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Background&Objective: Shiga-toxin producing E. coli (STEC) belonging to several different O serotypes are one of the etiological agent of diarrhea. The STEC strains are considered as an etiological agent for enteritis after non-typhoidal salmonellosis and Campylobacter. They have also been associated closely with the hemolytic uremic syndrome (HUS) and hemorrhagic colitis(HC). The aim of this study was to determine of the frequency of STEC in patients with hemorrhagic colitis referring to Tehran hospitals. Materials&Methods: From March to September 2004, 70 patients with hemorrhagic colitis (Case)an 70 patients with diarrhea (Control) were included in this study. The stx gene was detected by PCR and was used for the determination of STEC strains. Slide agglutination with specific antisera used to detect O serogroup. Polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) analysis of the flagellin gene (fliC) was performed for determining their flagellar antigen (H). Results: Two samples (2.9%) from Hemorrhagic colitis cases and 12 samples (17.1 %) from diarrheal cases were positive for STEC. There was no significant correlation between STEC and Hemorrhagic colitis but there was a significant correlation between STEC and diarrhea (p<0.05). STEC isolates O142:H48 serotype was from hemorrhagic colitis cases and O126:H47, O126:H6, O26:H4 and O111:H23 serotypes were from diarrheal cases. These serotypes were not reported in hemorrhagic colitis cases. Conclusion: Our data showed that there was no significant correlation between STEC and hemorrhagic colitis. This could be explained since serotype responsible for hemorrhagic colitis i.e. O157:H7 serotype is not present in Iran.

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Background and Objective: Post pain operative is common and a major complication which lead to numerous dangerous effects in various organs. The purpose of this study was to determine the effect of methocarbamol on postoperative pain following cholecystectomy. Materials and Methods: In a randomized, double – blind clinical trail study 60 ASA I, II patient in two group (n=30 in each group) between 30-50 years old and weigh lower of 100kg undergone general anesthesia for cholecystectomy. Elective surgery was selected in Besat Hospital, Sanandaj, Iran during 2008. Both group did not receive premedication and under similar condition of general anesthesia. Interventional group received 500mg Methocarbamol intravenus slowly and the control group received 5ml placebo slowly after operation. The pain score were measured by visual anesthesia scale (VAS) on the 1, 3, 6, 12 and 24 hours after operation and if necessitated narcotics (PRN, VAS>4) were prescribed. Data were analyzed using SPSS-16, ANOVA, Chi-Square and student’s t-tests. Results: There were no significant differences between two groups in terms of age, gender. The mean of score pain was lower for interventional group at 6.24 hours after operation (P<0.05). But no significant differences was observed at 1, 3 and 12 hours. The prescribe narcotic in interventional group was lower compared to controls (P<0.05). Conclusion: According to analgesic effects and low prescribe narcotics, it is suggested to use methocarbamol after operative due to analgesic effect.

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Helminthic infections were reported from tropical and subtropical locations in the world. The parasitic helminths develop and migrate to different organs. Unusual cases may afflict the gallbladder and the biliary tract. The parasites invade the bile ducts and cause inflammation, fibrotic lesions, acute and chronic cholecystitis. In this article, we reported three unusual cases of parasitic infection in Kermanshah, Iran. The worms were isolated from gallbladder and biliary tract. The specimens were diagnosed by macroscopic features and staining methods. Ascaris lumbricoides, Taenia saginata and adult type fasciola hepatica isolated from gall bladder and biliary duct. Cholecystectomy was done on all patients suffering from gall bladder inflammation and obstruction.

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Background and Objective: Nausea and vomiting are common complications after surgery which creates spasm, hypoxia and pulmonary aspiration. This study was done to determine the effect of ondansetrone, metoclopramide associated with dexamethasone on postoperative nausea and vomiting in cholecystectomy surgery using Laparoscopic method. Methods: In this double blind clinical trial study, 100 patients with ASA class I and II undergoing laparoscopic cholecystectomy divided randomly into two groups. The patients in the first group were received metoclopramide (10mg/kg/bw) with dexamethasone (8mg/kg/bw) and the second group were received ondansetron (4mg/kg/bw) with dexamethasone (8mg/kg/bw) intravenously 5 min before the final stage of surgery. Premedication and induction of anesthesia in patients were equal 5 minutes to 4 hours after surgery, postoperative nausea and vomiting were recorded for each patient. Results: The rate of nausea in the first and the second groups were recorded 38% and 28%, respectively. The rate of vomiting in the first and the second groups were recorded 30% and 16%, respectively. These values were not significant. Conclusion: Ondansetron with dexamethasone non significantly reduced postoperative nausea and vomiting after laparoscopic cholecystectomy in comparison with metoclopramide with dexamethasone.