Background and Objectives: Tennis elbow or lateral epicondylitis disease is caused by overuse of forearm muscle, and tension of carpi radialis brevis tendon. Since there are no accepted criteria for treatment of the disease, this study was conducted with the aim of comparative efficacy of four non-surgical treatment procedures in Shahrekord in 2003.
Materials and Methods: This double blind clinical trial investigated the efficacy of four non-surgical procedures in 120 patients (4 groups of 30) with mean age of 37 as follows: 1) local corticosteroid injection (20 mg of methylprednisolone + lidocaine), 2) administration of NSAID (500 mg of naproxen b.i.d for 2 weeks), 3) forearm supportive bands, 4) physical therapy and progressive exercise. The elbows of all patients were immobilized by cast for two weeks and they were advised to avoid repetitive arm movement for 21 days. The first evaluation was carried out before treatment and the data were recorded. Overall recovery evaluation was conducted in the 1st, 3rd, 6th and 9th months post – treatment through a 24-score standard and the data were analysed using SPSS version 12 software and paired t test.
Results: In the first evaluation the mean calculated score was 19.04 for all groups. In post-treatment period the results were as follows: by the end of the first month the scores for 4 groups were 6, 8, 11 and 12 respectively, by the end of the 3rd month 9, 11, 8 and 8 respectively by the end of the 6th month 9, 8, 6 and 5 respectively and by the end of the 9th months 8, 8, 5 and 3 respectively. Differences in mean score were statistically significant except the 3rd month which showed no significant difference (p=0.05). Furthermore, final score of the first month showed the highest difference in corticosteroid-treated group with pre-treatment period compared to other groups (p=0.001). By the end of the 9th month the change in final score in physical therapy group was the highest which showed a significant difference (p=0.005).
Conclusion: Local injection of corticosteroid is an effective method to relieve the pain in patients suffering from tennis elbow. However, recurrence of the disease is common during a tree-month period and the results at the end of the 9th month in physical therapy and exercise group is promising. Thus, the choice non-surgical treatment for the disease is probably the initial corticosteroid injection followed by long term physical therapy.

Background & objective: FMF is an autosomal recessive genetic disorder characterized by acute episodes of fever accompanied by severe abdominal pain, pleurisy, arthritis, and skin rashes. Clinical symptoms of the disease vary considerably in patients, and little is known about the origin of this variation. This study investigates a male patient suffering from severe FMF and his parents.
Materials & Methods: The subject was a six-month-old boy with recurrent fever accompanied by severe abdominal pain and skin rashes. Molecular screening was conducted through polymerase chain reaction (PCR) and sequencing exon10 of MEFV gene.
Results: The investigation to indentify common mutations، using ARMS-PCR and exon 10 sequencing revealed an M697/M680I compound heterozygote mutation in exon 10 of the related gene. Patient′s father and mother were heterozygote for mutations M680I and M694V, respectively without having the history of FMF attacks.
Conclusions: It seems that accompaniment of mutations M680I and M694V even in compound heterozygote form might lead to severe phenotype FMF. This is the first report of early onset and severe phenotype FMF case associated with a 694V/680I compound heterozygote mutation in Iran.

Background and Objective: Familial Mediterranean Fever (FMF) is an autosomal recessive disorder characterized by self-limited episodes of fevere and painful recurrent polyserositis that predominantly affects Mediterranean races. In recent years some reports have shown high prevalence of FMF in North-west Iran, with M694V and E148Q being most frequent reported mutations. The aim of this study is to evaluate the clinical manifestations of FMF in patients with these mutations. Materials and Methods: A cross sectional- descriptive study was performed in a 1 year period (January 2007 – January 2008). 71 patients younger than 18 years with clinical diagnosis of disease proved in Children Hospital of Tabriz-Iran were referred to genetic lab for mutation analysis. ARMS-PCR & PCR-RFLP were used to detect mutations. Only 45 patients were shown to have identified mutations and 41 patients among them had M694V and E148Q mutations which were assessed for various clinical manifestations. Results: M694V and E148Q mutations were seen in 55.7% and 35.5% patients respectively. Patients homozygous for M694V were found to have earlier age of onset, longer duration of attacks, higher prevalence of positive family history and more complications. In our patients, prevalence of some manifestations differed from other ethnic groups reported previously. Conclusions: M694V mutation in FMF patients especially in homozygous state is accompanied with more severe disease and more complications.

Background and Objective: Acne is one of the medical problems and propionibacterium acnes is the pathogenic agent that has received a considerable attention. Different parts of Juglans regia have been shown to have antibacterial activity on many bacteria. Its leaves have antioxidant property and if it shows antibacterial effect on propionibacterium acnes, it might be an alternative drug for the treatment of this problem. Therefore, this study was aimed to determine the antibacterial effects of walnut leaves on propionibacterium acnes in vitro. Materials and Methods: In this experimental study, ethanolic extract of walnut leaves was examined for antibacterial activities on propionibacterium acnes using the disk-diffusion minimum inhibitory concentration (MIC), minimum bacterial concentration (MBC) and macrodilution methods. Ampicillin (10µg) was used as a positive control. Results: Ethanolic extract of walnut leaves had an inhibitory effect on Propionibacterium acnes using the agar-diffusion and macrodilution methods. The most inhibition zone was 25 ± 1.7 mm in 150 mg/ml concentration. The minimum inhibitory concentration was 12.5 mg/ml while the minimum bactericidal concentration was 15 mg/ml. Conclusion: These findings showed that ethanolic extract of walnut leaves had antibacterial effect on Propionibacterium acnes and may be considered as an alternative drug for the treatment of external infections due to this microorganism.

Background and Objective: The increase in the blood concentration of lipids after meals has a significant effect on induction of atherosclerosis. Vaccinium myrtilus has an antioxidant activity, and in this study, we aimed to determine the effects of this plant on atherosclerosis risk factors. Material and Methods: In an experimental study, 24 male New Zealand rabbits were randomly designated into three groups of 8 rabbits: Group 1, normal diet Group 2, a diet containing 1 % cholesterol and Group 3, a diet containing 1% cholesterol and 2% Vaccinium myrtilus powder. The blood glucose, total cholesterol (TC), triglyceride (TG), apolipoprotein B (ApoB), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), LDL-C (low density lipoprotein), nitrite, nitrate, fibrinogen, and factor VII, which are considered as atherosclerosis risk factors, were measured before the experiment and 3 hours after feeding. The data were analyzed using One-Way Analysis of ANOVA. The P-values below 0.05 (P<0.05) were considered as significant. Results: Consumption of Vaccinium myrtilus significantly decreased the concentrations of LDL-C, TC, aminotransaminases (AST, ALT), ApoB, and fibrinogen compared to the hyper-cholesterolemic diet group (P<0.05). However, there were no significant differences was found between the group taking Vaccinium myrtilus and hyper-cholesterolemic diet group with regard to the serum glucose, TG, factor VII, nitrite, and nitrate (P>0.05). Conclusion: The results of this study show that acute consumption of Vaccinium myrtilus might have a protective effect on some atherosclerosis risk factors.

Background and Objective: Brucellosis is an endemic disease in Iran that has a worldwide spread and is associated with chronic disabilities in humans. Combination therapy of brucellosis leads to recovery of symptoms, shortening of the symptomatic intervals, and decrease in the rate of relapse and drug resistance. Considering the use of rifampin in the treatment of tuberculosis, and the necessity for an alternative treatment in regions endemic for both tuberculosis and brucellosis, in this study we compared the efficiency of the WHO's standard regimen of rifampin-doxycycline (RD) versus ciprofloxacin-doxycycline (CD) for the treatment of brucellosis. Materials and Methods: This randomized controlled trial was performed on 90 patients, affected with brucellosis, who were referred to the Infectious Disease Clinics at Arak University of medical sciences. The patients were randomly divided into two groups: the DR group, received 100 mg of Doxycycline twice a day and 300 mg of rifampin Bid daily for eight weeks and the CD group, received 100 mg of doxycycline plus 500 mg of ciprofloxacin twice a day for eight weeks. The patients were analyzed for the relief of symptoms, drug side effects, and laboratory findings during the treatment. Results: In this study, the rate of symptom relief and laboratory findings in both groups were similar. The relief of symptoms was seen in 93.2% and 83.9% of the patients for the DR and CD groups, respectively (P=0.182). The side effects of the drug were not significant in either groups, with no significant difference, and did not lead to discontinuation of the therapy. Conclusion: Due to the similar efficacy of CD and DR regimens in the treatment of brucellosis and considering the usage of rifampin in regions with high prevalence of tuberclusis, the CD regimen is recommended as an appropriate treatment.

Background and Objective: Articular cartilage abnormalities are important factors of skeletal disorders and usually are related to glycosaminoglycans synthesis in the cartilage tissue. Presence of some vitamins, amino acids, and minerals increases cartilage regeneration. In this study, Medicago sativa (Alfalfa), which is high in some vitamins, amino acids and minerals, was used for cartilage healing of the pinna in rabbits, and glycoseaminoglycans (GAGs) of the extracellular matrix (ECM) were investigated histochemically. Materials and Methods: Four holes (4-mm in diameter each) were punched in the medial portion of each pinna of 10 New Zealand male rabbits (randomly divided into 2 groups), after shaving the hair and anesthetization by 10% lidocaine (total of 80 holes). The ears of the experimental group were treated by alcoholic extract of M. sativa, while the control group was treated by normal saline daily. Samples of regenerating tissue from day 0 through day 50 after the punch were prepared for microscopic studies. A color intensity of Alcian blue in pH 1 for sulfated molecules and in pH 2.5 for carboxylated GAGs and toluidine blue (that has a metacromatic reaction with sulfated GAGs) were considered. Results: In all 3 histochemical staining methods, an early high-color intensity of cartilage was observed in the treated group compared with the control. Furthermore, the closure of the cartilage hole in the treated group happened faster. Conclusion: It seems that the M. sativa extract, probably because of its vitamin and amino acid composition, increases chondroblasts activity for secretion of carboxylated and sulfated GAGs in ECM, which leads to a faster cartilage wound healing. Therefore, the plant extract provides a good candidate for future studies on its potential role in wound healing and pharmacological applications.

Background and Objective: Adhesion bands comprise the most important unpleasant consequences of pelvic surgeries. Green tea (Camellia sinensis), due to its anti-oxidant and anti-inflammatory effects and prevention of production and accumulation of collagen seems to be beneficial in this event. Therefore, the present study was designed to elicit the effect of alcoholic extract of green tea on intra-abdominal adhesions. Materials and Methods: In this experimental study 30 healthy male Wistar rats were randomly assigned to two equal groups one group taking green tea (A) and the other group taking normal saline (B). After anesthesia, their abdominal wall was opened, three longitudinal and transverse incisions of 2 cm in length were made on the right side of peritoneal surface and a 2×2 cm piece of the left abdominal wall peritoneum was removed. Then, 4 ml green tea extract or normal saline was introduced into the abdominal cavity of the rats. Two weeks later in the second laparotomy, the adhesions were graded according to the strength, extent and appearance. Data were analyzed by Mann-Whitney test, using SPSS v.16. Results: There were significant differences between the scores of groups A and B (P=0.001). The median adhesion scores were 3 and 8 in groups A and B, respectively. Conclusion: The results of this study provide the evidence that green tea extract has a potential capacity to effectively prevent postoperative intra-abdominal adhesions in rats and might be beneficial during clinical surgeries.

Background and Objective: Ischemia in the brain of rats causes intensive neural injuries leading to learning and memory disorders in addition to pain. Ellagic acid is a polyphenol compound with antioxidant properties which is found in fruits like pomegranate, blackberry and all types of mulberry. The objective of this study was to investigate the effect of 14-day prescription of different doses of ellagic acid on memory, learning and pain followed by general ischemia in the brain of rats. Materials and Methods: In this study, 50 Wistar rats in weight range of 200-250 g were randomly placed in five different groups. To induce ischemia, common carotid arteries were separated from both sides, blocked from both parts and cut from the middle part. Memory was evaluated using passive avoidance learning test (shuttle box) and pain threshold was assessed using tail- flick device. Results: Ischemia caused reduction of memory (p<0.01) and pain threshold (p<0.001). Prescription of 10, 25 and 50 mg/kg doses of ellagic acid, particularly 50 mg/kg, led to improvement of defects in memory (p<0.01) and reduction of pain (p<0.001). Conclusion: It seems that using ellagic acid can reduce intensity of neural disorders caused by ischemic hypo-perfusion due to its antioxidant property and inhibition of free radicals.

Background and Objective: Clinically significant changes in central nervous system (CNS) function are observed following brief periods of CNS blood flow interruption. Stroke patients exhibit cognitive, emotional, and electrophysiological changes during the recovery phase. Lavender belongs to the Labiatae family and is used for a variety of cosmetic and therapeutic purposes in herbal medicine. This study investigates the effect of ethanolic extract of lavender on cerebral edema in a rat stroke model. Materials and Methods: Lavender extract was injected intraperitoneally (100 mg/kg and 200 mg/kg) for 20 consecutive days. 2 hours after the last dose cerebral artery ligation surgery was performed. 24 hours after the induction of ischemia, cerebral edema was assessed. Also, antioxidant capacities of plasma and brain tissue were assessed in the intact groups. Results: This study shows that treatment of rats with ethanolic extract of lavender caused a significant decrease in brain water content compared with ischemia group. Lavender extracts increased antioxidant capacity in serum and brain tissue in the intacts compared with the control group. Conclusion: The results indicated that lavender extract has neuroprotective activity against cerebral ischemia and the mechanism may be related to augmentation in endogenous antioxidant defense and inhibiting oxidative stress in the rat brain. References 1- Bhuiyan MIH, Kim YJ. Mechanisms and prospects of ischemic tolerance induced by cerebral preconditioning. International Neurourology Journal. 2010 14: 203. 2- Lakhan SE, Kirchgessner A, Hofer M. Inflammatory mechanisms in ischemic stroke: therapeutic approaches. J Transl Med. 2009 7: 97. 3- Warner DS, Sheng H, Batinić-Haberle I. Oxidants, antioxidants and the ischemic brain. J Exp Biol. 2004 207: 3221. 4- Crack PJ, Taylor JM. Reactive oxygen species and the modulation of stroke. Free Radic Biol Med. 2005 38: 1433-44. 5- Chan PH. Reactive oxygen radicals in signaling and damage in the ischemic brain. J Cereb Blood Flow Metab. 2001 21: 2-14. 6- Abramov AY, Scorziello A, Duchen MR. Three distinct mechanisms generate oxygen free radicals in neurons and contribute to cell death during anoxia and reoxygenation. J Neurosci 2007 27: 1129-38. 7- Moopanar TR, Allen DG. Reactive oxygen species reduce myofibrillar Ca2+ sensitivity in fatiguing mouse skeletal muscle at 37 C. J Physiol. 2005 564: 189-99. 8- Vincent AM, Russell JW, Low P, Feldman EL. Oxidative stress in the pathogenesis of diabetic neuropathy. Endocr Rev. 2004 25: 612-28. 9- Simard JM, Kent TA, Chen M, Tarasov KV, Gerzanich V. Brain oedema in focal ischaemia: molecular pathophysiology and theoretical implications. Lancet. 2007 6: 258-68. 10- Omidbaigi R. Production and processing of medicinal plants. Astane Ghods Publications, Mashhad. 2000 3: 106-22. 11- Hajhashemi V, Ghannadi A, Sharif B. Anti-inflammatory and analgesic properties of the leaf extracts and essential oil of Lavandula angustifolia mill. J Ethnopharmacol. 2003 89: 67-71. 12- Rabiei Z, Rafieian-Kopaei M, Mokhtari S, Alibabaei Z, Shahrani M. The effect of pretreatment with different doses of Lavandula officinalis ethanolic extract on memory, learning and nociception. Biomedicine & Aging Pathology. 2013 4: 71-76. 13- Bigdeli MR, Hajizadeh S, Froozandeh M, et al. Normobaric hyperoxia induces ischemic tolerance and upregulation of glutamate transporters in the rat brain and serum TNF-α level. Exp Neurol. 2008 212: 298-306. 14- Rabiei Z, Rafieian M. Effects of Zizyphus jujuba extract on motor coordination impairment induced by bilateral electric lesions of the nucleus basalis of meynert in rat. Physiology and Pharmacology. 2013 17: 469-77. 15- Benzie IF, Strain J. The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: the FRAP assay. Anal Biochem. 1996 239: 70-6. 16- Abdollahi M, Mostafalou S, Pournourmohammadi S, Shadnia S. Oxidative stress and cholinesterase inhibition in saliva and plasma of rats following subchronic exposure to malathion. Comparative biochemistry and physiology part C: Toxicol Pharmacol. 2004 137: 29-34. 17- Astrup J. Energy-requiring cell functions in the ischemic brain: their critical supply and possible inhibition in protective therapy. J Neurosurg. 1982 56: 482-97. 18- Quast MJ, Huang NC, Hillman GR, Kent TA. The evolution of acute stroke recorded by multimodal magnetic resonance imaging. Magnetic Resonance Imaging. 1993 11: 465-71. 19- Wang Y, Hu W, Perez-Trepichio AD, et al. Brain tissue sodium is a ticking clock telling time after arterial occlusion in rat focal cerebral ischemia. Stroke. 2000 31: 1386-92. 20- Rami A, Langhagen A, Steiger S. Focal cerebral ischemia induces upregulation of beclin 1 and autophagy-like cell death. Neurobiol Aging. 2008 29: 132-41. 21- Taghikhani M, Nasri H, Asgari A, et al. The renal toxicity of hydroalcoholic extract of stachys lavandulifolia vahl in wistar rats. Life Sci J. 2012 9: 3025-31. 22- Coyle JT, Puttfarcken P. Oxidative stress, glutamate, and neurodegenerative disorders. Science. 1993 262: 689-95. 23- Alnamer R, Alaoui K, Bouididael H, Benjouad A, Cherrah Y. Sedative and hypnotic activities of the methanolic and aqueous extracts of Lavandula officinalis from Morocco. Adv Pharmacol Sci. 2012 5: 1-5. 24- Rahmati B, Khalili M, Roghani M, Ahghari P. Anti-epileptogenic and antioxidant effect of Lavandula officinalis aerial part extract against pentylenetetrazol-induced kindling in male mice. J Ethnopharmacol. 2013 148: 152-7. 25- Mohagheghi F, Bigdeli MR, Rasoulian B, Zeinanloo AA, Khoshbaten A. Dietary virgin olive oil reduces blood brain barrier permeability, brain edema, and brain injury in rats subjected to ischemia-reperfusion. Sci W J. 2010 10: 1180-91. 26- Baradaran A, Madihi Y, Merrikhi A, Rafieian-Kopaei M, Nasri H. Serum lipoprotein (a) in diabetic patients with various renal function not yet on dialysis. Pak J Med Sci. 2013 29: 33-5. 27- Nasri H. Impact of diabetes mellitus on parathyroid hormone in hemodialysis patients. J parathyr dis. 2014 1: 9-11. 28- Madihi Y, Merrikhi A, Baradaran A, et al. Impact of sumac on postprandialhigh-fat oxidative stress. 2013. in press. 29- Setorki M, Rafieian-Kopaei M, Merikhi A, et al. Suppressive impact of anethum graveolens consumption on biochemical risk factors of atherosclerosis in hypercholesterolemic rabbits. J parathyr dis. 2013 4: 889. 30- Khosravi-Boroujeni H, Sarrafzadegan N, Mohammadifard N, et al. White rice consumption and CVD risk factors among Iranian population. J Health Popul Nutr. 2013 31: 252. 31- Akhlaghi M, Shabanian G, Rafieian-Kopaei M, Parvin N, Saadat M, Akhlaghi M. Citrus aurantium blossom and preoperative anxiety. Rev Bras Anestesiol. 2011 61: 707-12. 32- Roohafza H, Sarrafzadegan N, Sadeghi M, Rafieian-Kopaei M, Sajjadi F, Khosravi-Boroujeni H. The association between stress levels and food consumption among iranian population. Arch Iran Med . 2013 16: 145-8. 33- Azadmehr A, Hajiaghaee R, Afshari A, et al. Evaluation of in vivo immune response activity and in vitro anti-cancer effect by Scrophularia megalantha. J Med Plants Res. 2011 5: 2365-8. 34- Shirzad H, Shahrani M, Rafieian-Kopaei M. Comparison of morphine and tramadol effects on phagocytic activity of mice peritoneal phagocytes in vivo. Int Immunopharmacol. 2009 9: 968-70. 35- Amini FG, Rafieian-Kopaei M, Nematbakhsh M, Baradaran A, Nasri H. Ameliorative effects of metformin on renal histologic and biochemical alterations of gentamicin-induced renal toxicity in wistar rats. J Res Med Sci. 2012 17: 621. 36- Nasri H, Nematbakhsh M, Ghobadi S, Ansari R, Shahinfard N, Rafieian-kopaei M. Preventive and curative effects of ginger extract against histopathologic changes of gentamicin-induced tubular toxicity in rats. Prev Med. 2013 4: 316. 37- Heidarian E, Rafieian-Kopaei M. Protective effect of artichoke (Cynara scolymus) leaf extract against lead toxicity in rat. Pharm Biol. 2013 51: 1104-9. 38- Shirzad H, Taji F, Rafieian-Kopaei M. Correlation between antioxidant activity of garlic extracts and WEHI-164 fibrosarcoma tumor growth in BALB/c mice. J Med Food. 2011 14: 969-74. 39- Nikokar M, Shirzad M. Does royal jelly affect tumor cells? J Herb Med Pharmacol. 2014 2: 45-48. 40- Rafieian-Kopaei M, Baradaran A, Rafieian M. Plants antioxidants: From laboratory to clinic. J Nephropathol. 2013 2: 152.

Background and Objective: Adhesion formation is the commonest complication of abdominal surgery. Bearing an anti-oxidant activity, Silybum marianum may reduce adhesion formation. This study was an endeavor to shed light on the effect of Silybum marianum on intra-abdominal adhesions.

Materials and Methods: In this experimental study, 30 rats were randomly assigned to three groups: treated by 1% and 5% concentrations of the S. marianum extract (groups A and B) and distillated water (group C). After laparotomy, three longitudinal and transverse incisions (2 cm in length) were made on the right wall of the abdomen and a 2×2 piece was removed from peritoneal surface on the left side of the abdominal wall. In groups A, B and C, 3 mL of 1% and 5% of S. marianum extract or distillated water were administered into abdominal cavity of the rats, respectively. After 14 days, adhesion degrees were determined according to the number of adhesion bands (Canbaz scale). Data analysis was performed through SPSS 16 using Kruskal-Wallis and Mann-Whitney tests.

Results: There was a significant difference in adhesion formation among the groups (P=0.023). Adhesion degree in groups A and B were significantly lower than the control group (P<0.05).

Conclusion: S. marianum extract supported a preventive effect on intra-abdominal adhesion in rats, which gives rise to the evidence that it may be similarly effective for human cases. Throughout further clinical studies, this plant and its derived compounds might be applied in the treatment of such complications subsequent to abdominal surgeries.

Background and Objective: Acute bronchiolitis is one of the most common reasons for inflammation, small airways obstruction, and lower respiratory tract infection in infancy. Owing that there has been no study on the efficacy of hypersaline 3% in the treatment of acute bronchiolitis in Iran, the present study was undertaken to deal with this issue.

Materials and Methods: This double-blinded clinical trial was carried out in Hajar Hospital of Shahrekord in 2013-2014. 70 patients under 2 years of age with bronchiolitis were assigned to two groups of 35 each. The first group received nebulized Ventolin while the second group was given nebulized hypersaline 3% three times a day. Subsequent to these administrations, recovery duration was compared in both groups.

Results: The mean and standard deviation of recovery duration in the Ventolin group was 4.14±0.9 days and in the hypersaline 3% group was 3.06±0.6 days. T-test and mean recovery duration was significantly lower in the hypersaline 3% group (P<0.001).

Conclusion: Nebulizer hypersaline 3% had a better therapeutic effect than Ventolin in the treatment of acute bronchiolitis. Therefore, the use of this drug, rather than Ventolin, is recommended for the treatment of acute bronchiolitis in children under two years of age.

Background and Objective: In the modern era, nonalcoholic fatty liver disease (NAFLD) is a huge burden on the shoulders of health systems around the world. On the other hand, lack of a specific and effective therapeutic approach has persuaded scientists to look for new treatments, among which probiotics have recently raised interest. The aim of this study was to investigate the effect of probiotics in non alcoholic fatty liver disease treatment.

Materials and Methods: In this randomized clinical trial, 90 patient were enrelled with NAFLD and divided into two groups: 45 patients in the diet and exercise group, and 45 patients received 500 mg/d Familacat capsules in addition to diet and exercise. Then the serum level changes of FBS, Triglycerides, Cholestrol, AST and ALT as well as weight and blood pressure were compared between the groups.

Results: In the FamiLact group, BMI, FBS, cholesterol, LDL, AST and ALT had improved significantly. In the control group, the only insignificantly changed variable was serum LDL. Comparison of the groups showed a significantly better improvement in the FamiLact group in terms of cholesterol and LDL changes. However in the control group, changes in blood pressure and HDL levels were significantly better.

Conclusion: FamiLact is a safe and effective probiotic in improving blood sugar, BMI and lipid profile values (except for HDL) in patients with NAFLD.

Key words: Probiotic, FamiLact, NAFLD

Background and Objective: Breast cancer is one of the most common cancers in women worldwide. This study was conducted to analyze the factors related to survival of patients with breast cancer using two models of Cox proportional specific-cause and sub-distribution models (direct modeling of cumulative incidence). These patients were at the competitive risk of death from breast cancer and also death due to other causes that the occurrence of any of these events prevented another from happening.
Materials and Methods: This historical cohort study comprised 573 breast cancer patients who had referred to the Mahdieh medical center of Hamedan during 2004 to 2011 and were followed until 2015. To determine the risk factors among the competitive risks, the Cox specific-cause and cumulative incidence models were fitted. The data were analyzed using the SPSS and R softwares.
Results: The findings showed that among the causes of breast cancer death in the cumulative incidence model, only the tumor size had a significant effect (p = 0.0054) and for death due to other causes in the Cox model, the tumor size was also significant (P = 0.033).  However, the other variables in two models had no significant effect on death.
Conclusion: Considering the significance of the tumor size in the survival of breast cancer patients, the Cox model takes no account of the other risk information with censorship, the cumulative incidence function is recommended to be used in modeling the risk factors in breast cancer.