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Background and Objective: The risk of coronary heart disease (CHD) is proportional to the LDL-C lipoprotein. Due to frequent use of Friedwald formula in estimation of LDL-C in most laboratories, this study was done to compare the Friedwald formula and direct measurement to determine the serum levels of LDL-C Materials and Methods: This descriptive study was conducted on of 598 patients 226 male and 372 female whome referred to Imam Ali hospital Andimeshk cityin Khozestan province of Iran for health check up during 2009. 5 ml of the venous blood was drown. Total cholesterol (TC) (mg/dl), Triglyceride (TG) (mg/dl), HDL-C (mg/dl) and LDL-C (mg/dl) of serum are measured with Pars azmun company kits. The Friedwald formula was used for estimation of LDL-C. The K=3, 3.5 and 5 were used to stimate the lipid by Friedwald formula. Data were analyzed using SPSS-18, Pearson correlation coefficient and ANOVA tests. Results: A total of 598 serum samples collected 37.8% were men and 62.2% women. The mean age of participants was 38.8±10.77 years. Minimum age 21 years and maximum age was 77 years. Mean deviation for TG≤150, 201-300 and 301-400 in Friedwald formula (k=5) were -13.01±8.79, -17.11±13.17 and -18.63±18.54, respectively and with k=3 are -.39±12.04, -0.078±18.55 and 0.04±25.55 and for TG between 151-200 is -9.72±10.54 and with k=3.5 is equal to 0.82±13.70. Pearson correlation test showed that direct measurment and calculated from the equation Friedwald, for triglycerides in the area equal to or less than 150, 151-200, 201-300 and 301-400 mg/dl, with correlated to Pearson correlation coefficient were 0.982, 0.991, 0.991 and 0.975, respectively. Conclusion: This study showed that the direct measurement method is superior to the Friedwald equation, otherwise, equation Friedwald formula with K=3 is recommended.

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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: The etiology of childhood leukemia as the most common childhood malignancy remains largely unknown. This study was done to ascess the risk factors in childhood lymphoblastic leukemia in Shiraz-Iran. Materials and Methods: This case-control study was done on 141 children younger than 18 years suffering from acute lymphoblastic leukemia (ALL) whome resided at Fars Province of Iran during 2009. Patients were individually matched with 141 controls in respect to age, sex and residential area. Variables included: maternal age, parental education, father occupation, child birth weight and birth order, number of siblings, history of pet ownership including cat or dog, history of child day care attendance, history of leukemia in relatives, and history of mother diagnostic radiography during pregnancy. In order to evaluate the relationships between each variable and the risk of leukemia, odds ratio (OR) and 95% confidence interval (CI) were estimated using conditional logistic regression. Data were analyzed using SPSS-16 and Chi-Square test. Results: The agricultural occupation fathers in case and control were 17% and 5.7%, respectivley (P<0.01). The association between risk of childhood lymphoblastic leukemia with birth order≥3 (OR=5.939, 95% CI: 2.646-13.331, P<0.01), pet ownership (dog or cat) (OR=2.582, 95% CI: 1.265-5.269, P<0.009) and history of leukemia in first and second degree relatives (OR=3.5, 95% CI: 1.252-10.633, P<0.027) was significant. No relationship was found between birth weight, day care attendance, history of miscarriage, number of siblings and history of mother diagnostic radiology tests with risk of acute lymphoblastic leukemia. Conclusion: This study showed that father occupation, birth order, pet and history of leukemia in relation are risk factors of childhood acute lymphoblastic leukemia.

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Background and Objective: Continuous antigenic variation of Influenza a viruses causes a major concern to develop Influenza vaccine. Conserved antigens are suitable candidates for vaccine production due to its non-requirement to match the designed strains with circulating strains. The M2 gene is conserved among Influenza a viruses and has potential to be considered as a universal vaccine. This study was designed to evaluate the effects of aqueous Echinacea purpurea extract on immunogenicity of DNA vaccine encoding M2 gene of Influenza virus. Materials and Methods: This interventional study was carried out on female BALB/c mice with 3-4 week age (250-300 gr). Plasmid DNA encoding M2 gene (pcDNA-M2) of Influenza virus A/New Caledonia/20/99 (H1N1) was transformed into E.coli top10 f' and cultured in LB broth media. Large scale plasmid preparation was done and the concentration was measured by spectrophotometric method. Mice were divided into eight groups and immunized three times with fifteen days apart. Vaccine groups received inactivated Influenza virus or pcDNA-M2, alone or in combination with Echinacea extract. Control groups were injected pcDNA, Echinacea extract, and phosphate buffer. All animals were left to bleed before immunization and at 21 days after the last vaccination and specific anti-M2 antibodies were measured by indirect ELISA. Then the mice were intranasally challenged under an aesthesia with mouse-adapted PR8 Influenza virus and monitored for 3 weeks to evaluate the vaccine regimen efficacy in reduction of mortality rate compared to control groups. Data were analyzed using SPSS-16, One-way ANOVA and Kaplan–Meier tests. Results: The highest specific immune response was obtained in mice received inactivated virus plus extract (P<0.05). Immune responses in mice inoculated with pcDNA-M2 were significantly higher compared to all control groups mice (P<0.05). In addition the specific immune responses in group inoculated with pcDNA-M2 and aqueous extract was higher compared to the group receiving only pcDNA-M2 (P<0.001). The highest survival rate was observed in mice injected with inactivated virus or pcDNA-M2 plus extract. Conclusion: This study showed that pcDNA-M2 induced specific immunity and protected mice against lethal challenge with PR8 Influenza virus. Furthermore, application of Echinacea extract with M2 gene vaccine increased vaccine efficacy.

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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: The acute myeloid leukemia (AML) is a malignant disease with an accumulation of the abnormal and undifferentiated blastic myeloid cell in the bone marrow, leading to abnormal hematopoiesis. This study was done to determine the NPM1 and FLT3-(ITD) mutations and laboratory findings in patients with acute myeloid leukemia. Methods: This descriptive-analytic study was carried out on 40 (24 males, 16 females) patients with newly acute myeloid leukemia in Northwest of Iran. The mutation of NPM1 and FLT3-ITD were evaluated using PCR method in 25 patients. In all patients, the flowcytometry findings in the bone marrow, leucocytosis and the LDH levels were evaluated prior to the chemotherapy. Results: The mutation of FLT3-ITD and NPM1 genes was detected in 15 (60%) and 9 (36%) of patients, respectively. FLT3-NPM1+ mutation was seen in 4 (16%) patients. Leukocytosis, LDH level and AML in different classes did no show any significant difference between FLT3-NPM1+ and other gene mutations. Conclusion: The mutation of FLT3-ITD gene was nearly twice than NPM1 in acute myeloid leukemia.

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Background and Objective: Vulvovaginal candidiasis or Candida vaginitis is a common fungal infection among adult women during reproductive ages and it is the second most frequent infection of the female genital tract. This study was carried out to determine of the prevalancy and species of vulvovaginal candidiasis and related clinical findings. Methods: This descriptive - analytical study was carried out on 400 women whom reffered to gynological center in Chabahar city in South-East of Iran during 2013. Vaginal samples were examined with direct microscopy and cultured on sabouraud dextrose agar and corn meal agar. Germ tube test and sugar assimilation test were carried out to differentiate the Candida species. The clinical findings including burning and itching during intercourse, burning with urination, foul-smelling vaginal discharge, vaginal deliveries, pH of the vagina, cervix appearance, consistency and color of vaginal in patients with vaginal discharge were recorded. Results: The prevalence of vulvovaginal candidiasis was 45.8%. Isolated candida species were candida albicans with 80.87% and Candida non-albicans with 19.13%. There was significant correlation between itching (85.52%) and burning during intercourse (67.87%), hypogastric pain (80.53%) with vulvovaginal candidiasis (P<0.05). 73 patients (39.9%) reported urinary burning. The most common affected by vulvovaginal candidiasis was with marriages age of 11-20 years old (P<0.05). Conclusion: The most common isolated species was candida albicans. The common clinical findings were burning, itching, smelly discharge, vaginal parity.

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Background and Objective: Multiple sclerosis (MS) is the most common progressive neurologic disorder among young adults. This disease leads to lesions regarded to as demylinating plaques which are scattered in the white matter of CNS hence create various neurological problems. This study was done to evaluate the effect of 8 weeks selective training program with instructions focus of internal and external attention on statical balance of MS patients. Methods: In this quasi-experimental study, 23 MS patients were non-randomly divided into, two interventional and one control groups. Training program for two interventional were carried out in 8 weeks, three sessions per week, and each session lasted about one hour. Pre and post test to evaluate the fall risk of subjects using Biodex system was performed in three groups. Results: Statical balance was significantly improved in the two interventional compared to control group (P<0.05). Conclusion: The training program with instructions focus of internal and external attention significantly improves statical balance of MS patients.

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Background and Objective: Sleep is an important component of the circadian cycle is associated with the restoration of the physical and mental faculties. Physical activity is one of the confounding factors in improving sleep quality. This study was done to determine the effect of physical activity on quality of sleep in female students.

Methods: This cross-sectional study was conducted on 370 female students in Zabol University in south-east of Iran. Demographic data through a questionnaire were collected for each subject. Sleep quality and physical activity of subjects were recorded using standardized questionnaire Pittsburgh sleep quality index (PSQI) and physical activity Beck test. Subjects according to physical activity divided into active and inactive groups.

Results: Poor sleep quality was seen in 25.2% and 67.4% of active and inactive students, respectively. Mean of Sleep quality in both groups active 5.73±3.22 and inactive  7.21±3.75 was inappropriate but sleep quality in active females was higher than inactive females (P<0.05). A favorable condition for the quality of sleep was seen in 65.7% of the active group with BMI<25 and only 9.1% of students BMI was more than 25. In inactive students, 60.8% of subjects with BMI<25 had poor sleep quality. Both levels of BMI, sleep quality was significantly different between the groups, but this difference was higher in the active group (P<0.05).

Conclusion: Poor sleep quality was seen in high percentage of female students and physical activity influences the quality of sleep.

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Background and Objective: Ovarian cancer is the fifth common cancer among women and the number of new cases is increasing. Valproic acid is a histone deacetylase inhibitor effectively used to treat epilepsy and bipolar disease. Recently, this compound has attracted attention as an anti-cancer agent. Bim is one of the most important genes of mitochondrial pathway of apoptosis, and it plays an important role in the biology of cancer. Expression of this gene is greatly reduced in ovarian cancer. This study was done to evaluate the effect of valproic acid on the viability of ovarian cancer cells, apoptosis and Bim gene expression in A2780 line.
Methods: In this experimental study, the human ovarian cancer cells (A2780) were grown in RPMI-1640 medium in appropriate culture conditions. The cells were treated by various concentrations valproic acid (1-30 mM) and were incubated for 24, 48 and 72 hours. After the incubation of period, cell viability was investigated using MTT. Apoptosis was analyzed by flow-cytometry method in the cells were treated by valproic acid. The Real time PCR test was used to assess the effect of this drug on the expression of Bim gene.
Results: The results of MTT assay showed that valproic acid reduced the viability of A2780 cells, and this effect was time and dose-dependent. The reduction of cell viability at 30 mM concentration and 72 hours after treatment, was maximum and statistically significant (P<0.05). Exposure to valproic acid significantly increased the percentage of apoptotic cells (P<0.05). Also, Valproic acid significantly increased the expression of Bim (P<0.05).
Conclusion: Valproic acid reduced viability in ovarian cancer cell line A2780. Valproic acid increased cell death by altering the expression of genes involved in apoptosis in ovarian cancer cell line A2780.

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Background and Objective: Liver is an important organ with specific function in relation to drug metabolism. Haloperidol is a drug for the treatment of schizophrenia, mania in bipolar disorder and dizziness. This study was performed to determine the changes in tissue and hepatic enzymes in male rats born to mothers treated with haloperidol.
Methods: In this experimental study, 25 adult female Wistar rats were allocated into 5 groups. The control group, the sham group and experimental groups 1, 2, 3. Dams in experimental groups 1, 2, 3 in the pregnancy period were received 12.5, 25 ,50 mg/kg /bw of haloperidol for 21 days orally, respectively. The control groups were sham and three experimental, first, second and third experimental groups. Mothers of mice received 12.5, 25 and 50 mg/kg of haloperidol during the pregnancy as 21 days of gavage. At the end of pregnancy and 22 days of infant, all infants were weighed. Alanine aminotransferase (ALT), alkaline phosphatase (ALP) and aspartate transaminase (AST), albumin and total protein were measured by autoanalysis and liver tissues were stained using hepatoxylin-eosin method.
Results: The mean concentration of albumin and total protein in the second and third experimental groups significantly reduced in compare to control group (P<0.05). The mean concentration of AST in the second and third experimental groups significantly increased in comparsion with control group (P<0.05). The mean concentration of ALT and ALP in all experimental groups was significantly higher than the control group (P<0.05). The mean of liver indices in all experimental groups was not significant in comparison with the control group. In the tissue samples of the experimental groups, necrosis was observed with increasing dosage.
Conclusion: Haloperidol has been shown to increase liver enzymes and liver necrosis and increase liver necrosis in a dose-proportional manner.

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Background and Objective: Managed health care is one of the main components of universal health care systems, which recently has drawn more attentions. Therefore, based on the high costs of health system, poor quality of services, reduce efficiency, it is necessary to study and design a model to distinguish managed form unmanaged systems in Iran. This study was done to evaluate the managed health care in contagious and non-contagious diseases in Golestan province, northern Iran during 2016.

Methods: This descriptive-analytic study was done based on data collected from all urban and rural health centers of Golestan province, north of Iran during 2016 using standard checklists. Data were analyzed according to rural and urban area and type of diseses.

Results: Managed health care of tuberculosis was considerd in first rank following by hypothyroidism, leishmaniasis, hypertension, brucellosis and finally diabetes in a respective manner. In addition, managed cares in rural centers significantly had better condition than those of urban centers (P<0.05).

Conclusion: This study showed that managed care in rural areas is better than urbans and the tuberculosis has well condition according to managed health care.

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Background and Objective: Evaluation of effective factors in the incidence of leukemia, especially pollutants, such as Sodium Sulfide and lead acetate, can contribute to the treatment of cancer and prevention of disease. Npm1 gene is a multiple Phosphoprotein that contains several action domains. Npm1 gene is encoded between nucleus and cytoplasm and performs several functions including protein ribosome transfer and control of centrosome proliferation. Npm1 mutations are transferred from the nucleus to the cytoplasm. This study was conducted to compare the effect of lead static poisoning and sodium sulfide on Npm1 gene expression in adult male rats.
Methods: In this experimental study, 48 adult male rats were allocated into 6 groups. The experimental groups include control, the first and second experimental groups were received sodium sulfide with doses of 300 mg/kg/bw and 600 mg/kg/bw, respectively. The third and fourth experimental groups were received lead acetate with doses of 30 mg/kg/bw and 60 mg/kg/bw, respectively. The fifth experimental groups were received maximum doses of sodium sulfide and lead acetate, respectively. Lead acetate and sodium sulfide were gavaged daily for 4 months. After that, blood was taken from the mice and RNA was extracted. Then, CDNA synthesis and Npm1 gene expression compared to Ywhaz gene were evaluated quantitatively using Real Time PCR.
Results: Npm1 gene expression reduced in groups were received sodium sulfide at doses of 300 and 600 mg/kg body weight. Npm1 expression increased in lead static groups with doses of 30 and 60 mg/kg body weight.
Conclusion: This study showed that by increasing the expression of Npm1 gene expression, Threshold Cycle value decreases.

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Background and Objective: Exercise in cardiac patients after coronary artery bypass grafting (CABG) improves cardiovascular function by increasing the capillary density of the myocardium. Platelet-derived growth factor and stromal cell-derived factor-1 play an important role in angiogenesis and cell proliferation and differentiation. This study was performed to determine the effect of eight weeks of combined training on plasma levels of Platelet-derived growth factor (PDGF) and stromal cell-derived factor-1 (SDF1) in CABG patients.
Methods: In this clinical trial study, 24 patients who underwent coronary artery bypass grafting operation were selected using convenience and purposeful sampling method and randomly divided into two combined training and control groups. Subjects in combined training group were received aerobic and resistance training protocols for eight weeks, three sessions per week. Before and after training program, body composition assessments and blood sampling were performed to measure Platelet-derived growth factor (PDGF) and stromal cell-derived factor-1 (SDF1). ELISA method was used to measure PDGF and SDF1.
Results: The level of PDGF was significantly increased in intervention group in compared to control group (P<0.05). Although the level of SDF1 in the intervention group increased in intervention group in compared to control group; but this increase level of SDF1 was not significant.
Conclusion: This study showed that the eight weeks of combined rehabilitation training can promote desirable physiological adaptations in cardiovascular health by increasing the plasma levels of PDGF.