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Background and Objective: Dentate gyrus is a part of hippocampal formation that plays an important role in memory and learning. Astrocytes are one of the important glial cells in nervous tissue that play a more active role in neuronal activity, including regulating ion flux currents, energy production, neurotransmitter release, and synaptogenesis. The aim of this study was to determine the spatial memory effect on the number of astrocytes in Rat’s dentate gyrus. Materials and Methods: This experimental study, was done on 18 male Wistar Rats with using Morris water maze and Reference and Working memory methods. After spatial learning the Rat's brains was carried out and histological preparation was carried out, the slices were with PTAH method. The data analyzed, using T-test and One-way ANOVA. Results: The results showed significant difference in astrocytes number in dentate gyrus area between Reference memory (300.57±5.98) and control (73.73±22.61) groups (P<0.05). The difference between working memory (375.77±4.11) and control groups was significant. Comparing two groups there was a significant difference of number of astrocytes cell between the working memory and Reference memory group (P<0.05). Conclusion: This study showed that spatial learning such as Reference memory and Working memory increase the number of astrocytes in dentate gyrus and this increase can be due to duration of learning.

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Background and Objective: Due to high mortality and morbidity of the cervical cancer we decided to compare benefits and advers effects of Gemcitabine plus conventional chemoradiation with conventional chemoradiation with cisplatin alone in Imam Hossein hospital, in Tehran, Iran. Materials and Methods: This double blind clinical trial, was carried out on 34 patients with documented cervical carcinoma during 2006-07 the patients divided into two sub groups: (A)Conventional concurrent chemoradiation with cisplatin(N=18) versus(B) concurrent chemoradiation with cisplatin plus gemicitabine (N=16). The patients with clinical stage of IB2-IVA and normal cell blood count with normal renal and liver function tests included in the study. Irradiation was delivered to all patients through external and internal beams with same dose and schedule. The patients followed for 3 months at least. Clinical response rate and adverse events included Neutropenin, Thrombocytopenia, anemia, diarrhea, nausea, and vomiting compared in two groups with fisher exact test, and t-test. Results: Despite increasing of complete response rate with adding gemcitabine to conventional treatment(81.2% vs. 66.7%), the difference in two groups was not statistically significant. Conclusion: This study indicated that the addition of gemicatabine to conventional chemoradiation with cisplatinrevealed no significant benefits. All adverse events in combination chemotherapy group were greater than conventional treatment.

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Background and Objective: Many factors are known to be involved in a number of human pathologies of obesity including serum leptin and thyroid hormones levels. The purpose of this study was to compare the serum levels of leptin and thyroid hormones in obese and non-obese women, in Shiraz-Iran during 2006. Materials and Methods: In this case- control study, 35 women with BMI≥30 Kg/m2 recruited as an obese group (Case group) and 35 women with healthy BMI (BMI<25 Kg/m2) were selected as a control group. General information data were gathered from each sample using questionnaires and face-to-face interviews. Body weight, height, waist and hip circumferences were measured and BMI, WHR and percent of body fat (%TBF) were calculated for each subject. Venous blood samples were drawn from subjects and serum was separated to determine the concentrations of serum leptin and thyroid hormones (T4, T3 and TSH) levels. Results: Mean serum concentration of leptin was significantly higher in obese group than control group (p<0.001). Serum leptin levels positively correlated to anthropometric indices (BMI, WHR, %TBF). No significant difference was observed between obese and non-obese groups in serum thyroid hormones concentration. Serum leptin levels positively related to serum T3 levels (P<0.05). Conclusion: This study indicated that obese women had higher leptin levels compared to non-obese. The interaction between thyroid hormone in particular T3 and leptin can be one of the reason for increasing the serum leptin level among obse women.

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Background and Objective: Esophageal and gastric cancers are among the most common and fatal cancers. These are diagnosed at the latest phase and the prognosis is too poor. Due to the importance and high incidence rate of the upper gastrointestinal cancers in Golestan province, this study was conducted to explore the overall survival rate of these patients in rural area of this region. Materials and Methods: In this descriptive cross-sectional study, a total of 121 pathologically confirmed esophageal or gastric cancers, with rural place of residence, were retrieved from the cancer registry at the health department in Gorgan. After conducting interview with patients or their relatives, analysis of their sociodemographic and clinicopathologic features was performed. The median survival rate was compared regarding age groups and gender using Kaplan-Meier statistical test. Results: Male to female ratio in esophageal and gastric group were 1.2 to 1 and 3.8 to 1, respectively. Short-term survival rates were 54.76% and 26.2% for esophageal cancer and 66.6% and 37.5% for gastric cancer. Collected information regarding patients’ sociodemographic and clinicophathologic factors did not have significant association with patients’ survival in both esophageal and gastric cancers. The mean survival rate in patient with gastric and esophageal cancers according to age and gender was not significant. Conclusion: This study showed that the overall short-term survival rates for upper gastrointestinal cancers are very low in Golestan province. Therefore the need for intervention the need and allocating more diagnosis and therapeutic resources for upper gastrointestinal cancers are required.

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Background and Objective: Prostate cancer is the most commonly diagnosed cancer in men and it is the second leading cause of cancer deaths among men after lung cancer. Therefore, this study was done to assess of risk factors for prostate cancer in Mazandaran province, Iran. Materials and Methods: A matched case-control study was conducted on 104 prostate cancer patients and 104 controls in Mazandaran province during 2005. The addresses of the patients were obtained using the cancer registry information existed in Babol research center in Iran. The data were collected using a questionnaire by in-person interview of cases and their controls and were analyzed using STATA (8.0). Results: Univariate condition logistic regression showed that age, prostatitis, drinking alcohol, using chopoghe, family history of prostate cancer, having other cancer, intensity of activity, time of job activity were found to be the risk factors although higher BMI and execreise were protective for prostate cancer (P<0.20). In multivariate analysis, after adjusting for the effect of the confounders, prostatitis, age, alcohol consumption and family history of prostate cancer were found to the most important risk factors. Conclusion: This study identified prostatitis, age, alcohol consumption and family history of prostate as the independent risk factors for prostate cancer. We suggest that men after the age of 60 should be screened for prostate cancer annually.

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Background and Objective: Short stature among children is often due to physiological causes but it can be a sign of important and curable diseases. Thus early detection of problem, before epiphyseal closure, is critical. This study was done to determine the cause of short stature among children in Gorgan-Iran. Materials and Methods: This cross- sectional research study was done on 100 children of 6-14 years of age during 2005 in Gorgan-Iran. Children were selected by census. Demographic character of children, history of serious disease, prematurity, blood and provocative growth hormone tests, physical examination, wrist radiography and standard deviation score (SDS) were recorded for each child. Data were analyzed by t-student and chi-square tests. Results: The finding of this study showd that most children with short stature was girl (66%). mean+-SD of calendar and bone age of female children was 10.4+-2.25 and 8.4+-2.32 year, respectively. The most frequent causes of short stature were constitutional (57%), Growth hormone deficiency (30%) and familial causes (8%). Mean+-SD of calendar and bone age of males children was 10.79+-2.32 and 7.89+-2.19 years. Children with growth hormone deficiency had lower bone age and children with constitutional short stature had higher standard deviation score than others. (P<0.05). Conclusion: This study showed that since growth hormone deficiency was one of the common and important pathologic causes of short stature. Therefore growth hormone determination and theraphy is recommended, after elimination of familial and constitutional factors.

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Background and Objective: Carpal Tunnel Syndrome is the most common compression neuropathy which can cause mild, moderate and sever disability in patiens hands. The first standard treatment is to use Cock-up splint. This study was done to compare therapeutic effects of long (With MP Joint restriction) and short (without mp Joint restriction) Cock-up splint patients with Carpal Tunnel Syndrome. Materials and Methods: In this clinical trail study was done on 23 patients with mild and moderate Carpal Tunnel Syndrome in Shafa Yahyayian Hospital, Tehran, Iran. The diagnosis of Carpal Tunnel Syndrome in patients confirmed with electrodiagnostic method. In this study 23 Patients was treated with long & short cock-up splint in two groups. Group A (12 Patients) was treated by long Splint and group B (11) Patients was treated by short Splint for 4 weeks. Patients was evaluated by Semmes –Wein stein monofilaments, Two Point discrimination, Visual analog Scale (VAS), pinch and Grip Strength. Results: Both types of splints appear to be effective in decreasing CTS symptoms but long Splint more beneficial than Short splint. The results of SWMS, 2PD, Pinch & grip Strength in group A had higher significant difference than group B. (P<0.05). Two groups did not have significant difference in results of severity of pain according to VAS. Conclusion: This study revealed that long Cock-up Splint in comparision with short Cock-up splint demonestrate high efficasy in improving the signs of Carpal Tunnel Syndrome.

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Background and Objective: One of the most important routes of hepatitis B virus (HBV) transmission is from asymptomatic carrier mothers to their infants. It has been concluded that over 50% of Iranian carriers have contracted the infection perinatally, making this the most likely route of transmission of HBV in our country. In this study, we assessed the rate of HBV infection in children were born to HBsAg positive mothers that received hepatitis B immunoglobulin (HBIG) and the first dose of vaccine at birth and the second and third of doses of vaccine at 1 and 6 months of age, respectively. Materials and Methods: In this descreptive study, 123 infants born from HBsAg positive mothers assessed and serum sample of these subjects were tested by ELISA technique for detection of HBsAg, Anti-HBs and Anti-HBc markers. Data were then analyzed by the chi-square and fisher exact tests. Results: From 31241 pregnant women with delivery during this 5-years study about 140 (0.45%) of them were HBsAg positive. Children born to these mothers follow-up and 123 serum samples of them tested for serologic markers of HBV infection. HBsAg was found in 0.8% of the children and 91.9% had one or more serologic markers of HBV infection. Protective rate (Anti-HBs positive) and Anti-HBc positive were 82.1% and 8.9% respectively. Conclusion: This study showed that after having focuced on the vertical transmission route for many years, and implementing strategies such as vaccination and HBIG injection to neonates of HBsAg positive mothers, nowadays it seems that we should pay attention to horizontal route of HBV transmission in this area.

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Background and Objective: Plantar fasciitis is due to irritation and inflammation of the plantar fascia, which may occur in patients aged 30-60 years old. The aim of this study was to investigate the effect of new modified foot orthosis on improving the quality of daily life, sport and recreational activities in patients with plantar fasciitis.

Materials and Methods: This clinical trial study was done at orthotics and prosthetics clinics in Tehran during Aug 2007 to May 2008. 15 patients with plantar fasciitis including 4 male and 11 female with ranging age 25-45 yrs old (35±5.02) were selected by non probability sampling. Patients used new modified foot orthosis. FAOS questionnaire was used for evaluating the activity daily life and sport and recreational activities. 2 stages included: once before intervention and the second stage after 4 weeks after intervention. Data analysis has been done with paired T-Test , Smironov-Kolomogrov by SPSS-13.

Results: Quality of daily life was 44.30±10.16 before interventional treatment and 61.08±16.26 after intervention and difference between two stages was not statistically significant. The results for sport and recreational activity were 26.50±10.09 before interventional treatment and 52.50±12.23 after intervention and difference between two stages was statistically significant (P<0.05).

Conclusion: This study showed that the new modified foot orthosis was no effective on improving of activity daily life but, was effective in sport and recreational activities in patients with plantar fasciitis.

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Background and Objective: Trichomoniasis is a disease caused by Trichomonas vaginalis and is the most common sexually transmitted disease after viral sexually transmitted ones. Trichomoniasis is usually treated with oral metronidazole and both patient and her partner should be treated. Considering the probable teratogenic effect of metronidazole and parasite drug resistance, it is necessary to find an alternative medication for treatment of trichomoniasis. In this study in vitro effect of garlic and Freula assafoetida extracts on Trichomonas vaginalis were evaluated. Materials and Methods: This In Vitro study was done in Yasuj Faculty of Medicine, Yasuj, Iran. Trichomonas vaginalis was cultured in TYI-S-33 medium. Effect of garlic and Freula assafoetida extracts in specified times and concentrations on Trichomonas vaginalis were assessed. Garlic extract was used in 0.1, 0.05 and 0.025 mg/ml while Freula assafoetida extract was used in 2, 1 and 0.5 mg/ml. The inhibitory effect of extract on Trichomonas was assessed by counting the alive parasites 1, 2 and 24 hours after exposure with extracts. Results: Findings of this study showed that hydroalcoholic extract of Freula assafoetida at concentration of 0.5, 1 and 2 mg/ml killed 90% of the parasites in first hour of exposure and garlic extract at concentration of 0.1 mg/ml killed 95% of parasites after 2 hours. Moreover garlic extract killed 90% of parasites at concentration of 0.05, 0.025 and 0.0125 mg/ml after 24 hours of exposure even at low concentration. Conclusion: This study indicated that garlic and freula assafoetida have significat effect on Trichomonas vaginalis, therefore detecting the effective substances of these potent anti-parasitic herbs is recommended.

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Background and Objective: Erectile dysfunction (ED) is the most neglected complications of diabetes mellitus that reduce the quality of life. The purpose of this study was to evaluate the erectile dysfunction and related risk factors in diabetic patients. Materials and Methods: This descriptive analytical study was done on 700 diabetic men aged 20-69 years at Sina hospital and Abouzahr Health Center in Tehran- Iran during 2002-03. Patients were screened for erectile dysfunction using the International Index of Erectile Function (IIEF) questionnaire. Data were analyzed using SPSS software and Chi-Square test the P≤0.05 was considered to be significant. Results: Prevalence of erectile dysfunction was 35.1%. Prevalence rate of erectile dysfunction was 25.8% and 36.7% in type 1 and type 2 diabetic patients, respectively (P<0.05). Prevalence of mild, moderate and severe erectile dysfunction were 5.6%, 19.6% and 10%, respectively. Prevalence of erectile dysfunction reached from 9.7% in men aged 20-30 years to 35% in those aged over 60 years (P<0.05). In comparison with reporting diabetes lasting≤5 years (25.4%), prevalence of erectile dysfunction was less than those reported diabetes 6-11 years (34.3%) and 12-30 years (43.5%) (P<0.05). Erectile dysfunction increased significantly in those who had poor glycemic control. Prevalence of erectile dysfunction in good, fair and poor glycemic control was 28.4%, 39% and 44.4%, respectively (P<0.05). Conclusion: This study showed that good glycemic control and reducing the cigaret smoking are necessary to reduce prevalence of erectile dysfunction in diabetic men.

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Background and Objective: Anthropometric indeces are the best methods for determining of malnutrition and obesity in children and young adulescent worldwide. This study was designed to compare the physical growth status between Turkman and non-Turkman in rural area in Gorgan in North of Iran. Materials and Methods: This cross – sectional descriptive was done on 551 children of 2-5 years of age, Turkman and 895 of non-Turkman in the rural area of Gorgan North of Iran during autumn 2005. Height, weight and personal identification recorded by questioners. BMI percentile and under -1sd ,-2sd and -3sd from NCHS used for comparison. Data were analyzed by using Chi-Square and T-student tests. Results: Mean±SD of height in female Turkman and non-Turkman were 95.3±8.1 and 90.5±8.4 cm respectivly means±SD of height were 96.0±7.6 and 90.9±8.6 cm in Turkman and non-Turkman, respectively. Male childrens mean±SD of weight in were 14.5±2.4 and 14.2±2.9 and in male Turkman and non-Turkman children respectively. Also means±SD of weight were 15.0±2.03 and 14.5±2.3 cm in Turkman and non-Turkman male children, respectively. Turkman children are about 426 gram heavier and 4.9 cm taller than non-Turkman in all of age groups (P<0.05). Stunting and underweight were observed in 13.2% and 1.9% in Turkman group less than non-Turkman respectively by -2sd criterion. There was a significant differences between two groups by stunting (P<0.05). Obesity and overweight exist in Turkman group 24.5% and 2.6% less than in non-Turkman respectively. The difference in obesity statistically was significant between two groups (P<0.05). Underweight was shown in female more than male (7.2% vs 4.2%) and obesity in female less than male (25.6% vs 28.9%). Conclusion: This study showed that secular growth in two groups is incompatible and it is better in Turkman group than non-Turkman group. Malnutrition in Turkmans was less than Non-Turkmans children.

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Background and Objective: Biological activity of hydrogen sulphide in smooth muscle of vessel and non-vessel tissue are contradictory. The aim of this study was to examine the effect of hydrogen sulphide on smooth activity of muscle mice jejunum. Materials and Methods: Experiments were performed on mice jejunum and motor activity was recorded from in vitro segments of jejunum ~ 4 cm in length. jejunal segments were mounted horizontally in separate perfusion chamber. Furthermore, using vanilloid receptor 1 deficient mice (VR 1-/-) we tested hypothesis that extrinsic sensory nerves mediated alterations, in motor activity responses in the presence different concentration of of hydrogen sulphide (100-3000 μM). Results: Serosal application of NaHS (as hydrogen sulphide donor) produced a dose-dependent inhibition of motor activity that are not significantly different between VR 1-/- and VR 1 +/+ mice. In the presence of TTX (1μM) NaHS (300µM) caused a reduction in basal tone (19.5%, p<0.05, n=5) and inhibited the contraction evoked by 30µM bethanechol by 55% (n=5, p<0.05). Conclusion: This study showed that hydrogen sulphide is an important motor activity inhibitor in mice jejunum.

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Background and Objective: Previous reports on the effect of treatment on the serum immunologic parameters in patients with infective endocarditis are controversial. This study was conducted to asses the serum levels of CRP (C-reactive protein), RF (rheumatoid factor) and CIC (circulatory immune complex) before and after treatment in patients with infective endocarditis. Materials and Methods: In this discriptive study 30 hospitalized patients with infective endocarditis in Razi Hospital in Ahvaz during 2006. Blood samples obtained before and after treatment. 2.5 cc of each sample were used for CRP and RF and remaining 2.5 cc preserved at -20ºC until CIC examination. CRP and RF were measured by using nephlometry and CIC was detected by immundiffusion method. The data were analyzed using SPSS-16 and t-student test. Results: Out of 30 patients, 26 (86.7%) were male. Mean age was 29.53±10.28years. The mean values of CIC, CRP and RF before and after treatment were 0.847, 72.38, 60.45 and 0.80, 44.1, 41.2, respectively. The means of CRP and RF before and after treatment were statistically significant (p<0.05). Conclusion: This study showed that the serum level of CRP and RF reduce after effective treatments because most of the our patients were intravenous drug user, CRP and RF indeces may be useful measurment for treatment evaluation responses to infective endocarditis in these population.

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Background and Objective: Occult hepatitis B infection is a form of hepatitis in which despite of absence of detectable HBsAg, HBV-DNA is present in peripheral blood of patients. The mechanisms which are responsible for progression of OBI yet to be clarified but some investigators believed that the genetics and immunological parameters may are different in resistant individuals and patients. Cytokine network system could be leading alteration in viral immune response. The aim of this study was to investigate the relation between polymorphisms +874 region of IFN-Gama with occult hepatitis B infection. Materials and Methods: In this study, the plasma samples of 3700 blood donors were tested for HBsAg and anti-HBs by ELISA. The HBsAg negative and anti-HBc positive samples were selected and screened for HBV-DNA by PCR. HBV-DNA positive samples assigned as occult hepatitis B infection cases and ARMS-PCR technique were performed to examine the present polymorphisms in +874 region of IFN-Gama genes of patients with occult hepatitis B infection. Results: 352 (9.51%) out of 3700 blood samples were negative for HBsAg and positive for anti-HBc antibody. HBV-DNA was detected in 57 (16.1%) of HBsAg negative and anti-HBc positive samples. Our results showed that there was not any significant difference between patients and control group in polymorphisms in +874 region of IFN-Gama genes. Conclusion: This study showed that there is not any significant difference between polymorphisms in +874 region with IFN-Gama occult hepatitis B infection.

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Background and Objective: Life saving with a high quality health care programs in the shortest duration is the mainstay of emergency department system. Frequent monitoring and quality control of this process and the satisfaction of patients are among the very important indices in hospital quality. This study was designed to evaluate the clients satisfaction in the hospitals affiliated to Golestan University of medical sciences. Materials and Methods: This descriptive cross-sectional study was done on 2400 referred patients in emergency departments of different hospitals in Golestan province, northern Iran during 2006. Data were gathered by questionnaire included demographic data and questions about satisfaction of outpatients and emergencies. The Data analyzed by SPSS-15 software and chi-square test. Results: Level of satisfaction in emergency department, was reported as follow: physician attention and behaviors (86%), nursing behaviors (85%) responsibility to patients (84.1%) status of the environmental temperature (83.9%) and cleaning (81.9%). The lowest satisfaction was related to behavior of guardsman (33.8%). In emergency ward, levels of patient's satisfaction were as following: Access to telephone (49.7%) quality of the meals (47.4%) quantity of meals (44.1%) and the lowest level of satisfaction of patient was neglecting the patient's right (8.2%). Conclusion: This study indicated that more educational programs, should be arranged for the emergency units employees to observe patients right.

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Background and Objective: An increased risk of invasive infections with encapsulated bacteria such as Streptococcus pneumoniae has been described among splenectomized patients. Pneumococcal vaccination has been recommended in these patients. In this study, the serum antibody response to pneumococcal polysaccharide antigens in splenectomized patients with idiopathic thrombocytopenic purpura (ITP) or trauma who immunized with Pneumovax 23 was evaluated. Materials and Methods: This case - control study was performed on two groups of patients including fifteen cases of trauma patients (11 male, 4 female) and twenty patients with ITP (10 male, 10 female) along with 40 healthy volunteers as controls who were immunized with Pneumovax 23 to prevent pneumococcal infections. All patients received the pneumococcal vaccine before splenectomy. The serum antibody response (IgG and IgG2) to pneumococcal antigens was determined by enzyme-linked immunosorbent assay (ELISA) technique prior to vaccination and 4 weeks post-vaccination. Analyzing of data was performed using student t-test and linear regression test. Results: The mean of post-vaccination IgG or IgG2 titer to the pneumococcal antigens in ITP patient group was significantly lower than those in controls or in trauma group (P<0.05). No significant differences in IgG or IgG2 antibody titer increase were found between trauma group and healthy control group. Response to immunization was poor in 9 of 20 ITP patients. Conclusion: This study indicated that 45 percent of patients suffered from ITP who have undergone splenectomy responded poorly to pneumococcal antigens.

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Background and Objective: Polycystic ovarian syndrome (PCOS) is one of the most prevalent (6-10%) endocrine glands disorders among child - bearing women. In addition to the patients, their first degree relatives are exposed to some risk factors such as abnormal lipoproteins. Due to high prevalence PCOS among women and the role of genetic factors in this abnormality, it is necessary to recognize high risk people particularly among first degree relative. Therefore this study was conducted to determine the level of serum lipoproteins in first degree relatives of patients with PCOS. Materials and Methods: This case control study was done on 107 individuals of the first degree relatives of PCOS patients as cases and 107 normal individuals of the first degree of non-PCOS as controls in Shiraz, Iran during 2009. Participants completed a test assessing demographics and blood sample were taken from all participants in order to assay serum lipoproteins including total cholesterol, LDL, HDL and triglyceride. Data was analyzed by means of independent t-test and Fisher's exact test as well as Chi-Square. Results: The means±SD of total cholesterol, HDLc and triglyceride in cases was 191±31.64, 167±4.06 and 191±31.64 mg/dl, respectively. The means±SD of total cholesterol, LDLc and triglyceride in controls was 158.25±18.25, 123±21.33 and 120.42±17.11 mg/dl, respectively. Serum level differences of LDL and triglyceride in cases and controls were significant (P<0.05). The means±SD of HDLc in cases and controls was 40.06±6.95 and 45.9±6.7 mg/dl, respectively (P<0.05). Conclusion: This study showed that the serum level of lipoproteins in the first degree relatives of PCOS patients is significant higher than non-PCOS.

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Background and Objective: Intercostal and supracostal access tract are usual access for percoutaneous nephrolithotripsy (PCNL) for upper calices stones. But pleural complication of these tracts are high. This study was done to evalute percutaneous nephrolithotomy (PCNL) of upper calices with subcostal access. Materials and Methods: Seventeen patients (12 males, 5 females) with stones limited to upper calices with diameters of 11-27 mm and 1-5 in numbers, candidated for PCNL. Ultrasonography and intravenous urography were performed for all patients prior to surgery. In all patients PCNL performed in prone position and access is made at prolonged and deep inspiration from subcostal with fluoroscopic guidance. Following access to upper calices, guide wire inserted and dilatation of tract up to 28 or 30 Fr informed. After insertion of 28 or 30 Fr Amplatz sheat nephroscopy performed. Results: Two patients excluded and finally 15 patients were accounted. In 15 patients subcostal access performed successfully (88.2 %) . In 5 patients stones of less than 10 mm extracted with grasps. In 10 patients after pneumatic lithotripsy, particles of tones removed. 11 patients rendered stone free (73.3%). 4 patients had residual stones of greater that 5 mm in minor calices that in 3 patients after single ESWL resolved. 3 patients needed infandibular dilatation for complete stone extraction. No infection, transfusion, pneumothorax, hydrothorax, respiratory discomfort in operation and post operation period were seen. In one patient a perirenal collection of liquid with diameter of 5 cm was detected. Perirenal collection of liquid was removed with preventional treatment and antibiotics regiments. Conclusion: PCNL with subcostal access for upper calices stones is a feasible and safe with low complication and can be performed instead of supracostal access tracts.

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Background and Objective: Cutaneous leishmaniases with two forms of rural and urban is the endemic diseases and as a health problem in our country. Identification of parasite species and type of disease is very important for treatment of disease as well as for planning of control program. The microscopic observations by Giemsa-stained smears is the most common laboratory test for the diagnosis of cutaneous leishmaniasis, but the determination of parasite species is impossible and utilization of other ways such as biochemical and molecular methods is required. This study was carried out to determine the parasite species caused cutaneous Leishmaniasis by Nested PCR in Damghan, Iran.

Materials and Methods: This descriptive study was performed on 67 patients with dermal lesions that referred to Damghan health center laboratory in Iran during 2008. The patient's information were recorded in questionnaire. DNA of Giemsa-stained slides from patients was extracted and evaluated by specific primers of kinetoplast DNA using Nested PCR.

Results: Leishmania parasites were observed in 57 patients under light microscope. The 10 patients were infected by other dermal diseases. The PCR result showed the parasite presence in lesions of 57 patients is Leismania major. 54% of patients were male and 46% were female. 72% of the patients were lived in rural areas. 50.9% of disease was observed in over 25 years old patients. Hands were the most common region of ulcer (44.7%). 48% of the patients had one ulcer and the other patients had two or more ulcers. High prevalence (31.6%) of disease was observed in October.

Conclusion: This study showed that zoonotic cutaneous leishmaniasis to be prevalent in this area and Nested PCR method is a sensitive and accurate to leishmania species characterization.