Background and Objective: Tracheal intubation can result in trauma and nerve damage which may also account for postoperative throat symptoms such as hoarseness and dysphagia. The effects of beclomethasone inhaler and intravenous lidocaine in prevention of the above symptoms were documented in previous studies. The aim of the present study is comparison of the effects of beclomethasone inhaler with various clinically used dosages of intravenous lidocaine prior to endotracheal intubation on the incidence and severity of postoperative sore throat, cough, sputum, hoarseness, and dysphagia. Materials and Methods: A total of 120 patients undergoing elective operations were enrolled in this randomized double-blind clinical trial. Patients were assigned to one of four treatment modalities: lidocaine 1mg/kg (group L1), lidocaine 1.5 mg/kg (group L2), a dose of 50 micrograms beclomethasone inhaler (Group B), and normal saline (Group C). Incidence and severity of sore throat, cough, sputum, hoarseness, and dysphagia were compared between the groups before leaving the operating room, 1 hr later, at the time of the first postoperative drink or meal ( for assessment of dysphagia), and in the morning after the surgery. Results: In all time intervals of evaluating postoperative symptoms, the incidence and severity of sore throat were significantly lower in groups L2 and B than in group C (P <0.05). One and twenty hours after emergence of anesthesia, the incidence and severity of cough were significantly lower in groups L2 and B than in group C (P <0.05). The incidence and severity of sore throat or cough was not significantly different between groups L2 and B. Throughout the study, the incidence and severity of sputum were significantly lower in group B than in group C (P <0.05). Conclusions: Beclomehtasone in comparison with intravenous lidocaine prior to intubation decreases the postoperative sore throat and cough. In addition, beclomethasone inhaler decreases the incidence and severity of postoperative sputum.

Background and Objective: Generalized Anxiety Disorder (GAD) is one of the most common psychological disorders characterized by excessive and uncontrollable worry and it has ahigh comorbidity with other anxiety disorders and depression. The aim of this study was to compare the efficacy of metacognitive therapy (MCT), pharmacotherapy and neurofeedback treatment in treating Iranian patients with GAD.
Methods and Materials: 42 outpatients meeting DSM-5 criteria for GAD who had been referred to Sohravardi clinical psychology and psychiatry center in the city of  Zanjan were chosen on the basis of convenient sampling and were randomly assigned into three treatment groups: metacognitive therapy (n=14), pharmacotherapy (n=14) and neurofeedback treatment (n=14). All patients in each group were treated for 8 weeks. The General Anxiety Disorder Scale (GAD-7) was administered blindly Pre and Post intervention.Alpha brain waves in the occipital area (O1 and O2) using neurofeedback (pro-comp-5) were registered Pretest and Posttest. Throughout the research, 36 patients remained in the study while 6 patients forfeited. The results were analyzed using ANCOVA, ANOVA, Kolmogorov–Smirnov test, ANOVA with repeated measures and post hoc test.
Results: The ANCOVA and post hoc results showed that neurofeedback, MCT and pharmacotherapy led to significant improvements in GAD-7. Also regarding alpha amplitude enhancement, the results indicated that neurofeedback led to a more significant increase when compared to MCT and pharmacotherapy.
Conclusion: It seems that neurofeedback is more effective than MCT and pharmacotherapy for the treatment of GAD and the results of this study confirm the effectiveness of O1-O2 protocol (alpha brain wave amplitude increase) in GAD symptoms severity improvement.

Background & Objective: Lifestyle is an important factor in determining family and community health. Therefore, the current study aimed to determine the status of mothers' lifestyle in Zanjan province, Iran.
Materials & Methods: The study is part of a national cross-sectional project implemented by the National Institute for Medical Research Development (NIMAD) in Iran. This study used multi-stage cluster sampling and included 1039 mothers from Zanjan province in 2015-2016. The data gathering tools were the lifestyle questionnaire (LSQ) and a demographic questionnaire. Data were analyzed by SPSS 20.
Results: The results showed that the lifestyle status of 4.6% of the mothers was lower than the normal level, 89.3% at the normal level, and 6.1% was good. Mean and standard deviation of the total lifestyle of mothers was 2.01±0.31. Evaluating the mean of lifestyle components showed that the highest mean of lifestyle status in mothers in Zanjan province was related to drugs avoidance (M=2.65) and the lowest mean was related to sport and health components (M=1.44).
Conclusion: The lifestyle status of the studied samples was predominantly at normal level. However, their status in such components as exercise and health, environmental health, weight control, nutrition, and physical health was not very favorable, which makes it necessary to plan more precisely in this area. Results showed that mothers living in the city had a significantly better lifestyle than those living in rural areas. Findings also indicated that mothers with a higher level of education had a better lifestyle than those with a lower level.

Background and Objective: Migraine is a neurological syndrome that involves one-way or two-way recurrent headaches with a moderate to severe severity and lasts from 2 to 72 hours. Chronic migraines occur for about 3 months and at least 15 days or more per month, with a global incidence of 1.4 to 2.2 percent. The aim of this study was to compare the effectiveness of neurofeedback and transcranial direct current stimulation (tDCS) in reducing symptoms of women with migraine.
Materials and Methods: This is a quasi-experimental study with pre-test, post-test, and follow-up for 2 months. The sample consisted of 20 migraine patients aged 15-55 years. Initial evaluation (entrance examination and exit), implementation of the Ahvaz Migraine Questionnaire (AMQ), and Blanchard Headache Diary (BHD) were performed. Patients were randomly assigned to the neurofeedback treatment group (N=10) and tDCS (N=10). Subjects of each group were evaluated 4 times consisting before intervention. The data were analyzed using SPSS 23 software.
Results: The results of Mann-Whitney U test indicated that there was no significant difference between the two treatments during the stages of evaluation in the severity, duration, and number of pain attacks per month. The results of Friedman test showed that there was a significant difference between the severity of headaches and the number of pain attacks in one month in the treatment groups during the stages of evaluation, but the duration of pain relief in each group in the evaluation steps did not differ significantly.
Conclusion: Neurofeedback and tDCS treatments reduce the symptoms of migraine disease, but there is no significant difference between the two treatments in terms of headache symptoms improvement.

Background and Objective: Given the importance of the benefits of natural childbirth and the complications of recurrent cesarean section, we have conducted the present study to determine the maternal and neonatal complications of natural childbirth after cesarean section.
Materials and Methods: In this case-control study, the obstetric complications of 84 women who had undergone a previous cesarean delivery referred to Baqiyatallah Hospital in 2018 for vaginal delivery after cesarean section (VBAC) delivery compared with 84 women with a previous vaginal delivery, who intended to give birth vaginally for the second delivery. Demographic, anthropometric, obstetric, and perinatal data of them were collected and registered in a researcher-developed form. Two groups were compared using the t-test and chi-square test.
Results: The mean age in VBAC and control group was 30.49±6.83 and 32.08±7.28 years, respectively (P=0.15). There were not any occurrence of urinary rupture, bladder rupture, stool control disorder, uterine rupture, nephrotic infection, and ICU hospitalization of the mothers in the two groups. Regarding puerperal infection (3.57% in the VBAC group and 4.76% in the control group, P=0.69) and hospitalization of neonates in ICU (9.52% in the VBAC group and 5.95% in the control group, p=0.39), there was no significant difference between the two groups.
Conclusion: It seems that the overall incidence of obstetric complications in women attempting vaginal birth after cesarean delivery is low and not higher than those with prior vaginal delivery. Therefore, for the achievement of benefits of natural childbirth for both the mother and the fetus, women with a prior cesarean should be offered VBAC.

Background & Aims:  This study was carried out to compare the efficacy of tocilizumab versus rituximab in the treatment of refractory rheumatoid arthritis.
Materials & Methods: Twenty-two women with refractory rheumatoid arthritis were randomly divided into rituximab (n= 11) and tocilizumab (n= 11) treatment groups. In the first group, rituximab was injected intravenously at a dose of 1 gram. In the second group, tocilizumab was injected subcutaneously at a dose of 20 mg /2 weeks for 6 months. Before the intervention, intensity was measured according to visual analog scale (VAS), along with vital signs and side effects. After 6 months, the clinical disease activity index (CDAI), pain intensity, tender joint count (TJC for 68 and 28 joints) and swollen joint count (SJC for 66 and 28 joints) were assessed. SPSS version 26 was used for data analysis.
Results: The mean age for rituximab and tocilizumab groups was 54.63 (±10.76) and 49.91 (±11.14) years, respectively. After 6 months of follow-up, the means of TJC (68 and 28 joints), SJC (for 66 and 28 joints), CDAI and pain intensity were not significantly different in the rituximab and tocilizumab groups (P>0.05). However, the mean of all the above-mentioned items before and 6 months after follow-up was statistically significant within each of the rituximab and tocilizumab groups (P<0.05).
Conclusions: The efficacy of tocilizumab and rituximab in the treatment of refractory rheumatoid arthritis was similar, therefore, both drugs can be used to treat these patients.