Background & Objectives: Observations show that the majority of women referring to hospitals to terminate their pregnancy in the third trimester have not initiated uterine contractions. Regarding the importance of infant-mother health and unnecessary cesarean section, the present research was conducted to determine the causes of pregnancy termination in the third trimester and its association with the fate of mother and fetus in Shahrekord in 2005.
Materials & Methods: In this cross - sectional study 750 pregnant women who had been hospitalized to terminate pregnancy in the third trimester were selected randomly in three morning, afternoon and night shifts. Data collection tools were questionnaires and checklists which were completed through original examination of the patients, file study, interview with mother, and postnatal examination of the infant. The fate of infant and mother was determined through the type of delivery , pregnancy age and infant weight. The data were then classified and analysed using SPSS software, t-test, 2 and Pearson correlation coefficient.
Results: 298 ( 39.7%) of mothers referred to the hospital due to labor pain and 452 (60.3%) of them were advised to terminate their pregnancy by the physician. 23.2% of the above-mentioned patients had been hospitalized due to the causes such as previous cesarean section, a tendency toward cesarean, and mother – infant problems during the pregnancy. The results showed that there was a significant relationship between the cause of pregnancy termination and type of delivery after exclusion of repeated cesarean section cases and tendency toward cesarean, and the patients advised by the physician had undergone more cesarean section (P=0.001). Pregnancy age in the group advised by a physician for hospitalization was more than the group who had been hospitalized due to labor pain (P=0.003). Infant weight had no significant difference in two groups.
Conclusion: Elective termination prior to labor pain can enhance the risk of cesarean section. Taking precise pregnancy history, performing sonography in the first 26 weeks, gestation and training the pregnant women the time of referring to hospital can prevent termination of pregnancy.

Background & Objective: Systemic lupus erythematosus (SLE) is a disease with life-threatening complications. Since evidence indicates that measurement of triglyceride (TG) and HDL levels and tumor necrosis α factor (TNF- α) and its types I and II soluble receptors plays a major role in evaluation of lupus activity, this study was conducted to investigate the relationship between the above mentioned factors and lupus activity in Tehran in 2005.
Materials & Methods: In this cross-sectional study fasting blood samples were obtained from 86 SLE patients who had been entered into the study through convenient sampling and the disease activity was calculated using the Systemic Lupus Erythematosus Disease Activity Index [SLEDAI]. Scores ≥ 6 were considered as active lupus and <6 as dormant lupus. Serum levels of TNF- α, sTNFR1 and sTNFR2 were measured through ELISA (Bender Medsystem) and blood TG and HDL through routine biochemical tests within 12 hours overnight fasting. The results were analysed by t-test, Mann-Whitney and Pearson correlation tests.
Results: 46 people (53.5%) suffered from dormant disease and 40 people (46.5%) from active disease. TG level had significant relationship with disease activity, sTNFR2 (P=0.001) and TNF-α (P=0/01), while HDL level had inverse significant relationship with SLEDAI (P=0.007), TNF (P=0.01), STNFR1 (P=0.001). There was no significant relation between TG and HDL with STNFR2. Multiple linear analysis of regression showed that three variables (TG, sTNFR1 and sTNFR2) are maintained in the model for prognosis of the disease while TNF-α and HDL are omitted.
Conclusion: Dislipoproteinemia (elevated TG and reduced HDL) correlates with SLE activity following an increase in TNF-α and its soluble receptors. Thus, serum levels of TG, HDL and TNF-α and its soluble receptors are connected with lupus activity and are valuable markers for the disease activity.

Background & objective: Among the most common problems in patients with diabetes mellitus is the faulty healing of foot ulcer wounds which leads to foot or leg amputations. Many attempts were done to treat diabetic foot ulcers. This study evaluated the effect of vacuum-compression therapy (VCT) on healing diabetic foot ulcers.
Materials & Methods: A single-blinded, randomized clinical trial was conducted in Zahedan in 2006. Twenty-two patients with diabetic foot ulcer limbs were used for this study through simple non-probability sampling. Patients were randomly assigned to either an experimental group or a control group. The surface area of the foot ulcer was measured serologically based on Cavalieri’s Principle after 3 weeks and before any intervention. The point counting method was chosen to measure the surface area. In addition to the conventional therapy, the experimental group was also treated with vacuum-compression therapy produced by Vasotrain (VCT). The control group received conventional therapy only, which included debridement, systemic antibiotics, wound cleaning with normal-saline, and daily dressings. Independent-samples t-test and paired t-test allowed for comparisons between the pretreatment and post-treatment test results between groups and within groups, respectively.
Results: The mean of foot ulcer surface area decreased from 48.05±10.3 mm2 to 34.6±4.4 mm2 in the experimental group (P<0.01) and also from 59.9±14.4 mm2 to 56.8±13.8 mm2 in the control group (P<0.01). The surface area of the foot ulcer in the experimental group and control group decreased by 28.4 percent and 6 percent respectively (P<0.05). After the treatment a significant decline in the surface area of the foot ulcer was observed within the experimental group in comparison to the control group (P<0.01).
Conclusion: Vacuum-compression therapy enhances diabetic foot ulcer healing when used in conjunction with appropriate wound care. It is recommended that patients with diabetic foot ulcer and non-healing wounds achieve wound healing and limb preservation by using a vacuum-compression therapy.

Background and Objective: Prolonged pregnancy influences different aspects of maternal and neonatal health. Although it is generally accepted that drug intervention is necessary before labor in prolonged pregnancy, there is still debate about the termination time of the pregnancy. Regarding the high prevalence of prolonged pregnancy we studied the neonatal health in the  hospitalized women with prolonged pregnancy in kashan, in 2002-2003.
Materials and Methods: This descriptive study was carried out on 450 women at gestational age over 40 weeks (based on their LMP or sonography before 30 weeks) admitted for termination of pregnancy by induction. The cases had no obstetrical problems. Neonatal health including type of delivery and dystocia, fetal distress, meconium, apgar in 5 minutes, NICU (neonatal intensive care unit) stay and weight were recorded and the cases were categorized into 4 groups based on gestational age: 40 weeks to 40weeks and 3days, 40weeks and 4days to 41weeks, 41weeks and 1days to 41weeks and 3days and 41weeks and 4days and more. The results were analyzed by descriptive statistics chi-square, Kruskal-Wallis, and Mann-Whitney.
Results: The results showed that studied women terminated their pregnancy as follows: 131 individuals (29/1%) terminated their pregnancy during 40 to 40weeks and 3 days, 150(33.3%) during 41 weeks and 1 day to 41 weeks and 3 days, and only 39 women (8/7%) terminated their pregnancy after 41weeks and 3days, 12 (2/7%) of whom were over 42 weeks. There was no significant difference between women in fetal stress, meconium, apgar in 5 minutes, NICU stay, neonatal weight, type of delivery and dystocia. However, the studied groups differed singnificantly in terms of cesarean cause based on pregnancy. Statistical tests showed that the studied groups in terms of mother's age (P=0.4), the history of prolonged pregnancy (p=0.08), number of parities (p=0.7), dilatation (p=0.2), cervix effacement based on pregnancy age had no significant difference.
Conclusion: Based on the study results, termination of pregnancy prior to 41.5 weeks of gestational age due  to fear of neonatal outcome is not necessary. Pre- term intervention  can cause enhancement of cesarean. Thus, pregnancy termination could be delayed in pregnant women who are under control and have no compilcations.

Background and Objective: In recent years, management of patients with chronic low back pain has been focused on transversus abdominis and multifidus muscles. The evidences have demonstrated dysfunction of these muscles in these patients. This study was aimed to compare the usefulness of motor-control exercises and conventional exercises on the lumbar local stabilizing muscles thickness, activity limitation and pain in patients with chronic low back pain.
Materials and Methods: A double-blind, randomized clinical trial was conducted at Razmjo-Moghadam Physiotherapy Clinic, Zahedan University of Medical Sciences, in 2006-2007. Forty-nine patients with chronic low back pain were randomly assigned to either a motor-control (n=25) or a conventional exercise (classic abdominal and back extensor exercises) group (n=24). Before and after intervention, multifidus and abdominal muscles thickness (mm) was measured using a 7.5 MHz B-mode transducer ultrasound, pain and activity limitation (both ordinal) were assessed using visual analog scale and Back Performance Scale, respectively. A 16 session exercise program, for 8 weeks, twice weekly, and 30 minutes per session was performed for both groups. Independent T-test, Mann-Whitney, paired T-test and Wilcoxon tests were used for comparing the pre-treatment and post-treatment inter-group and intra-group test results, res pectively.
Results: The mean transversus abdominis thickness increased from 1.87±0.63 mm to 2.39±0.63 mm in the motor- control group and from 1.93±0.49 mm to 2.22±0.47 mm in the conventional group (P<0.0001). The mean multifidus thickness increased from 8.63±2.37 mm to 9.69±2.49 mm in the motor control group and from 8.83±1.53 mm to 9.26±1.56 mm in the conventional group (P<0.0001). There was no significant difference between the two groups after treatment with the exception of pain severity (P>0.05). More pain relief was achieved in motor- control group (P=0.015).
Conclusion: The results showed that both motor-control and conventional exercises can cause increase in transversus abdominis and multifidus thickness, lumbar mobility and pain reduction in patients with chronic low back pain with no signs of spinal instability. However, the motor control exercises are more effective than conventional exercises in pain reduction.

Background and Objective: Sulfur mustard is a potent chemical vesicant warfare agent that remains a significant military and civilian threat. Inhalation of sulfur mustard gas causes inflammation and injury to airways and bronchioles. Mast cells promote allergic reactions when exposed to some chemical compounds such as HD. Hexamethylenetetramine has been shown to protect human lung cells against HD toxicity and has also been shown to be effective against the chemical warfare agent phosgene in vivo. The aim of this study was to evaluate the effects of HMT on the number of mast cells in the lamina propria of visceral layer of pleura in male rats after exposure to sulfur mustard. Materials and Methods: Twenty seven Albino Wister male rats weighting 200±20 gr were randomly divided into 5 groups (Normal Saline (N.S), HMT, HD, Pre-exposure and Post-exposure). HD, Pre-exposure and Post-exposure groups received sulfur-mustard and N.S group received Normal Saline as a solvent by intratracheal catheter. HMT, Pre-exp and Post-exp groups received HMT via intra-peritoneal for 14 days. After the day 14, body weight changes, the rate of lung tissue injury and the number of mast cells measured in the pleura's visceral layer of the rats' lungs. Results: Histological examination and mast cells count showed no significant difference when compared among NS, HMT, Pre-exposure and Post-exposure groups. However, significant reduction was seen in the number of mast cells in HMT and NS groups in comparison with the HD group (p < 0/001). The number of mast cells in the Pre-exposure and Post-exposure groups was also significantly lower than that of the HD group (p < 0/001). Conclusions: From the results of this study it can be concluded that HMT may have a positive protective and therapeutic effect on lung tissue in rats. Key words: Sulfur mustard, Lung, Mast cell, Hexamethylenetetramine, Rat

Background and Objective: There is a strong relationship between trigger points with neck pain and headache. This study aimed to compare the effects of muscle energy technique using low-level laser on reducing neck and shoulder pain and disability in patients with myofascial trigger points in the upper trapezius and levator scapula muscles. Materials and Methods: This double-blinded randomized controlled trial was performed in Zahedan in 2009. Thirty patients with trigger points in the upper trapezius and levator scapula were randomly assigned to one of the three groups in equal numbers. In the laser group, a low-level Ga-As laser was applied with a pulse duration of 200 ns and 6 J/cm2 dosages. By contrast, in the muscle energy group, we used stretching following post-isometric relaxation, and in the placebo group used low-level laser without an output. A 10-session treatment program was performed for each group. Prior to and following the intervention, We assessed the cervical ranges of motion with a goniometer, and neck and shoulder pain and disability with Neck Disability Index and Shoulder Pain and Disability Index respectively. Paired t-test and one-way Anova were used for data analysis. Results: The data shows that the neck pain decreased from 8.2 ± 1.2 to 3.5 ± 0.85 in the muscle energy group, and from 8.4 ± 1.4 to 2.6 ± 1.2 in the laser group. The shoulder pain and disability decreased from 102.9 ± 10.7 to 24 ± 10.3 in the muscle energy group, and from 104.7± 11.8 to 22.6 ± 10.7 in the laser group (P<0.05). There were no significant differences seen between the two treatment groups regarding either the neck and shoulder pain or disability or ranges of motion (P>0.05). Conclusion: The results show that low-level laser and muscle energy technique are both equally effective in decreasing the neck and shoulder pain and disability in patients with myofascial trigger points in trapezius and levator scapula muscles.

Background and Objective: Photodynamic therapy is a treatment that uses photosensitizer and intense visible light. When photosensitizers get exposed to a specific light wavelength (preferentially in the red region), they produce reactive oxygen species that are toxic to cells. Recently, attention has been focused on porphyrins and their analogs as photosensitizers. Zn (II) tetrapyridinoporphyrazin complex is a water-soluble photosensitizer that has a good potential for application in photodynamic therapy. In this study, phototoxic effect of this complex on HeLa cancer cell line has been investigated. Materials and Methods: HeLa cell cultures were treated with different concentrations of Zn (II) tetrapyridinoporphyrazin. The cytotoxic effects were measured both in the presence and absence of light using the MTT assay. The light source was a 150W tungsten halogen lamp equipped with a red filter. Results: Our data indicate that porphyrazine’s photocytotoxicity is remarkably more significant than its cytotoxycity in the dark. Statistical analysis showed the effective dose (ED50) values in the dark and light conditions were 8.6 and 4.2 µM, respectively. In addition, the results imply that in the range of 0-12 µM, the increase in the complex concentration correlates with the increase in the cytotoxicity effect. However, the cytotoxicity decreases at the higher concentration (50µM), which is likely due to aggregation of the complex. Conclusion: Our results show that Zn (II) tetrapyridinoporphyrazin complex may be a promising photosensitizer for innovative photodynamic therapy and may have a high potential application in cancer treatment. Furthermore, it seems to have more benefits compared to other known photosensitizers.

Background and Objective: Muscle weaknesse particularly in association with quadriceps muscle is known as a risk factor in the development and progression of knee osteoarthritis (KOA). The objective of this study was to compare quadriceps muscle strength (QMS) between asymptomatic controls and KOA patients and to elucidate its relationship with knee pain and radiographic changes.

Materials and Methods: 77 patients with mean age of 53.6 ± 9.8 years and 75 asymptomatic controls with mean age of 55.8 ±2.8 (p=0.06) and respective BMI of 28.3±4.7 and 25.8 ±2.7 kg/m2 comprised the study. Diagnosis of KOA was confirmed by the criteria of American College of Rheumatology. QMS was determined by dynamometry method radiographic changes were assessed through Kellgren-Lawrence method, and Knee pain was measured using WOMAC index.ْ Statistical analysis was performed to compare QMS between two groups and to evaluate the relationship of QMS to knee pain and radiographic changes.

Results: QMS in both limbs of the experimental group was significantly lower than the control group. The magnitude of reduction in both limbs was significantly lower in men (30.1%) than in women (31.6%) (p=0.002 and p=0.001, for both limbs). There was no relationship between QMS and knee pain or radiographic changes.

Conclusion: In knee osteoarthritis, quadriceps muscle strength is lower compared with healthy controls regardless of pain or radiographic changes.

Background and Objective: Behcet's syndrome is a chronic vasculitis disease that affects multiple organs, including the eyes. Since the involvement of eyes due to inflammation can lead to blindness, therefore it is important that the identifying factors that are associated with increased inflammation be recognized. In recent years the potential role of mineral elements such as zinc in inflammatory conditions has been suggested. The aim of this study was to evaluate the level of zinc in Behcet's disease with eye involvement.
Materials and Methods: This cross-sectional study was carried out on 75 patients with Behcet's disease who were divided into three groups consisting of active uveitis, without uveitis and improved uveitis. Venous blood samples were collected from all patients to measure zinc levels using ELISA. Data were analyzed using SPSS software.
Results: The mean serum zinc level was 130 ± 89/44 in patients with active uveitis, 147 ± 92/26 in the group with improved uveitis and 146 ± 92/24  in the control group. In patients with active uveitis serum zinc levels were lower than the other two groups but this difference was not statistically significant.
Conclusion: In this study, there was no significant reduction in serum zinc levels in active uveitis group. Therefore, unlike similar studies, we could not find evidence to claim that Behcet's disease is associated with zinc deficiency and its effects on the exacerbation of ocular inflammation at least in our patients. Therefore, further studies with a larger population of patients and more accurate methods of measurement can be helpful to elucidate such relation.

Background and Objective: Nowadays, colors are widely used in various food industries, including sweets, confectionery, ice cream, beverages, and so on. Colors can have asthma-like complications, hyperactivity in children and cancers. Therefore, the aim of this study was to evaluate the direct mutagenic effect of several types of natural colors via Ames method.
Materials and Methods: After preparation of 6 natural colors from three different brands, their direct mutagenesis was investigated by Ames test. In this test, the strains of Salmonella typhimurium TA98 and TA100, carrying the selective mutation in His-Hiscoprotein Histidine, were cultured on glucose culture medium at least in the presence of color samples, and only the bacteria that had His + mutation were colonized.
Results: Direct mutagenicity of the food colors was measured by counting colonies in the plates containing edible color and comparing it with negative controls. The results showed that the number of referent colonies in plates containing cherry red and golden yellow for company B for both strains and the dark brown color of company B and C, and orange color for TA100 and TA98 strains in some concentrations were more than twice comparing the negative control plates and had direct mutagenic effects. The dark green and light green colors of the A, B, C, and golden yellow for companies A, C and cherry red and orange for companies C did not show direct mutagenic activity.
Conclusion: Based on these results, some of the studied colors, despite being declared natural, showed direct mutagenic activity.

Background and Objective: Perioperative myocardial ischemia remains one of the most serious complications of cardiac surgery. This study aimed to evaluate the effect of bolus esmolol versus its infusion on hemodynamic responses after laryngoscopy and intubation in patients undergoing coronary artery bypass grafting (CABG).
Materials and Methods: This double-blind randomized clinical trial was conducted on 75 patients that were allocated into three groups. In the infusion group, 10 minutes prior to laryngoscopy 0.5 mg/kg esmolol was injected, and then, 200 µg/kg/minute esmolol was infused. In the bolus group, 2 minutes prior to the laryngoscopy 1.5 mg/kg bolus dose of esmolol was injected intravenously. In the control group, a bolus dose of normal saline was administered. Heart rate (HR), Systolic (SBP) and diastolic (DBP) blood pressures and mean arterial pressure (MAP), were recorded every one minute from 10 minutes prior to laryngoscopy to 10 minutes after intubation. Repeated measure ANOVA was applied as statistical analysis.
Results: SBP was at the lowest rate since laryngoscopy was started until 10 minutes after intubation in the esmolol infusion group (P= 0.029). From the initiation of laryngoscopy to 6 minutes after the intubation, DBP was at the lowest rate in the infusion group. There was a significant difference between the groups regarding DBP changes during the measurement. ANOVA model showed that interaction between time and groups on SBP, MAP, and HR (P< 0.05).
Conclusion: According to our results, the exact doses of esmolol infusion significantly reduced the level of SBP during intubation, compared with bolus esmolol.

Background and Objective: Oral mucositis (OM) is one of the most painful, and disabling oral inflammatory conditions caused by chemotherapy. This study aimed to determine the pomegranate seed oil (PSO) effect on improving chemotherapy-induced mucositis.
Materials and Methods: This single-blind, randomized, clinical trial recruited patients with chemotherapy-induced mucositis in the oncology ward of Shahid Beheshti Hospital in Kashan, Iran, in 2018 (n = 70). Patients were divided into two groups by randomized block design. The control group was treated with 15 ml of routine mouthwash 4 times daily for 14 days. The intervention group was treated with mixed solution of routine mouthwash and PSO (50:50). The mucositis severity was evaluated on the 1st, 7th and 14th days after the intervention using a checklist for assessing the mucositis severity. Data were analyzed using Chi-square, Fisher's exact, independent t and repeated measures ANOVA tests.
Results: The subjects’ mean ages in the intervention and control groups were 57.48±14.742 and 58.81±14.134 years, respectively. Groups were matched for clinical and demographic characteristics (P>0.05). The mean mucositis severity in the intervention group decreased from 1.97 on the 1st day to 0.52 on the 7th day and to 0.03 on the 14th day (P<0.001). The rates of mucositis severity in the control group were 1.98, 1.47 and 0.63, respectively on these days (P<0.001).
Conclusion: The mouthwash containing PSO improved chemotherapy-induced mucositis further than the routine mouthwash. Therefore, PSO can be used along with routine medicinal solutions to relieve and prevent oral mucositis symptoms.

Background and Objective: Mesenchymal stem cells (MSCs) promote metastasis in colorectal cancer; however, the mechanism underlying this process is not fully understood. Epithelial to mesenchymal transition (EMT) is a key step in tumor acquisition of metastatic phenotype. We aimed to investigate the effect of MSCs on the expression of EMT markers, as well as cancer stem cell markers in HT-29 colorectal cancer cells.
Materials and Methods: MSCs were isolated from bone marrow tissue, and their multi potency was confirmed. The HT-29 cell line was prepared and co-cultured with MSCs for 3 days using 6-well transwell co-culture plates (membrane pore size: 0.4 µm). Cell morphology was observed by inverted microscopy. The expression levels of EMT-related genes, namely E-cadherin, Vimentin, and β-catenin, were investigated by the RT-qPCR method. Also, the surface expression levels of CD44 and CD133 cancer stem cell markers were analyzed by flow cytometry.
Results: The co-culture of HT-29 cells with bone marrow-derived MSCs resulted in changes in cell morphology from epithelial to mesenchymal forms. The expression of mesenchymal stem cell markers, namely Vimentin and β-catenin, were significantly increased (2.25 and 1.83 folds, respectively), while the expression of the epithelial marker, E-cadherin, was reduced (0.3 folds). The expression of CD133 was also increased (51.5%).
Conclusion: Tumor-resident mesenchymal stem cells can promote colorectal cancer metastasis inducing EMT as well as increasing cancer stem cell frequency in the tumor microenvironment. It seems that direct contact between MSCs and colorectal cancer cells is not required for the interaction. Our findings may help scientists to find effective strategies against cancer metastasis by targeting tumor-resident MSCs.