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Abstract Background Low back pain (LBP) is a common disorder and is considered one of the leading causes of disability worldwide, resulting in adverse health, social, and economic outcomes. This study aimed to investigate the effects and durability of 8-week Dynamic Neuromuscular Stabilization (DNS) exercises on pain, functional disability, and quality of life in individuals aged 30 to 50 years with non-specific chronic low back pain (NSCLBP). Methods This research employed a pre- and post-test design with a follow-up period, in which 29 participants (16 in the control group and 13 in the exercise group) remained until the end of the study. Pain intensity, functional disability, and quality of life were assessed using the visual analog scale (VAS), the Oswestry Disability Index, and the SF-36 questionnaire, respectively, before intervention, immediately after, and two months post-intervention. The control group continued their routine daily activities, while the exercise group performed DNS exercises three times a week for 8 weeks. The data was analyzed using a mixed-design ANOVA (P ≤ 0.05). Results The results showed improvements in pain (F (2,24) = 5.31, P = 0.01, η2 = 0.31), functional disability (F (2,24) = 4.17, P = 0.03, η2 = 0.26), and quality of life (F (2,24) = 4.70, P = 0.02, η2 = 0.28) in the exercise group at the Post-test compared to the Pre-test. However, the durability of the exercise effects at the follow-up assessment was not sustainable compared to the Post-test and Pre-test (P > 0.05). Conclusion An 8-week period of DNS exercises can improve pain, functional disability, and quality of life in individuals with NSCLBP. However, a 2-month period of detraining can reduce the positive outcomes of these exercises. Trial registration The researchers retrospectively registered this trial on 21/04/2024, with the identifier IRCT20240107060646N1 in the Iranian Registry of Clinical Trials (IRCT) at the following address: https://irct.behdasht.gov.ir .

Background: Nowadays, increasing the use of pesticides to manage the agriculture production resulted in increased pesticide residues in final products and concerns about environmental pollution and prevalence of emerging diseases. This study aims to investigate the residual amount of Phosalone toxin in the early and late varieties of peach orchards in Saman city located in Chaharmahal and Bakhtiari province. Methods: In this study, 60 samples of early and late peach varieties of peach orchards were selected randomly. Phosalone residues in early and late peach varieties before and after washing, and after peeling were extracted by QUECHERS method and the amount of extracted toxin were measured by high-performance liquid chromatography (HPLC). The data were analyzed using SPSS v.24 software. Results: Phosalone residues in early peach varieties before and after washing were 3.55 ± 0.94 and 0.31 ± 0.29 mg/kg, respectively. The concentration of Phosalone residues in unwashed early and late peach varieties before washing was 3.17 ± 0.97 mg/kg but decreased to 0.64 ±0.74 mg /kg after washing. Peeling reduced 97.79% of the Phosalone residues in late peach. Early and late peaches covered by the plant pathology clinic and unwashed late peaches not covered by plant pathology clinic were significantly (P < 0.05) higher than the Iranian national standard (2 mg/kg). Conclusion: Washing and peeling the peach significantly decreased the toxin residues. In order to minimize the risk of exposure to Phosalone residues, integrated pest control management programs are essential.

Background and aims: Given the prevalence of urolithiasis and the popularity of black radish extract for the treatment of this problem, the present study was designed to investigate its effect in alkalizing urine in stone-forming patients referred to Imam Ali clinic in Shahrekord (Iran). Methods: In this clinical trial, the urine pH was measured along with the 24-hour urine assessment for urine volume and urine citrate, oxalate, calcium, uric acid, and creatinine levels of 20 patients before and after the intervention. Results: The results showed a significant increase (P < 0.001) in mean urine pH after the administration of Raphanus sativus syrup for 14 days. The mean 24-hour urine volume and citrate level increased significantly (P < 0.05). In addition, the mean uric acid and oxalate levels decreased significantly (P < 0.05). Mean changes in 24-hour urine creatinine and calcium levels were not statistically significant after intervention (P > 0.05). Conclusion: Raphanus sativus extract treatment can increase urine pH, urine citrate level, and urine volume and decreases uric acid and oxalate levels. Therefore, the plant may be used for the treatment and prevention of uric acid and cystine stones.

Background and aims: Multiple sclerosis (MS) is one of the most common progressive neurological diseases in young people. Tremor is a common and debilitating symptom in people with MS, significantly affecting their quality of life. This study aimed to evaluate the effect of a self-care program based on a mobile application on tremors in people with MS. Methods: This semi-experimental study was conducted on 72 patients with MS in Chaharmahal and Bakhtiari province in 2019. Samples were selected by convenience sampling and randomly assigned to intervention and control groups (36 people in each group). For the intervention group, a self-care program in the form of a mobile application was installed on their mobile phones and, for two months, used by patients. The use of the program was measured using self-report checklists and telephone tracking. The control group receives routine intervention only. Data were collected before and two months after the intervention using the Fahn-Tolosa-Marin Tremor Rating Scale and analyzed using SPSS software version 21 and descriptive and inferential statistics (chi-square, independent t test, and paired t test). Results: There was no statistically significant difference between the two groups in the mean tremor score before the intervention (P=0.768). However, after the intervention, this difference was significant (P=0.022). Conclusion: According to the findings, teaching a self-care program through a mobile application effectively improves the tremor of patients with MS and can be considered an effective intervention method.

Background and aims: The distraction of thought is a technique in which a pleasant stimulus is presented to the patient. This study aimed to investigate the effect of the distraction of thought by music on pain relief in patients undergoing extracorporeal shock wave lithotripsy (ESWL). Methods: This clinical trial was performed on 120 patients referring to Ayatollah Kashani Hospital in Shahrekord for ESWL in 2019. Patients were randomly divided into two experimental and control groups. In addition to routine care, the experimental group received the natural sound of the event, along with its beautiful scenery, while the control group only received routine care. The pain score was measured by the McGill Pain Questionnaire. The data obtained were analyzed by SPSS (version 18) using paired and independent t-tests and Tukey’s test. Results: The two groups were significantly different in terms of pain changes (P=0.007). The mean difference in addictive drug consumption between the control and experimental groups was significant (P=0 004). Conclusion: Thought distraction by music reduces pain and narcotic use of analgesics by the patients under ESWL.

Background: Chronic Obstructive Pulmonary Disease (COPD) is an irreversible condition and it is of great importance for the patients to practice self-care. Given the impact of inadequate health literacy on people's self-efficacy in a self-care program, the aim of this study was to improve health literacy and self-efficacy in people with COPD. Materials and Methods: The present quasi-experimental study was conducted on 70 patients with COPD admitted to Shahrekord educational hospitals in 2019. Using random allocation software, the samples were randomly divided into intervention and control groups. Data collection tools included three questionnaires including demographic, health literacy, and perceived self-efficacy questionnaires. A training program, with three weekly sessions of theoretical and practical trainings, was conducted for the intervention group in classes in the hospital. The time of each session was 40 min. Data were collected three times i.e., before, immediately after, and three months after the trainings. Data were analyzed by means of SPSS 21 statistical software using descriptive and inferential statistics. Results: Before the intervention, the mean scores of perceived self-efficacy and health literacy did not differ significantly between the two groups, but after the intervention, the scores of the members in the intervention group increased significantly (f = 62.15, p < 0.05). Conclusions: The results of the study indicated an increase in the scores of perceived self-efficacy and health literacy in people with COPD. The use of targeted educational interventions can have a positive effect on the treatment and control of the disease.

Backgroundand Aim. Natural organic matter (NOM) has become one of the most serious environmental problems due to its persistence in aqueous solutions and the risk of carcinogenesis. In this study, the removal efficiencies of real and synthetic humic acid (HA) by multi-walled carbon nanotubes (MWCNTs) coated with iron oxide were evaluated. Materials and Methods. The MWCNs were synthesized and coated with iron oxide. In addition, the effects of pH, contact time, mixing speed, and adsorbent dose on the removal efficiency of NOM by MWCNTs-Fe3O4 were studied. Then, the removal efficiency of NOM from real samples was investigated at optimal conditions. The MWCNT-Fe3O4 was characterized by scanning electron microscopy (SEM) test and X-ray diffraction (XRD), respectively. Data analysis was performed using Minitab software based on the Taguchi method. Results. The results showed that MWCNTs were coated with Fe3O4. The SEM test shows particle (MWCNTs-Fe3O4) size in the range of 48–143 nm, and the particles have uniform spherical shapes. Enix software was used to identify the phase in this sample. The conditions including pH=3, mixing speed = 120 rpm, adsorbent dosage = 1.5 g·L−1, and contact time = 90 minutes were selected as optimal for NOM adsorption. The mean removal efficiencies of NOM in synthetic samples at 5, 10, and 20 mg·L−1 concentrations were 86.6%, 84.87%, and 95.41%, respectively. In addition, the mean removal efficiency of NOM in Choghakhor Wetland was 77%. Conclusion. Our findings demonstrated that the MWCNTs-Fe3O4 can be potentially used as an adsorbent for removing natural organic matter (HA) from aqueous solutions.

Introduction: Coagulation disorder is one of the major phenomena following the trauma which can deteriorate the condition of the patients. The aim of this study is to determine some factors predicting the incidence of coagulation disorder among acute trauma patients. Methods: The generalized estimation equations were used to determine the predictors of blood coagulation disorders in a sample of 736 people over 16 years of age with acute trauma in Shahid Rajaei Hospital in Shiraz. The response variable was converted based on PT, PTT, INR, and fibrinogen level criteria as a two-state variable (with/without coagulation disorder). In the data analysis, the correlation of the coagulation disorder was considered in the first and second stages. Results:The prevalence of coagulation disorders (mild, moderate and severe) was 19% in two stages and coagulation disorders (moderate and severe) was 7.5%. Motor vehicle accident was the most common cause of injury.The variables of blood sugar, diastolic blood pressure, pH, and sodium had a significant effect on coagulation disorders (mild, moderate, and severe). Moreover, blood phosphorus, age, and pupillary reflex had a significant effect on coagulation disorders (moderate and severe). Conclusion: Predictors of coagulation disorders (mild-moderate-severe) include blood sugar, diastolic blood pressure, pH, and sodium. Moreover, blood phosphorus, age, and pupil reflex are predictors of moderate and severe coagulopathy. this model that taking into account the exchangeable correlation of first- and second-stage coagulopathy had a better fit than the model ignoring this correlation.

Objectives: The birth of a premature baby can change all the emotions of parents and replace stress. It is necessary to identify the factors that aggravate and relieve maternal stress and adopt strategies to reduce it. The aim of this study was to analyze the effect of supportive care program based on Bandura’s self-efficacy on aggravating and stress relieving factors of mothers of neonates admitted to the neonatal intensive care unit Methods: A quasi-experimental study was performed in 2020 on 90 mothers of premature infants admitted to the neonatal intensive care unit of a Hospital in Shahrekord by convenience sampling method. The experimental group has received an educational intervention based on the theory of self-efficacy in four two-hour sessions with the presentation of an educational booklet. Data were collected using a self-designed questionnaire before and after the intervention in both groups and were analyzed using SPSS software version 24 performing paired t-test, independent t-test, and Chi-square. Results: The results showed that the mean score of stressors in mothers of preterm infants in the control group decreased from 42.73 ± 6.26 to 42.62 ± 7.09, which was not statistically significant (P= 0.906) while in the experimental group it was decreased from 48.78 ± 4.36 to 25.33 ± 4.84, which was statistically significant (P

Background and aims: Stroke is the first leading cause of disability in adults. Long-term disability after stroke necessitates long-term caregiving by family members. The family caregivers (FCGs) of patients with stroke (PWS) experience different problems and hence, require self-management (SM) skills. The aim of this study was to assess the effects of an SM program based on Strauss and Corbin’s SM model on perceived social support (PSS) among the FCGs of PWS. Methods: This quasi-experimental study was conducted in 2019–2020. Participants were eighty FCGs of PWS who were hospitalized in Kashani hospital, Shahrekord, Iran. They were purposefully- recruited and randomly allocated to a control and an intervention group. An SM program based on Strauss and Corbin’s SM model was implemented in six ninety-minute sessions for participants in the intervention group. The Multidimensional Scale of PSS was used for PSS assessment before, immediately after, and two months after the intervention. Data were analyzed using the SPSS software (v. 16.0). Results: There was no significant difference between the groups in terms of the pretest mean score of PSS (P=0.76), while the mean score of PSS in the intervention group was significantly greater than the control group at both posttests (P0.05), but significantly increased in the intervention group (P

Background and aims: Stress and anxiety during coronary angiography (CA) can lead to serious complications such as cardiac dysrhythmias, coronary artery spasm, and coronary artery rupture. This study aimed to evaluating the effects of clinical simulation on stress, anxiety, and hemodynamic parameters among the candidates for CA. Methods: This clinical trial was conducted on eighty candidates for CA. Participants were conveniently recruited from Tehran Heart Center, Tehran, Iran, and randomly allocated to a control and an intervention group through block randomization with a block size of 2. The Beck Anxiety Inventory, the Cohen Perceived Stress Scale, and a datasheet for hemodynamic parameters were used to assess participants’ anxiety, stress, and hemodynamic parameters before and after the study intervention. Participants in the intervention group received routine care services and a clinical simulation intervention, while participants in the control group solely received routine care services. Data were analyzed using the chi-square, independent-sample t, and paired-sample t tests. Results: The mean scores of stress and anxiety and the mean values of systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) significantly decreased in the intervention group (P0.05). The pretest posttest differences in the means of stress, anxiety, SBP, DBP, and HR in the intervention group were significantly greater than the control group (P

مقدمه: با استفاده از تکنولوژی مبتنی بر موبایل، می‌توان باعث افزایش کیفیت زندگی بیماران شد. مطالعه‌ی حاضر، با هدف بررسی تأثیر اجرای برنامه‌ی توان‌بخشی قلب با استفاده از اپلیکیشن موبایل بر روی تحمل فعالیت بدنی، خستگی و تنگی نفس بیماران پس از سکته‌ی قلبی حاد در بیمارستان‌های وابسته به دانشگاه علوم پزشکی شهرکرد در سال 1397 انجام شد. روش‌ها: در این کارآزمایی بالینی، 100 بیمار مبتلا به سکته‌ی قلبی حاد در دو گروه شاهد (50 = n) و مورد (50 = n) به صورت تصادفی انتخاب شدند. گروه مورد با استفاده از اپلیکیشن موبایل، تحت برنامه‌ی توان‌بخشی قلبی قرار گرفتند. در اپلیکیشن توان‌‌بخشی قلب، پایش هفتگی، یادآوری داروها، آزمایش‌ها، فعالیت ورزشی، اعلام هشدار در موقع تنگی نفس و خستگی و درد قفسه‌ی سینه، افزایش یا کاهش فشار خون و ضربان قلب، آموزش خانواده‌ها، عوامل خطر و کاهش مصرف سیگار برای مدت 8 هفته به اجرا گذاشته شد. برای گروه شاهد، آموزش‌های معمول بیمارستان انجام شد. در پایان برنامه‌ی توان‌بخشی، داده‌های مربوط به نمره‌ی فعالیت بدنی، خستگی و تنگی نفس بیماران در ابتدا و پایان مداخله و همچنین، بین دو گروه، مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: بعد از مداخله، میانگین نمره‌ی فعالیت بدنی در گروه آزمون با میانگین 23/1 ± 92/3 به طور معنی‌داری بیش از گروه شاهد با میانگین 28/1 ± 90/2 بود (001/0 > P). همچنین، خستگی و تنگی نفس بیماران در گروه مورد به ترتیب با میانگین 15/1 ± 57/3 و 73/2 ± 48/3 به طور معنی‌داری کمتر از گروه شاهد به ترتیب با میانگین 17/1 ± 02/4 و 48/3 ± 66/4 بود (050/0 > P). نتیجه‌گیری: اجرای برنامه‌های توان‌بخشی با استفاده از اپلیکیشن، باعث تخفیف خستگی و تنگی نفس و بهبود تحمل فعالیت بیماران سکته‌ی قلبی شد.

Background & Aim: Acute coronary syndrome is the most common cardiovascular disorder. Hope and optimism lead to adaptation to and moderation of the damaging effects of depressed mood on the outcome of this disorder. The aim of this study was to determine the effect of positive psychology-based audio messages on hope and optimism among patients with acute coronary syndrome. Methods & Materials: In this randomized controlled clinical trial, 84 patients with acute coronary syndrome were assigned to either intervention or control groups in Shahrekord educational hospitals in 2017-2018. The intervention group received audio messages based on positive psychology and cardiovascular self-care, and control group only received self-care messages in two hospital admissions and six weeks after discharge. The Life Orientation Test-Revised and the Snyderchr('39')s Hope Scale were completed before the intervention, at the discharge time, one week and six weeks after the intervention. Data were analyzed by c² and Fisher exact tests and analysis of variance using the SPSS software version 20. Results: No significant difference is observed in the mean score of hope before the intervention and at the discharge time. However, the mean score of hope was significantly different between the two groups, one week and six weeks after the intervention (P

Introduction: The most important compliant of post-operative orthopedic patients is severe and intolerable pain. This pain has negative impacts on patient’s satisfaction with pain management and bone healing after surgery. This study was conducted with the aim of evaluating the effects of Melissa officinalis (Melissa) tea and Matricaria chamomilla (Chamomile) tea on pain intensity and satisfaction with pain management in patients after lower limb orthopedic surgery. Methods: This was a randomized controlled trial conducted on 96 patients after lower limb orthopedic surgery in Ayatollah Kashani hospital of Shahrekord city, Iran. Patients were randomized to M. officinalis, Chamomile and control groups with blocking randomization method. For M. officinalis group, 1 g of Melissa tea, for Chamomile group 1 g chamomile tea and for control group black tea was prescribed 3 times a day. Study variables were evaluated before and 30 min after each stage of intervention and then the mean changes of pain intensity and satisfaction before interventions and after each step of intervention were compared between groups. Significance level was considered as P

Background and Aim: ICU is one of the vital departments in the hospital to reduce mortality and morbidity. The department where nurses face complex situations that require decision-making skills. In fact, problem solving is an important and complex issue clinical practice, and decision-making is an important indicator. The purpose of the study was to investigate the effect of SBAR-based patient safety education program on nurseschr('39') clinical decision making in intensive care unit nurses. Methods: The quasi-experimental study was performed on 60 nurses working in intensive care units of Ayatollah Kashani and Hajar hospitals in Shahrekord, Iran in 1398. The subjects were randomly assigned to two experimental and control groups (30 people each). For the experimental group, five SBAR-based training program was held (Situation, Background, Assessment, and Recommendation). Data were collected using Lori et al. (2001) clinical decision making questionnaire before and one month after the intervention respectively. The collected data were analyzed using analysis of covariance in SPSS software (version 22). Results: According to the findings, the clinical decision-making score of the test group nurses before the intervention was 69.1± 5.44 and after the intervention was 80.8 ± 7.22 (P

In this study, experiments on LAS solution were performed using the methylene blue active substances (MBAS) method. The effectiveness of sonochemical and photochemical reactors for LAS degradation is evaluated with an emphasis on the effect of the contact time, pH values, type of process and initial concentrations. Experiments were carried out at the initial concentrations of 0.5 mg/L, 14.00 mg/L and 21.00 mg/L, the contact time of 8, 16, and 24 minutes, pH of 3, 7, and 11, the ultrasonic frequency of 42 kHz, the acoustic power value of 160 W, an ultraviolet lamp with 150W power and the wavelength of 254 nm. This study showed that LAS degradation was increased by increasing the contact time. In addition, in alkaline pH, the removal efficiency increases. Overall, the results obtained from this research demonstrated that by themselves, both the sonochemical and photochemical reactors may not be useful for completely reducing the complex wastewaters with high surfactant loads, but the succession UV/US process has a significant effect on the removal of anionic detergents. These findings demonstratedthe removal efficiency in alkaline conditions and the contact time of 24 minutes was equal to 96.97 percent.

Background and aims: Constipation is one of the most common issues in pediatrics. The aim of this study was to compare the effect of polyethylene glycol and the simultaneous administration of polyethylene glycol along with probiotics in the treatment of chronic functional constipation. Materials and Methods: In this randomized double-blind clinical trial, 150 children with chronic functional constipation referred to Imam Ali Clinic affiliated with Shahrekord University of Medical Sciences from 2017 to 2018 were included. The first group (A) consumed 1 g/ kg of body weight per day of water-soluble polyethylene glycol powder and the second group (B) consumed a probiotic powder and 1 g/kg of body weight of the water-soluble polyethylene glycol powder daily. In weeks 0, 1, and 2, questionnaires were filled out by the parents of the children and the data were analyzed. Results: The results showed that there was no significant difference in any of the variables between groups A and B (P=0.07) including the frequency of fecal excretion in week 1 (77% and 71%) and week 2 (4% and 5.4%) and stool consistency in week 1 (4% and 6.7%) and week 2 (86.7% and 92%). Moreover, there was no significant difference between groups A and B in any of the variables frequency of painful excretion in week 1 (74% and 73%, respectively) and week 2 (5.3% and 4%, respectively), frequency of abdominal pain in week 1 (61.3% and 49.3%, respectively) and week 2 (4% and 5.3%, respectively), and the frequency of fecal incontinence in week 1 (22.77% and 18.7%, respectively) and week 2 (6.7% and 1.3%) (P>0.05, respectively). Conclusion: Our results indicated that the administration of probiotic supplement (Lactobacillus Rhamnosus, Lactobacillus acidophilus, Lactobacillous Bulgaricus) has no effect on the improvement of symptoms in children with chronic constipation.

Background and aims: Multiple sclerosis (MS) is an inflammatory disease of the central nervous system. The impact of the number of attacks on the disease is undeniable. The aim of this study was to analyze the number of attacks in these patients. Methods: In this descriptive-analytical study, the registered data of 1840 MS patients referred to the MS clinic of Ayatollah Kashani hospital in Isfahan were used. The number of attacks during the treatment period was defined as the response variable, age at diagnosis, sex, employment, level of education, marital status, family history, course of disease, and expanded disability as the explanatory variables. The analysis was performed using zero-inflated negative binomial model via Bayesian framework in OpenBUGS software. Results: Age at diagnosis (CI: -0.04, -0.20), marital status (CI: -0.56, 0.002), level of education (CI: -0.81, -0.26), Job (CIHousewives vs Employee=[0.04, 0.64], CIUnemployee vs Employee=[-1.10,0.008])), and course of disease (CI: -0.51, -0.08) had a significant effect on the number of attacks. In relapsing-remitting patients, the number of attacks was partial significantly affected by expanded disability status scale (EDSS) (CI: -0.019, 0.16). Conclusion: Aging, being single (never married), high education, and not having a job decrease the number of attacks; therefore, lower age, being married, primary education, and being a housewife increase the number of attacks. An interventional or educational program is suggested in order to prevent the occurrence of further attacks in high-risk groups of patients and to increase their chances of recovery.

Bioremediation of polycyclic aromatic hydrocarbons (PAHs) in contaminated soils are reported in many literatures. Composting, in addition to bioremediation, can simultaneously increase soil organic matter content and soil fertility and is thus regarded as one of the most cost-effective methods of soil remediation. In this study, biodegradation of phenanthrene (PHE) and pyrene (PYR) is reported by microbial consortia enriched by vermicompost. After soil samples preparation and grinding, the samples were contaminated with 100, 200, and 300 mg/kg of PHE and PYR concentrations and inoculated with three concentrations (2, 4, and 6 wt.%) of vermicompost. PHE and PYR concentrations were analyzed by HPLC during bioremediation. After 70 days, two highly capable microbial consortia were used to remove the pollutants in bioaugmentation conditions. Analysis of their microbial composition revealed that the consortia contain several Proteobacteria phylum bacterial species, and the most common genera were Pseudomonas and Citrobacter. Decontamination rates for PHE and PYR were estimated to be 89% and 83% over 45 days, respectively. Biodegradation kinetics revealed that microbial degradation followed a first-order kinetics. This study provides clear evidence on the biodegradation of PHE and PYR, paving the way for the development of bioremediation technologies for the recovery of polluted ecosystems.

Introduction: The aim of this study was to determine the effect of thinking distraction on the anxiety severity in patients undergoing extracorporeal shock wave lithotripsy in the ESWL department of Ayatollah Kashani hospital in Shahrekord. Methods: This is a clinical trial study that was conducted in 2018 in 120 patients referred to Ayatollah Keshāni Hospital in Shahrekord for the purpose of extracorporeal shock wave lithotripsy. Patients were selected through convenience sampling and divided into experimental and control groups in a quasi-random method. In addition to routine care, the test group received the natural sound of the event along with its beautiful scenery, and the control group received routine care only. The patientchr('39')s anxiety was measured based on the Spielberger questionnaire. The collected data were analyzed using SPSS software, descriptive statistics and t test. Results: Mean anxiety score changes in distraction receiver group, - 21/56± 98 and in the control group was -5/21± 8/12. There was a significant difference (p = 0.001) between the control group and group receiving the thinking distraction . Conclusion: distraction method is effective in reducing anxiety in patients undergoing extracorporeal lithotripsy and can be used to manage pain in the future.

Introduction: Usually, in the toxicological studies of airborne particulate pollutants, inhalation exposure chambers are used for providing and distributing the test atmosphere uniformly and stability in the respiratory zone of laboratory animals. The purpose of this study was to design, evaluate and optimize a whole-body exposure chamber, specifically for small laboratory animals exposed to particulate matter. Material and Methods: In the first, the papers and scientific resources which had provided the technical details and performance of the inhalation exposure chambers were studied, and the advantages, disadvantages and those factors affecting their performance were extracted. Then the assumptions of the initial design of the chamber were prepared with regard to the principles of fluid dynamics and the standard conditions of lab animal housing. To create a uniform distribution of particles inside the chamber, guide plates of flow were used in the upper cone. Numerical simulation and ANSYS Fluent software were used to optimize the initial design. Drawing geometry of the chambers was done using Design modeler software and meshing of the computational field using ANSYS meshing software. The particles used had a mean aerodynamic diameter of 10 μm, spherical, inert, and a density of 1,400 kg. m^-3 and entered the chamber at the carrier gas velocity. Particle concentration was measured in the chambers along the cylindrical radius at 10 cm intervals on the x-axis. Then the percentage of variation coefficient of the particle concentration for each line was calculated. In the final analysis of the results, the geometry design with the lowest coefficient of variation of particle concentration along the selected sampling line was selected as the best chamber design. Results: The optimized inhalation chamber has a dynamical flow and consists of a cylinder with two upper and lower cones. The flow enters from the upper cone and after passes through the guide plates, distributes in the interior of the chamber and exits from the lower cone. The k-ε turbulence and Discrete Phase Models could have modeled this problem. Design No. 7 was optimal design with the lowest coefficient of variation of the concentration (4.08%). Conclusion: The numerical simulation method for planning and optimizing of the chambers, at a much lower cost than the empirical methods, was able to provide comprehensive information on the solution field. The analysis of this information led to the selection of the best chamber design to provide uniform concentration of the particles in the respiratory region of the animals.

Background: Inadequate ventilation with mask and difficult intubation are the most common adverse respiratory outcomes in patient undergoing anesthesia .The aim of this study was to compare Mallampati test in different sitting positions in traditional approach and during phonation for predicting difficult laryngoscopy and intubation in candidates for surgery. Methods: In this diagnostic value study on 385 patients, in different positions of supine and sitting with and without abeslang, Mallampati test was examined by a blind person regarding the condition of the mallmpati, laryngoscopy grade, and the severity of intubation. The results of these four positions of mallampati were compared in predicting laryngoscopy grade and the severity of intubation. Findings: All mallampati test scenarios had acceptable diagnostic value (P < 0.001). The accuracy of the Mallampati test in supine position with open mouth was lower than in other cases, and in the both positions of sitting with abeslang and supine with open mouth, diagnostic values were not suitable for assessing difficult and comfortable mask ventilation (P > 0.050). Mallampati test accuracy in supine position with open mouth was less than other positions. However, with a low accuracy, this position had the highest sensitivity (100%). Positive predictive values of supine and sitting positions with abeslang were higher than other positions. Conclusion: According to the results of this study, the Malamapati test in the position of supine with abeslang was better in determining the severity of laryngoscopy and intubation.

Aims: Atherosclerosis and ischemic heart disease are more common in diabetic patients. Atherosclerosis process can disturb the normal functioning of the vascular endothelium and increase vessel wall thickness. The aim of this study was the comparison of Carotid intima-media thickness (CIMT) with Exercise tolerance test as an alternative way to evaluate cardiac ischemia in diabetic patients. Methods: In a cross-sectional study, 30 diabetic patients with positive exercise test and 30 diabetic patients with negative exercise test were enrolled. CIMT of the carotid artery in both groups of patients was measured. Result: CIMT in the patients with positive and negative exercise test were 1.04 ± 0.21 mm and 0.61 ± 0.11 mm, respectively (P

17β-Estradiol (E2) has a significant health risk to humans, even at the ng/L level, and is discharged to the aqueous environment through wastewater. Advanced oxidation processes were proposed as an efficient process for the removal of E2. In this study, a combination of ultraviolet-C (UV-C) and KMnO4 was applied for the removal of E2. Results have shown that the removal efficiency of E2 in pH 4 (acidic condition) was 93.80 ± 0.42%. But, removal efficiency in neutral (7) and alkaline (10) conditions was 78.3 ± 2.12% and 84 ± 0.71%, respectively. The effect of Fe+2, Ca+2, Mg+2, Mn+2, and Fe+3 ions (1 mg/L) was investigated in optimized pH (4). Mn+2, Fe+2, and Ca+2 ions enhanced the removal efficiency to 94.8 ± 0.84%, 95.55 ± 0.07%, and 94.7 ± 0.14%, respectively p>0.05, while Mg+2 and Fe+3 ions decreased the removal efficiency significantly to 76.15 ± 1% and 83.91 ± 0.3% p0.05. The result indicates that the rate of oxidation of E2 is related to the second exponent of the initial concentration of E2 for optimum pH and the presence of all ions. But, in the presence of humic substances, the first-order kinetic reaction was best applicable in describing oxidation of E2. Removal of chemical oxygen demand for E2 after 120 minutes’ of contact time at optimum pH (86 ± 4.2%) demonstrated mineralization of these compounds at acceptable levels. Results presented that the UV-C/KMnO4 process is efficient for the removal of hormones from the aqueous solution.

Some medications and herbal drugs are suggested to ameliorate impaired plasma glucose and its complications in pre-diabetic patients. This study aimed to assess the effect of cumin essential oil supplementation on metabolic markers and serum leptin in pre-diabetic subjects. In a double-blind randomized controlled trial, subjects of intervention group received one cumin soft gel (containing 75 mg of cumin essential oil) per day for 10 weeks, while subjects of control group received one placebo soft gel. Glycemic indices and serum leptin did not significantly improve in intervention group. Except serum total cholesterol, other markers of lipid profile as well as anthropometric indexes improved in intervention group. Subgroup analyses represented that lipid profile and anthropometric indexes were ameliorated in women after intervention, while did not show significant improvement in men. It can be concluded that cumin essential oil can be used as an adjuvant therapy to ameliorate metabolic status in pre-diabetics.

Abstract Background Prospective cohort studies are considered ideal choices to study multiple outcomes and risk factors for Non-communicable diseases (NCDs). Our aim is to set-up the protocol and analyze risk factors, incidence rates, prevalence, trends, and the models of environmental and genetic determinants of NCDs and their outcomes as well as interaction among such determinants. Methods Shahrekord cohort study (SCS) that is a population-based prospective, study on a cohort consisting of people aged 35-70 years started in November 2015 in Iran. The sample size of the original cohort is at least 10,000 people. Annual follow-ups (200,000 person-year) of the cohort were designed to be conducted up to 2036. Exposures (a detailed demographic, socioeconomic, general health, quality of life, physical activity, anthropometric indexes, stress, health literacy, social capital, nutrition and eating habits, lifestyle, occupational history, living place, blindness, deafness, electrocardiography, lung capacities, blood pressure, sleep, smoking and alcohol, contact to animals, physical examinations and medical history, dental health, used drugs and supplements, glucose and lipid profiles) were measured by relevant standard methods and questionnaires. Incidence of common NCDs (cardiovascular diseases, cancer, gastrointestinal, respiratory, renal, hepatic, accidents, injury and neurological diseases), trend of risk factors, hospitalization, disability, and death were considered the outcomes of the cohort. The definition of disease was determined based on the International Classification of Diseases 10th version (ICD-10). Routine hematologic and biochemical tests were conducted and an all-inclusive biobank (blood, hair, nail, and urine specimens) of the cohort was stored for future studies. All steps of data collection and examinations are directly monitored by the quality control team. Discussion The SCS is a unique study conducted in southwest of Iran that is a notable work given the climate conditions and ethnicity population (especially in Bakhtiari) of this region. By providing high quality the protocol and introduce it, the SCS can serve as a solid foundation for management and researchers in southwest of Iran. The SCS provides prerequisites for collaboration and regional, national, and international studies on NCDs. Data are available at the modeling in health research center, Shahrekord University of Medical Sciences, Shahrekord, Iran, for any collaboration.

Background: Treatment has a major effect on attacks in patients with multiple sclerosis (MS). This study aimed to determine the effect of the type of used drug on occurrence and number of attacks in patients with multiple sclerosis. Methods: In this cross-sectional study, 1815 patients with multiple sclerosis referred to Ayatollah Kashani hospital in Isfahan, Iran, whose information was recorded in iMED software and followed at least for 34 months, were included. The effect of the type of drug on occurrence and number of attacks was determined using Negative Binomial Hurdle model by R software. Findings: The type of drug had a significant effect on the occurrence of attack; so that, compared to interferon beta-1a (muscle), interferon beta-1a (subcutaneous), fingolimod, glatiramer acetate and azathioprine were less effective, especially for relapsing-remitting types. Interferon beta-1b and glatiramer acetate had more and less effective on the occurrence of the attack in women and men, respectively. In women, fingolimod drugs, glatiramer acetate, and azathioprine had less effect on the number of attacks, respectively. The effect of age was significant on the occurrence and number of attacks in men and women, and both the recurrence and progressive clinical course. Conclusion: Younger patients had more occurrences of attacks. Interferon beta-1a (muscle) has a better performance than other drugs in reducing occurrence of attacks. In women, patients taking interferon beta-1b had fewer attacks compared to patients taking interferon beta-1a (muscle). In men, patients taking interferon beta-1a (muscle) had fewer attacks than those taking glatiramer acetate.

This paper investigates cyanide photodestruction (at pH 9) using the S, N-TiO2 photocatalyst synthesized by the sol-gel method and stabilized on glass microbeads. The main raw materials were thiourea, as a source of N and S, and tetra butyl ortho titanate. The effects of S and N doses, visible light (a 400W light), sunlight, irradiation time, and different initial cyanide concentrations (50, 100, 200, and 300 ppm) were studied on cyanide photodestruction. Cyanide concentration was measured by the titration method and the photocatalyst film was characterized by X-ray diffraction (XRD), UV-Vis diffuse reflection spectroscopy (DRS), Scanning Electron Microscopy (SEM), and Energy dispersive X-ray (EDX) analysis. XRD patterns and SEM images were used to determine the nanoparticle size of the photocatalyst on glass microbeads. EDX and DRS analyses confirmed the presence of S and N as well as the activity of the photocatalyst in the visible region, respectively. The S, N-TiO2 film with 0.25 g Thiuourea proved to be the best cyanide photodestruction agent in the visible light. Based on the results obtained, S, N-TiO2/ glass microbead was capable of destroying cyanide (50 ppm) by up to 94% in the visible light and by approximately 100% in the sunlight. The results also indicated that S, N-Tio2/scoria stone was capable of destroying cyanide by 85% in the visible light and by 94% in the sunlight within 4 h. The reaction kinetic for all cyanide concentrations and two photocatalyst substrates were described by a first order equation. Finally, it was concluded that the S, N-TiO2 stabilized on glass microbeads could be effectively used as a new method for treating wastewater containing free cyanide under the sunlight.

Helicobacter pylori is an important risk factor for chronic gastritis, peptic ulcer, and gastric cancer. Three-drug regimen is the first-line treatment for this infection, but the response rate to treatment varies in different geographical regions. This study was conducted to comparatively determine the effect of amoxicillin and metronidazole on three-drug regimen to treat H. pylori infection in 1–15-year-old children. This clinical trial was conducted on 82 patients aged 1–15 years with convenience sampling referring to the Endoscopy Unit of Hajar Hospital, Shahrekord. Group 1 was administered with clarithromycin, amoxicillin, and omeprazole (CAO), and Group 2 with, clarithromycin, metronidazole, and omeprazole (CMO). One month after completion of the treatment, stool antigen test was used to study the eradication of H. pylori. Data were analyzed using SPSS software by Chi-square test. Three of the 82 patients were excluded from the study because of side effects caused by drugs. Nearly 87.2% of the patients in CAO-treated group and 92.5% in CMO-treated group had response to treatment. There was no significant difference in eradication rate between the two regimens (P = 0.43). The two regimens displayed no superiority over each other for eradicating H. pylori infection and response rate to treatment in children aged 1–15 years.

BACKGROUND: Patient safety culture is an integral part of patient care standards and a prerequisite for safe care. SBAR is an acronym for Situation, Background, Assessment, Recommendation; this communication model has gained popularity in health-care settings, especially among professions such as nursing. However, there is little evidence that nursing professional education can enhance patient safety culture. The aim of this study was to investigate the effect of a SBAR-based training program on patient safety culture in intensive care unit (ICU) nurses. MATERIALS AND METHODS: The quasi-experimental study was carried out in 2018–2019 at areas covered by Shahrekord University of Medical Sciences, Iran. This study was performed on 60 nurses working in ICU. The participants were randomly assigned to two experimental and control groups of 30 each. For the experimental group, five workshop sessions of SBAR-based program were held. For the control group, the patient delivery process was performed according to the ward routine. Data were collected using patient safety culture questionnaires before and 1 month after the intervention, and were analyzed using descriptive and analytical tests such as paired t-test, independent t-test, and Chi-square test by SPSS 22. RESULTS: The mean score of safety culture was 31 ± 23.5 and 55.2 ± 28.6 in frequency of reporting events, 32.8 ± 17.8 and 54.3 ± 19 in overall perception of patient safety, 23 ± 20.1 and 52.9 ± 26 in communication channel openness, and 35.2 ± 19.8 and 52.4 ± 18.8 in information exchange and conveyance before and after training intervention, respectively, so that they improved from poor level to neutral-moderate level. There was no strength in any dimensions of safety culture; however, the implementation of the SBAR-based program was significantly associated with patient safety culture (P < 0.001). CONCLUSIONS: Improving patient safety culture requires attention to patient safety models such as SBAR approach that provides an appropriate and reliable structure for quality improvement. SBAR-based program training is effective in promoting patient safety culture; therefore, it is recommended that managers use this technique to promote patient safety culture.

Phenolic compounds are among the priority pollutants due to their adverse effects on human health and other living organisms. Advanced Oxidation Processes (AOPs) offer promising prospects for the removal of pollutants in water and wastewater due to their high efficiency as well as acceptable health and environmental effects. Persulfate, especially when used with iron, is far stronger than many other oxidants with respect to oxidation properties since it produces sulfate radicals which create a higher oxidation potential. In this research, efforts have been made to achieve the best conditions for phenol removal from aqueous environments by activating persulfate with iron ions. The experimental design was accomplished using the Taguchi statistical method and the Minitab 16 software. For the purposes of this study, four factors, each with five levels, were considered to determine the optimal conditions for phenol removal. The optimum conditions for phenol removal by integrated persulfate/iron ions were found to comprise a contact time of 120 minutes, a persulfate/iron molar ratio of 5/4, and PH=3. Phenol removal efficiencies of 94.93%±0.708 and 58.21%±0.675 were obtained under the optimum conditions for the experimental minimum (50 mg/l) and maximum (750 mg/l) phenol concentrations, respectively. The results revealed that among the parameters affecting the process, environmental pH with 54.80% and persulfate concentration with 11.05% have the highest and lowest effects, respectively. It is expected that this process is also capable of removing phenol from industrial wastewaters with removal efficiencies in the range of 59‒95%.

OBJECTIVE AND AIM: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. The patient's fear and anxiety of shortness of breath and coughing during exercise may lead to a decrease in patients' daily activities. Therefore, the present study aimed to determine the effect of empowerment program based on the social cognitive theory (SCT) on the daily activity of patients with COPD. METHODS: This quasi-experimental study was performed on 70 patients with COPD referred to Kashani and Hajar centers in 2019. Samples were randomly divided into two groups of experimental and control. Data collection tools included demographic information questionnaire and activity of daily living questionnaire, specific for COPD, and a researcher-made questionnaire for measuring SCT constructs. For the experimental group, the training program consisted of four theoretical and practical sessions of 40 min/week. The data were collected at three time points, before, immediately and 3 months after the training are 3 time. The data were analyzed by SPSS software using descriptive and inferential statistics. RESULTS: The difference between the mean scores of behavioral ability, self-efficacy, and empowerment in the three stages was significant only in the experimental group (P < 0.001). The mean daily activity score of patients before, immediately, and 3 months after intervention showed a statistically significant difference between the two groups (52.46 ± 21.98, 63.36 ± 21.95, and 71.34 ± 19.02), respectively, in the intervention group, and (51.79 ± 19.29, 53.70 ± 19.28, and 53.82 ± 19.26), respectively, in the control group (P < 0.001). CONCLUSION: The results of this study showed that empowerment of patients through interventions based on SCT can increase the daily activity of patients with COPD. Because nurses play an important role in patient education and improvement, it is hoped that the findings of this study will be used as a strategy to increase the daily activity and ultimately improve the quality of life in these patients.

BACKGROUND: The present study aimed to describe the long-term alterations of pulmonary function and also to describe its association with post-operative pain after coronary artery bypass grafting (CABG) surgery. METHODS: In this prospective study, thirty non-smoker male patients undergoing isolated on-pump CABG were consecutively included in this study. Pulmonary function measurements were performed, in a sitting position, preoperatively, a week postoperatively, and 6 months after the surgery using a Medical Graphics PF/Dx pulmonary function system. Pain was determined by using visual analog scale (VAS) pain scores with a standardized questionnaire’s. RESULTS: Regarding functional class, all patients had New York Heart Association (NYHA) Class II to III. A week after operation, a severe restrictive pulmonary impairment was revealed with a mean decrease in VC to 60.9 ± 9.2% and in forced expiratory volume in one second (FEV1) to 64.6 ± 12.2% of pre-operative values (P < 0.001). Regarding sternotomy related pain, the mean pain VAS score was preoperatively 3.3 ± 1.5 that reached to 6.2 ± 2.5 and 4.8 ± 2.2 1 week and 6 months after the operation (P < 0.001). The trend of the changes in pain score within 6 months of operation was significantly similar to the trend of the changes in some pulmonary function indices such as FEV% and residual volume (RV). CONCLUSION: A significant reduction is expected in most pulmonary functional parameters following CABG despite normal pulmonary function state preoperatively. Severe pain originated from sternotomy may be an important factor related to pulmonary dysfunction following CABG.

Background: This study was carried out in order to evaluate the relationship between retinopathy and carotid intima-media thickness (CIMT). Materials and Methods: In a cross-sectional study, 154 diabetic patients who had a history of diabetic disease were evaluated in two equal groups of 77 patients with and without retinopathy, respectively. CIMT was evaluated in all of the patients. Results: Mean age of the patients was 59.65 ± 9.37 years. Mean CIMT of all patients was 0.84 ± 0.18. CIMT of patients with retinopathy was significantly greater than patients without retinopathy (P < 0.001). CIMT also correlated with age, duration of diabetes, systolic blood pressure, blood urea nitrogen, and serum creatinine. Conclusion: CIMT may be used as a simple, available and noninvasive method for screening of macro and microvascular complication of diabetic patients.

Introduction: Jaundice is one of the most common causes of admission to hospital in newborns which is often associated with several complications. Aim: The present study was conducted to evaluate the effect of H. vulgare in reducing jaundice. Materials and Methods: In this double-blind, randomized controlled trials 70 term infants hospitalized due to jaundice in 2014 were enrolled. Control group was treated with full-time phototherapy alone using LED except when the infants were breastfed and case group with phototherapy, as per the protocol in the control group, along with and topical H. vulgare seed flour three times a day. Data were analysed using and analysis of covariance (ANCOVA) and paired t-test in SPSS version 16.0. Results: There was a significant difference in mean indirect bilirubin level between the two groups p0.05. Conclusion: H. vulgare flour can cause decrease in indirect bilirubin. Because the rate of decrease in indirect bilirubin can be effective in preventing severe complications due to bilirubinemia, H. vulgare can be used as a complementary therapy to treat jaundice.

The inability to communicate easily and clearly can have far-reaching debilitating effects, not only in childhood, but throughout a lifetime. The aim of this study was to determine the prevalence of stuttering, voice disorder, and speech sound disorders in Persian preschoolers in Shahrekord, Iran. Information about 1,387 children ages 5 to 6 was obtained via face-to-face screening and assessment. The total prevalence of speech disorders was 17.1%. The prevalence of stuttering was 1.5%, while 13.4% had a speech sound disorder, and 2.2% had voice disorder. The prevalence of stuttering was higher in males (2.2%) than females (0.7%); of speech sound disorders was higher in males (17.4%) than females (9.1%); and of voice disorder was higher in males (2.6%) than females (1.6%). The prevalence of stuttering and speech sound disorder was significantly different according to gender and positive family history. The prevalence figures revealed that a considerable number of preschoolers with speech disorders were missed in parents’ and teachers’ reports. Those children required more intensive communication support than they were receiving. Therefore, classroom teachers should work with speech and language pathologists to identify and assess preschoolers with communication disorders, and to develop intervention strategies.

Introduction: Crown–rump length (CRL) has been demonstrated to be an accurate predictor of birth growth and can cause many complications. Aim: This study was conducted to determine the association between CRL in the first trimester and weight, length and Head circumference (HC) at birth. Materials and Methods: This was a prospective, cohort study in Hajar Hospital of Shahrekord, southwest Iran from March, 2013 to June, 2014 (within 15 months). Thirty women achieving pregnancy with intrauterine insemination and in vitro fertilization were compared with 60 women getting pregnant naturally. Between the days 59 and 83 after insemination, fetal CRL was examined by ultrasound. Then, the patients were followed up and weight, length and HC at birth were recorded. The data were analyzed by SPSS 22. Results: There was a direct correlation between CRL and length in the studied infants (0.91, p

Objective:To determine the effect of oral zinc sulfate supplementation given with coamoxiclav when compared with coamoxiclav alone for treatment of otitis media with effusion (OME). The efficacy of the drug was assessed 3 and 6 weeks after administration . Methods: In a double-blind, randomized trial 4 to 14 years old children with OME who referred to ear, nose and throat clinic, were randomly assigned into two groups : 1) Zinc group: Zinc sulfate + Coamoxiclav + Pseudoephedrine + Nacl nasal drop 2) Placebo group: Placebo + Coamoxiclav + Pseudoephedrine + Nacl nasal drop . Atotal of 52 children were studied consisting zinc group 29 and placebo group 23 children. Children were examined by otoscopy and tympanometry at entry and after 3 weeks of treatment. For children who had not been cured completely after 3 weeks , treatment continued for more 3 weeks (total of 6 weeks ( . Results: At the end of the first course of treatment (3 weeks) 62.1% of children in the zinc group had clinical improvement compared with 43.5% of children in placebo group. Tympanometrically, 70.9% of children in zinc group had improvement compared with 65.5% for placebo group with no statistically significant difference . There was no significant difference between the two groups at the end of second course of treatment (6 weeks). But the response rate of zinc group was better than the placebo group (43.8% versus 12.5% clinically and 56.3% versus 40% tympanometricall). Zinc dministration and cycles of treatment had no significant relationship.Conclusion: Although in this study oral zinc sulfate supplementation had not significant effect on treatment of OME, the response rate was better in zinc group compared to placebo group specially in longer administration . According to the findings, it seems more studies about oral zinc supplementation in the treatment of OME is needed .

Introduction & Objective: Patients with Major depressive are difficult to treat, and the relative efficacy of medications and cognitive therapy in the treatment of depression is still a matter of deabath. The purpose of this study was to compare the efficacies of antidepressant medication, cognitive therapy and combination of cognitive therapy and antidepressant medication. Materials & Methods: In an experimental study, 120 depressive patients were randomly selected and divided in three groups as well. Group A, were treated with cognitive therapy Group B, were treated with antidepressant medication and Group C, were treated with combined therapy (medication and cognitive therapy). Outcomes were assessed with the Beck Depression Inventory. Results: Outcome showed cognitive therapy, medication and combination Cognitive therapy intervention and medication had positive effect on depression therapy. There was no significant difference between medication and cognitive therapy, But significant differences between cognitive therapy and medication with combination method. Conclusion: Depression can be treated with medications, cognitive therapy, or both. Outcomes have showed that the combination of medications and cognitive therapy was more effective in our cases

Background: Considering the increasing trend of childhood obesity and subsequent burden of the disease in Iran and other countries and importance of early life intervention for achieving sustained effect on health of children and adolescents, this study aimed to investigate the effect of two different dose of folic acid on homocysteine (Hcy) level and insulin resistance of obese children. Materials and Methods: In this randomized, double-blind controlled clinical trial study, 60 obese and overweight children aged 5–12 years were enrolled. Selected obese children randomly allocated in two interventional (1 mg/day folic acid and 5 mg/day folic acid, for 8 weeks) and one control groups. Biochemical measurements including folic acid, Hcy, insulin and insulin resistance were measured between and within groups before and after trial. Results: In each group, 20 obese children were studied. The three groups were age and sex matched. After folic acid administration, mean of Hcy, insulin resistance and insulin decreased significantly in two groups which folic acid administrated with two different doses (P < 0.05). The reduction in studied biochemical variables was similar in two interventional groups (1 and 5 mg folic acid daily) (P > 0.05). Mean differences for Hcy, insulin resistance and insulin, in two intervention groups were significantly higher than the control group (P < 0.0001). Mean differences of Hcy, insulin resistance and insulin, in two intervention groups were not different significantly (P > 0.05). Conclusion: The findings of current trial showed that folic acid in two studied doses could be a safe and effective supplement for obese children to reduce Hcy level and insulin resistance, which consequently could prevent obesity-related complications including cardiovascular and metabolic disorders.

Abstract Introduction: Multiple sclerosis is a progressive disease of the central nervous system that deteriorates myelin sheath and produce plaques in white matters of the brain and spinal cord. Studies indicated that Language skills of these patients are affected .Speech and Language Pathologists take a little attention to the language skills of these patients. The purpose of this study was to comparison some of the syntactic skills in Relapsing Remitting Multiple sclerosis and normal adults’ resident in Esfahan Province. Materials and Methods: In this cross-sectional descriptive- analytical study was investigated 17 adult with Relapsing Remitting Multiple Sclerosis from Esfahan MS centre and 34 normal adults that matched in age, sex and education with patient group. When persons had entry criterion then was took speech sample about their biography. This sample was recorded and wrote. Then was gathered and compared data. Results: This study found significant difference between normal and patient groups in mean max leanghtsntence(Pvalue = 0/043) and number total sentence (Pvalue =0/001). There was no significant difference between two groups in mean leanght sentence and simple sentence ratio and compound sentence ratio. Conclusion: however patients in this study suffered to mild degree Multiple sclerosis (EDSS mean = 1/35) but they had differences in some of syntactic skills. Conclusion:This findings conform need to assessment language skills of this patients and intervention this problems. Keywords: Relapsing Remitting Multiple Sclerosis, cognition, language, syntax