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Introduction: Tuberculosis  is  one  of  the  most  important  health  problems  in  all  around  the  world.  Despite  of  progression  in  effective  treatment, the  disease  reduction  rate  in  countries  in  very  slow  or  ever  in  significant.
Materials  and  Methods: This  research  is  conducted  in  a  descriptive-analytic  method  among  38 hospitalized  patients  at  internal  and  infections  disease services  in  Vali-Asr  hospital (may  97  to  may  98).
Results: 15  men (39%) and  23  women (61%)  were  identified. The  major  population  was  observed  at  age  61-70  and  the  least  over  80  and  under  20  years  old.  The  means  mean  age  was  56.5  years  (SD=185)  and  womens  54 (SD=16).  The  citizens  mean  age  was  47.6  and  country  people  64.6  that  their  difference  is  significant (p=0.01).  the  above  delay  was  observed  3.2  months  for  pulmonary  tuberculosis  (both  smear  positive  and  smear  negative)  and  5.3  months  for  extrapulmonary  tuberculosis, which  were  50%  lymphatic, 20%  bone.  12.5%  pritone  and  female  genital (8 of  38).  70%  were  smear  positive. WBC  were  in  normal  range (3000-10.000)  among  79%. 74%  were  anemic.  The  mens  mean  hemoglobin  was  significant  more  than  in  womens (p=0.03).
Conclusion:  According  to  there  are  not  significant  signs  for  tuberculosis, physician  must  be  more  attention  to  clinical  patient  finding.
 

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Introduction: Normal growth of children is an index of their health. So growth monitoring is a routine service provided in most health care systems. This study has been performed in order to assess the effectiveness of growth monitoring regarding incidence of failure to thrive (FTT) and head circumference. Materials and methods: There was a historical cohort study in which the children who were 12 -14 months old at the time of study under the coverage of health service of Aboozar health center, Tehran medical university, were evaluated. We used linear, logistic and Cox modeling for detecting statistical association of the distinguished variables. Results: There was no significant association between number of growth monitoring visits and the size of head circumference (linear model). In addition to, there was a significant association between the number of growth monitoring visits and incidence of FTT (logistic model). Conclusion: According to our data, it seems that growth monitoring has a preventing role in growth of failure to thrive children.

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Introduction: Sensory stimulation of comatos patients is an important nursing intervention for increasing their LOC and tactile stimulation especially massage is one of the most important stimulations. The nurse as a person, who is responsible for this, must know the effects of this intervention on patients. But there are some conflicts about this intervention's effects especially on vital signs (pulse, blood pressure and respiration). This study was done to determine the effect of massage on comatos patient's vital signs who were hospitalized in intensive care unit. Materials and Methods: This study is a clinical trial. Samples were consisted of 100 comatos patients, divided into two equal groups randomly. The two groups were matched in age, geneder and glascow coma scale. Samples in experimental group received 20 minutes massage on their back, feet and hands in three continuous days. Vital signs in experimental group were measured before and immediately after intervention and vital signs in control group were measured at the same time with experimental group. A check list used was used for collecting data. Data was analyzed using descriptive and analytic statistics (T, paired T and Chi-square tests). Results: Findings showed that massage decreased vital signs significantly as followed: pulse rate and diastolic blood pressure in each three days (p<0.05), systolic blood pressure in first and third days (p<0.05), respiration rate in second day (p<0.05). Conclusion: This study showed that massage can decrease comatos patients' vital signs which can be the indicator of their relaxation and decreasing stress.

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Introduction: Irritable bowel syndrome (IBS) is the most common functional bowel disorder. Stress triggers or aggravates it's symptoms. This investigation is carried out to determine the effect of Benson relaxation therapy on anxiety level and severity of symptoms in patients with irritable bowel syndrome. Materials and Methods: In this clinical trial 30 patients with irritable bowel syndrom were randomly divided into case and control groups. The control group was treated by only usual medical therapy but the case group was treated by combined medical- relaxational therapy. The two groups continued therapy for three months. Anxiety level and gastrointestinal symptoms of case and control groups were compared at three different times (two weeks before intervention and one week and three months after intervention). Also, patients were asked to document 6 common gastrointestinal symptoms in their daily symptom diaries, 2 weeks before intervention to 3 months after intervention. At the end of each week, these symptoms were compared in the two groups. Data was analyzed using chi square , Man - Whitney U and Wilcoxon tests. Results: Mean state and trait anxiety of the case and control groups two weeks before and one week after intervention did not show significant difference. But the results after 3 months showed a significant difference (p<0.001).The mean severity of gastrointestinal symptoms, 2 weeks before intervention, was significantly higher in case group, but the comparison of gastrointestinal symptoms severity, 1 week after intervention, did not show any significant difference between the two groups, and 3 months after intervention a significant difference was observed in the two groups (the control group had more severe symptoms than the case group). The comparison of 6 common gastrointestinal symptoms based on weekly self-report showed that abdominal pain, eructation and distention were significantly lower in case group, but there was no significant difference between diarrhea and constipation. Conclusion: Three months Benson relaxation therapy significantly decreased the state and trait anxiety level and severity of symptoms in patients with irritable bowel syndrome.

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Introduction: Oculogyric crisis which is a dystonic reaction, is commonly caused by neuroleptics and rarely occurs with atypical antipsychotics specially Clozapine. In this article a case of Clozapine induced oculogyric crisis is reported. Case: The patient was a 25 years old woman with auditory hallucination, loosening of association and persecutory delusion that was admitted and treated. Because of poor response to typical antipsychotics, Clozapine was prescribed. Then she experienced multiple episodes of oculogyric crisis and was treated successfully with anticholinergic medication (Artane). Conclusion: In this special case, Clozapine caused oculogyric crisis. This side effect is rare but should be considered as a possible adverse effect of Clozapine. On the basis of this report, Clozapine induced oculogyric crisis may be treated successfully with Artane

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Background: Radiotherapy is one of the cancer treatment methods. Prescribed dose for each fraction is considered based on radiosensitivity of tumoral and normal tissues. Viral agents are the effiectiv factors on tissue sensitivity. This research aimed to determine the effect of ionizing radiation of Cobal 60 on radiosensitivity of Hela cells infected with Measles virus. Methods and Materials: In this study, the radiosensitivity of Hela cells is investigated experimentally and qualitively. The cells have been cultivated in two groups (experimental and blank) and plating efficiency has been obtained. Then 100λ measles virus with serial dilution method was used to induce infection in different ratio for experimental group. After cell growth and passage, the two groups were irradiated with 2Gy gamma radiation of cobalt 60. Results: Results respectively indicated cell death increases up to 5-7%, 15-20% and 50-65%, after 2Gy irradiation by Co 60 for contaminating to Measles in low, moderate and high concentrations. Conclusion: Radiosensitivity of tumoral cells increases when they are infected by viral agent. The result in radiotherapy of cancers showed, in prescribing dose fraction non cancer disease should be considered.

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Background: Diabetes Mellitus is a heterogeneous group of different metabolic disorders that are characterized by chronic increase of blood glucose and proteins, lipids and carbohydrates metabolism disorder. The aim of this study was to investigate the effect of 8 weeks of aerobic exercise on metabolic factors, quality of life and mental health of women with type II diabetes. Materials and Methods: In this semi-experimental investigation, 18 women with type П diabetes referring to Arak Petroleum Company Clinic were selected and divided into two groups: aerobic (10 participants) and control (8 participants). Aerobic group performed selected exercises in 8 weeks (three 30-50 min sessions per week). In this investigation, we used metabolic factors (such as total cholesterol, triglycerides, HDL, VLDL, LDL, FBS, HbA1c and Insulin serum) and SF-36 quality of life (QOL) and GHQ mental health (MH) questionnaires. The level of significance was considered to be 95% (P<0/05). Results: There were significant differences between the means of pre-test and post-test measures of FBS, HbA1C, Insulin serum, QOL and MH in aerobic group. There were no significant differences between the means of pre-test and post-test measures of TC, HDL, LDL, VLDL and triglycerides in aerobic group and all factors in the control group (P<0/05). Conclusion: Aerobic exercise affects metabolic factors, QOL and MH in type П diabetic patients and it results in their improvement.

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Background Vancomycin resistant enterococcus (VRE) is the third major cause of nosocomial infections in hospitals after staphylococcus and E. coli. The aim of this study was to evaluate resistance pattern of VRE to the antibiotics recommended by CLSI. Materials and Methods: In this clinical trial, 833 enterococci, obtained from urine, wound, blood, and stool, were selectively collected from hospitals in Tehran. After verification of the VRE isolates through the use of 30µg vancomycin disc and agar dilution, VREs were isolated, and their inhibiting concentrations were determined. The sensitivity of these enterococci to antibiotics was assessed at CLSI’s M100 standard. Results: Of the 833 isolated enterococci, 4% had a high level of resistance to vancomycin, and 38.5% had a low level of resistance to vancomycin. Of the VREs, 8.5%, 85%, 50%, 42%, 94%, 30%, 70%, 24%, 6%, and 97% were resistant to vancomycin, ampicilin, erythromycin, tetracycline, rifampin, chloramphenicol, gentamicin, synercid, linozolid and penicillin, respectively. All these VRE isolates were sensitive to nitrofurantoin. Conclusion: In this study, all VRE isolates were sensitive to nitroforantoin, and this antibiotic, as a drug of choice for urinary tract infections, can also be recommended in the treatment of resistant enterococci.

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Background: One way of embryo preservation is cryopreservation, but this process may damage and lead to the loss of the embryos, and bring about chromosomal abnormality. This has led researchers to seek techniques for short term preservation of embryos in 0-10 ºC temperatures. The aim of this study was to determine the effect of short time exposure to 4°C temperature on the expression profiles of mono-carboxylic transporter genes 1,2 ,3, and 4(MCT1-4) in 4-cell mouse embryos. Materials and Methods: In this fundamental study, forty 4-cell mouse embryos from NMRI strain were randomly divided into two groups. The first group consisted of fresh 4-cell embryos, and the second group included 4-cell mouse embryos that were exposed to 4°C temperature for 24 hours. After RT-PCR, the samples were electro-phoresised for expressing the MTC1-4 genes. Results: The expression of MCT 1-3 was observed in the first group, but the obtained results did not indicate their expression in the second group. Conclusion: Preservation of 4-cell embryos in 4°C for 24 hours inhibits the expression of MCT 1-3 genes. Keeping embryos in 4°C temperature is not a proper way for their short time preservation.

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Background: Nowadays, the use of inflammatory biomarkers in the diagnosis of appendicitis is on the rise. On the other hand, the role of oxygen free radicals in various inflammatory states has been verified. Noticing the high prevalence of negative appendectomy (9.3-22.2%), the aim of this study was to investigate the level of blood total antioxidant capacity (TAC) as a biomarker for early diagnosis of acute appendicitis. Materials and Methods: In this prospective analytical trial, over a one-year period, 407 patients, with preoperative diagnosis of acute appendicitis who had undergone operation, were studied. After measuring the TAC level, data were analyzed through the analytic ROC curve and parametric mean comparison tests. Results: Of all the patients, 298 were identified with appendicitis. TAC levels in adult female and male groups were respectively 663.9±164.75 and 752.58±167.37 µm/L which revealed a significant difference (p<0.0001). Also, in children, the mean of TAC level in perforated appendicitis sub-group was significantly greater than those in gangrenous and suppurative groups. Conclusion: TAC level can be used as a predictive factor for the diagnosis of perforated appendicitis in children however, it cannot be used as a biomarker for the diagnosis of appendicitis. Because of the significant difference existing between the level of TAC in male and female patients, further studies are suggested to investigate the level of inflammatory biomarkers with respect to menstrual cycle in women.

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In the Holy Quran, it is stated that “eating honey has healing for people” “Fihe shefaho lenas”. The word “healing” in Quran has not been used about any other food but honey and one Sura in Quran is dedicated to Nahl (bee). This study investigates the importance of honey from the perspective of Quran and medicine. This review article investigated the therapeutic properties of honey from the perspective of Quran and medicine through text analysis and manual and online search. Medicine has proven that honey due to its low moisture, high osmosis, and high acidity inhibits the growth of infectious agents and creates a sterile coat on the wound. Prophet Mohammad said, “Lam yastashfeo almariz bemasale sharbato olasal”, meaning that nothing cures the sick person the way honey does. Studies have shown that honey is effective in strengthening child development and treatment, prevention, and improvement of skin, respiratory, liver, gallbladder, eyes, ears, and nose diseases and cancer. The application of natural honey to healing diabetic and cutaneous ulcers and the topical application of honey to open wounds can accelerate the healing process. Oral administration of dates honey syrup can enhance the natural progression of delivery and womb contractions which decrease the need for cesarean. It can be concluded from the review of the literature that emphasis of Quran on the use of honey in diet and its reference to the healing property of honey for people has not been without a cause. Modern medicine also verifies the curative properties of honey for many diseases.

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Background: Diagnosis of acute appendicitis is one of the challenges that surgeons face in the emergency ward. Although Alvarado score has been recommended in the diagnosis of acute appendicitis, this criterion has some limitations in terms of age, sex, and race. The aim of this study was to evaluate the effectiveness of Alvarado score in the diagnosis of acute appendicitis based on the age and gender. Materials and Methods: In this cross-sectional study, 407 patients who underwent operation with the preoperative diagnosis of acute appendicitis from June 2008 to August 2009 were included in the study. The patients’ data were recorded by the investigators. The data were compared by parametric tests. The sensitivity and specificity were determined by the optimal cut-off point on ROC curve using MedCalc software version 10.2.0.0. Results: The optimal cut-off point for women was lower than men (6 and 7, respectively). The rate of negative appendectomy in the group with Alvarado scores 9 and 10 was 11.8%, while the negative appendectomy rate in the other two groups with Alvarado scores 7 and 8 and 5 and 6 were 29.9% and 52.8%, respectively. Conclusion: The diagnostic value of Alvarado score of 8 and less in physical examination is lower than the abdominal tenderness exam alone. Also, the cut-off point for the diagnosis of acute appendicitis in women should be considered lower than that in men. On the other hand, the cut-off point in adolescents and children is higher than adults.

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Background: Brucellosis is a zoonotic disease in humans and animals that its control is dependent on the prevalence of diseases in animal populations. The purpose of this study was to compare the sensitivity and specificity of common diagnostic tests for brucellosis. Materials and Methods: In an analytical cross-sectional study, 297 serum samples from an infected herd that had a history of abortion were prepared and evaluated through standard tube agglutination, Rose Bengal, 2-Mercaptoethanol, complement fixation, and ELISA tests. In addition, microbial culture was done for positive serum samples, lymph nodes, and infected organs. Results: Based on the total 297 serum samples tested, the sensitivities for standard tube agglutination, Rose Bengal, 2-Mercaptoethanol, complement fixation, and ELISA tests were 89, 81.5, 75.3, 89.7, and 93.2% , whereas specificities were determined to be 97.4, 94, 96, 98, and 99.3%, respectively. Conclusion: The findings of this study show that the standard tube agglutination test, complement fixation test, and ELISA are more sensitive than other tests. Moreover, ELISA test was the most sensitive and specific serological test for diagnosis of brucellosis in the present study

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Background: One of the most important complications of tonsillectomy is laryngospasm which leads to airway obstruction, arterial hypoxemia, and hypercarbia. Thus the present study was carried out to compare the effect of propofol with sodium thiopental, as an induction agent of anesthesia, on the incidence and intensity of laryngospasm after extubation in tonsillectomy. Materials and Methods: This double-blind clinical trial was done on 60 3-12-year-old patients who were chosen for elective tonsillectomy at Qods Hospital in Qazvin. The patients were randomly divided into two equal groups. Method of anesthesia was the same in these two groups except for the induction of anesthesia one group received sodium thiopental and the other group received propofol. At the end of the operation, patients were extubated after the restoration of spontaneous respiration with adequate tidal volume and respiratory rate. Then the incidence and intensity of laryngospasm was evaluated. Data were analyzed by t-test, Chi-square, and Fisher's exact test using SPSS software. Results: Overall, 83% of the patients in the sodium thiopental group and 93% of the patients in the propofol group did not develop laryngospasm and there were no statistical differences between the two groups in terms of the incidence and intensity of laryngospasm after extubation in tonsillectomy (P=0.535). Conclusion: As an induction agent in general anesthesia, propofol has the same effect as sodium thiopental on the incidence and intensity of laryngospasm after tonsillectomy.

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Background: Live attenuated Shigella vaccines have shown promise in inducing protective immune responses in human clinical trials. The aim of this study was to design and construct pDS132::∆icsA as a suicide plasmid for targeted deletion of a region of icsA gene in Shigella. Materials and Methods: In this experimental study, species and serotypes of Shigella isolated from diarrhea samples of children at Firozabadi and Milad Hospitals of Tehran were confirmed by using serological and PCR tests. Identification primers of icsA gene were designed and then cloned to the pGEM-5zf vector and sequenced. According to icsA restriction enzyme map, 1751 bp of icsA gene was deleted by HincП restriction enzyme and the ∆icsA was constructed successfully. The pGEM∆icsA vector was digested by use of SphI and SalI enzymes and was then cloned to a suicide vector (pSD132). Precision of the process was confirmed by phenotype and genotype tests. Results: The Shigella dysenteriae type 1 strain was verified by serological tests and PCR. Sequence of the icsA gene in the native strain was identical to the strains submitted in the gene-bank database. Since the pDS132::∆icsA contains 1484 bp derived from icsA gene, it can be used to disrupt icsA gene as a specific suicide vector. Conclusion: Application of suicide systems facilitated mutant construction in more specific and effective methods in comparison with the other primary techniques such as serial passage.

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Background: The aim of this study is to assess antioxidative and pro-oxidative efficacy of ascorbate on serum albumin during iron-induced oxidative stress. Materials and Methods: In this experimental study, albumin was placed in the oxidative system containing iron ions and different concentrations of ascorbate. To monitor albumin degradation, sodium dodecyl sulfate polyacrylamide gel electrophoresis was performed according to Laemmli procedure. Oxidative modification of albumin was demonstrated using a method for determination of carbonyl groups by 2,4-dinitrophenylhydrazine. Results: By applying the carbonyl assay, ascorbate showed a dual effect: initial pro-oxidative effect on albumin changed to an antioxidant one in a dose-dependent manner. Our findings showed prooxidant effects for ascorbate in low concentrations (0-100 µM) and antioxidant effects in higher concentrations (100-300 µM). Also, electrophoretic pattern of plasma proteins showed significant protein aggregations in the range of 35 to 45 kDa of MW and protein degradations in the range of 115 to 180 kDa. Conclusion: Ascorbate can produce reactive oxygen species and can also inhibit the production of these oxidants in the presence of iron ions as well. These findings may be directly applicable to oxidative states during the administration of ascorbate and may be important in preventing oxidative modifications of proteins in blood circulation and other biological fluids.

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Background: Leukemia is the most common type of cancer in children which its relapse decreases the patients’ survival rate. The aim of this study was to determine the risk factors involved in leukemia relapse in patients in Shahid Faghihi Hospital, Shiraz, during 2004-2009 years. Materials and Methods: In this retrospective cohort study, 280 patients with acute lymphoblastic leukemia and acute myeloid leukemia were included. Patient characteristics were analyzed with respect to their association with recurrence through Chi-square test, Fisher’s exact test, and logistic regression model using SPSS software version 16 (P-value<0.05). Results: Logistic regression model revealed a statistically significance relationship between age and recurrence of the disease (odds ratio (OR) = 0.35, 95% confidence interval (CI) = 0.15-0.82), odds ratio of relapse in the 5-10 years old age group was 0.35 times more than the 0-5 years old age group (p=0.01). Conclusion: Noticing the greater likelihood of relapse in 0-5 years old age group compared with the 5-10 years old age group, more attention and better follow-up for decreasing the side effects of the disease and enhancing the survival rate of the 0-5 y/o age group are recommended.

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Background: Numerous factors, such as Enterococcus antimicrobial resistance and expression of virulence factors, may account for the maintenance and prevalence of Enterococci infection. The aim of the present study was to assess the occurrence of esp and eep genes in the E.faecalis and E.facium strains isolated from the patients with urethral system infections. Materials and Methods: In this experimental study, 214 clinical samples, including 80 catheters and 134 urine samples, were collected from the patients. The identification of the isolated samples was based on the growth on Bilesculin agar culture media, tolerance of 6.5% Nacl, gram staining, and catalase, hydrolysis of hyporate, telorite reduction, arginine hydrolization, and fermentation of the carbohydrates tests. The assessment of genes was done by PCR method. Results: esp gene was present in 83% of the urine samples and in 97% of the catheters while eep gene was present in 100% of the urine samples and 90% of the urine catheters. The results of antibiogram indicated that the multi-antibiotic resistance was about 78.1% against vancomycin and tetracyclin, 75% against cyprofeloxin and tetracyclin, 59.3% against vancomycin and cyprofeloxin, and about 53% against vancomycin and streptomycin. Conclusion: The findings of this study indicate that esp gene plays an important role in formation of biofilm in patients. Due to the presence of eep gene in almost all of the samples, it can used as a rapid identical agent for the assessment of pheromone production and provision of suitable conditions for plasmid transformation between clinical strains and the prevalence of antibiotic resistance.

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Background: Multiple sclerosis, an immune-mediated demyelinating disorder, is one of the most common diseases of the central nervous system. Two-thirds of patients with multiple sclerosis are women in their child bearing age, 20s and 30s. Multiple sclerosis is followed by neurological disability in young people. The purpose of this study was to determine pregnancy outcomes in patients with multiple sclerosis and compare them with healthy pregnant women. Materials and Methods: In this cohort study,37 pregnant women with multiple sclerosis and 73 healthy pregnant women were compared in terms of pregnancy, child birth, and infant variables. Patient information was collected through questionnaires and evaluated using independent t-test, Chi-square, and Mann-Whitney test. Results: The results showed that pregnancy complications like preeclampsia and gestational symptoms in women with multiple sclerosis were higher than the control group (p=0.001). Instrumental delivery was more in women with multiple sclerosis (p=0.05) and there was not a significant difference between the two groups in terms of neonatal outcomes. Conclusion: The resultsof this study show that some of the complications of pregnancy are higher in women with multiple sclerosis. Also, normal delivery and instrumental vaginal delivery were more in women with multiple sclerosis that couldbe due to fatigue in this population. Hence, these findings should be taken into consideration in planning andmanaging pregnant patients.