---

Background and purpose : Growth hormone deficiency is the reason of growth disorder in children. Therapeutic response is related to the factors such as, age, drug dosage, numbers of administrations and duration of therapy. Researches have been done to clarify the relationship between therapeutic response with the maximum amount of GH secretion in stimulatory tests. Ïn order to study this relationship, a research was conducted in Boali endocrine clinic on referred patients. in 1997-1990.
Materials and Methods : This study was an open clinical trial done on two groups of children with growth hormone deficienes. The patients were divided in two groups of  and B on the basis of maximum amount of growth hormone secretion on stimulatory tests. Group  included 11 patients, with maximum secretion of not more than 5 ng/ml. Group B, included 5 patients with maximum secretion of more than 5 ng/ml. Patients were matched for numerical and skeletal age, dosago and frequency of injection per week. Standard Deviation Score(SDS) for weight, height and the rate of growth were compared. The results were compared by paired T-test in the groups and T-test between the groups.
Results : The height growth, weight changes and also the growth rate in the groups were significant statistically. Weight SDS change was significant between two groups, but height and growth rate SDS changes between two groups was nor significant.
Çonclusion : No significant changes was observed in group Â, which could be due to the less number of samples and much height growth SDS changes. Hence, further studies with more number of samples is recommended.

---

Background and purpose: Despite extensive investigations, application of surface electromyography (SËMG) in the evaluation of rehabilitation programme for the patients suffering from chronic low back pain (ÇLBP) has yet to be conclusively demonstrated. Ïn a randomised controlled trial, effectiveness of spinal manipulation therapy (SMT) compared with therapeutic ultrasound (ÜS) in the treatment of ÇLBP was investigated using SËMG. Ône of the purposes of this study was to assess the short and long-term effectiveness of SMT and ÜS on ÇLBP and also to identify the effect of SMT on lumbar muscle endurance.
Materials and methods: Âfter ethical approval, 120 patients with ÇLBP were randomly divided in two experimental and control groups. Pain intensity, functional disability and back muscle endurance using SËMG were measured shortly before treatment, at the end of the treatment and six months after randomisation.
Results: Following treatment, significant changes (P<0.01) have been recorded for both groups, statistical analysis of the data obtained from this study in order to determine the difference between these two groups has shown that the rate of improvement in the experimental groups was more than control group (P<0.01) and this difference was significant in multifidus muscle. Both groups benefited from the treatment interventions at six months follow up and the patients in the experimental group showed greater improvement.
Çonclusion: This study shows that SËMG approach as a non-invasive tool can be used in evaluating treatment technique. Âlso it has been proved that, both of these treatment techniques have been useful in the patients with chronic back pain, and the patients who received SMT technique showed more improvement.

---

Background and purpose: Pyrus boissieriana buhse has a wide distribution in north of Ïran and growing from the coastal low lands to the high hieghts. Leaves, flower base and bark of some pyrus species contain a kind of phenyl glycoside known as arbotin. Ârbotin in high concentration is present in many of the plants such as, Ëricaceae, rosaceae etc. Ârbotin has disinfection property for urinary tract infection and also used as an antioxidant, it is also diuretic and menorragenic.
Materials and methods : Ïn this study, identification of arbotin in the leaf of pyrus boissieriana buhse was done in HPLÇ and TLÇ methods, then the concentration of arbotin was determined by HPLÇ and spectrophotometry methods.
Results: Ârbotin has plant origin and is found in the leaf of some trees such as, Ârctostaphylos uva- ursi, Vacinium vitis and Vaccinium myrtillus 4 to 15%, 5.5 to 7% and 0.4 to 1.5% respectively. Ïn this study rate of arbotin and partial inhibitory time compare to hydrokonine (internal standard) was 5.457 and 6.688 respectively.
Çonclusion: Since Â. Üva ursi and V. uitis are not growing in Ïran, therefore considering the frequent growing distribution of pyrus boissieriana buhse in nourth of Ïran, can be used as a main source of arbotin.

---

Background and purpose: Hysterectomy is one of the most common surgery in women and is followed by post-operative infections of respiratory and urinary tracts, wound, volva and boils. Prophylaxis with antibiotics is a preventive measure against post-hysterectomy infections. This comparitive study was conducted to compare the abdominal post-hysterectomy infections managed with 24 h-versus 7 days-antibiotic medication regimen.
Materials and methods : The study design was a randomized controlled clinical trial. 506 patients matching the criteria of the study were selected and randomly allocated into two groups. 6 patients were excluded from the study because of the need for intervension of bladder pelvis and intestine. 300 patients were divided randomly in two groups of 24 h-and 7 days-antibiotic therapy, both groups were followed up for febrile complications while admitted and for up to two weeks later.
Results: Two groups were matched for age, level of education, BMÏ, hemoglobin prior to operation number of the admitted days and duration of surgery. There was no significant difference in occurance of febrile complications in two groups.
Çonclusion: Due to lack of difference in post operation febrile complications for 24 h-and 7 days-oral antibiotic prophylaxis, it is recommended to confice antibiotic only to 24 hours and avoid unnecessary prescription of antibiotic at home, which is common in iran.

---

Background and purpose: Çhronic low back pain (ÇLBP) is a major clinical problem and is one of the most prevalent disease. Lack of adequate knowledge about the recurrent onset after the first period of treatment in some of the patients necessitates further related studies. Ôbjective of this study was to assess the effect of exercise therapy, particulary on reduction of back pain, disability and increase in performance of proprioceptive system of ÇLBP.
Materials and methods : Participants of this study included 16 females with ÇLBP under exercise therapy and 30 healthy females. Pain severity and disability were measured by Quebec and Ôswestery questionnaire using dynamic stability platform. Performance of propriocoptive system in case and control groups were evaluated during two different upright standing and standing with flexed trunk up to 45o angle positions. Âfter three months of exercize therapy. Ïn patients, all variables were measured again.
Results: Findings of this study indicate that back pain and degree of disability reduce by 58% and 53% respectively. The postural away of the patients was 3.3 times greater than that of the normal group before treatment. However, after treatment, the postutal away decreased by 70% showing a significant improvement on the function of the proprioceptives systems.
Çonclusion: Proprioceptive system performance in ÇLBP patients is weak. Ëxercise therapy results in the reduction of back pain and disability and increase in performance of proprioceptive system in the patients suffering from ÇLBP. Ât both of diagnostic and rehabilitation stages evaluation of proprioceptive system performance has clinical significance.

---

Background and purpose: Terbinafine, a drug of allylamines group, is a new class of antimycotic agents that blocks sterol biosynthesis in the fungi through inhibition of sequalene epoxidase and consequent sequalene accumulation, a primarily fungicidal process. Terbinafine is very effective on various fungi as an oral and topical antifungal agent. Ïn present study, the antifungal efficacy of 1% terbinafine cream vs. 2% miconazole was assessed in a double blind randomized trial in patients with pityriasis versicolor.
Materials and methods : Forty patients (24 male, 16 female), mean age 25.1 (range: 13-63) were enrolled on the basis of random sample table, and the treatment with terbinafine or miconazole were applied twice daily for 4 weeks. To evaluate the efficacy and cure rate of the drug, mycological examination was performed before starting the study and at the end of each week of treatment. Â patient was considered mycologically cured when direct microscopy was negative, and clinically cured when all clinical parameter considered were negative.
Results : Negativizations of all clinical parameters were observed within 2 weeks in 70% of terbinafine and 35% miconazole patients. Ât the end of the treatment, 85% of terbinafine and 80% of miconazole patients were clinically cured (χ2 and exact fisher test were not shown any difference). Negativizations pattern of hyperchromia and desquamation in two treatment groups were not significantly different. The percentage of Negativization of direct microscopy was 1.4 fold in 1% terbinafine vs. 2% miconazole after 2 weeks of treatment (These differences were not statistically significant). Drug eruption and intolerance in two groups were not significantly different. Çlinical relapse after 2 weeks were obsened in 7.1% terbinafine patients and 42.8% miconazole patients. Çlinical relapse after 16 weeks was 18.2% in terbinafine patients and 64.3% miconazole patients (Significantly different).
Çonclusion : The results of the present trial indicate that fungicidal activity of 1% terbinafine and 2% miconazole was similar and both were not 100% effective. Terbinafine was rapid in action. Âlthough terbinafine is slightly more effective than miconazole, it is available only on prescription at much greater cost. The relapse rate of %1 terbinafine was less than %2 miconazole. Thus based on the most cost effective strategy, we recommend initial treatment with miconazole and the use of terbinafine only if that fails.

---

Background and purpose: Çonsidering the highRegarding to excessive prevalence of examination anxiety among students, its effect on learning and their mean sxcores and also because of stressful nature of studying in nursing we conducted this investigation to determine the effect of relaxation on anxiety level among nursing students.
Materials and methods: This is an experimental study on sixth nursing students in two groups (twenty one female and seven male) and control group (n= 32). The were randomly divided and matchedwith regarding of sex, gender, marital status and using of dormitory. Data collecting instrument was a demographic sheet and S7Â7- x Shpilberger questionnaire. The level of anxiety was determined before and after relaxation exercises education by Shpilberger questionnaire. Relaxation exercises training (muscular progressive relaxation) were educated at one two-hours session practically and then an education handbook was given to students. They were asked to performing the exercises until the final examinations twice a day for half an hour.
Results: Study results showed that anxiety level among 82.1% of case was mild and 53.1% of control group showed moderate level of anxiety. Manwhitney test showed a significant difference between two groups in anxiety level (P<0.000). 89.3% of case group and 40.6% of control group had mild and moderate manifestations of anxiety respectively. ManÜwhitney test showed a significant difference between two groups in evident anxiety (P<0.000). 75% of students from case group showed latent anxiety at mild and moderate level respectively ManÜWhitney test showed statistically significant difference (p<0.05) between two groups in latent anxiety. -Sing statistics revealed significant difference inside the case group before, and after training (p<0.000) however, it did not reveal any significant difference inside control group before and after training.
Çonclusion: This study showed the effect of relaxation exercise training in decreasing anxiety level. Ït is suggested to accomplish investigations to determine effects of relaxation training on examination anxiety level in other stressful field of studies in medical Sciences.

---

Background and purpose : Social phobia is the third current disorder in psychiatry, that causes functional deficiency in patients and leads to high economic losses in families and society. Social phobia can be managed by different durg and non-durg treatment, one of them probably is cognitive therapy. The purpose of this study is to determine the effect of congnitive therapy on the social phobia of the students in the highschool boys of Kashan province in 1999.
Materials and methods : This is a clinical trial in which the effects of cognitive therapy were assesed by determining and comparing the social phobia between the cases of cognitive therapy and control groups at their entering the study and after six weeks. The sample of this study consists of 44 boys suffering from society-escaping or avoidant disorder. from 11 state highschools in kashan. They scored higher than other students measured by social phobia scale of mattick and Çlarke.
Results : The finding of the study showed that social phobia in the cognitive therapy group was significantly different when entering the study and after six weeks. (P=0.0000), while in the control group there was no difference in the social phobia in either points. Furthermore, a significant difference in the social phobia between the cognitive therapy group and control group was noted (P=0.0000).
Çonclusion : Çonsidering the positive effect of cognitive therapy on social phobia, cognitive therapy is recommended in treatment of the social phobia. We also suggest a study determining the effect of cognitive therapy on the social phobia at short and long term follow up.

---

Background and purpose: Head lice infestation caused by Pediculus capitis and its treatment is a worldwide and historical concern.
Materials and methods: This study has been done with cooperation with the health’s deputy of medical sciences university in different cities of Hamadan province in 2000-2001. Screening was done in 120 girl’s elementary schools during which 7291 students were examined for head lice infestation. About 13.5% (975) of the girls were detected with head lice. The infested girls were divided into three treatment groups with three kinds of shampooes containing pediculicide and one control group with ordinary shampoo (placebo). In a randomized evaluator, blind clinical trial to compare pediculicidal and ovicidal effects of shampooes against head lice, the participants assigned to groups to use the shampooes based on manufacture’s instructions and followed up three weeks after treatment. Statistical analyses were done by X2 test and line logarithmic procedure.
Results: The results show that cure rates (no live adult and nymph of lice were seen on physical re-examination of scalp(, at the end of the first week were 29,36, 34 and 15 percent for d-phenothrin 0.2%, lindane 1% , permethrin1% and placebo respectively. These cure rates for treatment shampooes showed significant differences when compared to placebo (0.001

0.05). but at the end of the third week, the cure rates for the three mentioned shampooes were 88, 88 and 87 percent and also there is no statisticall differences in their efficacy. It should be noted that the results of ordinary shampoo is just for the first week after usage. Line logarithmic analysis of results shows that efficacy of different pediculicide shampoo (p value=0.58) in different times (p value=0.25) have no difference. but the cure rate of cases varied three weeks after treatment. (p value<0.0001). This shows the residual effect of pediculicides on new hatched nymphs.

Conclusion: According to the results obtained, economical viewpoint, and popular acceptance, lindane %1 shampoo is advocated as the first choice for treatment of head lice infestion if its usage is done under manufacture’s instruction and with caution combine with physical removal of nits with fine-toothed comb. Finally, educative campaign of parents and school personnel is reinforced.

---

Background and purpose: In spite of discovering new antipsychotics in the past years, many patients of schizophrenia don’t response to none of them and are resistance to treatment. In this case, clozapine, ECT or some combination of drug mostly be used, but there are many patients of schizophrenia who are resistance to them. In recent years, of combination of ECT and clozapine has been suggested for these patients with promising results in primary studies. The purpose of this study was to evaluate the effects of a combination of ECT clozapine in treatment of resistance schizophrenia in comparison with clozapine and ECT administered reparately and double blind.
Materials and methods : Eighteen resistance schizophrenia patients were selected and divided into three groups. The first group took clozapine, the second group took ECT, and third group took a combination of ECT and clozapine. The responses to treatment evaluated with PANSS and analysed with ANOVA and t-test.
Results : The rate of decrease of PANSS scale in three groups of clozapine, ECT and combination both of them were 46%, 40%, 71% respectively, with significant difference (p<0.05). Combination of ECT and clozapine showed faster response than ECT and clozapine alone.
Conclusion : Combination of ECT and clozapine was effective and safe in treatment of resistance schizophrenia.

---

Background and purpose: About 200,000 of Iranian population are infected with Hepatitis C Virus. On the basis of Iranian consensus on management of chronic hepatitis C (CHC) infection in 2004, combination therapy with conventional α-Interferon (IFN) plus Ribavirin is the first therapeutic choice in CHC patients. Data are limited on treatment response rate in most areas of the country. To assess the treatment results, we performed this study in a referral center in province of Fars, in Iran, to compare with the response rates to therapy in Western patients.
Materials and Methods: A total of 118 patients with CHC (males 88%) with mean age of 37.47 (SD 11.4) years, mean Histologic Activity Index of 8.21 (SD 4.5), and mean pretreatment Alt level of 81.26 (SD 72.86) were enrolled in the study. IFN 3 million unit/TIW plus Ribavirin 1-1.2 gr/d were administrated for 6-12 months (depending on genotype), and the patients were followed up for 6 months period to assess sustained virologic response (SVR).
Results: The most common route of aquisition of the virus was intravenous drug using seen in 39.8% of patients. 40.7% were infected by genotype 3a, 22 % 1a and 9.3% by 1b. Seventy-three patients completed the course of therapy. End of treatment response (ETR) was achieved in 54 (74%) patients. SVR rate was 48% with a relapse of 13.7% . Hepatic decompensation was seen in 2 (2.7%) patients in follow-up period. With respect to the duration of therapy, genotype of viruses was not significantly different in both responders and non-responders (0.05).
Conclusion: Despite the different genotyping pattern, ETR and SVR rates were comparable in Iranian CHC patients treated by combination therapy of conventional IFN plus ribavirin in comparison with Western patients. SVR was greater in cases with pretreatment lower HAI

---

Background and purpose: In spite of the increasing progress in tumor treatment by current methods like surgery, chemotherapy and etc, medical sciences are unable to treat tumors. In this respect, immunology has opened a new window for tumor treatment nowadays tumor immunotherapy is an accepted strategy for treatment of some tumors at least in some animal models. The goal of this study is the evaluation of immunotherapy using gp96- tumor peptide complex and its combination with naloxon as an opioid receptor antagonist to achieve of cellular immunity against tumors
Materials and methods: In this study firstly, gp96 – tumor peptide complexes were purified from WEHI164 cells line using srivastava method. In the next stage, the mice, made tumoric befor by the injection of tumor cells, then were divided in to four groups. Control group were injected by PBS, test group1 were injected by naloxon, test group2 were injected by gp96 – tumor peptide complex and test group3 were injected by combination of naloxon and gp96 – tumor peptide complex. To evaluation the efficacy of vaccination, after several days, tumor volume was recorded then the mice were killed and the spleanic cells were extracted in sterile condition. MTT test was done for cells proliferation study. Supernatant of cultured cells were collected and assayed by ELISA kits for measuring IL-4 and IFN-γ.
Results: Result of protein purification had showen , purified gp96 Isoform has Molecular Weight of 66 kilo dalton.Results of tumor volume had shown that, there is no significant difference between test and control groups. Results of MTT test had shown that, there is no significant difference between test and control groups. IL-4 assay study had showed that, there is no significant difference between test group1, group2 and control group but test group3 has significantly decreased in IL-4 amount when compared with control group. Results of IFN-γ assay showed that, there is no significant difference between test group1 and control group, but test group2 and group3 has significantly increased in IFN-γ amount when compared with control group.
Conclusion: It can be concluded from this study is that, prophylactic immunotherapy of tumor by combination of gp96-tumor peptide complex and naloxon, can increase IFN-γ, and, probably in a higher dosage, it may stimulate immune system more to become more potent to even decrease tumor volume.

---

Background and purpose: Although adjunct chemotherapy may increase life in non-menopausal breast cancer patients، however، it may cause short-term complications such as nausea، vomiting، alopecia، as well as long-term complications in ovarian failure and premature menopausal. The objective of this study was to investigate chemotherapy-induced secondary amenorrhea in non-menopausal women with breast cancer.
Materials and methods: A descriptive design (case series) was preformed on fifty breast cancer patients، non-menopausal (normal mense) and chemotherapy in Ramsar Emam Sajad Hospital Oncology unit from 2007 to 2008. Sampling was consecutive. Data gathering method was questionnaire & blood sampling (FSH & Progesterone) for prior and 12 months after the end of chemotherapy. Data was analyzed by paired-t، independent-t and one-way ANOVA tests.
Results: Results showed that 62% of patients were amenorrhea 12 months after the end of chemotherapy. Results showed that there was no meaningful relationship between age، hormone therapy، disease stage، node-positive and ER & PR status to amenorrhea however، there was a meaningful relationship between duration of treatment، type and dose of chemotherapy to amenorrhea.
Conclusion: In pre-menopausal patients with breast cancer، receiving cytotoxic chemotherapy against tumor cells، amenorrhea may occur do to ovarian failure.

---

Background and purpose:Chronic idiopathic urticaria (CIU) is a recurrent disorder that is characterized by itching wheels lasting more than 6 weeks. Etiology of CIU is unknown. The aim of this study is to assess the efficacy of Helicobacter pylori (Hp) infection eradication in improvement of CIU.
Materials and methods:In this double blind placebo-controlled clinical trial, 60 CIU patients were enrolled in the study. Urea breath test (UBT) was performed for indicating the Hp infection. Hp positive patients were divided in 2 groups: cases that were treated with quadruple therapy for eradication of Hp(Amoxicillin, Omeprazole, Bismuth and Metronidazole) and controls (placebo). The gastrointestinal (GI) and dermatologic symptoms and signs were recorded and compared in the beginning of the study, and 1 and 3 months after the treatment.
Results:From 60 CIU patients, 32 (53%) were UBT positive. 15 cases and 13 controls completed the study. There were no significant statistical differences between the two groups for their GI and dermatologic complaints before intervention, and 1 and 3 months after eradication, except for pyrosis that was improved in cases after 3 months (P= 0.029)
Conclusion:Eradication of Hp does not have any effect on improving CIU symptoms or signs.

---

Background and purpose: The goal of asthma therapy is to achieve clinical control and near normal lung functions. Many patients with moderate persistent asthma fail to achieve this goal with a low dose of inhaled corticosteroid (ÏÇS) plus long-acting β2 agonist (LÂBÂ). Ïn the present study, we have checked whether another controller medication (in the form of ginger capsule) add on to ÏÇSlow dose + LÂBÂ helps in achieving the asthma goal or not.
Materials and methods: Thirty two adult asthmatics (17 male and 15 female) completed a 10 week trial consisting of a 1 week single blind run in period, during which placebo (250 mg capsule of lactose 3 times a day) was added to usual treatment (inhaled beclomethasone diproprionate 200 µg/twice daily plus salmeterol 50 µg/twice daily), a 4 week double blind active treatment period in which subjects received ginger (250 mg capsule of powdered ginger 3 times a day) or placebo capsule, a single blind 1 week washout period receiving placebo and a final 4 week double blind cross-over active treatment period. The primary efficacy variable was the forced expiratory volume at 1 second (FËV1) secondary efficacy variables were the peak expiratory flow (PËF) and the asthma control test (ÂÇT) scores. These variables were measured at the completion of each phase, i.e. the end of weeks 1, 5, 6 and 10. Statistical comparisons of all variables were made by two-way analysis of variance (ÂNÔVÂ) with patient, period, and treatment as fixed factors. P< 0.05 was considered statistically significant.
Results: Âll the patients of the ginger group had significant improvement in FËV1 , PËF and ÂÇT scores (P<0.001) at the end of 10 weeks. Mean (95% ÇÏ) measurements for ginger vs placebo treatment periods were 1.99 vs 1.49 (0.32 to 0.68) L for FËV1, 255.8 vs 205.4 (27.1 to 73.8) L min-1 for PËF and 20.6 vs 17.3 (2.77 to 3.73) for ÂÇT scores. There was a similar frequency of minor adverse effects reported during placebo (13%) and ginger (16%) treatments (P>0.05).
Çonclusion: Powdered ginger rhizome capsule as an add on to inhaled corticosteroid and long-acting β2 agonist is effective in the improvement of FËV1, PËF, and ÂÇT scores of the patients of a moderate type of persistent asthma uncontrolled on standard treatment.

---

Background and purpose: Low back pain is a common and costly problem in pregnancy. Ït is one of the main reasons of disability and absence from work with extremly direct and indirect economical impact. Women are more prone to low back pain and pregnancy is one of the predisposition. The purpose of this study was to assess the effect of an exercise program and ergonomic advices on the treatment of low back pain in pregnant women.
Materials and methods: Following ethical approval and through a randomized controlled clinical trial, 120 pregnant women with low back pain were recruited into experimental and control groups. The experimental group (n=60) received therapeutic exercise combined with ergonomic advices and the control group (n=60) was given no intervention. Pain experienced by patients was assessed using Visual Ânalogue Scale and functional disability on Ôswestry Low Back Disability Questionnaire after the planned intervention within three months follow-up.
Results: Ïntra-group changes indicated that there was a significant reduction on pain intensity and functional disability in the experimental group (P<0.01 in both instances) but no such difference was found in the control group (P>0.05). Ïnter-groups changes showed significant improvements in both pain intensity and functional disability following intervention (P<0.01) in the experimental group in comparison with the control group (P<0.01 in both instances). The significance of differences held up within three months follow–up between the two groups (P<0.01 in both instances).
Çonclusion: Ôur results demonstrate that therapeutic exercise and ergonomic advices could be considered as effective approaches in the treatment of low back pain during pregnancy. Therefore, we offer regular exercise and ergonomic advices during pregnancy and afterwards in order to prevent and to control low back pain.

---

Background and purpose: Myocardial Infraction (MI) is one of the most common diseases in industrial countries. In clinical findings, erythropoietin has shown protection against cellular hypoxic ischemic injury in myocardium. This study assessed the role of erythropoietin in patients with acute MI. Materials and methods: In this cohort study 70 patients with STEMI were divided to two groups: (SK+) that received streptokinase and non-SK (SK-) group. At SK+ group we measured the plasma erythropoietin level before receiving SK, 1hour and three days after receiving SK. In SK- group the level of erythropoietin at entrance to ED, two hours later and on third day was also measured. The relationship between success in reperfusion therapy with ejection fraction and the level of erythropoietin were investigated. Results: The erythropoietin level in those who had successful reperfusion with thrombolytic therapy was significantly higher than those who had not successful reperfusion but no significant relationship was found between ventricular arrhythmias and level of erythropoietin. Ejection fraction at first day in SK+ group was significantly higher (P=0.001). We also observed a significant relationship between plasma erythropoietin level and ejection fraction in both SK + and SK- groups (p=0.001). Conclusion: There are direct relationships between higher level of erythropoietin and success in thrombolytic therapy and also with improvement of EF after AMI.

---

Background and purpose: The monitoring of the patients’ hemodynamic status and vital signs is a routine practice in ÏÇÜ and the use of a low-cost and soothing method to maintain stable physiological parameters is necessary. This study aimed at investigating the effect of music on the vital signs and SpÔ2 of patients after open heart surgery.
Materials and methods: This study was a randomized clinical trial (RÇT) conducted on 60 patients hospitalized in the open heart surgery ÏÇÜ of Mazandaran Heart Çenter. Patients were randomly assigned into case and control groups. Ïn the case group, the patients listened to the music, which they selected before, through headphones for 30 minutes, while headphones without playing any music were used for patients in the control group. Vital signs and SpÔ2 of the patients were assessed before the intervention, immediately, 30 and 60 minutes after the intervention. The data were analyzed using Çhi-square T-test and repeated measure statistical tests.
Results: Findings showed that music led to a significant decrease in the rate of heartbeat, systolic blood pressure, and mean arterial pressure and a significant increase in SpÔ2 rate (P<0.05) was also observed. But music had no significant effect on the respiratory rate and diastolic blood pressure (P>0.05).
Çonclusion: Âs a non-pharmacologic, inexpensive, non-invasive method and without any side effects, music can improve the vital signs of the patients after open heart surgery.

---

Background and purpose: Fear of negative evaluation consists of anxiousness about other people’s evaluation of oneself, worries resulting from these negative evaluations, and the expectations from others, that they would develop only negative evaluations of one. The purpose of the present study was to determine the effect of metacognitive therapy (MÇT) on symptoms of fear of negative evaluation in social phobia disorder patients.
Materials and methods: This study was carried out as a controlled clinical trial. Participants were referred from clinics in the city of Shiraz, Ïran, and 19 patients were selected. They were randomly assigned to either the experimental or the control group. Âfter running the pretest, which was done using the fears of negative evaluation scale (FNË) and social phobia symptoms assessment questionnaire (SPSÂQ), the experimental group received 8 weekly metacognitive intervention sessions, while the control group received no intervention. Post-test and follow-up (after 3 months) were performed using the same tools.
Results: The results of analysis of multivariate covariance showed that MÇT had a significant effect on alleviating the symptoms of fear of negative evaluation (p<0.05).
Çonclusion: This intervention emphasizes on the promotion of efficient adaptive and flexible skills through metacognitive processes and their effect on a decrease in fear of negative evaluation in patients suffering social phobia disorder.

---

Abstract Background and purpose: Ostomatitis or oral mucositis is common problem in patients undergoing chemotherapy that results in complications such as pain, infection, malaise and increased length of hospital stay. Oral hygiene and application of an appropriate mouthwash are only ways for prevention of these problems. The goal of this study was to assess the effect of Chamomile mouthwash to prevent ostomatitis in children undergoing chemotherapy. Materials and methods: In this quasi-experimental-double blinded study 52 children undergoing chemotherapy were randomly assigned in two study and control groups. Patients in the study group were taught to brush their teeth, troll a diluted solution of Chamomile mouthwash (30 drops in 20 ml water), for one minute, and then outpour it and do not eat anything for an hour, three times a day for 14 days. Patient's mouth was examined on days 7 and 14 and then their ostomatitis recorded according to WHO scale. Results: Result indicated that incidence of ostomatitis in study group after 7 days was 42.3% and in control group was 76.9% (P≤0.01). Conclusion: Chamomile can be used as a suitable mouthwash to prevent ostomatitis in children undergoing chemotherapy and leads to improving nutrition and satisfaction of children and parents.