinical screening to assess the individuals suffering from social phobia. This study aimed at investigating the reliability and validity of the Social Phobia Inventory (SPIN) among students with social anxiety.Materials and methods: The participants included 110 students in Lorestan Pyame Noor University who suffered from social anxiety. They were selected using cluster sampling. The reliability of SPIN was assessed using Cronbach's alpha, split-half reliability, Spearman-Brown coefficient and, test-retest. The validity of the instrument was evaluated by investigating the relationship between SPIN subscales and other scales including SCL-90-R, Cognitive Error Questionnaire (CEQ), Self-Esteem Rating Scale (SERS), and Multidimensional Body-Self Relations Questionnaire (MBSRQ) using the Pierson's correlation coefficient.Results: Convergent validity of the SPIN by SCL- 90-R and CEQ was r= 0.83 and r=0.47, respectively. Its discriminate validity was r=-0.70, r=-0.44 using the SERS and MBRSQ, respectively (a<0.001) .The Cronbach’s alpha, Spearman-Brown coefficient and test-retest of SPIN was 0.97, 0.97 and 0.82 respectively (a<0.0001).Conclusion: Social Phobia Inventory can be used as a valid and reliable tool in investigating the mental health issues in students.

Background and purpose: Sense of security in patients is a prerequisite for developments in delivering appropriate health services. It can play a major role in finding solutions to improve the quality of care being delivered. The aim of this study was to design and validate a questionnaire to evaluate the sense of security in hospitalized patients.Materials and methods: This methodology was conducted in 900 patients in selected hospitals in Mazandaran province, Iran. A questionnaire consisting of 78 items and 11 factors based on a Likert scale of 1 to 5 was designed. The content validity of the scale was examined by content validity ratio and content validity index and construct validity was examined by exploratory factor analysis. The reliability of the questionnaire was evaluated by Cronbach's alpha.Results: Only six items were found with no appropriate content validity. Exploratory factor analysis showed that the first factor (11 items) had the maximum of factor loadings (27.66) and factor 11 (4items) exhibited the minimum factor loadings (1.54). The internal consistency in all items was found to be more than 0.80.Conclusion: The questionnaire designed is a valid and reliable scale for evaluating the sense of security in patients.

Background and purpose: Gestational diabetes (GA) is a common complication associated with perceived stress. Patient’s commitment for self-care induces much stress in routine life which requires appropriate coping styles. The aim of this study was to determine the relationship between self-care behaviors and coping strategies in women with gestational diabetes.Materials and methods: A predictive correlational study was done in 400 women with gestational diabetes attending the clinics and health centers affiliated with Mashhad University of Medical Sciences in Mashhad, Iran, 2015. Data was collected by recording the participants’ personal information, using self-care questionnaire retrieved from Summary of Diabetes Self-Care Activities (SDSCA), and Ways of Coping Questionnaire (WOC; Folkman & Lazarus). Data analysis was performed by Descriptive Statistics, Pearson correlation coefficients test, Liner regressions model, and Multiple regression.Results: In this study, 312 women (78%) with gestational diabetes were using problem-focused coping styles and 261 patients (65.2%) had moderate levels of self-care. Pearson correlation coefficient showed a significant direct correlation between problem-focused coping style and self- care, (P<0.0001 and r=0.21); but, there was no significant linear relationship between that and emotive-focused coping style (P=0.200 and r=0.06). According to Liner regressions model, only the problem-focused coping is considered as a predictor variable of self- care (P<0.0001, b=0.345, and F=20.140).Conclusion: According to the findings, clinical staff, especially midwives can improve self-care behaviors in women with gestational diabetes by encouraging them to apply problem-focused coping strategies.

Background and purpose: Ferula szowitsiana is one of the Iranian medicinal plants that could be effective for pain relief since it affects opioid, cannabinoid and adenosine receptors. In this study the effects of hydroalcoholic extract of Ferula szowitsiana on pain was investigated in rats.Materials and methods: Hydroalcoholic extract of Ferula szowitsiana was solved in saline, ethanol and tween 80 (8:1:1). Male rats weighing 200-250g were placed in different groups: control, control with visceral pain, intraperitoneal administration (i.p.) of solvent, solvent with visceral pain, doses of 50, 100, 200, and 400 mg/kg of extract, naloxone, extract with naloxone, extract with visceral pain, intrathecal administration (i.t.) of solvent, 8mg/10ml of extract and 8mg/10ml of extract with visceral pain groups. Tail flick apparatus were used for thermal pain assessment.Results: Ferula szowitsiana extract reduced thermal pain threshold (P<0.01). The i.t administration of equivalent concentration of effective dose of extract which was used in i.p administration did not lead to a significant hyperalgesia unlike the systemic administration. On the other hand, the results showed no significant difference between the group receiving the extract and extract-naloxone groups. Also i.p. administration of extract caused a visceral pain (P<0.001).Conclusion: Ferula szowitsiana extract leads to visceral pain in i.p. administration and referred pain in tail region, therefore, it causes the activation of TRPV1 receptors in indirect pathway and then reduce thermal pain threshold.

The H1N1 virus is one of the highly contagious strains that leads to epidemic influenza every year in winter. In this outbreak sometimes rare complications of this infection occur. This report presents a rare case of encephalitis caused by H1N1 virus in a 52-year old man. After a day fever and flu like symptoms the patient was admitted in hospital due to decreased level of consciousness. Brain CT was found to be normal and since it was the flu season empiric treatment with vancomycin, ceftriaxone, acyclovir, and Tamiflu was started. In third day of treatment the patient was alert and had no brain dysfunction. CSF samples were positive for H1N1. Staining and culture were negative for CSF and ten lymphocytes were found in CSF samples, also protein and sugar levels were in normal ranges. The patient with encephalopathy associated influenza was treated with Tamiflu within 10 days and he was discharged in good condition. It is noteworthy that influenza can cause loss of consciousness due to encephalitis or meningoencephalitis, especially during influenza season.

Background and purpose: Antibiotic prophylaxis is an effective strategy for reduction of postoperative infection. Prophylactic cefazolin and vancomycin are used in patients undergoing hip and knee surgeries. The aim of this meta-analysis was to determine the knee and hip infection after surgery in patients under cefazolin and vancomycin regimen/s.Materials and methods: A literature search was performed in electronic databases including Google scholar, Pubmed, Web of science, and Scopus. The search keywords were hip, knee, cefazolin, and vancomycin. Eligible articles were determined after considering the inclusion/exclusion criteria. Finally, the heterogeneity among the results were defined by Q and I2 tests. Prevalence of infection were determined via randomized effect model based on heterogeneity results.Results: The meta-analysis included 19 articles in which hip and knee infections were investigated in 77108 patients. Prevalence of infection (95% confidence interval) in patients receiving cefazolin, vancomycin, and both antibiotics was 1.2% (0.9-1.5), 0.9% (0.04-1.7), and 1.3% (1.04-1.6), respectively.Conclusion: Current results showed low rates of postoperative knee and hip infections. There was no significant difference between the types of these antibiotics.

Background and purpose: Medicinal plants have received much attention in treatment and control of many diseases due to rich nutritional values and antioxidant properties. Garlic is one of these plants that is mentioned in Islamic sources because of its beneficial effects on human health. In traditional medicine it was used to treat different diseases. This review study aimed at presenting the nutritional properties of garlic according to Islamic sources and its therapeutic applications in traditional medicine.Materials and methods: A narrative review study was carried out, searching online databases including Google Scholar, Scopus, Pub med, Science direct, ISC, Magiran, and SID. Articles published in 1994-2015 were selected. Also, Holy Quran, Islamic narrations and hadith, traditional medicine and medicinal plants books were studied. The search keywords were Allium stivum, medicinal plant, and Holy Quran. Data was then categorized and analyzed.Results : Garlic contains some antioxidant compounds and micronutrients such as selenium and alicin, diallyl disulfide and diallyl trisulfide that are effective in improving joint diseases. Also, ajoene, diallyl disulfide and diallyl trisulfide which are found in garlic have proapoptotic activities and reduce cancer cell growth.Conclusion: Garlic contains antioxidant compounds such as selenium, allicin and diallyl trisulfid that have antimicrobial and antitumor activities. Identifying its effective compounds and mechanisms could help in deciphering the inspiration of holy Quran about some specific plants.

Background and purpose: In Persian medicine, thirst is regarded as a disease and its different aspects including the causes, mechanisms and treatment options are explained. The aim of this study was to determine the Persian medicine and conventional medicine view of thirst and its etiology to help researchers in clinical studies.Materials and methods: A search was conducted in Persian medical textbooks using thirst as the keyword. Then an electronic search was done in databases including pubmed, google scholar, Scopus, and SID using the following keywords: thirst, etiology, and physiology. After extracting the data, the results were presented in concepts and tables.Conclusion: Thirst is the feeling of needing to drink water and Persian medicine has different divisions for this feeling. Many of these divisions are formed based on the causes of thirst which are divided into bodily and nonbodily causes. Bodily causes include: ill-tempered, swelling, and obstruction and non-bodily causes include some medications or having certain foods.Result: Persian medicine and conventional medicine share similar views about thirst. However, compared to Persian medicine, conventional medicine does not address some causes of thirst. Therefore, traditional Persian medical textbooks are believed to be useful in treatment of patients.