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One of the major determinative of the outcome of the ophthalmologic surgeries, is how efficiency the anesthesiologist can lower the intraocular pressure (IOP) and prevent it from rising in response to such maneuvers as laryngoscopy and tracheal intubation. In our study, we have chosen Midazolam and Propofol for comparing their effects on IOP during induction of anesthesia, laryngoscopy and tracheal intubation, with the purpose of identifying the drug which can more effectively decrease IOP and prevent it’s during laryngoscopy and tracheal intubation. 100 patients were selected randomly and received either Midazolam 0.2 mg/kg, Sufentanil 0.2 microgram/kg, Atracurium 0.5 mg/kg (Group 1) or Propofol 2.5 mg/kg, Sufentanil 0.2 microgram/kg, Atracurium 0.5 mg/kg (Group 2). The IOP was measured before and after induction and immediately after intubation. Both groups showed a meaningful decrease in IOP following induction of anesthesia (P?0.0001). Laryngoscopy and intubation, increased IOP in group 1, however not significantly and still lower than the base line IOP (P=0.09). Group 2 showed no such increase (P<0.0001). We concluded that Propofol in comparison to Midazolam is more effective in prevention of IOP rise in response to laryngoscopy and tracheal intubation.

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Background and Objective: Home surplus drugs are an important problem in the developing countries especially in Iran. Iran is one of the most important consumers of drugs in the world. Materials and Methods: The study was descriptive and limited one and included 257 families of Yasuj (25 clusters) that are selected by random sampling. The method of survey is done by questionnaires and intends to evaluate home surplus drugs on basis of value, dosage forms, which is wasted from the therapeutic categorie and expiry date of drugs. Results: The findings that 83% of families had home surplus drugs on basis of dosage forms tablets, capsules, syrup and ampoules (Vials) are ranked. On basis of the therapeutic categories, gastrointestinals, analgesics, antibiotics, CNS and antihistamines are ranked. 80.50% of families are covered by one of the current insurance organizations and 19.5% are not. Conclusion: The average value of drugs for every one family was 8869 girls and from macroeconomic point of view, it will be a huge amount of money budget of country.

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Background & Objective: Enteroparasitic infections constitute a serious public health problem in different populations including developed countries. Patients who receive chemotherapy of cancer have an increased probability of acquiring parsitic infections, generally with a high degree of severity. The aim of present study was to ascertain the frequency of intestinal parasites in patients admitted in oncology ward for chemotherapy. Materials & Methods: In a descriptive study, all the patients whith malignancy who admitted in Sina Hospital in Hamadan, Iran, during 2005 were included. Data including demographic characteristics, type of malignancy, and the time past from the diagnosis entered the questionnaires. A stool specimen were examined for each patients. Data were analyzed using SPSS software. Results: Out of 190 patients, 94 (49.5%) were male and 96 (50.5%) were female. The mean age was 48.518.7 years (12-88 years). Thirty-one (16.3%) patients were involved intestinal parasites. The most common parasites were: Ascaris (41.9%), Giardia (35.5%), Indolimax nana (3.2%), Blastocytis hominis (3.2%), and Cryptosporidium (3.2%). The highest prevalence of intestinal parasites belonged to 40-60 years age group Conclusion: This study indicated that, the prevalence of intestinal parasites in patients undergoing chemotherapy for malignancy is lower than general population, which can be related to the effect of antineoplastic agents.

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Background and Objective: Celiac is a hereditary disease presented with chronic inflammation of small intestine. Several studies supposed a relationship between Celiac disease and Inflammatory Bowel Disease (IBD). Tissue trans-glutaminase antibody is one of the best serological markers in Celiac disease. This study was designed to evaluate the association of Celiac and IBD using tissue trans-glutaminase antibody.

Materials and Methods: In this descriptive study 127 confirmed IBD patients who were referred by gastroentrologists 2005-08 enrolled into the study. A questionnaire was completed and tissue trans-glutaminase antibody was evaluated with ELISA method with a Cut-off=12 U/ml.

Results: Among 127 referred patients, serum samples of 102 patients were collected. Mean±SD of age was 36.17±15.2 years and 48% were males. Ulcerative colitis, Crohn’s disease and other colitis were observed in 76 (74.5%), 7 (6.9%) and 19 (18.6%) of patients, respectively. Tissue trans-glutaminase antibody was positive (19.8 U/L) in one 46-years-old male patient with ulcerative colitis.

Conclusion: Tissue trans-glutaminase antibody titer was not significantly different between IBD patients and controls, thus it seems not appropriate to suggest as one of the routine tests in IBD patients.

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Antibiotics usage in domestic animals, as antibiotic growth promoters (AGPs) was considered from middle of 1950 onwards. Antibiotic feed additives as growth promoters have long been supplemented to animal food in very low amounts (5 to 20 ppm) to stabilize the intestinal microbial flora, improve the general performances, and prevent some specific intestinal pathogens. The widespread use of antibiotics as AGPs is playing a significant role in the emergence of resistant bacteria. The resistant bacteria in animals due to antibiotic exposure can be transmitted to human through the consumption of their products, from close or direct contact with animals, or through the environment and consequently, the increased concern about the potential for antibiotic resistant bacteria was led the European ::::union:::: and the United States regulations banning the use of AGPs in animal food since 2006. Various studies always look for a suitable replacement antibiotics to substitute to preserve the valuable role of these compounds. Extensive efforts on these alternatives have been started in last decades and some of these alternatives such as probiotics, prebiotics, synbiotics, ionophores, acidifier, organic acids, medicinal herbs and phytogenic can be pointed out. Hence, the aim of this review is to evaluate the antibiotic replacement strategy particularly medicinal herbs and their mechanisms as new growth and health promoters.

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Background and Objective: Alpha thalassemia is one of the most common hemoglobin disorders. Some combination of alpha globin gene mutations may cause HbH disease with severe anemia or intermediate thalassemia. genotype common deletions are routinely tested for suspicious alpha thalassemia couples but because of lack of information about the nature and frequency of point mutations and higher expenosor of sequencing, less attention was paid to them. This study was done to determine the prevalence of common point mutations of alpha globin gene in Babol, Iran.

Materials and Methods: This descriptive study was carried out on DNA of 153 adult suspected to α-thalasemia with deleted α- golobolin gene referred to genetic laboratory in Babol, Iran during 2005-09. a1 and a2 genes were amplified by using specific biotinilated primers by PCR method. PCR products were assayed using 11 specific probs corresponding to common point mutations in alpha gene (C19, IVSI (-5nt), C59, Hb constant spring, Hb Icaria, Hb seal Rock, IVSI (148), C14, poly A (-2bp), poly A2, Poly A1) and fixed on byodine C membrabe. Hybridization between the probes and PCR products was visualized after a colorimetric reaction using of conjugated streptavidin peroxidase and TMB (tetra methyle Benzidine) and H²O².

Results: The prevalence of point mutations in poly A2, 5nt, Hb constant spring and poly A1 were 28.75%, 14.38%, 7.84% and 2.61%, respectively.

Conclusion: Point mutation in alpha globin genes was detected in %53.60 out of 153 adults suspected with alpha thalassemia without common deletion mutations.

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Background and Objective: According to world health organization statistics, at least 5.2% of world population is carrier for a main hemoglobin disorder. Previous reports showed that more than 10% of people are carrier for beta-thalassemia Northern Iran. This study was done to determine the prevalance of hemoglobinopathies in premarriage individuals referred to Babolsar, Iran.

Materials and Methods: This descriptive study was carried out on 8500 individuals  (4200 women and 4300 men) whome were attended the thalassemia counseling program in Babolsar, North of Iran during 2006-09. After performing the CBC test, for those MCV and MCH were less than 80 and 27 respectively, Hemoglobin A2 was evaluated. Subjects whome were volunteers for more comprehensive tests, basic and acidic electrophoresis and genetic tests were applied, subsequently.

Results: 1200 (14.11%) subjects had low hematological indexes. 474 (5.57%) subjects had high HbA2 and were classified as beta-thalassemia carriers and 726 (8.54%) had normal HbA2 level and were classified as alpha-thalassemia carriers. 6 (1.2%) subjects were identified with HbF level more than 10 and were identified as carriers for beta-gene cluster deletion carrier. Also, 16 (3.2%) individuals had HbE, 16 (3.2%) had HbS, 4 had HbD and 4 had HbH (0.33% in 1200 and 0.047% in 8500 subjects). Genetic study of 317 individuals for beta carriers and 145 subjects for alpha-carriers showed IVSII-1G>A (74.5%) in beta-globin and single gene deletion of 3.7 (47.5%) in alpha-globin genes were the most frequent mutations.

Conclusion: This study showed that carriers for alpha - thalassemia (8.5%) are more frequent compared with beta- thalassemia (5.57%). Also other hemoglobin variants included HbS, HbE, HbD or different beta-gene cluster deletions in the region are considerable and should be screened.

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Background and Objective: Pseudomonas aeruginosa is one of the important causes of nosocomial infections. Extended spectrum-beta Lactamases (ESBLs) and Metallo-beta Lactamase (MBL) producing strains have become resistant against a wide range of antibiotics. The aim of this study was to determine the effect of Methanol extract of Camellia Sinensis on Pseudomonas aeruginosa producing ESBL isolated from burnt wounds of patients.

Materials and Methods: This descriptive study was done on burnt wounds of 245 hospitalaized patients in Shafa hospital, Kerman, Iran during 2006-07. ESBLs producing strains were detected by phenotypic confirmatory test and also E-test strips were used for MBL detection. P.aeruginosa MIC was determined for Cefotaxime, Ceftazidime, Azteronam, Imipenem, Meropenem and methanol extracts of plant Camellia Sinensis prepared by Maceration method.

Results: 120 of burnt wound infected with P.aeruginosa, out of them 41 isolates contained ESBL while lacked MBL. 60% of isolates were resistant to Cefotaxime, 66% to Ceftazidime, 42% to Azteronam, 3% to Imipenem and 5% to Meropenem. Among the extracts, green Tea had the highest antibacterial effect on standard strains and P.aeruginosa producing ESBLs in 1.25mg/ml concentration.

Conclusion: This study showed that methanolic extract of green tea has higher antibacterial effect aginst β-lactamase P.aeruginosa strains than Cefotaxime and Ceftazidime.

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Background and Objective: Several studies have shown that during stroke changes occur in some paraclinic parameters which may have either prognostic or diagnostic value, including electrocardiographic changes. This study was done to evaluate the prognostic value of prolonged QT segment in patients with ischemic stroke. Materials and Methods: This descriptive study with an easy convenient sampling was carried out on 175 patients (73 male and 102 female) with acute ischemic stroke whome have been diagnosed by brain imaging (computed tomography scan and magnetic resonance imaging). All patients were suffering from stroke for the first time and if they use any drug or have underlying disease except diabetes mellitus- hypertension- heart disease and hyperlipidemia were excluded. In the first 24 hours of admission, an electrocardiogram (ECG) were taken for measurement of QT segment and according to death or discharge, patients were divided into two groups, and the mean of QT segment (corrected QT) subsequently were assessed. Data were analyzed using SPSS-15, Chi-Square and independent t-tests. Results: Twenty patients died in the course of admission. The mean of QT segment (corrected QT) in dead patients was 471.15±61.70 and in discharged patients was 421.52±62.96 (P<0.05). The abundance of prolonged QT segment accompanied with death was more frequent. Hypertension, diabetes mellitus, hyperlipidemia and heart disease were significantly correlated with morbidity and mortality (P<0.05). There is no relation between mortality with age and sex. Conclusion: This study showed that mean of QT segment (corrected) and also cases of prolonged QT segment were abundant among dead patients, therefore prolongation of QT segment has prognostic value in patients with ischemic stroke.

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Background and Objective: Since accurate and quick clinical and paraclinical diagnostic methods are not available, in some cases diagnosis of active pulmonary tuberculosis occurs after considerable time from the onset of disease. This study was designed to determine the diagnostic value of High Resolution Computed Tomographic (HRCT) scan in active pulmonary tuberculosis, in Gorgan, Golestan province, North of Iran. Materials and Methods: This diagnostic screening study was carried out on 135 (79 male and 56 female) hospitalized patients suspected with active pulmonary tuberculosis, and HRCT was used in their course of treatment as recommendation of their clinician. The patients were chosen from 5th Azar hosptial during 2009-10. Also it should be mentioned that patients were selected on avaliabity bases, and they were examined by smear, and sputum culture. The patients with negative smear and culture were set up as true healthy group (64 subjects). The lung or small nuddles in HRCT was considered as proper position of lung involvument in active lung pulmonary. The HRCT findings between the case group (71 subjects) and healthy group were compared. According to HRCT findings, the sensitivity and specifity were determined for each patient. Data were analyzed using SPSS-16 and Chi-Square test. Results: In this study, sensitivity, specificity, positive predictive value and negative predictive value of HRCT in active pulmonary tuberculosis were equal to 97.2%, 71.9%, 79.3% and 95.8% respectively. Involvement of upper and middle lobe of the right lung and upper lobe of the left lung were significantly higher than the control group (P<0.05). Conclusion: This study showed that HRCT has high sensitivity and specificity in diagnosis of active pulmonary tuberculosis and can be used as a quick diagnostic way in active pulmonary tuberculosis, especially in patients with strong clinical suspicion and negative smear.

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Background and Objective: Toll-like receptors (TLRs) have been discovered as the most important receptors in innate immunity. One of the most important TLRs is TLR4, the key receptor for the LPS component of gram-negative bacteria. Two polymorphisms, D299G (rs4986790) and T399I (rs4986791), in TLR4 gene are associated with a decreased response to LPS. This study was done to estimate the expression of different polymorphisms of TLR4 gene in colorectal cancer cell line by flowcytometery. Materials and Methods: In this laboratory study, the HCT116 cells were transfected with plasmids containing different variants of TLR4 gene including Flag-tagged-TLR4 wild type, flag-tagged D299G and T399I Using TurboFect transfection reagent. Transfection efficiency was evaluated by GFP plasmid. Expression of different variants of TLR4 was assessed in transfected cells by flowcytometery. Data were analyzed using SPSS-11.5 and chi-square test. Results: TLR4 was detected on HT29 and CaCo2 cell lines at low levels. HCT116 cells did not express detectable amounts of TLR4 by flowcytometery prior to transfection. Gene transfer efficiency for GFP plasmid was about 80% in HCT116 cells by flowcytometery and microscopic analysis. TLR4 expression and LPS responsiveness significantly was higher in HCT116 cells which were transfected with wild type TLR4 gene compared to non-transfected and mutant transfected cells (P<0.05). Conclusion: Lower expression of TLR4 on cells with mutant TLR4 showed that these polymorphisms affect on expression patterns of TLR4 on colon cancer cells.

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Background and Objective: Hemoglobinopathies are among the most prevalent genetic disorders worldwide, and occur as a result of mutations in the gene involved in synthesizing hemoglobin chains. By now more than 1000 defects in hemoglobin chains are discovered. Hemoglobin D (Hb D) is one of these disorders, identified by a single nucleotide mutation on codon 121 of beta globin chain. This study was carried out to evaluate Hb D mutations through molecular methods in Mazandaran province of Iran. Materials and Methods: This descriptive laboratory study was done on 70 patients with an electrophoresis band in hemoglobin-S zone in Mazandaran province of Iran during 2010-11. Capillary zone electrophoresis was done to find out Hb D in 51 patients. Subsequently, PCR-RFLP was performed to evaluate the samples at molecular level. Results: Molecular investigation revealed all cases are carriers of hemoglobin D-Punjab. Two patients were shown to be homozygote carriers of the abnormal gene. Conclusion: This study showed all Hb D affected patients were carriers of Hb D Punjab.

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Background and Objective: Ferula gummosa Boiss. (Barije.) contain medical and antimicrobial properties. This study was done to determine the effect of aqueous and alcoholic extracts of roots of Ferula gummosa Boiss. on the growth of Pseudomonas aeruginosa. Materials and Methods: In this laboratory study, the plant was dried in dark place and aqueous, alcoholic extracts of Barije's root, powder were prepared using Soxhlet method. The efficacy of 0.1 dilution of different values of extracts of Ferula gummosa Boiss. on the strain of Pseudomonas aeruginosa (PTCC 1430) were evaluated by disk diffusion, Agar-well diffusion, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) methods. Results: Pseudomonas aeruginosa was completely resistant to the aqueous extract, and the MIC for the methanol and ethanol extracts was 1.25×10⁴ μg/ml and 6.25×10³ μg/ml, respectively. Conclusion: Methanolic and ethanolic extracts of Ferula gummosa Boiss. have antimicrobial activity against Pseudomonas aeruginosa in in-vitro model.

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Background and Objective: Diabetes is a major risk factor for stroke. Some studies have shown that difference between clinical signs and prognosis in diabetic patients with stroke compared to non-diabetic patients with stroke is due to difference in pattern of cerebral vascular involvement. This study was done to compare the findings of extracranial and transcranial doppler sonography in diabetic and nondiabetic patients with thrombotic stroke. Materials and Methods: This case – control study was done on 70 diabetic patients and 70 non-diabetic patients with thrombotic stroke. All patients were new cases. Extracranial and transcranial doppler sonography was performed for all subjects. Results: Basilar artery stenosis was significantly more frequent in diabetic cases in comparison with non-diabetic patients (P<0.05). The prevalenc of posterior circulation stenosis in diabetic patients was significantly higher than non-diabetic patients (P<0.05). Conclusion: In diabetic patients, stenosis in vertebrobasilar circulation was more frequent. Higher morbidity and mortality in diabetic patients may be due to vascular stenosis pattern.

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Background and Objective: Mayer Rokitansky Kuster Hauser (MRKH) syndrome is characterized by Mullerian duct aplasia in an XX individual with female phenotype presenting primary amenorrhea at adolescence. This study was done to determine the mutations of cystic fibrosis transmembrane conductance regulator (CFTR) gene including DF508, G542X, N1303K, W1282X in patients with MRKH syndrome. Methods: This case-control study was performed on 25 females with MRKH syndrome and 25 healthy females. Blood sample was taken from each subject. DNA genomic was isolated by standard methods and common mutations of CFTR gene analyzed by ARMS-PCR. Results: DF508 gene was found in 3 in case and one individual in control group. G542X, N1303K and W1282X gene was not detected. Conclusion: DF508 gene was found in 12% of patients with MRKH syndrome.

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Background and Objective: The causes of non traumatic abdominal pain are varied from mild to severe onset. This study was carried out to assess the outcome of the patients with non-specific abdominal pain discharged from the emergency department. Methods: This cohort study was carried out on 247 patients (68.4% female, 31.6% male) with non-specific abdominal pain which referred to the emergency department of Imam Hossain hospital in Tehran, Iran during 2010-11. The existence or improvement of pain, readmission to hospital and possible subsequent complications diagnose and death was recorded after four-week through telephone follow-up. Results: 247 patients with non-specific abdominal pain were enrolled. Out of 158 patients with recurrence pain, 71 (45%) patients were admitted to the hospital again that finally, cause of pain was diagnosed in 45 (28.5%) patients. The most common cause of abdominal pain was irritable bowel syndrome (3.2%). History of similar pain (OR=4.04, P<0.05), abnormal findings in abdominal ultrasonography (OR=8.2, P<0.05), abnormal urine analysis (OR=7.4, P<0.05) and abdominal pain persisted for more than 2 days (OR=4.04, P<0.05) were independent factors to identifying the causes of abdominal pain. Conclusion: Nonspecific abdominal pain will not lead to appropriate recognition and most of them recover without any complication.

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Background and Objective: Fusarium solani is the common etiological agent of fungemia and disseminated fusariosis, which is associated with high incidence of mortality in immune-compromised host. Due to high level of resistance of antifungals in Fusarium solani, rapid and specific identification of organism is essential. This study was done to evaluate the PCR method for rapid and specific diagnosis of Fusarium solani in serum samples of HIV positive patients. Methods: In this descriptive study, the PCR test based on mitochondrial cytochrome b gene as the target gene with 330 bp product was optimized. PCR was applied on 45 serum samples of HIV positive patients after evaluation of sensitivity and specificity of the test. Results: In the optimized PCR test, the 330 bp product was amplified. The sensitivity of the test was a copy of Fusarium solani genome, and its specificity was 100%. Among 45 serum samples, 9 cases (20%) were positive for Fusarium solani. Conclusion: The PCR method has functional capabilities for direct, rapid and specific clinical diagnosis of Fusarium solani in HIV positive patients.

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Background and Objective: Anti tuberculosis drugs therapy is the most effective method for controling the tuberculosis (TB). Early detection and appropriate treatment can prevent the TB-drug resistance. This study was carried out to determine the complications leading to hospitalization due to consumption of anti-TB drugs in patients with tuberculosis. Methods: In this descriptive-analytic study, 1550 records of patients with TB in urban and rural health centers of Gorgan, north of Iran were assessed during 2007-12. Checklist consists of demographic and clinical data for each patient was recorded in a questionare. Results: 44 cases experienced the complications of anti-TB drugs. 27 (61.4%) of cases with complications were women. 77.3% and 22.7% of patients affected with pulmonary and extra pulmonary tuberculosis,respectively. 38.6% of patients were diabetic. The hepatic complication was seen in 37 cases (84.1%). Skin and other complications were seen in 5 and 2 cases, respectively. There was not any relationship between drug complications and other disases. Conclusion: Hepatic damage is the most common complication leading to hospitalization in tuberculosis patients using anti-TB drugs.

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Background and Objective: MIRU-VNTR typing is currently one of the most frequently-used standardized genotyping systems in molecular epidemiology of tuberculosis in the world. This sudy was done to determine the Mycobacterium tuberculosis genotyping by MIRU-VNTR method. Methods: This descriptive study was done on sputum, gastric lavage clinical specimens of 53 tuberculosis suspected patients. Fifty-three isolates were identified by 16S rRNA and Rv-typing followed by RD typing. They were then subjected to a 12-locus (ETRA, ETRB, ETRC, ETRD, ETRE and ETRF, MIRU-10, MIRU-26, MIRU-39, MIRU-30 plus QUB-11b) MIRU-VNTR typing system. Results: In MIRU-VNTR typing, forty-four types were identified with 13 isolates classified in 4 clustered and the remaining 40 isolates representing 40 orphan patterns. In comparative analysis of MIRU-VNTR loci, MIRU-26 with 7 alleles displayed the highest diversity level (Simpson’s diversity index = 0.767. Out of the 53 isolates, only one was identified as Mycobacterium bovis. All the remaining isolates were characterized as Mycobacterium tuberculosis. None of the samples was affected to Mycobacterium complex strain. No evidence of either double or co-infection of the patients with more than one species/strain was detected. Conclusion: While the genomic diversity observed by MIRU-VNTR typing sounds extensive, the population genomic structure on the whole however, seems to be homogenous. Recent transmission between studied patients does not appear to be a frequent event as only 13 isolates representing 4 MIRU-VNTR types, were assumingly epidemic.

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Background and Objective: Genuvarum is considered as one of the risk factors for the incidence of osteoarthritis. This study was done to compare the knee joint muscles activity during single leg drop landing from different heights among men with genu varum and men with normal knee.

Methods: This case – control study was done on 20 male students with genu varum deformity and 20 male students with normal knee. Genu varum deformity was measured by a kolis and goniometer. Muscle activity of lower limb was recorded with electromyography.

Results: There was significant difference in muscles activity of medialis gastrucnemius, peroneus longus, biceps femoris and gluteus medius in cases and controls (P<0.05), while no significant difference was observed in other muscles.

Conclusion: The changes in the knee normal structure might affect daily activities and possibly lead to in injuries due to physical training.