فهرست مطالب alireza kamali

As with other diseases during COVID-19, there are psychiatric aspects that require monitoring. The main objective of this study was to investigate the variation of psychiatric consultations requested in hospitalized patients with COVID-19 and the relationship between these consultations and patient prognosis.

In this cross-sectional study, the patients included those were  from admitted to the COVID-19 departments of Arak University of Medical Sciences. DSM-5 criteria were reviewed.

This study has shown that approximately 5.9% of COVID-19 patients admitted to hospitals have experienced psychiatric disorders, with delirium being the most common manifestation, especially among older individuals. The occurrence of delirium is significantly associated with higher mortality rates and low blood oxygen levels (p<0.05). The relationship between gender and specific psychiatric disorders was also investigated, revealing a significant correlation with anxiety, depression, and delirium (p<0.05). Moreover, concerning delirium disorder, a meaningful correlation was found with the prevalence and a history of neurological and psychiatric disorders (p<0.05).

By examining the patients, variety of consultations were divided into three categories: depression disorders, anxiety disorders, and delusions. It was found that the most common category which was clearly related to the death of patients was delusions.Therefore, the history of delirium disorder in the patient as well as the occurrence of delirium during hospitalization are important risk factors for patient mortality.

Calling for Tawhid and monotheism is the important goal of divine prophets. They have come, one after another, to teach humans monotheism and the way to approach Him and achieve perfection and salvation. The Prophet of Islam, as the last divine messenger, was sent to the land of Hijaz. The most important task of his mission is the call to monotheism and sincere worship of the Almighty. Therefore, in the Meccan verses, the command "So supplicate Allah, putting exclusive faith in Him" has been mentioned in Surahs: Ara'af, Zummar and Ghafir. The present article follows the interpretation of the verses "mukhlisan / mukhlasina lah ul-Din" in Meccan Surahs in a descriptive and analytical way. The interpretative study of these verses shows that worship has levels that each person is adorned according to his position in the system of perfection. Therefore, in the discussed verses, the Prophet of Islam is the first person who is responsible for sincere worship. Also in these verses of the Prophet's worship, he is mentioned along with the word "abd" and the worship of others with the word "du`a". The verses commanding everyone to pray sincerely, while declaring that this invitation is right, are accompanied by encouragement and threats and a request to ignore the reluctance and argumentativeness of the disbelievers. The result of following these noble verses is to ensure the personal and social happiness of Muslims.

 Total knee arthroplasty (TKA) is a standard surgical procedure for individuals with debilitating knee arthritis. Effective postoperative pain management is essential for successful recovery, although traditional opioid-based methods have limitations.

 This study aimed to compare the efficacy of Apotel and Remifentanil patient-controlled analgesia in managing postoperative pain after TKA.

 This double-blind, randomized, controlled clinical trial took place at Amir-al-Momenin and Qods Hospitals in Arak, Iran, spanning from June 2022 to September 2023. Sixty-two eligible patients scheduled for knee joint replacement were randomly assigned to receive either Apotel (Group A) or Remifentanil (Group R) as part of multimodal analgesia administered via a pain pump for postoperative pain relief in TKA. The study assessed hemodynamic parameters, pain levels (measured using the Visual Analog Scale), analgesic duration, and narcotic consumption. Statistical analyses were performed using SPSS v.27 and Plotly.

 Subjects exhibited no statistically significant differences in age, gender distribution, duration of surgery, or anesthesia. The hemodynamic status assessment in the recovery room showed no significant differences in SPO2, PR, or MAP between the groups. However, Remifentanil demonstrated superior effectiveness in reducing pain over 24 hours post TKA surgery compared to Apotel, as evidenced by lower average Visual Analog Scale (VAS) scores (P < 0.001), longer duration without the need for narcotic painkillers (P < 0.001), and lower cumulative opioid analgesic consumption in Group R (P < 0.001).

 Remifentanil demonstrates superior pain control in a multimodal pain management approach compared to Apotel, providing sustained pain reduction over 24 hours post-surgery. Moreover, Remifentanil offers longer-lasting pain relief and results in lower cumulative narcotic painkiller consumption compared to Apotel.

Preventing ventilator-associated pneumonia (VAP) as one of the most common and also the most fatal complications caused by intubation and mechanical ventilation in intensive care units (ICU) has always been emphasized in countless studies. Chlorhexidine mouthwash is commonly used as a gold standard in the control of dental plaques and prevention of VAP. Given the increasing prevalence of gram-negative infections due to resistance to commonly used antibiotics and the associated complications, this study aimed to investigate and compare the impact of tea tree oil/aloe vera herbal mouthwash, known for its antibacterial and anti-inflammatory properties, on the occurrence of ventilator-associated pneumonia.

This study is a double-blind randomized clinical trial. 62 intubated patients, aged from 16 to 65 and hospitalized in the intensive care units of Hazrat Waliasr Hospital in Arak City in 2023, were assigned using a simple randomization method in two interventions (tea tree oil/aloe vera mouthwash) and control groups (chlorhexidine mouthwash). Mouthwash bottles were covered before distribution. None of the patients, colleagues (nurses), and the specialist determining the final result of the study were aware of the allocation of patients in the intervention or control group. Oral care in both groups was performed by washing hands, wearing gloves, evaluating the mouth condition, adjusting the pressure of the endotracheal tube cuff (20-30 Cm.H2O), brushing with a soft toothbrush, mouthwash twice daily and open suctioning of oral and subglottic secretions. Lastly, at intervals of 3 days (to assess the incidence of early VAP) and 7 days (to assess the incidence of late VAP) after the intervention, the modified clinical pulmonary infection score (MCPIS) was calculated and a score greater than or equal to 6 was considered as a diagnosis of pneumonia. This tool has been utilized in similar studies and its validity and reliability have been confirmed. Eventually, the data was statistically analyzed using the chi-square test, independent t-test, and repeated measures test to investigate the effect of the intervention over time with SPSS version 20 software.

According to the results, 64.5% of the participants were male and 35.5% of them were female. There was no statistically significant difference between the two groups in terms of average age, gender, reason for admission, history of underlying diseases, invasive interventions, average number of drugs and antibiotics, type and amount of nutrition, and duration of mechanical ventilation. The incidence of early-onset pneumonia was 9.7% in the intervention group and 12.9% in the control group. Although the incidence was lower in the intervention group, there was no statistically significant difference between the two groups (P-value=0.99). The incidence of late-onset pneumonia in the intervention group was 12.9% and 16.1% in the control group. Despite of lower incidence of late-onset pneumonia in the intervention group, there was no statistically significant difference (P-value=1.00). Moreover, according to the results of Bonferroni's paired comparisons test, the difference in the average MCPIS score between 3 days and 7 days later in the intervention group was not significant and did not increase significantly (P-value=0.06), which means that in this group, the effect of the intervention can be seen at this time.

Oral care using tea tree oil/aloe vera mouthwash or 0.2% chlorhexidine has no preference or significant advantage over each other, and both can be effective in reducing ventilator-associated pneumonia. Considering the lower incidence of early and late pneumonia in the intervention group, it is recommended to conduct studies with a larger sample size and also use accurate oral assessment tools to confirm the removal of dental plaque (plaque score) in this population of patients.

Bleeding is a significant complication of cardiac surgeries, leading to increased blood product utilization, higher rates of reoperation, and mortality. Tranexamic acid is one of the main medications used to control postoperative bleeding in these patients. Therefore, the aim of this study was to compare the effects of intravenous, topical, and oral tranexamic acid in reducing postoperative bleeding after coronary artery bypass grafting (CABG) surgery. This clinical trial was conducted on 96 patients scheduled for CABG surgery. The patients were divided into three groups of 32, receiving oral, intravenous, and topical tranexamic acid. After the surgery and administration of the respective medication, the amount of bleeding within 72 hours postoperatively, as well as the amount of packed red blood cells, platelets, and fresh frozen plasma received within 24 hours postoperatively were assessed. The mean age of the participating patients was 64±5.4 years, and the three groups did not significantly differ in terms of age, gender distribution, number of grafts (P=0.421), and duration of surgery (P=0.624). There was no significant difference in the bleeding score among the three groups, with scores of 3.9±0.88 in the intravenous group, 4.1±1.1 in the oral group, and 4.4±0.98 in the topical group (P=0.221). The average amount of packed red blood cells, platelets, and fresh frozen plasma received during and after surgery was similar in all three groups, with values of 2 (P=0.422), 3.5 (P=0.402), and 2.4 (P=0.412), respectively. In general, the results of this study indicate that the use of tranexamic acid in all three available forms (oral, intravenous, and topical) leads to a reduction in postoperative bleeding with similar outcomes. Therefore, concerning the fewer side effects of the topical and oral forms and their sufficient effectiveness, physicians can utilize these methods for prescribing tranexamic acid.

One of the important goals in health policy is to ensure social justice in health, so the present study was conducted with the aim of investigating the role of religiosity and sense of social security in predicting social justice in the health system.

The research method was descriptive-correlation. The research population included all citizens aged 18 to 69 in Tehran in 2022, and 768 people were selected by stratified sampling (men and women) based on Cochran's formula. The data collection tools included Alivardinia et al.'s religiosity questionnaires (2015), Asl et al.'s sense of social security and trust (2023), and Riahi et al.'s (2018) social justice questionnaires. Data analysis was done using Pearson correlation test and multiple regression with SPSS version 24 software.

The results showed that the relationship between religiosity (r=0.600) and feeling of social security (r=0.688) with social justice was positive and significant (p<0.01). Also, 37.3 percent religiosity and 47.6 percent social security predict social justice.

Based on the results, religiosity and feeling of social security lead to the expansion of social justice, so the research results show the importance of the role of religiosity and feeling of social security in promoting social justice of citizens.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has been associated with severe respiratory disease incidence and increased morbidity and mortality of patients all over the world. The aim of this study is evaluation of Atorvastatin effect on patients with COVID-19. This is a prospective randomized controlled trial with 100 adults diagnosed with COVID-19. Participants randomly received Atorvastatin or just routine protocol of treatment for 10 days. Primary outcomes are duration of fever and cough, atrial oxygen saturation (SPO2), length of hospitalization and ICU stay, duration of oxygen therapy or intubation, and mortality rate. Secondary outcomes contain white blood cell count, lymphocyte percentage, lactate dehydrogenase, and creatine phosphokinase level. There was no significant difference in age and sex between two groups. Atrial oxygen saturation (SPO2) with/without non-invasive oxygen therapy was significantly higher in statin group (P=0.001, P=0.002, respectively). However, other primary and secondary outcomes was similar in both groups. Statin use was associated with higher percentage of SP02, but there were no significant differences in other outcomes.

Depression is a prevalent mental disorder affecting more than 300 million people of all ages globally. Despite being the first-line treatment for depression, antidepressant medications are only effective for 60% - 70% of patients. Electroconvulsive therapy (ECT) is an effective treatment for severe cases, although it can result in short-term side effects.

This study aimed to compare the effectiveness of remifentanil, dexmedetomidine, and metoral as premedications for ECT in patients with major depressive disorder (MDD).

In this prospective double-blinded randomized controlled clinical trial, a total of 120 MDD patients aged 18 - 60 were included. They were randomly assigned to receive remifentanil, dexmedetomidine, or metoral in combination with thiopental before ECT. Hemodynamic responses (mean arterial blood pressure, pulse rate, arterial blood oxygen saturation), seizure duration, recovery time, agitation scores, and patient satisfaction scores (reverse coded) were measured and compared.

Dexmedetomidineexhibited superiorhemodynamiccontrol with lowermeanarterial blood pressure (P< 0.001)andpulse rate (P < 0.001) than remifentanil and metoral. Patients receiving dexmedetomidine or remifentanil showed reduced agitation (P < 0.001) and better satisfaction than the metoral group (P < 0.001). Remifentanil displayed intermediate outcomes, while metoral exhibited the least favorable results. Seizure duration was not significantly different between the dexmedetomidine and remifentanil groups (P = 0.843).

Dexmedetomidine is considered the most satisfactory group due to the better control of blood pressure, heart rate, and agitation and better patient satisfaction despite the longer recovery time.

This study aimed to compare diltiazem-ointment and safflower oil in reducing the necrosis of accidental rat flaps.

We divide 40 mice into four groups. We created a 10  3 random flap on the back of rats after washing with ketamine intraperitoneal. The flap was used for these four groups of ointments from two days before surgery to five days after surgery. We used diltiazem ointment in the first group, safflower essential oil in the second group and vaseline in the third group. The fourth group was for control

The mean necrosis of the flap was observed in 49% of the vaseline group, 52% of the diltiazem group, 53% safflower essential oil group, and 47% of the control group. The P-value with the independent groups’ test was more than 0.05 and confirmed no significant difference between Wistar rat groups. Vaseline, diltiazem, and safflower essential oil did not increase blood flow to the random flap in mice.

Diltiazem and safflower did not improve blood flow to the flap. Since this drug has not been used for flaps, it is suggested that further studies be conducted in this field.

Novel coronavirus disease 2019 (COVID-19) has become a public health concern with over 6.5 million cases and 390,000 deaths around the world. This research aimed to find an association between computed tomography (CT) scores and clinical and laboratory findings to estimate the extent of lung infection in patients with COVID-19. The study sample enrolled 129 patients diagnosed with COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, images were segmented and scored by the degree of involvement from 0 to 4, and the relationship between them and clinical and laboratory findings were analyzed statistically. This study included 74 men and 59 women with a mean age of 55.08 years. Different abnormalities were observed; the mean CT score was 8.52 (7.83 to 9.21) and the most frequent lesions were GGO and consolidation. Our results revealed significant differences between groups categorized by dyspnea, sore throat, and low oxygen saturation concerning CT scores. There was also a significant correlation between CT scores and WBC counts and CRP levels (P<0.05). The evidence from this study implies that clinical and laboratory data, such as CRP, dyspnea, lymphopenia, and symptom onset closely correspond to chest CT scores and may be employed as initial tools to estimate the extent of lung involvement in COVID-19 patients.

Prayer is a category of worship and among the things that are in line with human nature. Those of prayer are connected to God on the basis of their pure nature and are engaged in praising and worshiping Him. This article tries to present the most important outputs and effects of prayer in the presence of the Almighty based on the narrations of the infallibles. Since man has two dimensions, material and spiritual, in other words, physical and spiritual, prayer affects both dimensions. According to Islamic traditions, things like: calming, increasing endurance and tolerance, not being afraid of arrogant people, attaining material blessings, including the effects of prayer, are in the material sphere, and such things as: feeling closeness to God Almighty, removing neglect, salvation through sincerity in prayer, and development of ethical virtues, hope-creating and hope-raising, humility-creating, mobilizing are among the works and achievements of prayer in the spiritual aspect of man.

Despite the importance of mangrove forests, mismanagement and insufficient knowledge about the environmental factors affecting these ecosystems is the first step in their sustainable management. In this research we extracted the drainage structure of watersheds from the digital elevation model (DEM) by 30 meters cell size and the 81 basins on the coastline of Hormozgan province were identified and partitioned. Then 22 morphological variables for each watershed were calculated using computational methods and geographic information system software features. In the next step, the principal component analysis (PCA) used for dimension reduction and feature selection to investigate the correlation between the formation of mangrove forests and upland watersheds characteristics. Based on principal components analysis results six watershed variables identified as independent variables and entered to the regression model. The results showed 93.21% of the variance of the dependent variables explained by these six variables which including: equivalent circle diameter, time of concentration (Kirpich method), Horton coefficient, the maximum elevation and the main stream variables. The equivalent circle diameter was the first effective factor and had a direct relationship while the Kirpich time of Concentration and Gravelius or compactness coefficient were also considered as very important factors with an inverse effect on the presence and area of mangrove forests downstream. Generally, the results of this study indicated a strong systemic relationship between upstream watersheds and coastal and downstream mangrove ecosystems, and in the management and protection of these ecosystems, the characteristics of the upstream watershed should be considered.

Pain is one of the most common problems after surgery. Various strategies have been used to alleviate it. To achieve the optimal pain management, various analgesics and narcotics are used, despite of having side effects. Numerous sources of Iranian Traditional Medicine have indicated the analgesic effects of lettuce. This study aims to evaluate the effects of lettuce syrup as an adjunctive therapy on pain relief after inguinal hernia surgery.

This is a triple-blind clinical trial. Seventy patients candidates for inguinal hernia surgery referred to Valiasr Hospital in Arak, Iran were randomly divided into two groups of intervention and placebo. From 3 days before surgery to after surgery, lettuce and placebo syrup were prescribed separately as well as morphine, if needed. Pain was measured using visual analogue scale (VAS) during recovery and 1, 2, 4, 6, 12 and 24 hours after surgery. The data were analyzed by independent t-test, chi-square test, and repeated measure ANOVA. 

The acute pain level during recovery after surgery significantly decreased in the intervention group compared to the control group. The mean VAS score 24 hours after surgery was 0.68±1.94 in the intervention group and 2.75±8.13 in the control group (P<0.05).

The use of lettuce syrup as an adjunctive treatment is effective in reducing pain after inguinal hernia surgery.

The increasing prevalence of SARS-COV-2 infection necessitates further epidemiological studies in the field of this epidemic.

during 66 days (20/02/2020 to 01/06/2020) all patients diagnosed with SARS-COV-2 infection referred to Valiasr Hospital in Arak were monitored. Thus, based on the pre-prepared questionnaire, the information of the mentioned patients was extracted from the Hospital Information System (HIS) by the required formats and after eliminating the incomplete cases, it was aggregated based on coding (to preserve the patients' information). The results were evaluated using spss. v25 software.

Out of 535 patients with SARS-COV-2 included in the study, 295 (55%) were male and 240 (45%) were female. Women with a mean age of 61.03 years were significantly (p = 0.009) at a higher age than men with a mean age of 56.59 years. Nearly 60% (304 patients) of patients had a history of underlying disease. Gender comparison of patients with a history of underlying disease infected with SARS-COV-2 infection did not show any significant difference between male and female patients. Comparison of the mean age of the improved and dead patients shows that the mean age of the dead patients with a significant difference (P <0.001) was higher than the improved subjects. This result is also true for people with a history of underlying disease (p<0.0001). The number of patients with arterial oxygen saturation <93% was significantly higher in the group of patients with a history of at least one chronic underlying disease than who did not have any chronic disease (P <0.0001). The mortality rate in ICU patients was significantly higher than those admitted to the normal ward (p < 0.0001).

Aging, gender, underlying diseases and arterial oxygen saturation (<93%) at the time of admission have important role in the hospitalization rate, severity of the disease and mortality in patients with COVID-19.

To have a thorough understanding of epidemic surveillance, it is essential to broaden our knowledge of death tolls worldwide. This study aimed to determine the age‑standardized mortality rate (ASMR) and predictors of mortality among coronavirus disease 2019 (COVID‑19) patients.

In this cross‑sectional design, all COVID‑19 patients with a positive polymerase chain reaction test in the population covered by Arak University of Medical Sciences (AUMS) were entered to the study. Data collection was conducted by phone interview. The study variables comprised age, sex, coronary heart diseases, diabetes, and some symptoms at admission. The adjusted odds ratio (OR) and 95% confidence intervals (CIs) were obtained by logistic regression. The direct method was applied to calculate ASMR (per 100,000) of COVID‑19. The analysis was applied by STATA software 12.0.

A total of 208 cases of COVID‑19 (out of 3050 total infected cases) were dead and 2500 cases were recovered. The mean age of dead patients was 70 years. The COVID‑19 fatality rate in the population equaled 6.8%; in those patients who were 70 years old or more, however, the case fatality rate was 16.4%. The ASMR of COVID‑19 was 12.9 (CI 95%: 11.2, 14.8). The odds of COVID‑19‑related death in the age over 60 were 10.87 (CI 95%: 6.30, 18.75) times than lower 45 years old. Moreover, it was observed that COVID‑19 significantly increased the odds of COVID‑19‑related death in diabetes patients (OR = 1.45, CI 95%: 1.02, 2.06, P = 0.036).

The ASMR of COVID‑19 was relatively higher in males than females. In general, the COVID‑19 fatality rate was relatively high. We found that older age and diabetes can have impact on the death of COVID‑19, but the headache was found to have a negative association with the COVID‑19‑related death.

The recent outbreak of the new coronavirus (Covid-19) has caused a great deal of stress and anxiety around the world. Given that health care workers are at the forefront of the fight against infectious diseases and Covid-19 disease, they are the first to be exposed to the virus.

In this cross-sectional descriptive study, 402 medical and administrative staff of Jahrom University of Medical Sciences in 1399 participated. Data collection tools in this study included the Demographic Information Questionnaire and the Corona Disease Anxiety Scale (CDAS).

The mean score of psychological symptoms of clinical staff (46.91%) was higher than the mean score of psychological symptoms (42.63%) of administrative staff. Also, the mean score of physical symptoms of clinical staff (12.80%) was higher than the average score of physical symptoms (10.94%) of administrative staff. There is a significant difference between clinical and administrative staff in terms of mean anxiety (P=0.030).

 The medical staff in both areas of anxiety scored higher than the administrative staff. Therefore, considering the prevalence of Covid 19 disease worldwide and the rate of deaths due to this disease in health care workers due to being in the forefront of the fight against this disease, so it is recommended to reduce the anxiety of medical staff, policymakers Health, think of the necessary measures to take care of this group as people who work as caretakers of the health and well-being of members of the community.

The COVID-19 pandemic is capable of severely affecting the mental health of health care workers, who are at the forefront of this crisis; while the official staff of health organizations is facing the same danger. Therefore, monitoring awareness and other mental health issues to understand the mediating factors and awareness of appropriate interventions is a necessary priority. Therefore, the purpose of this study was to compare the level of knowledge, attitude, and practice of medical and administrative staff in facing the COVID-19 virus.

This cross-sectional descriptive study was performed on 160 medical and administrative staff of Jahrom hospitals in 2020. Demographic information questionnaire and researcher-made questionnaire of knowledge, attitude and practice of medical personnel about coronavirus (Covid 19) were used to collect information. Data were analyzed using SPSS software version 21 and descriptive and inferential statistical tests.

65% of subjects were women and the rest were men. In most of the answers given to each item in both groups, the medical and administrative staff’s answers were close to each other. In the case of the statement "I am more likely to get a corona", 54.4% of the medical staff chose the strongly agreed option, while this percentage is 16.5% for the administrative staff. This indicates that the medical staff is very afraid of getting COVID-19. According to the results, the mean knowledge scores of the medical staff (with an average of 94.35) were significantly higher than the administrative staff (with an average of 87.75) (t=5.96, p<0.001). But the performance of administrative staff (with an average of 93.14) is significantly higher than medical staff (with an average of 87.17) (t=-2.710, p=0.007). No significant difference was observed between the mean scores of the attitude scores of both groups (p=0.438).

The results of this study showed that the level of awareness in the face of corona virus in the administrative staff is significantly lower than the medical staff, but the administrative staff has a better performance in facing of the corona virus than the medical staff. It seems that educational measures are necessary to increase the awareness of these people.

The study addressed the comparative hemodynamic and analgesic effects of subcutaneous dexmedetomidine versus marcaine 0.5% on herniorrhaphy scheduled patients, as well as postoperative pain management.

This double-blind trial enrolled three groups of patients (N=120) scheduled for herniorrhaphy at Valiasr Hospital (Arak, Iran): (i) MAR-DEX group, receiving marcaine 0.5% (5 mg) + dexmedetomidine (1 mcg/kg), (ii) MAR group, marcaine 0.5% (5 mg), and (iii) PBO group, placebo, subcutaneously. We measured vital signs (BP/HR/SaO2), as well as pain scores (using the visual analog scale) at recovery and certain time points (1, 2, 4, 6, 12, 24 hrs post-op), and the overall opioid administered postoperatively and side effects. This was afterward followed by an SPSS (20) analysis.

Lower pain was revealed in the MAR-DEX group and higher one in the PBO group (p = 0.0001), whereas the lowest opioid use was observed in the MAR-DEX group (p = 0.0001).

Adding dexmedetomidine had benefits of relieving pain and reducing opioid use without any side effects.

Hysterosalpingography plays an important role in diagnostic work-up and treatment planning for infertile women. This procedure is usually uncomfortable and painful. The present study plans to investigate the effect of intramuscular Hyoscine-N-Butyl Bromide (HBB) on fallopian tube spasm and pain perception during and after hysterosalpingography (HSG) in infertile women.

This randomized single-blind controlled clinical trial (IRCT2017021132455N2) was conducted on infertile women scheduled for HSG in one radiology clinic affiliated to Arak University of Medical Sciences between July and August 2017. Patients were selected by convenience sampling and were randomly assigned to HBB (n=50) and a control group (n=50). Women received 20 mg/1cc HBB intramuscularly in the intervention group, 30 minutes before the procedure. Women in the control group did not receive any medication. The patients were requested to complete the Numeric Pain Rating Scale after injection of the dye, and also 30 minutes following the end of the HSG. Presence or absence of tubal spasm was determined after checking the radiographic images. For the data analysis using SPSS version 18, descriptive statistics, and analytical tests such as independent sample t-test, Mann- Whitney test, chi-square or Fisher’s exact tests and logistic regression and ANCOVA were used.

Statistically significant differences were not observed in pain scores between the HBB and the control groups at the point of dye injection and 30 minutes after ending the HSG (p>0.05). Also, tubal spasm in the HBB group was lower than in the control group, but the differences were not statistically significant between the two groups (p=0.37).

The use of intramuscular HBB before HSG has no advantage in reducing tubal spasm and the induced pain during dye injection and 30 minutes after the HSG procedure. Thus, we don’t recommend HBB use before the HSG in order to relief from pain and spasm.

The holy Quran`s attending to the subject of hijab, like most social subjects, is in a gradual way and based on a sociological basis. God, the Almighty, having explained natural and fundamental problems of hijab and preparing appropriate cultural ground and making a reference to a lawful relation between man and woman as guarding one`s modesty and eye, attends to the how and limit of hijab. One of the most important verses in the field is 31 of Noor light, which describes women`s lawful dressing in detail. Despite numerous interpretations, due to the absoluteness of some of its words, lack of exact examples and contrary traditions the verse has been disputed, especially in the recent centuries due to the prevalence of Western culture and a different view on women. Some view common interpretations of the verse critically and give contrary ideas in the field. Regarding various comments, demurs and the traditions of the subject, the paper has studied the verse.

Nowadays, Interurban Buses play an important role in passengers transfer between the cities. Contaminated drinking water in Buses may threaten the health of travelers. This study investigated the microbial and chemical quality of drinking water supplied in the coaches transporting the passengers from/to Soffeh terminal in Isfahan.
In this study, 60 samples of potable water supplied in the coaches were randomly collected. Bacterial contamination of the samples was examined using multiple tube method, (MPN). Chemical parameters including EC, TDS, total hardness, chlorine, turbidity, pH and temperature were measured according to the standard methods. Data were analyzed using SPSS version 23.
Findings: The results showed that total coliform and fecal coliform were positive in 20% and 7% of the samples, respectively and so that all contamination was related to Water Dispenser. About 35% of the samples had EC levels more than the recommended standard (500 µmhos/cm2). The turbidity value in 11.6% of the samples was higher than 1 NTU and the residual chlorine in 98.3% of the samples was zero.
This study showed that most of potable water served to the passengers via chillers installed in the coaches was polluted to the fecal coliforms. Whereas, the pollution was not observed in the bottled potable water available inside the coaches. Thus, collection of the tap equipped-chillers and supplying only bottled potable water in all the coaches can prevent the passengers from intestinal diseases.

A religious rule is known to be that in which all levels of management are in accordance with religious beliefs, judgments and values. The ends of a system lie in some general affairs toward which it moves. In the paper, it has been intended to study Alawi teachings and manner of political and behavior life and survey general purposes of an Islamic rule in political, social, economic, cultural and military fields. One, relying on Imam`s speeches, may divide the ends of an Islamic rule into final ends and middle ends. Pursuing the former, Islamic government tries to lead human being to happiness and Divine approximation and, pursuing the latter, tries to administrate society on the basis of Islamic laws, supporting meritocracy, lawful relation to other government, making justice widespread, satisfying social needs and developing public well-fare, establishing and extending Islamic pure teachings and knowledge in society, increasing the citizens` economic power, constructing and building the country, developing trade, technology and agriculture, establishing public security and managing social crises.

concerning the high prevalence of post dural puncture headache and nausea & vomiting among parthurient we deaided to study the effects of different doses of ondansetron of preventing of the PDPH.
In this double blinded randomized clinical trial patients allocated to three groups randomly. Patients reciewed 8mg ondansetron and placebo in first second & third (couliol) respectively. Patients were evaluated concerning both in the first week of postoperative period
PDPH was more prevalent in third (control) group in every house comparing to other groups and was less in first group in comparison with the second one but was not statistically meaning.
based on our finding, 8mg/iv ondansetron could be effective in reduction of pdph among partients.

It is well-recognized that collimator-detector response (CDR) is the main image blurring factor in SPECT. In this research, we compensated the images for CDR in molecular SPECT by using STIR reconstruction framework.
To assess resolution recovery capability of the STIR, a phantom containing five point sources along with a micro Derenzo phantom were investigated. Influence of the lesion size on SPECT quantification was addressed by calculating recovery coefficients (RCs) as well as spill-over ratios (SORs) for reconstructed NEMA image-quality phantom. Impact of the resolution modeling on noise properties was also studied. The RCs were then compared with those of experimentally obtained. In all cases, the images were iteratively reconstructed using an OSEM algorithm with 4 subsets and 32 subiterations.
CDR compensation gives rise to a significant drop in tomographic resolution from 2.45 mm to 1.55 mm. RC for hot rods of the NEMA IQ phantom monotonically grows as rod diameter increases, and results in an improvement of the RC up to a factor of 1.24 for the 5-mm rod diameter. PSF modeling also leads to a reduction in SOR from 0.24 to 0.16 averaged for the two cold cylinders. As a consequence of resolution recovery, a 15.5% overshoot near sharp edges imposing Gibbs ringing artifact occurs. In addition, a blobby noise texture is also observed. Furthermore, STIR results are consistent with the experimental ones.
Our findings demonstrate that resolution recovery is required for quantitative molecular SPECT imaging, and CDR compensation by the STIR framework offers superior SPECT image quality.