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Background and Objective: Cutaneous leishmaniasis is one of the zoonosis disease which is transmitted by sand fly and has been considered as one of the most important health problems in Iran. This study was designed to assess the status of cutaneous leishmaniasis in Gonbad Kavoos, North of Iran. Materials and Methods: This descriptive-analytical retrospective study was performed on the two groups consist of: 1799 patients (995 men and 804 women) referred to health centers of Gonbad Kavoos in Golestan Province North of Iran during 2009-11. Also 278 men and 271 women were selected randomly in one of the villages for the assessment of acute and scar wounds. Patient’s characteristics such as age, sex, habitat, number and sites of ulcer(s), month and years of incidence were registered. Data were analyzed using SPSS-13 and Chi-Square test. Results: From 1799 under care patients, 995 cases (55.3%) were males and 804 cases (44.7%) were females (P<0.05). 1542 patients (85.7%) resided in rural areas, while 257 (14.3%) lived in urban areas (P<0.05). The most frequent age group was 0-9 years old (43.3%) (P<0.05). Hands were the most common sites of ulcer (42.3%) and 37.9% of the patients with one ulser. The highest prevalency of disease was observed in months of October and November (68.4%) 4% and 78.6% of subjects selected from villages were presented with acute wound and scar, respectivley. Conclusion: This study showed that Cutaneous leishmaniasis in 2010-11 was dispersed in Gonbad-Kavoos a city in North of Iran. The endemicity situation of this disease in this area is hypoendemic.

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Background and Objective: Control of postoperative pain is one of the most important stages in the recovery of patients after surgery. This study was done to compare the effectiveness of combined Ondansetron and Apotel on the post-operative pain after surgery of upper limb fractures.
Methods: This double blind clinical trial study was done on 50 individual (41 male and 9 female) with upper limb fractures referring to 5 Azar hospital in Gorgan northern Iran during 2017. Patients were assigned (block randomization) into control and intervention groups. After the end of operation in the recovery phase, both groups received pain PCA (Patient Controlled Analgesia). In control group, the pain pump consisted of 2 grams of Apotel and in the intervention group; the pain pump consisted of 2 grams Apotel and 8 mg of ondansetron. Visual Analogue Score (VAS) was evaluated in both groups after surgery for 24 hours. Pain score of patients compared in the 2 groups during the 3 time intervals after surgery.
Results: 4 hours after upper limb fracture surgery, the mean pain was significantly decreased in the intervention group (3.20±0.707) compared to control group (3.64±0.569) (P<0.05). 12 hours after upper limb fracture surgery The Mean pain, in the intervention group (1.88±0.927) was significantly reduced in compare to control group (2.64±1.186) (P<0.05). 24 hours after upper limb fracture surgery, The Mean pain was significantly reduced in the intervention group (1.40±0.645) in compare to control group (2.08±0.997) (P<0.05).
Conclusion: This study showed that administration of compination of Apotele and Ondansetron in post-operative pain of upper limb fractures is effective than apotele alone.

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Background and Objective: Propofol is one of the most commonly used drugs in anesthesia with the pain during an injection is a side effect of this drug. This study was conducted to compare the effect of Lidocaine, Magnesium Sulfate, and Ketamine on reducing pain caused by intravenous injection of Propofol in patients Undergoing surgery.
Methods: In this double-blind randomized clinical trial study, 80 patients aged 18 to 65 years were randomly blocked and assigned into four groups including Lidocaine, Ketamine, Magnesium Sulfate and Normal Saline. The pain was measured with the Ambesh Score. Hemodynamic changes of patients were evaluated in 1, 3, and 5 minutes.
Results: The patients in Lidocaine, Ketamine, and Magnesium Sulfate groups with 75%, 70%, and 55%, respectively, did not feel pain after Propofol injection compared to Normal Saline group (25%) (P<0.05). The mean time trend of Systolic and diastolic blood pressure and mean arterial blood pressure between the studied groups were significant (P<0.05).
Conclusion: The use of Lidocaine or Ketamine during Propofol injection can be effective in reducing pain during injection in patients undergo surgery.

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Background and Objective: The psychological experience of mental pain can lead to distress similar to that caused by actual injury or trauma. As such, it poses a life-threatening consequence for chronic patients, although it is rarely assessed and treated in clinical settings. One of the diseases associated with high levels of physical and mental pain is the rare disorder neurofibromatosis. This study aimed to evaluate mental pain in patients with neurofibromatosis and its association with disease severity.
Methods: This descriptive-analytical study was conducted on 207 patients with neurofibromatosis who were members of the Iranian Neurofibromatosis Support Association during 2023. Data collection tools included a demographic and clinical information registration form and the Orbach and Mikulincer Mental Pain Scale (OMMP), which comprises 44 items and 6 subscales, with a scoring range from 44 to 220.
Results: The total mental pain score was 121.15±42.41, with a range of 44 to 206. The total mental pain scores for men and women were 123.67±38.98 and 120.31±43.58, respectively. The "confusion" subscale had the highest average score, while the "fear of loneliness" subscale had the lowest average score. There was a statistically significant association between the total mental pain score and its subscales with the severity of the disease and the patient's educational level (P<0.05).
Conclusion: The mental pain scores of patients with neurofibromatosis were evaluated to be relatively unfavorable.