Background: Post-traumatic stress disorder (PTSD) is a stress-related psychosomatic disorder caused by occurrence of a traumatic event and the hippocampus volume of the patients with Post-traumatic stress disorder decreased. However, the mechanisms that cause such damage are not well-understood. The aim of this study is to detect the expression of apoptosis-related Bax, Bcl-2, Caspase-3 and Insulin-like growth Factor-I proteins in the hippocampus region in the Predatory stress rats. Materials and Methods: A total of 70 male wistar rats were divided into Predatory stress groups of 1d, 2d, 3d, 7d, 14d, 30d and a normal control group (N = 10). Rats were subjected to 5 min of predatory stress and then exposed to the elevated plus-maze (EPM). Serum corticosterone and Insulin-like growth factor-1 level of Hippocampus were measured by ELISA technique. The expression of Bax, Bcl-2, and Caspase-3 were detected by western blotting. Results: Rats spent significantly more time in closed arms of the elevated plus maze (EPM) than control group after exposure to stress. Serum levels of corticosterone significantly increased at 2d-3d. The expression of hippocampal IGF-1 was significantly up-regulated at 1d-2d after stress. Both Bax and the ratio of Bax/Bcl-2 significantly peaked at Predatory stress 2d-14d. Caspase3 was significantly active among 2d-30 compared to the normal control. Conclusion: The activation of caspase-3 in the stress groups indicates that apoptosis may be one of the reasons inducing hippocampus atrophy and play roles in the pathogenesis of PTSD. Increase in hippocampus levels of IGF-1 during early PTSD might be involved in the early molecular inhibitory mechanism of apoptosis in PTSD.

Background: Axonal polyneuropathy (APN) is a common kind of neurologic disorders, which is normally diagnosed by electrodiagnostic methods. Different muscles were studied to find a muscle, which can be considered as a reliable site for early diagnosis of mild APN; this muscle should be easily activated by patient, has the highest sensitivity to EMG changes of APN, and has the lowest rate of false positive results in normal subjects. Materials and Methods: Based on the inclusion and exclusion criteria, 32 patients were recruited, and all of them underwent needle EMG of 3 different muscles including Peroneus tertius (PT), tibialis posterior (TP), and dorsal interoseous pedis (DIP). EMG Findings of different muscles [Motor Unite Action Potential (MUAP) duration, MUAP amplitude, polyphasic MUAP, fibrillation potential (FP), and the ability of subjects to contract special muscle] were recorded and compared. Results: Mean of MUAP amplitude was significantly different between all 3 muscles (P-values < 0.001). PT showed a significantly higher frequency of polyphasic MUAP than others (P-value: 0.001). The frequency of FP was significantly lower in TP than PT and DIP (P-values: 0.03 and 0.001, respectively). DIP showed significantly shorter MUAP duration than PT and TP (P-values 0.002 and 0.003, respectively). All cases were able to activate TP and PT voluntarily though only 20 patients could activate DIP (P-value < 0.0001). Conclusion: The higher frequency of polyphasic MUAP, the higher frequency of FP, and finally, the ability of all patients in activation of PT voluntarily, all support the usefulness of PT for EMG studies in APN patients.

Clear cell hidradenoma or nodulocystic hidradenoma or acrospiroma are histologically distinct relatively rare tumors of sweat gland duct origin, found mainly in adults with a female preponderance. We report a case of eccrine hidradenoma in a 31-year-old man who presented with an asymptomatic, solitary nodule on occipital region. A few reports are available in literature regarding presence of this tumor on occipital region of young man and present case is being reported because of its rarity in this region of scalp and in this sex.

Gallbladder cancer is found in about 1-2% of patients after laparoscopic cholecystectomy and it is difficult to diagnose preoperatively. Laparoscopic cholecystectomy may disseminate gallbladder cancer to peritoneum and even port sites. Here, we present a case of a 59-year-old female patient operated for gallstone disease and her histopathology was suggestive of well-diffentiated gallbladder carcinoma (T1N0M0). Patient presented to us with port site and distant peritoneal metastases after 3 months.

Multiple sclerosis (MS) and celiac disease (CD) are considered to be T-cell-mediated autoimmune disease. We discuss about a known case of CD-showed relapsing - remitting neurological symptoms compatible with MS. In this rare co-occurrence subject, MS-CD patient, the interaction between MS - and CD-related inflammatory processes is open to discussion.

Background: Drug-resistant strain of Herpes simplex virus type 1 (HSV-I) has increased the interest in the use of natural substances. Aims: This study was aimed to determine minimum inhibitory concentration of hydroalchoholic extract of a traditionally used herbal plant, Quercus persica L., on HSV-1 replication on baby hamster kidney (BHK) cells. Setting: The study was conducted in Shahrekord University of Medical Sciences, Iran. Design: This was an experimental study. Materials and Methods: BHK cells were grown in monolayer culture with Dulbecco's modified Eagle's medium (DMEM) supplemented with 5% fetal calf serum and plated onto 48-well culture plates. Fifty percent cytotoxic concentration (CC50%) of Q. persica L. on BHK cells was determined. Subsequently, 50% inhibitory concentration (IC50%) of the extract on replication of HSV-1 both in interacellular and exteracellular cases was assessed. Statistical Analysis: Statistic Probit model was used for statistical analysis. The dose-dependent effect of antiviral activity of the extracts was determined by linear regression. Results: Q. persica L. had no cytotoxic effect on this cell line. There was significant relationship between the concentration of the extract and cell death (P<0.01). IC50s of Q. persica L. on HSV-1, before and after attachment to BHK cells were 1.02 and 0.257 μg/mL, respectively. There was significant relationship between the concentration of this extract and inhibition of cytopathic effect (CPE) (P<0.05). Antioxidant capacity of the extract was 67.5%. Conclusions: The hydroalchoholic extract of Q. persica L. is potentially an appropriate and promising anti herpetic herbal medicine.

Peutz-Jeghers syndrome is a rare autosomal dominantly inherited condition, characterized by the presence of hamartomatous gastrointestinal polyps and mucocutaneous pigmentation. Patients with this syndrome can be associated with other neoplasms such as ovarian neoplasms known as sex-cord tumor with annular tubules that are associated in one third of the cases with this syndrome and other types of malignancies. We report a 42-year-old woman with a history of Peutz-Jeghers Syndrome and bilateral breast cancer that presented with abnormal uterine bleeding. Total abdominal hysterectomy with bilateral salpino-oophorectomy was done and an ovarian sex cord tumor with annular tubules was incidentally diagnosed. By reviewing literatures and in agreement with previous studies we suggest routine screening for malignancies in patients with Peutz-Jeghers syndrome.

Thalassemia is a hematologic disorder that causes ineffective hematopoiesis and is related to severe anemia, iron overload, extramedullary hematopoiesis, and hepatomegaly. Hepatomegaly is related to significant extramedullary hematopoiesis. The other sites that are involved in extramedullary hematopoiesis are spleen, lymph nodes, paraspinal regions, kidney, pleura, and intestine, but intracranial involvement is a rare presentation. We discuss about a case with intracranial medullary hematopoiesis in a thalassemic patient.

Background: Although Wilms' tumor gene (WT1) was initially known as a tumor marker in Wilms' tumor, nowadays its role is well known in other sorts of malignancy. This study aimed to evaluate WT1 protein expression levels and its association with cellular proliferation in astrocytic brain tumors by immunohistochemical methods. Materials and Methods: This cross-sectional study performed on 73 randomly selected archived tissue samples of astrocytic brain tumors. Sections were observed after immunohistochemical staining regarding WT1 protein expression and MIB-1 staining index. Tumors were classified based on World Health Organization grading system. Results: WT1 protein expression was seen in the majority of samples (97.3%) with significantly higher index in high-grade tumors (P<0.001). MIB-1 staining index was also significantly higher in high-grade tumors (P<0.001). Moreover, a significantly positive correlation was found between WT1 protein expression and MIB-1 staining index (r: 0.64, P<0.001). Conclusion: Astrocytic brain tumors express WT1 protein. It was also found that high-grade tumors are accompanied with higher WT1 protein expression, which is correlated with MIB-1 staining index. WT1 can be used as a marker of malignant cell proliferation and diagnostic tool to differentiate normal astrocytes from neoplastic cells.

Introduction: The aim of this study was to evaluate the accuracy of modification of diet in renal disease (MDRD) and Cockraft-Gault (C-G) formulas for estimating GFR in a sample of Iranian adult. Materials and Methods: This study was an analytic cross-sectional study on 54 patients with chronic kidney disease. Glomerular filtration rate was measured by kidney scan via TC99m-labeled diethylenetriaminepentaacetic acid, and it was estimated by MDRD and Cockraft-Gault formulas. Results: The mean of measured GFR and estimated GFR by MDRD and C-G formulas was 61.64 ± 34.26 ml/min, 51.80 ± 25.47, and 54.29 ± 24 ml/min respectively (P-value < 0.001, r = 0.818 and P-value < 0.001, r = 0.847, respectively). Pearson correlation test showed direct linear relationship between sGFR and GFR as estimated by the Cockraft-Gault and MDRD formulas. Conclusion: Based on our results, modification of diet in renal disease (MDRD) and Cockraf-Gault (C-G) formulas are accurate formulas in Iranian adults but they need a correction factor.

Background: CD4+(TH1, and TH2) cell groups in the point of view of chemokine receptor expression were considered in blood of stomach cancer patients. Materials and Methods: The percentage of blood CD4+ T cells expressing chemokine receptors (before and after gastrectomy) was determined by flow cytometry (Becton Dickinson, USA) using the following chemokine receptor antibodies: anti-CCR5, anti-CXCR3, anti-CCR3 and anti-CCR4. Results: The means of CD4 ⁺ CCR5 ⁺ expressing cells was 1.23% ± 0.90, 0.83% ± 0.34 and 1.34% ± 0.74 in control, pre- and post-operation groups, respectively. CD4 ⁺ CXCR3 ⁺ expressing cells were 19.09% ± 8.4, 16.95% ± 5.71 and 25.08% ± 9.31, respectively. Similar pattern was seen for CD4 ⁺ CCR3 ⁺ and CD4 ⁺ CCR4 ⁺ expressing cells. Pearson correlation analysis shows no relationship between CCR3 and CCR4 expressions on TCD4 cells (r = 0.211, P = 0.126). The complex expression TH1 (CD4 ⁺ CXCR3 ⁺ CCR5 ⁺ ) receptors determined 1.14% ± 0.54 for control group, 0.86% ± 0.49 for pre-T and 1.57% ± 0.67 for post-T group. Moreover, the TH2 (CD4 ⁺ CCR3 ⁺ CCR4 ⁺ ) expression was 1.60% ± 1.05 for control group, 1.57% ± 0.83 for pre-T and 1.27% ± 0.66 for post-treatment group. Pearson correlation analysis shows that only the CCR3 and CCR5 expression was statistically correlated (r = 0.321, P = 0.018). Conclusion: Due to low expression of CCR5 in TH1 and CCR3 in TH2 cells, it seems that utility of these is extremely limited for clinical evaluation, but not scientific purpose. Moreover, considering the CXCR3 for TH1 cells and CCR4 expression for TH2 cells, due to considerable expression, may be practical.

Background: This study was performed to determine the demographic and outcome of penetrating abdominal trauma in patients attending to emergency medicine department. Materials and Methods: This was a descriptive cross-sectional study in Imam Hossein Medical Center. Seventy five patients who came to our department with penetrating abdominal trauma during a 1 year period were enroled into this study and their demographic data and outcome (during the hospitalization) were recorded. The study was at Imam Hossein Medical Center, Tehran, Iran, from 2009 to 2010. Results: Our findings indicate these notable results: 84% of patients were less than 40 years old, most patients attended emergency department during the spring and summer, 72 patients (96%) arrived between 7 pm and 7 am, 74 patients (98.7%) had stab wound and one person (1.3%) was shot, eventually 46 patients (61%) had laparatomy performed and 2 patients (2.7%) died. 59 patients out of 75 study cases appealed to police department and legal medicine council. Conclusions: The incidence of abdominal penetrating trauma due to stab wound is much higher than gunshot in our community, which indicates the importance of educating the emergency staff and preparing the emergency department work place to attend to these patients, especially during the night hours.

Tuberculous dactylitis is a distinctly uncommon, yet well recognized form of tuberculosis involving the small bones of the hand or foot. It occurs in young children in endemic areas under 5 years of age. Tuberculosis of the short tubular bones like phalanges, metacarpals or metatarsals is quite uncommon beyond 6 years of age, once the epiphyseal centers are well established. The radiographic features of cystic expansion have led to the name " Spina Ventosa" for tuberculous dactylitis of the short bones. Scrofuloderma is a mycobacterial infection affecting children and young adults, representing direct extension of tuberculosis into the skin from underlying structures e.g. lymph nodes. An 8-year-old malnourished girl had multiple axillary ulcers with lymphadenopathy. Tuberculous dactylitis with ipsilateral axillary scrofuloderma was suspected on clinical and radiological grounds. The suspicion was confirmed by histology and bacteriology. The patient responded to antitubercular drugs with progressive healing of the lesions without surgery. Concomitant presence of these dual lesions suggesting active disseminated tuberculosis in immune-competent child over 6 years is very rare and hardly reported.

Colloid milium is a rare cutaneous condition with at least three distinct subtypes, characterized clinically by the development of yellowish translucent papules or plaques on sun-exposed skin, and histologically by the presence of colloid in the dermal papillae. In this case report, we present a man with multiple small papules on dorsum of his hands that in pathology confirmed to be colloid milium. Colloid milium is more commonly observed in fair-skin patients and remain unchanged; however our patient had dark skin type (Fitzpatrick skin type III) and lesions were increasing in summer and decreasing in winter.

The classic presentation of malaria with paroxysms of fever is seen only in 50-70% of the patients. The development of immunity, the increasing resistance to anti-malarial drugs, and the indiscriminate use of anti-malarial drugs have led to malaria with the presentation of unusual features. Cerebellar ataxia, extrapyramidal rigidity and various psychiatric symptoms have been described either as early manifestations of cerebral malaria or as a part of post malaria neurological syndrome. In this case report, we will discuss one such patient of falciparum malaria infection who developed midline cerebellar signs, and responded to anti-malarial treatment.

Background: Up to date different methods have been used in order to dimensions reduction, classification, clustering and prediction of cancers based on gene expression profiling. The aim of this study is extracting most significant genes and classifying of Diffuse Large B-cell Lymphoma (DLBCL) patients on the basis of their gene expression profiles. Materials and Methods: We studied 40 DLBCL patients and 4026 genes. We utilized Artificial Neural Network (ANN) for classification of patients in two groups: Germinal center and Activated like. As we were faced with low number of patients (40) and numerous genes (4026), we tried to deploy one optimum network and achieve to minimum error. Moreover we used signal to noise (S/N) ratio as a main tool for dimension reduction. We tried to select suitable training data and so to train just one network instead of 26 networks. Finally, we extracted two most significant genes. Result: In this study two most significant genes based on their S/N ratios were selected. After selection of suitable training samples, the training and testing error were 0 and 7% respectively. Conclusion: We have shown that the use of two most significant genes based on their S/N ratios and selection of suitable training samples can lead to classify DLBCL patients with a rather good result. Actually with the aid of mentioned methods we could compensate lack of enough number of patients, improve accuracy of classifying and reduce complication of computations and so running time.

Background: Acute promyelocytic leukemia (APL) is an acute leukemia diagnosed by translocation of chromosomes 15 and 17 [T (15,17)] and aggregation of neoplastic promyelocytes which are incapable of being converted into mature cells. Today, many tend to use medicinal herbs in studies and clinical applications for treatment of cancers. Cinnamon with scientific name "cinnamomumzelanicum" is a shrub of Laurales order, lauraceae family with cinnamomum genus. It is a medicinal shrub with anti-proliferation effect on tumor cells. This study was conducted to determine the effects of aqueous cinnamon extract on HL-60 cells as a model for APL. Materials and Methods: In this in vitro experimental study, HL-60 cell line was cultured under the influence of cinnamon extract's concentrations of 0.01, 0.1, 1, and 2 mg/ml in with intervals of 24, 48, and 72 h. Growth inhibition and toxic effects of cinnamon extract were evaluated through tetrazolium salt reduction. The effect of this herb on the cell cycle was studied by flow cytometry. The Hoechst stain was used to detect apoptotic cell nuclei. Results: Cinnamon extract inhibited the growth of HL-60 cells as correlated with concentration and time. After 72 h of treating HL-60 cells with 0.01 mg/l cinnamon extract, the growth of cells was inhibited by 90.1%. Cinnamon extract stopped the cell cycle in G1 phase and the Hoechst staining verified the apoptotic process in those cells. Conclusion: Considering the inhibitory property of cinnamon extract, we recommend it as a single drug or besides other medications for treating promyelocytic leukemia.

Background: P300 is a member of the mammalian histone acetyl transferase (HAT) family, an enzyme that acetylates histones and several non-histone proteins including P53 (the most important tumor suppressor gene) during stress, which plays an important role in the apoptosis of tumor cells. Hereby, this study describes the potency of CTB (Cholera Toxin B subunit) as a P300 activator to induce apoptosis in a breast cancer cell line (MCF-7) and a lung fibroblast cell line (MRC-5) as a non-tumorigenic control sample. Materials and Methods: MCF-7 and MRC-5 were cultured in RPMI-1640 and treated with or without CTB at a concentration of 85.43 μmol/L, based on half-maximal inhibitory concentration (IC50) index at different times (24, 48 and 72 h). The percentage of apoptotic cells were measured by flow cytometry. Real-time quantitative RT-PCR was performed to estimate the mRNA expression of P300 in MCF-7 and MRC-5 with CTB at different times. ELISA and Bradford protein techniques were used to detect levels of total and acetylated P53 protein generated in MCF-7 and MRC-5. Results: Our findings indicated that CTB could effectively induce apoptosis in MCF-7 significantly higher than MRC-5. We showed that expression of P300 was up-regulated by increasing time of CTB treatment in MCF-7 but not in MRC-5 and the acetylated and total P53 protein levels were increased more in MCF-7 cells than MRC-5. Conclusion: CTB could induce acetylation of P53 protein through increasing expression of P300 and consequently induce the significant cell death in MCF-7 but it could be well tolerated in MRC-5. Therefore, CTB could be used as an anti-cancer agent.

Background: In recent years, antibiotic resistance of Staphylococcus epidermidis to methicillin has significantly increased, making it essential to study resistance to methicillin, which is a determining factor in the appropriate treatment pattern. The purpose of this study was to identify methicillin-resistant genes in S. epidermidis strains using polymerase chain reaction (PCR) and to determine their mean minimum inhibitory concentration (MIC) to methicillin using E-test method. Materials and Methods: MIC was determined on 146 samples of S. epidermidis using E-test method. Moreover, all samples were tested for the presence of mecA gene using PCR. Results: PCR test showed 75.34% of the samples to contain mecA gene. Methicillin resistance test was performed using E-test on all the samples, which showed resistance in different dilutions. Conclusion: The frequency of mecA gene in S. epidermidis isolates was 75.34%. Among the various applied tests used for determining methicillin resistance, sensitivity and specificity of PCR were the highest and reached 100%. Sensitivity and specificity were found to be 95.3% and 94.7%, respectively, for phenotypic test (E-test) and 86.5% and 80.9%, respectively, for disk diffusion method. Based on the above results, it seems that resistance of S. epidermidis to methicillin is on the rise, and therefore more research is warranted.

Background : Urinary incontinence is relatively common in women and is usually associated with pelvic organs prolapse. Our aim was to determine the relationship between type and intensity of urinary incontinence and different grades and types of pelvic organ prolapse among women. Materials and Methods: One-hundred female patients with the chief complaint of incontinence, who were diagnosed with pelvic organ prolapse participated in this study. Intensity of prolapse, stress and urge incontinence were evaluated using POP-Q (Pelvic Organ Prolapse Questionnaire), SEAPI (Stress related, Emptying ability, Anatomy, Protection, Inhibition) and Freeman criteria, respectively. Results: Patients' mean age was 51.95 ± 12.82 years. The most common type of incontinence was stress incontinence (53%) and the most common prolapse type was cystocele (76%). Cystocele and rectocele had a significant relationship with stress (P value = 0.012) and urge incontinence (P value = 0.035), respectively; however, no relationship was observed between different grades of cystocele, rectocele and enterocele with different types of urinary incontinence (P value > 0.05). In patients with urge and mixed incontinence, prolapse grade significantly increased with age, but no such relationship was found in patients with stress incontinence. The number of vaginal deliveries had a significant relationship only with cystocele and rectocele grade; however, the relationship between other variables such as intensity of different types of urinary incontinence and enterocele grade with the number of deliveries was not significant. Conclusion: Pelvic organ prolapse had a significant relationship with urinary incontinence regardless of intensity and POP should be examined in all of these patients.

Background: Periodontitis is inflammation of the supporting tissues of the teeth caused by specific microorganisms. Intra-periodontal pocket, mucoadhesive drug delivery systems have been shown to be clinically effective in the treatment of periodontitis. The aim of this study was to formulate a mucoadhesive gel from the seed hull of Quercus brantii and fruits of Coriandrum sativum for the treatment of periodontitis. Materials and Methods: The semisolid concentrated extracts were incorporated in gel base. Mucoadhesive gels were prepared using carbopol 940‚ sodium carboxymethylcellulose (sodium CMC) and hydroxypropyl methylcellulose K4M (HPMC) as bioadhesive polymers. Physicochemical tests‚ mucoadhesive strength measurement and in vitro drug release study were carried out on two formulations containing carbopol 940 and sodium CMC polymers (Formulations F ₄ and F ₅ ). We investigated the antibacterial activity of formulation F ₅ against Porphyromonas gingivalis using the disk diffusion method on supplemented Brucella agar. Results: Eight gel formulations were prepared. Physical appearance, homogeneity and consistency of F ₄ and F ₅ were good. Mucoadhesion and viscosity of F ₅ (1% carbopol 940 and 3% sodium CMC) was more than F ₄ (0.5% carbopol 940 and 3% sodium CMC). Drug release from F ₅ was slower. Both of formulations were syringeable through 21 G needle. In the disk diffusion method, F ₅ produced significant growth inhibition zones against P. gingivalis. Conclusion: The ideal formulation for the treatment of periodontitis should exhibit high value of mucoadhesion, show controlled release of drug and be easily delivered into the periodontal pocket preferably using a syringe. Based on in vitro release and mucoadhesion studies‚ F ₅ was selected as the best formulation.

Background: Peripartum hysterectomy is associated with significant morbidity and mortality. We determined the factors leading to and maternal mortality and morbidity rates among the women whose underwent peripartum hysterectomy in Iran. Materials and Methods: This case-series study was conducted from March 2004 to March 2009 in the Department of Gynecology and Obstetrics at two central university hospitals (Azahra hospital and Shahid Beheshti Hospital) in Isfahan. Forty one women among 29,444 deliveries underwent peripartum hysterectomy. Women who had delivery before 24 weeks and a hysterectomy for other reasons like sterilizations were excluded. Incidence, indications and maternal complications including maternal death and urological, infectious and wound complications were evaluated after operation. Results : During the study period, the incidence of peripartum hysterectomy estimated about 1.39 per 1,000 deliveries. The maternal mortality rate was 17.07%. There was no statistical difference in mortality rates between referrals and non-referrals women ( P = 0.6). Post-operative complications included infection (22%), bladder injuries (7.3%), urine retention (4.8%) and wound dehiscence (4.87%). The main indication was placenta accreta 28 (68.3%). Conclusion : This study indicated the high rate of mortality among patients underwent peripartum hysterectomy. Evaluation of management during referring the patients and designing more studies to evaluate the mortality and morbidities are warranted.

Background: Plastination is a new method of preserving tissue samples for a long time. This study aimed to compare the new plastination technique with the conventional preservative method in glycerin for fetus skeleton tissues and young rats dyed by Alizarin red- Alcian blue double staining. Materials and Methods: In this study, 4 groups of 1-day, 3-day, 12-day and mature rats were selected and, after being anesthetized and slaughtered, their skin was completely removed. In Alizarin red- Alcian blue double staining method, first the samples were fixed in 95% ethanol and then their cartilages were dyed by 0.225% Alcian blue solution; after that, they were cleared in 1% KOH. Then, the bones were dyed in 0.003% Alizarin red solution and finally the tissue was decolorized in 95% ethanol. In each group, half of the samples were preserved by the conventional method in a glycerin container and the other half were plastinated. Results: In the present study, the samples preserved by plastination technique were dry, odorless, indecomposable and tangible. Quality of coloring had an inverse relationship with rats' age. Transparency of the plastinated samples had also an inverse relationship with rats' age. Therefore, skeletal tissue of younger rats had higher quality and transparency in both preservation methods (glycerin and plastination). Conclusion: This study showed that plastination technique was an appropriate method in comparison with glycerin preservation, which conserved skeletal tissue of fetus and young rats colored by Alizarin red- Alcian blue double staining. And the final result was that plastination technique can generate dry, odorless, indecomposable and tangible samples.

Background: Pseudomonas aeruginosa, is the most common pathogen in patients with cystic fibrosis (CF) that shows various resistance to antibiotics, acquires mucoidity and multiple genotypes. This survey was performed to study phenotypic and genotypic variations among P. aeruginosa isolates in CF patients at Alzahra Hospital in Isfahan, Iran. Materials and Methods: The isolates of Pseudomonas aeruginosa from CF patients at Alzahra Hospital was identified by appropriate biochemical and microscopic tests, then performed antibiotic resistance tests and mucoid colony morphotyping. The genum of isolates extracted and confirmed on 16S rDNA-based PCR assay and typed on 16S rDNA-23SrDNA spacer, restricted with Hinf1 restriction enzyme. Results: P. aeruginosa was isolated from 21 of the 59 CF patients (35.5%), Out of 21 isolates 9 (42.8%) strains were revealed mucoid morphotype. 81.8% isolates of mucoid strains were resistance to at least one of four antibiotics (GM, AN, PIP and CP). Most of the isolates (86%) showed resistance to ceftazidime. Ribotyping revealed two patterns (P1, P5). Conclusion: The isolates of P. aeruginosa showed meaningful difference between drug resistance to antibiotics. The majority of P. aeruginosa isolated from CF patients showed pattern1 of PCR-Ribotyping.

Background: Currently, imatinib is the drug of choice for initiation of medical treatment of chronic myeloid leukemia (CML) in the chronic phase. The current study was carried out to compare effectiveness and safety of Iranian vs. Indian imatinib. Materials and Methods: The clinical study was performed on newly diagnosed CML patients in Seyyed-oShohada Hospital (Isfahan) and Khansari Hospital (Arak) from January to June 2011. The control group consisted of CML patients who received Indian imatinib previously. The drug was initiated with the dose of 400 mg daily. The patients were followed for six months, and the treatment outcomes (WBC <10 ⁴ ) and molecular response. Finally, the two groups were compared in these respects. Result: We evaluated 43 patients in each group. The hematological and molecular responses for the Iranian Imatinib were respectively 86.0% and 46.5%, while the rates were respectively 86.0 and 44.2% for the Indian imatinib. The two groups were similar with regard to the treatment outcome. The two groups were not significantly different with regard to the drug adverse effects. Conclusion: According to the findings, the Iranian imatinib is not different from the Indian drug in the hematological and molecular responses in treatment of the chronic phase of CML patients. Furthermore, the adverse effects of the two kinds were not significantly different. Compared with the results of other studies, the effectiveness of Iranian imatinib is equivalent to the Indian drug can be employed for treatment of CML patients in the chronic phase.

Background: To examine the prevalence of high-risk subjects of obstructive sleep apnea (OSA) and its predictive factors in patients undergoing elective surgery by using the Berlin Questionnaire. Materials and Methods: 300 surgical ASA physical status I, II, III, and IV patients were surveyed. Patients were screened with the Berlin questionnaire for obstructive sleep apnea. Data of sex, age, BMI and HTN also evaluated. Data were analyzed by Chi-square test and P < 0.05 was meaningful. Results: The Berlin questionnaire identified 25.3% (76/300) of patients as being at high risk of sleep apnea (95% confidence interval, 20%-28%). This group consisted of 195 (65%) males and 105 (35%) females. The prevalence of high-risk subjects in men were more significantly than women ( P = 0.001). High-risk subjects also were increasing with age ( P = 0.000) and increasing with obesity ( P = 0.000) and arterial hypertension ( P = 0.000). Conclusions: Predictors of high risk for OSA-related symptoms were female sex, age more than 50 years, and body mass index.

Background: Cutaneous nerves on the dorsum of foot are at risk for iatrogenic damage while performing arthroscopy, local anaesthetic block, surgical approach to the fibula, open reduction and internal fixation of lateral malleolar fractures, application of external fixators, elevation of a fasciocutaneous or fibular flaps for grafting, surgical decompression of neurovascular structures, or miscellaneous surgery on leg, foot and ankle. Hence the present study was undertaken to classify the different patterns of cutaneous innervation on the dorsum of foot of foetuses which will help in minimizing iatrogenic damage to the nerves. Materials and Methods: A total of 40 lower limbs from 20 foetuses were dissected and the branching patterns of nerves were noted and specimens were photographed. Results: Four distinct patterns of innervation with additional subtypes were identified and designated as Type 1 a-g; 2 a-d; 3; 4 a-c. Conclusion: Detailed knowledge about the pattern of cutaneous innervation of dorsum of foot may decrease the damage to these nerves during operative procedures near the foot and ankle.

Background: There is conflict of interest in the treatment of intracapsular femoral neck fractures and the outcomes. The aim of this study was evaluation the treatment outcomes of closed and open reduction and internal fixation with screw in 18-50-year-old patients. Materials and Methods: This clinical randomized study was conducted in Ayatollah Kashani Center in Isfahan from Nov 2010 to Nov 2011. In 42 patients selected in a randomized manner, fractures were reduced by closed reduction or open if necessary and C-ARM was controlled in AP and lateral plans. Movement range and femur pain severity were evaluated according to Visual analogue Scale (VAS) score at 3 and 6 months after surgery. Data were analyzed by SPSS 18. Chi-square, t-test, one-way analysis of variance (ANOVA), and descriptive statistics such as frequency distribution, mean, and mean deviation were used. Results: Forty-two patients with femoral neck fracture were treated by open [31 patients (73.8%)] or closed reduction [11 patients (26.2%)] and also osteosynthesis. Their mean age was 47.3 ± 9.8 years; 29 of them were males and 13 were females. Twelve patients had bad range of motion (ROM) (28.6%), 16 had intermediate ROM (38%), and 14 had good ROM (33.4%). After 6 months, 12 patients (28.6%) had bad ROM, 10 (23.8%) had intermediate ROM, and 20 (47.6%) had good ROM. There were 11 cases of non-union (35.5%) in the open reduction group and 4 in the closed group. Conclusion: This study showed that femoral neck fracture is associated with several complications, especially if open reduction was necessary. So, the surgical method and necessary equipments such as radiolucent bed, C-ARM machine, and implant cannulated screw set should be considered.

Background: Staphylococcus aureus is a common human pathogen in community- and hospital-acquired infection, and its capsule is involved in pathogenesis. The predominance of 2 capsular polysaccharides types 5 and 8, on the surface of clinical isolates, led to the development of conjugate vaccine (Staph VAX) based on capsular polysacchrides types 5 and 8 conjugated to a carrier protein. The aim of this study was to determine the prevalence of capsular polysaccharides types 5 and 8 Staphylococcus aureus strains among isolates and their comparison with respect to methicillin resistance. Materials and Methods: We studied the capsular genotypes of 193 isolates that encompassed both hospital- and community-acquired infection in Al-Zahra Hospital of Isfahan city from 2008 to 2009. Cap5 and 8 genes were detected by PCR method. Methicillin resistance was determined by PCR (mecA) and disk diffusion methods as well. Result: In this population (193 cases), most of the clinical isolates (73%) expressed capsular polysaccharide type 5 (24%) and 8 (49%), whereas 27% were non-typeable. The prevalence of MRSA in type 8 was 67.9%, whereas MRSA isolates in the capsular genotype 5 were 22.2%. Conclusion: This study Staphylococcus aureus confirms that the prevalence of capsular polysaccharide types (5 and 8) are predominant, and Staphylococcus aureus type 8 is more resistant to methicillin compared to type 5.

Background: Considering that protocols of postoperative pain management would be planned regarding the facilities of each center or region and the importance of its proper management to reduce its related complication and improve patient's satisfaction, in this study we compared the effect of orally administrated tramadol and acetaminophen-codeine in this regard. Materials and Methods: In this prospective randomized double-blind clinical trial, 136 (68 in tramadol and 68 in acetaminophen codeine groups) ASA I and II patients scheduled for open cholecystectomy under general anaesthesia were enrolled. They randomly allocated to receive oral tramadol (50 mg capsule) or acetaminophen-codeine (325/10 mg) 1 hour before surgery. After surgery they evaluated for postoperative pain using VAS score, analgesic consumption and vomiting. Results: Mean of postoperative pain score during 24 hours after surgery was 2.1 ± 1.0 and 3.8 ± 2.0 in tramadol and acetaminophen-codeine groups, respectively (P < 0.05). Mean of analgesic consumption (morphine) during 24 hours after surgery was 6.2 ± 4.4 mg and 12.9 ± 5.7 mg in tramadol and acetaminophen-codeine groups, respectively (P < 0.05). Mean of vomiting during 24 hours after surgery was 1.2 ±0.9 and 0.4 ± 0.5 in tramadol and acetaminophen-codeine groups, respectively (P < 0.05). Conclusion: The findings of current study indicated that in lower dose of tramadol (50 mg) and acetaminophen/codeine (325 mg/10 mg) the analgesic effect of tramadol is better and its side effects are higher than acetaminophen/codeine, which limit its use for mentioned purpose. It seems that administration of each of studied agents it depends on patients' tolerance and decision of the physician.

Background: Veal is a rich nutrient medium that provides a suitable environment for proliferation of veal spoiling microorganisms and common food-borne pathogens. In this study, the effects of irradiation on the veal microbiological quality and half life of minced beef during chilled storage was investigated. Materials and Methods: Twenty samples of minced veal were irradiated with doses of 2, 5, 7, and 10 kGy (Cobalt-60, gamma cell 220) and evaluated for their microbiological quality up to 10 days. Results: The results showed that gamma irradiation reduced the number of microorganisms in all the irradiated minced veal samples, with 2, 5, 7, and 10 kGy (P < 0.01). Moreover, the half life of the samples were increased considerably (P < 0.01). In addition, the results indicated that there was a significant difference in the number of coliformes between untreated and irradiated samples (P < 0.05). While, Staphylococcus aureus could not be detected in the irradiated samples with doses of 7 and 10 kGy. Conclusion: These results indicated that irradiation could be employed as an effective mean to inactivate common food-borne pathogens namely S. aureus and increases the half life of veal.

Background: Essential oils have been used as an alternative and complementary treatment in medicine. Citrus fragrance has been used by aromatherapists for the treatment of anxiety symptoms. Based on this claim, the aim of present study was to investigate the effect of aromatherapy with essential oil of orange on child anxiety during dental treatment. Materials and Methods: Thirty children (10 boys, 20 girls) aged 6-9 years participated in a crossover intervention study, according to the inclusion criteria, among patients who attended the pediatric department of Isfahan Dental School in 2011. Every child underwent two dental treatment appointments including dental prophylaxis and fissure-sealant therapy under orange aroma in one session (intervention) and without any aroma (control) in another one. Child anxiety level was measured using salivary cortisol and pulse rate before and after treatment in each visit. The data were analyzed using t-test by SPSS software version 18. Results: The mean ± SD and mean difference of salivary cortisol levels and pulse rate were calculated in each group before and completion of treatment in each visit. The difference in means of salivary cortisol and pulse rate between treatment under orange odor and treatment without aroma was 1.047 ± 2.198 nmol/l and 6.73 ± 12.3 (in minutes), which was statistically significant using paired t-test (P = 0.014, P = 0.005, respectively). Conclusion: It seems that the use of aromatherapy with natural essential oil of orange could reduce salivary cortisol and pulse rate due to child anxiety state.

Background: Postoperative pain relief is important in procedures of the lower extremity. Several previous studies have evaluated the efficacy of intra-articular (IA) pethidine as a compound, which has local anesthetic and opioid agonist properties, on postoperative pain relief in arthroscopic knee surgery (AKS). This study compared the postoperative analgesic effect of pre- and post-surgical IA pethidine administration in AKS. Materials and Methods: Seventy-five patients of American Society of Anesthesiologists (ASA) I and II undergoing AKS with general anesthesia were enrolled in this double-blind study. Patients were randomized in three equal groups to receive either 50 mg IA pethidine before surgical incision incision and saline after skin closure (PS), saline before surgical incision and pethedine after skin closure (SP), and only saline at two different times (SS). In each patient with operated knee joint, pain at rest and joint movement was evaluated at 1, 2, 6, 12, and 24 h after surgery completion using Visual Analog Scale (VAS). Data were analyzed using analysis of variance (ANOVA)-repeated measure, t-paired, and Chi-square tests. Results: Postoperative pain score at rest and joint movement in PS group was significantly lower than those in other groups. The time (Mean ± SD) between completion of operation and patient's request for morphine, total morphine consumption (Mean ± SD) in postoperative 24 h, and the numbers of patients requesting analgesic in PS, SP, SS, groups were: 5.2 ± 1.3, 3.3 ± 1.5, and 2 ± 1.3 h (P < 0.05); 4.4 ± 2.4, 8.7 ± 2, and 11.6 ± 4.4 mg (P < 0.05); 11, 18, and 21 persons (P < 0.05), respectively. Conclusion: The present study shows that preemptive intra-articular pethidine 50 mg injection is more effective than preventive injection for postoperative pain relief at rest and joint movement in arthroscopic knee surgery.

Background: Catamenial epilepsy is a kind of epilepsy, known in this name, when the periodicity of the exacerbation of the seizure is in association with menstural cycle. The present study examined the progesterone effectiveness as a complementary treatment in women with intractable catamenial epilepsy. Materials and Methods: The present study was conducted as a double-blind randomized controlled trial on 38 women with intractable catamenial epilepsy. Patients were assessed in two groups: The case group received in addition to AEDs, two (Mejestrol) 40 mg progesterone tablets in the second half of the cycle from 15 ^th to 25 ^th day. And the control group received in addition to AEDs, two placebo tablets daily. Age, BMI, epilepsy duration, types of the drugs used, progesterone level, and the number of the seizures in 3 months before and after the study were compared. Results: Based on the results of which there was no statistically significant difference in regard to age, BMI, epilepsy duration, types of the drugs used, progesterone level between the case and the control groups (P-value > 0.05). The number of the seizures after treatment has significantly decreased compared to before-treatment state. The degree of decreasing in the case group receiving the progesterone was higher than in the control group receiving the placebo. The difference, thus, is significant, based on statistical tests (P-value = 0.024). Conclusion: Based on the findings of this study using progesterone in women with intractable catamenial epilepsy has a significant effect on the degree of decreasing in the number of the seizures.

Background: Throughout the world, bloodstream infections (BSI _s ) are associated with high rates of morbidity and mortality. Rapid pathogens identification is central significance for the outcome of the patient than culture techniques for microbial identification. To develop an end point multiplex PCR to identify a group of bacteria including Enterococcus spp., Pseudomons aeruginosa, Staphylococcus spp., Acinetobacter baumannii, 16S rDNA, and Drosophila Melanogaster were used as internal control (IC). Materials and Methods: Design of primers was done using Mega4, Allel ID6, Oligo6 and Oligo analyzer softwares. Genetic targets for primer designing and identification of genus Enterococcus spp., Staphylococcus spp., and species of Acinetobacter baumannii, Pseudomons aeruginosa, included the rpoB, rpoB and gyrA, sss respectively. Then PCR and multiplex PCR were performed Results: The intended specificity was obtained for the bacteria, which used in this study and there wasn't seen any unspecific amplification by the multiplex PCR. The test showed a sensitivity ranging from 1 to 100 target copies per reaction depending on the bacterial species. Conclusions: The presented multiplex PCR offers a rapid and accurate molecular diagnostic tool for simultaneous detection of some pathogenic microorganisms. The IC exists in the multiplex PCR accompanied by other primers in the system, can serve as a simple, cost- effective internal control for the multiplex PCR assay.

Our proband is a 29-year-old man, who is affected with soft cleft palate and hypernasality. A study of about six generations of this family pedigree shows that cleft palate has repeatedly occurred in males, with probably a X-linked recessive pattern of inheritance. Interestingly, the sister of the proband is affected with hypernasality and she has an affected son. This is the first report of X-linked inheritance pattern of cleft palate in Iran.

Background: This study is planned to obtain a better understanding of the correlation between sudden sensorineural hearing loss and cardiopulmonary bypass. There are many causes for sudden hearing loss which include infectious, circulatory, inner ear problems like meniere's disease, neoplastic, traumatic, metabolic, neurologic, immunologic, toxic, cochlear, idiopathic (unknown cause) and other causes. One of the less common cause is surgery include cardiopulmonary bypass procedures. Materials and Methods: This study is a self controlled clinical trial on 105 patients that was carried out in chamran Hospital, Esfahan, Iran. Participants were including all those patients undergoing coronary artery bypass surgery in the hospital who fell under the criteria for inclusion. Patients underwent audiometric testing at our hospital on three or two different occasions during the course of this study, Initially before the procedure to test the baseline hearing capacity; then two week after the procedure to assess any changes in hearing ability following the surgery. Data analysis performed by co-variance analysis. Results: In our study the changes in the threshold of hearing in frequency of 1000 in right ear and in frequencies of 2000 and 4000 in left ear were significant, but this changes were about 2-3 db and were not noticeable. The difference in degree of SNHL, before and after surgery in different frequencies were been shown. Conclusion: As loss of the patients with symptomatic sensory neural hearing loss in this study, It isn't commanded the routin auditory assessment pre and post surgery was been done.

Background: This prospective study was performed to identify whether the early use of nasal continuous positive airway pressure (n CPAP) would reduce the rate of endotracheal intubation, mechanical ventilation and surfactant administration. Materials and Methods: This study was conducted from June 2009 to September 2010 in the Shahid Beheshti University Hospital, Isfahan-Iran. A total of 72 preterm infants with 25-30 weeks gestation who needed respiratory support at 5 min after birth entered the study. Infants were randomly assigned to the very early CPAP (initiated 5 min after birth) or to the late CPAP (initiated 30 min after birth) treatment groups. The primary outcomes were need for intubation and mechanical ventilation during the first 48 h after birth and secondary outcomes were death, pneumothorax, intraventricular hemorrhage, duration of mechanical ventilation and bronchopulmonary dysplasia. Results: There were no significant differences between the two groups with regard to mortality rate, bronchopulmonary dysplasia and patent ductus arteriosus. The need for surfactant administration was significantly reduced in the early CPAP group (P = 0.04). Infants in the early CPAP group less frequently required intubation and mechanical ventilation. Conclusions: Early n CPAP is more effective than late n CPAP for the treatment of respiratory distress syndrome. In addition, the early use of n CPAP would reduce the need for some invasive procedures such as intubation and mechanical ventilation.

Background: Tumor growth requires expansion and development of vascular network. An increase in Gleason score is representative of an increase in tumor invasion and extent. In this study, the relationship between Gleason score and vascular characteristics of needle biopsy samples in prostate cancer patients has been evaluated. Materials and Methods: We evaluated vascular characteristics including density and size of vessels; and percentage of vessels with irregular shape in 62 cancer-positive samples obtained by prostate needle biopsy under ultrasound guide, and compared them to Gleason score. Result: Gleason scores of 23 patients were ≤6; Gleason scores of 18 patients were 7 and 21 patients had their Gleason score from 8 to 10. An increase in Gleason score was associated with increased vascular density (P < 0.0001), increased percentage of vessels with irregular shape (P < 0.02) and decreased average vascular diameter (P < 0.015), from which the relationship with vascular density was clearer and more evident. Conclusion: Vascular morphological characteristics can be representative of angiogenic potential of prostate cancer which is required for tumor progression. As Gleason score can prognosticate the behavioral characteristics of prostate cancer in future, vascular characteristics may also be able to express tumor behavior. With attention to vascular characteristics in biopsy samples and apart from Gleason score, we may also be able to divide patients into other subtypes in a way being helpful for the establishment of treatment plan.

Mohs micrographic surgery (MMS) is a technique for the treatment of cutaneous malignancies. Subtle determination of tumor margin would end to fewer stages of surgery. Our aim was to compare these three ways for determining tumor extension before initiation of MMS, examination with the naked eye, dermoscopy and curettage. Sixty patients who had basal cell carcinoma (BCC) in head and neck area were randomized in three groups (curettage, dermoscopy and examination with the naked eye). Each group encompassed twenty patients. The total number of resection stages in MMS was recorded for each patient. Demographic data of the patients and the total number of resection stages in MMS were statistically analyzed. Based on analysis of variance (ANOVA) test results, there was no significant difference for total number of stages in statistical point of view between three groups (P value = 0.1). In this research, the Pearson correlation coefficient showed that there is a direct relation between the age and resection stages (r = 0.19, P value = 0.04). The Chi-square test showed no differences between three groups in age, residence and radiotherapy history.

Background: To investigate the effect of polyacrylate polyalcohol copolymer (Vantris) injection for the correction of VUR in children according to ureteral orifice shape and VUR grade. Materials and Methods: Forty children (29 girls and 11 boys) with 61 renal refluxing units (RRU) and primary VUR underwent endoscopic correction of their reflux, using Vantris. Under general anesthesia, routine cystoscopy was performed and ureteral orifice configuration and dynamic hydro distention grade were determined. The injection technique was STING, HIT or a combination of them. Ultrasound scan was performed one and 3 months after injection and radionuclide cystography (RNC) was performed 3 months after the operation. Results: The mean volume of injected Vantris was 0.62 cc. Reflux was corrected in 52 (85.2%) of the 61 RRU after single injection and this equates reflux correction in 37 of the 40 patients. No significant correlation was observed between ureteral orifice shape and VUR correction rate. Conclusions: Our results showed that there was no correlation between the ureteral orifice configuration and the success rate of endoscopic surgery for VUR in short term.