---

Background & Objective: Gorgan Gulf, with unique environmental value, has been located at the eastern south region of the Caspian Sea. It has not only valuable fish species such as strugen, Caspian roach, carp and vobla fish which supply a great part of daily protein need of our country and the world, but also its beaches are used for swimming. Therefore Lack of observation for environmental regulations result in entrance of microbial pollutants into Gorgan Gulf and creates dangers both for human health and for marine environment. So the evaluation microbial pollution for these beaches and comparing them with standards is an essential need. This study was done to evaluate microbial pollution for Caspian Sea at Gorgan Gulf. Materials & Methods: 40 sea water samples were collected during spring and autumn of 2004 at Gorgan Gulf for evaluation of sea water in Gorgan Gulf microbial pollution and also the mean total number of bacteria, coliforms, fecal coli forms and fecal streptococci was determined by standard method. Results: The results indicated that the mean total number of bacteria, coli forms, fecal coli forms and fecal streptococcus were 5001/1cc, 1555/100cc, 817/100cc and 59/100cc respectively. Conclusion: Mean results compared with related standard (both for swimming beach and piscicultres) and we found that Gorgan Gulf beaches have been polluted for swimming applications, but it is not the case for piscicultures.

---

Granuloma faciale is an uncommon cutaneous lesion characterized by asymptomatic skin nodules and plaques without any systemic presentation. The lesions mainly seen in middle aged males. We report an uncommon presentation (multiple cutaneous lesions) in trunk,upper arm and face)of a 32 years old male.

---

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.

---

Background and Objective: Cystic fibrosis (CF) is the most common inherited disorder in Caucasian populations caused by mutation in cystic fibrosis transmembrane conductance regulator (CFTR). The type of mutations and their distributions varies widely between different countries and/or ethnic groups. The aim of this study was to characterize mutations involved in this disease in Mazandaran province, Iran. Materials and Methods: In this descriptive study thirty unrelated Iranian cystic fibrosis patients were screened for deltaF508, N1303K, G542X, R347H and W1282X mutations in the CFTR gene using Reverse Dot Blot method during 2004-06. This technique uses biotinilated PCR products for simultaneous hybridization with several normal and mutant probes specific to known mutations fixed on Biodyne C membranes. Results: DeltaF508 mutation was found in 13 (21.66%) alleles. 6 patients were homozygote and one was compound heterozygote for this mutation. Conclusion: These findings reveal an important heterogeneity of CFTR gene mutations in Mazandaran Province. Thus regarding the relative low rate of detectable mutations, it is necessary to undertake larger studies for molecular diagnosis of cystic fibrosis in this province.

---

Background and Objective: Primary TORCH (Toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus) and Treponema palidum infections in the mothers can lead to severe fetal anomalies. This study was done to explore the prevalance of TORCH antibodies in newborns with congenital malformations and their mothers in Gorgan-Iran. Materials and Methods: This descriptive, cross-sectional study was done on newborns with major congential malformations, during 20 months (2003-04) in Dezyani hospital- a referal gynecology center in Gorgan, in north of Iran. The blood sample of 64 newborns with congenital malformations and their mothers collected. Serologic testes were done on newborns and mothers' sera to determine IgM and IgG levels against rubella, toxoplasma gondeie, Cytomegalo virus, Herpes simplex type II with ELISA test. For Terponema palidum PRP test was used. Results: Four of 64 infants (6 %) had positive IgM antibody titers for Toxoplasma, Rubella, and Cytomegalovirus. Nine of mothers with affected newborns (14%) had positive IgM antibody titers for Toxoplasma, Rubella, and Cytomegalovirus. Conclusion: This study showed that the prevalance of TORCH antibodies are observed in 6% of birth defects, in this region.

---

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.

---

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.

---

Adrecortical virilizing tumors are rare in the pediatric age group. There is 1% incidence for adneral cancer. In comparison with adult patients , there is function adrenalectomy tumor in pediatric group. The patient in this report was a 20 months old female presenting with clinical signs of virilizition that were characterized by increased bone mass, pubic hair growth external genitalia. The laboratory test showed: High level of testosterone (400 ng/dl) , andrestandion (3.6ng/ml) and progestron (19.9ng/ml) and very high level of (8000ng/ml) dehydroepiandrosterone. In CT scan there was right adrenal mass with size>5 cm. The diagnosis of right an adrenocortical functional tumor led to the choice of open surgical adrenal with flank apreach between 10 and 11 ribs. Pathologic examination showed carcinoma of the adrenal. Patient discharged 5 days after operation. Surgery was done via lumbar incision and follow up was carreid out for 10 years, and there was not any pathological lesion.

---

Background and Objective: Treatment of Cutaneous leishmaniasis (CL) with oral therapeutic drugs, ideally cheap, with good tolerance and safe are highly desirable.The aim of this study was to assess the efficacy of azithromycin (AZ) for treatment of patients with CL in Ahvaz – Iran. Materials and Methods: In a randomized controlled clinical trial study, 28 patients with CL as cases (AZ group) and 26 patients as control (C group) were studied. Cases were treated orally 500 mg/day of azithromycin in single dose for 28 days. Patients in control group did not receive any treatment. Both groups were followed up in days 14, 28 and month 2 and 5. Data were analyzed in SPSS-11.5 by using chi square and exact Fisher's tests. Results: Means±SD age of subjects was 20.26±8.45 years. Male to female ratio was 1.5:1. The half of the patients resided in rural area. At the end of study treatment. 46.4% of patients in AZ group and 15.4% of patients in control group were cured (P<0.02). One relapse of CL was observed in AZ group, no serious drug side effects was observed. Conclusion: This study showed that azithromycin has an acceptable effect on the treatment of cutaneous leishmaniasis in Iranian patients and can be used alternatively in treatment of cutaneous leishmaniasis.

---

Background and Objective: Treatment of the femural shaft fracture is imporoving. The aim of this study was to compare the outcome of Dynamic Compression Plating (DCP) and intramedullary nailing in the femural shaft fracture. Materials and Methods: This clinical trial study was done in orthopedic department of Shahid Kamyab Hospital in Mashhad – Iran during 2002-03. 40 patients with open fracture of femur divided into two groups. One group was treated by dynamic compression plate and the other group by intramedullay nailing. Follow-up time was 9-14 months. Results: Out of 40 patients, 75% were male. The time of clinical and radiological bone :::::union::::: was the same in both groups. There was 4 implant failure in the plate group (P<0.05). There was one deep infection in the intramedullary nailing group. Conclusion: This study showed that there is no difference between plate and intramedullary nailing group according time of bone :::::union:::::. But because of 4 implant failure in DCP groups, intramedullary nailing is recommended for femural shaft fracture.

---

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.

---

Background and Objective: The thalassemic syndromes are geneticaly structural disturbance of Alfa and Beta globin chains. In major Beta-thalassemia the life expectancy depended on frequent blood transfusions that lead to over storage and deposition of Iron in different body-organs (Hemochromatosis) including parathyroid glands, which may cause hupoparathyroidism. This study was done to evaluate the frequency of hypoparathyroidism in thalassemic patients referred to teaching hospitals in Hamedan – Iran. Materials and Methods: This descriptive, cross-sectional study was done on 56 thalassemic patients, which received blood transfusion. Serum Ca , P , PTH , total protein , albumin , Ferritin and BUN cratinine were checked two weeks after last transfusion. The hypoparathyroidism was defined when calcium was less than 8mg/dl and phosphorus more than 5.5mg/dl and PTH less than 10 ng/dl. Results: In this study, 14.2% of patients had hypoparathyroidism. 37.5% of hypoparathyroid ones had clinical manifestation of hypocalcemia. There were statistically meaningful association (P<0.05) between The hypoparathyroidism with desferal administration, splenectomy and diabetes. Conclusion: This study showed that the frequency of hypoparathyroidism in Beta-thalassemic patients receiving blood transfusion was relatively high, so clinical and labratory evaluation for endocrine glands specially parathyroid is recommended since early second decay of life.

---

Background and Objective: One of the problems in urban areas is nitrate contamination of ground waters. High nitrate concentration can cause methemoglobinemia, appearing as a risk factor is provided by ground waters. More than 80% of drinking water of Gorgan, Iran. So this investigation was done to determine of nitrate level in ground waters in Gorgan. This study has been carried out for investigation of nitrate rate in drinking water supply networks and not drinking water ground water wells of Gorgan city. Materials and Methods: This discriptive study was done on 43 ground waters and surface water samples which collected in spring and winter, in Gorgan during 2005. K+, Cl-, NO21-, NO31- of samples were analyzed by spectrophotometery method. Results: The chemical analysis of ground waters of drinking water resources of Gorgan city showed significant variation of nitrate between 3.52 to 69.52 mg/l. The rates of nitrate in certain ground waters wells in vicinity of landfills were between 84.48 to 145.2 mg/l which is more than drinking water standards. Nitrate concentration in agricultural lands such as Shast-kula and Garmabdasht aquifers is lower than Ziarate aquifer in vicinity of urban area. Conclusion: Nitrate contamination in aquifers in vicinity of urban area and unsanitary disposal of solid waste substance may result from house sewage effluents and infiltration of landfill leachs to ground water wells.

---

Background and Objective: To evaluate the effectiveness of Neonatal Intensive Cares Many different data banks have been developed. Furthermore, various scoring systems such as SNAP and CRIB have been validated to designate and compared differences among hospitalized patients in NICU. This study was done to determine mortality rate and prevalence of complications in neonates admitted to Taleghani and Dezyani NICU centers in Gorgan - Iran. Materials and Methods: In this discriptive study a questioniare including sex, birthweight, gestational age, duration of hospitalization, age at the time of discharge or death, complications and other information needed for CRIB scoring system, was completed for 46 neonates with gestational age of less than 37-week old and birth weight of less than 1500 grams. Results: Mortality rate was 37% (17 neonates) with the most common cause being respiratory failure. RDS was associated with a 101-fold increase for the chance of death (OR=1.1, CI=12.9-793.6). This probability was 4.7 fold for delivery-time asphyxia. The mean of birthweight, gestational age and CRIB in living and dead infants were 1201 and 934 grams, 30 and 28 weeks and 3.76 and 11.7, respectivly. Using a ROC curve, a cut off point of 7 was reached to predict neonatal outcome for CRIB scoring. Conclusion: This study showed that the mortality rate was higher than the rate in most centers of the world. The mortality rate was directly related with the increase of CRIB score,especially for scores more than 11.

---

Background & Objective: Trauma is the second most common cause of death regardless of age in Iran and the health system annually defrays a vast cost for trauma patients. The majority of cases comprise abdominal trauma. This study was performed to determine individual and pathologic characteristics of patients with blunt abdominal trauma in Gorgan – Iran. Materials & Methods: This descriptive and retrospective study was done on 239 patients with blunt abdominal trauma in 5 Azar hospital, Gorgan - Iran from March 2001 to March 2005. Results: 197 (82.4%) of cases were male and 42 (17.6%) were female. The mean age of patients was 23.4 years. The mean of hospital stay was 8.8 days. The most common cause of blunt abdominal trauma was traffic injury. The most common damaged organs were spleen (49.4%) and liver (21.3%) respectivly. Mortality rate was 16.3%. The hypovolumic shock was the major cause of mortality. Conclusion: This study showed that epidemiology of trauma is similar to those in other regions of our country. Therefore, programming and attempts of governmental organizations are needed to prevent and decrease traffic accidents.

---

Background and Objective: In clinical situation, pain occurs during intravenous Catheterization (IVC). Finding methods to reduce pain related with insertion of Angiocut. This study was performed to evaluate the effect of types of Transcutaneous Electrical Nerve Stimulation (TENS) on the pain severity regarding to insertion of Angiocut is very important. This study was performed to evaluate the effect of types of transcutaneous nerve stimulation (TENS) on the pain severity regarding to insertion of Angiocut. Materials and Methods: This clinical trial study was performed on the 80 patients of Internal and CCU wards of Fatemieh Hospital in Semnan, Iran during 2001. In this study, severity of pain related with insertion Angiocut assessed and compared in four conditions No TENS, low TENS (5 Hz), high TENS (100 Hz) and burst TENS (with frequence 100 Hz And burst frequence 2 Hz). The severity of pain measured by testes visual analogue scale (VAS), One-way ANOVA, Tukey, and Dunnett tests were used for comparing means of pain severity in different conditions. Results: Findings showed significant difference between severity of pain during Angiocut insertion in four conditions (P<0.05), so that the lower intensity of pain was in the high-TENS group, while higher pain was in the No TENS group. Significant difference was between intensity of pain in the No TENS group with high TENS and burst TENS group (P<0.05), but no significant difference was between low TENS and No TENS groups. Conclusion: This study showed that TENS was a effective method to reduce pain during Angiocut insertion. The lowest severity of pain was obtained in high TENS method. therefore, high TENS method can suggest as a effective method to reduce pain during Angiocut insertion.

---

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.

---

Background and Objective: The increase of nosocomial systematic fungal infections due to pathogenic yeast, led to researchers on finding novel antifungals with potent inhibitory activity toward a wide range of pathogenic fungi. In the present study, antifungal effect of aqueous garlic extract individually and in combination with Fluconazole, Itraconazole and Ketoconazole were studied against some pathogenic yeasts. Materials and Methods: Broth microdilution method was used for evaluating antifungal activities of aqueous garlic extract with 0.03-256 µg/ml individually and in combination with Fluconazole, Itraconazole and Ketoconazole against Candida albicans PTCC5057, Candida dubliniensis CD36, Cryptococcus neoformance CNE1 and Malassezia furfur MF1, in vitro. The microdilution method was used for assessing antifungal susceptibility of above-mentioned compounds in two culture media sabouraud dextrose broth (for all fungi except M.furfur) and modified Dixon broth (for only M.furfur). The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of aqueous garlic extract and antifungal drugs tested were determined by on comparison of colony forming units (CFU) between test and control groups. Results: Aqueous garlic extract inhibited the growth of all fungi tested in a dose-dependent manner, in a concentration comparable with azole drugs.The MIC ranges of aqueous garlic extract, Candida albicans, Candida dubliniensis, Cryptococcus neoformances and Malassezia furfur was determined to be 0.25-64 g/ml. The MIC ranges of aqueous garlic extract in combination with Fluconazole was determined 0.125-8, 0.25-16, 0.125-16 and 0.5-8 µg/ml, respectively. The MIC ranges of aqueous garlic extract in combination with Itraconazole was determined 0.25-8, 0.125-2, 0.125-16, 0.25-4 µg/ml, respectively.The MIC ranges of aqueous garlic extract in combination with Ketoconazole was determined 0.125-4, 0.125-1, 0.125-8 and 0.125-2 µg/ml, respectively.The results indicated that the antifungal activities of drugs were increased in combination with aqueous garlic extract (P<0.05). Conclusion: This study showed that, the aqueous garlic extract increased the antifungal activity and decreased MIC of drugs in combination with them.

---

Background and Objective: The diagnosis of oral lesions can be more difficult than skin lesions, it either may be missed, or have no difference in color with near mucosa. The correct diagnosis is important, because treatment and prognosis either of them is different. The purpose of this study was to survey the pathological oral lesions in Ahwaz the capital city of Khozestan rpovince in South-West of Iran. Materials and Methods: This retrospective descriptive cross sectional study was done on 588 pathologic specimen, types of oral lesions, on patients referred to department of pathology, Imam Khomeini hospital in Ahwaz, since 1994 to end of 2004. Results: The mucosal oral lesions were more common in women than men (305 cases, 54%), the most lesions were benign (461 cases), the numerous lesions were nonspecific, most of the patients were in range of 20-30 years. The most common malignant tumor was squamous cell carcinoma and the rarest malignant tumor was malignant melanoma that all of them were on lower lip. The most common site for lesions was lower lip (155 cases, %27.6). The malignant cases were more common in men than women. Conclusion: This study showed the benign mucosal oral lesions were more common in female, than males. The lower lip was the most common site which is similar to other reports. Squamous cell carcinoma was the commonest malignant tumor which has a correlation with other studies.

---

Background and Objective: Diabetes mellitus is the most frequent cause of chronic renal failure. Microalbuminuria is the first clinically important sign of renal impairment in diabetes mellitus. The main pathophysiology of diabetic nephropathy is not understood. This study was done on 100 patients with type 2 diabetes for determination of the prevalence of diabetic nephropathy with urine albumin assay in Sina Hospital in Tabriz, North-West of Iran. Materials and Methods: In this discriptive study, 100 patients with type 2 diabetes whome consecutively referred to Endocrine and Diabetes Clinic of Sina Medical Center in Tabriz were enrolled. At the first visit clinical and biochemical parameters such as systolic and diastolic blood pressure, age, sex, body weight, length, body mass index, FBS, HbA1C, plasma creatinine, urine microalbumin and urinary creatinine were measured. FBS, HbA1C, plasma creatinine, urine microalbumin and urinary creatinine measurements repeated every 2 months up to three times during the study. Patients with confounding factors such as uncontrolled hypertension, urinary tract infection, congestive heart failure and hyperlipidemia were excluded. Results: The prevalence of diabetic nephropathy was 36% in our patients. There were not statistically significant differences in age and sex and diastolic – systolic blood pressure and creatinine between nephropathy and, non-nephropathy groups. There was significant differences in body mass index between two sex groups, females were more obese than males. Mean duration of diabetes in diabetic nephropathy group and in diabetic patients without nephropathy were 12.4±8.1 and 9.1±5.5 respectively (P<0.05). Comparison of HbA1c, FBS and drugs used for diabetes treatment were not significant differences between these groups. Conclusion: This study showed that prevalence of diabetic nephropathy was higher than other studies, although there were not significant differences between FBS, HbA1c and hypertension in patients with and without diabetic nephropathy.