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For a patient under any treatment it is very important to maintain a stable cardiovascular system (CVS) under anesthesia. The CVS can be disturbed due to many factors, and one of the factor which can later the hemodynamic system of the patient is laryngoscopy and intubation. Hence the assessment of the variations in the blood pressure (BP) and heart rate (HR) of the patient during laryngoscopy and intubation is very important. Hypertension and Tachycardia as a great disorders causing great problems. Such as cerebral hemorrhagia and myocardial infection, which are occurred during general anesthesia. Laryngoscopy and endotracheal intubation is necessary for airway management prevention of the aspiration of gastric contents. The amount of blood pressure and heart rate is measured in 1, 3, 5 after laryngoscopy and intubation. 70 patients ASA1 with the age of 16-55, undergone elective surgery and a general anesthesia were selected. Some drug pre-medication and induction were the same in rate about all patients. 35 patients are intubated orally and the rest of them nasally. The subjects were chosen among patients who did not have difficult intubation and cardiovascular disorders. Before laryngoscopy and 1, 3, 5 minutes blood pressure and HR measured. According to outcoming results, blood pressure and HR increasing after laryngoscopy in both group (Oral intubation and nasal intubation). The increase of nasotracheal intubation was more than oral one remarkably. The difference would be meaningful according to statistic point (P<0.05). According to research finding the most amount of increase in the blood pressure and HR was related to the laryngoscopy and intubation. These changes can make problems for some cardiovascular patients. So it is suggested that all anesthetists should lessen the probable complication of patients under laryngoscopy a tracheal intubation by monitoring BP and HR.

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Background & Objective: The deterious effects of pressor response (Tachycardia and hypertension) are not hidden from any personal of anesthesia group. The present study is performed in Chamran Hospital affiliated to the university of medical sciences, Shiraz, with the aim to introduce the most effective, cheapest as well as the easiest method to prevent or reduce the pressor response to direct laryngoscopy and intubation. Materials & Methods: This randomized clinical trial was conducted in Chamran Hospital in Shiraz. 90 patients scheduled for elective surgical fixation of femur or tibia were randomly divided in group A (30 patients), group B (30 patients) and group C (30 patients). In-group A patients were directly sprayed with Lidocaine 10%, hypopharyngealy, after induction of anesthesia and 3 minutes before tracheal intubation. Patients in group B were sprayed with Lidocaine 10% oropharyngealy before induction of anesthesia while the patients, were awake, patients in group C were not sprayed with Lidocaine (Control group). Premedication and drugs used for induction of anesthesia were same in 3 groups. The heart rate, systolic and diastolic blood pressure were recorded in all patients included in the study, before tracheal intubation (Base line) just after tracheal intubation and 3 and 5 minutes after intubation. Results: Spraying Lidocaine oropharyngealy before induction of anesthesia and hypopharyngealy after induction of anesthesia both were effective in controlling the pressor response to laryngoscopy and tracheal intubation, but spraying Lidocaine oropharyngealy before induction of anesthesia is more effective than spraying Lidocaine hypopharyngealy after induction of anesthesia (P<0.05). Conclusion: According to the results of present study, applying Lidocaine spray, oropharyngealy is a simple, very effective as well as cheap method for controlling pressor response to tracheal intubation.

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Background & Objective: Examinations are among the most important stressors in schools and universities that result to psycho physiological outcomes but these effects on children has not been paid much attention. This study was done to determine the effect of stress of final examinations on the activation of hypothalamus-pituitary-adrenal axis (change of salivary cortisol) and autonomous nervous system (pulse rate) in children. Materials & Methods: A total of 100 children (50 boys, 50 girls) in 5th grade aged less than 12 years from two primary schools of five educational district in Tehran were chosen randomly. The subjects completed Adolescent’s Eysenck personality inventory. Physical and mental health was reviewed the medical history, clinical examinations and after controlling sleep, food, drug and sport variables, salivary samples and pulse rates were taken five times as follows: once a week before and then three times through mathematics, history and science exams and once a week after passing the exams at 9 to 10 am .Salivary cortisol samples were analysed by ELISA method. Results: Cortisol levels increased significantly during examinations in compare with cortisol levels before and after examinations. Depending to sex, psychoticism, neuroticism and extroversion –introversion variables, only the effect of psychoticism and extroversion –introversion are statistically significant (P<0.05). Also repeated analysis of variance for pulse rate indicated the increase rate of later factor (P<0.05). Conclusion: Final examinations as a stressor resource increase salivary cortisol and pulse rates of children. Personality factors can modulate the effect of examinations on salivary cortisol. Sex also modulates pulse rates increasing during academic examinations.

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Background & Objective: Pulse pressure is a marker of arterial stiffness. In old age the pressure wave reflection also contribute to disparity of pulse pressure between upper and lower limbs. This study was done to determine the relation between ageing and increased pulse pressure of upper and lower limbs. Materials & Methods: In this discriptive study blood pressure measured in 40 nonsmoker men, all free from medication and disease history, insubjects divided in two groups: 18-25 and 50-70 years old with mean age of 22±1.3 and 59±2 years respectively. Using a mercury-column sphygmomanometer (ERKA) with appropriate cuff size and after five minutes of quiet rest, the blood pressure was determined in supine posture at three separate times. The lower limb pressure was measured with placing the cuff on calf muscle and the stethoscope on posterior surface of internal malleolus. The mean of the second and third records rounded and were used for analysis. Results: The right and left brachial and ankles pulse pressure in two groups were: 44.50±2.03, 44.50±1.71, 37.90±2.24, 37.25±2.30 mmHg in 18-25 years old group and 47.10±2.74, 46.90±2.65, 56.05±3.18, 55.90±4.48 mmHg in 50-70 years old group, respectively. Significant differences were found between brachial and ankle pulse pressure in both sides in first group, (P<0.05). In the second group this difference was only significant at right, (P<0.05). The ratio of brachial pulse pressure to ankle pulse pressure in 18-25 years old group was greater than 1 and in 50-70 years old group it was less than .15 In both side the ankles pulse pressure was significantly greater in 50-70 years old group (P<0.05). Conclusion: This study showed that in subjects of more than 55 years of age, the increasing of pulse pressure was more prominent in lower limb. The ankle pulse pressure may be a proper index of central pulse pressure changes and atherosclerosis of elastic arteries with ageing.

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Background and Objective: Hysterectomy is stressful in women operation, due to increased release the level of catecholamines some physiological reactions including increase in breathing, heart rate and blood pressure are clinically observed. Massage therapy helps to improve the nervous and cardiovascular system and modifies physiological responses. This study was done to determine the effect of foot massage on the vital signs of patients after hysterectomy.
Methods: In this clinical trial study 60 women underway hysterectomy were randomly divided into intervention (n=28) and control (n=29) groups. Subjects in intervention group were received a
20 minute foot massage according to the mentioned method in two sessions first and second day after surgery, with 24-hours interval. Before and 30 minutes after intervention , vital sign including systolic and diastolic blood pressure, pulse, breathing were recorded for each subject.
Results: In the intervention group, all of the signs of vital signs before and after massage in the first and second days after the operation showed a significant decrease (P<0.05). The number of pulses and diastolic blood pressure in the first and second day after surgery and systolic blood pressure on the second day in the control group showed a significant reduction (P<0.05). At the end of the first day after the intervention group, the systolic blood pressure and respiratory rate showed a significant decrease compared to the control group (P<0.05).
Conclusion: Foot massage improves systolic blood pressure and breathing at the first day after hysterectomy, which may indicate an increase in parasympathetic activity.