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Introduction: Sweet,s syndrome (SS) is characterized by painful plaque on extremities, face and neck fever and peripheral leukocytosis. In this study patients with Sweet,s syndrome are described in a 10 years period.
Cases: This is a case series study in which 9 patients admitted to dermatology unit of Bu-Ali hospital were studied between 1992 to 2002. Basic characteristics of skin lesions in each patient were as following: red, painful and raised lesions on hand and lower leg of the first patient large, flaccid bullae containing hemorrhagic fluid on both lower legs and upper portion of one thigh and scar over both ankles in the second patient papule and nodule on left hand with pain, itching and hemorrhagic secretion in the third patient bullae over internal surface of thighs and trunk and hyperpigmented, diffused macula over abdomen in the forth patient painful papule and nodule on hands and right lower leg in the fifth patient painful plaque and nodule in the sixth patient erythematous and painful papule on both lower leg and abdomen in the seventh patient erythematose papule and nodule with burning sensation over abdomen and right hand in the eight patient and painful bullae on neck and right lower leg in the ninth patient.
Conclusion: Some special findings were found in these patients. For example, hemorrhagic and flaccid bullae, epidermal changes such as regional hyper keratosis and acanthosis and scar formation due to the illness which were not mentioned in previous reports of the disease.

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Introduction: Sexual instinct which is the cause of numerous changes in one’s life could be influenced by numerous factors such as menopause and aging. This study was focused on comparison of women’s sexual functioning disorders before and after menopause. Materials and Methods: This is an analytic cross sectional study in which data related to before and after menopause sexual activities of 174 married women (living with their spouses), referring to health centers in Isfahan in 2003 was collected and investigated. Data was collected by a self constructed sexual dysfunction inventory in which reliability and validity were reached by content validity and α chorenbach index. Findings were analysed through descriptive and inferential (MC-Nemar) statistics. Results: Findings showed that relative frequency of sexual functioning disorders in productive period was 38% and in menopausal period 72.4%. There was a significant association between sexual functioning disorders before and after menopausal period (P < 0.001). Frequency distribution of sexual functioning disorders in productive period of these women according to severity of disorders were: sexual desire disorder (49/2%), dyspareunia (34/3%), arousal dysfunction (26/8%), orgasmic dysfunction (23/8%), and vaginismus (16/4%). Frequency distribution of sexual functioning disorders in menopausal period of these women were: arousal dysfunction(75/3%), sexual disire disorder (62/6%), orgasmic dysfunction (56/3%), dyspareunia (34/9%) and vaginismus (15/8%).
Conclusion: As revealed by the findings of the study,a high percentage of women experience sexual functioning disorders in productive and menopausal periods. Menopause can be a cause to occur, or continue these disorders. The role of health care professinals in conselling and education is emphasized.

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Introduction: Studies showed that following spontaneous epilepsy in rats, the permeability of CA1 region of Hypocampus to calcium is increased. In this study the role of voltage dependent calcium channels on the development of kindling induced by Pentylenetetrazol (PTZ) was investigated in rats.
Materials and Methods: In this experimental study rats were divided into two groups. In the test group, Verapamil (calcium channel blocker) was injected in the Hippocampus (4 g/4 min). After 20 minutes kindling was established by PTZ in subconvulsive dose (37.5 mg/kg ip). Convulsing activities were monitored for 20 min. The control group was the same age and undergone the same procedure exept for the injection, in which ACSF was injected without Verapamil.
Results: Verapamil significantly (p<0.01) reduced the number of needed stimulations to progress from stage 0 to 5 of the convulsion and also significantly (p<0.05) prolonged the fifth stage of seizure.
Conclusion: The results of this study suggested that interahippcampal injection of Verapamil facilitated the Pentylenetetrazol kindling in rats but had inhibitory effects on kindled animals.

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Introduction: Different groups of drugs are used for prevention of migraine headaches. Howevere, there are controversy about the afficacy of these drugs. Furtheremore, the priority of one to other group is not clear. This study was designed therefore, to compare the effects of Propranolol and Nimodipine on sevierity, duration and frequency of migraine headache.
Materials and Methods: In a clinical trial study, 102 patients with migraine headache refered to neurology clinic were chosen. Patients were devided into two drug groups. Group one received 40 mg Propranolol per day and group two received 30 mg Nimodipine. Data was collected by a questionnaire. Patients were asked to record the severity, duration and frequency of their migraine attacks. Data was analysed using t-test. p<0.05 was considered significant.
Results: The duration and severity of migraine attacks in Propranolol group were less compared to Nimodipine group (p<0.05). However, there was no statistical differences in the frequency of migraine of these two groups.
Conclusion: Propranolol seems to be more effective than Nimodipine in prevention of migraine headaches

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Introduction: Dysmenorrhea is one of the most prevalent complaints of women which is due to Prostaglandin release and is treated by chemical drugs. Today regarding side effects of these drugs, scientists are increasingly moving toward using herbal drugs. This study is planned to comparison the effects of Thymus Vulgaris and Mefenamic acid on primary dysmenorrhea.
Materials and Methods: This is a clinical trial study. Target population was women suffering from primary dysmenorrhea and study population was women reffering to marriage consulting center. Based on α=0/5, β=0/20, sample size was calculated 214 which were divided into two groups randomly. Samples were asked to determine their pain severity before using the drug, by a visual scale (0-10cm). In the study group each sample cosumed 15 grams Thyme leaf brewed in a glass of water and in control group samples used 250mg Mefenamic acid capsules. Then pain severity was determined again 1, 2 and 3 hours after using drugs. Data was analysed by mean and standard deviation indexes and K-S, man-whitney and chi-square tests. Helsinki declaration was regarded at all stages of the research.
Results: Pain severity mean, before using the two drugs had no significant difference between groups. In each group, pain severity was significantly decreased before and after using the drug (p=0.05). But the rate of decreasing pain between the two groups showed no significant difference.
Conclusion: Regarding results, it seems both Mefenamic acid and Thymus Vulgaris decrease pain at the same level which seems to be due to Thyme,s antiprostaglandin and antispasmodic effects.

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Introduction: Recent studies have demonstrated that hypothermia after hemorrhagic shock (HS) can decrease need of fluid therapy and increase arterial pressure that results in increase the survival rate. But it has not been determined how hypothermia causes these beneficial effects. This study reviews hypothermia effects in this area.
Materials and Methods: This is an experiential study in which 24 rats were divided into four groups. Rats were anesthetized by pentobarbital. In groups 1and3, bilateral renal sympathectomy was done and in the groups 2 and 4 renal nerves remained intact and only lateral incisions were done to preserve similar conditions. Then rats underwent HS phase (phase I) for 90 minutes, by withdrawing 4-6 ml of blood during 10 mines. After shock induction, only in groups 1 and 2, body temperature was lowered to 32oC. At the end of phase I, rats underwent resuscitation phase (phase II) by reinfusion of blood & additional Ringer Lactate to retain normal arterial pressure. Stage II lasted 60 minutes.
Results: In hypothermic groups (1 and 2) in comparison to normothermic groups (3 and 4) there was less blood or fluids needed for resuscitation (p<0.05). Arterial pressure before shock was the same in all groups but at the end of phaseII was higher in hypothermic ones (p<0.05).
Conclusion: It seems that mild hypothermia has beneficial effects on survival of animals with HS. Although it is obvious that intact kidneys have vital role in maintaining body fluid balance during HS, but it seems hypothermic rats requires lesser fluid therapy even without nerve of kidney. More studies could be probably required to confirm this.

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Introduction: Hyperlipidemia is one of the main known risk factors for coronary artery disease. Regarding the undesirable consequences of hyperlipidemia and its long-term treatment, it is important to use drugs with lesser complications during the long period of treatment.
Materials and Methods: This study was a double-blind randomized clinical trail that carried out on 65 patients with hyperlipidemia. Patients were divided into two groups. Case groups took dill pearl, and control group took placebo pearl for one month. Serum lipids of both groups were measured before and one month after interference. Data was analysed with t-test and p<0.05 was considered significant.
Results: In this study , differences between mean level of cholesterol, triglyseride, HDL and LDL in case group before and after interference were statistically significant (P<0/05) but in control group only difference between HDL before and after interference was significant .
Conclusion: Regarding the result of the study dill pearl can be a useful drug for treatment of hyperlipidemia.

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  Insulin dependent diabetes mellitus, human leukocyte antigens

Introduction: Insulin dependent diabetes mellitus (IDDM) or type 1 diabetes is created by autoimmune destruction of insulin-producing beta cells of the pancreas in genetically susceptible individuals. The relationship between human leukocyte antigens (HLA) associated factors and susceptibility to IDDM disease, was reported by several investigators. Association with different HLA types depends also on the studied populations. The aim of the present study was to determine HLA antigens which represent a high susceptibility to develop the IDDM disease in this area. Materials and Methods: In this study, the prevalence of HLA class-I and II antigens has been determined in 31 Arakian patients with IDDM and 57 normal healthy controls with similar ethnic background and from the same geographical area. The typing of HLA antigens was carried out using standard microlymphocytotoxicity method. Results: A significantly higher frequency of HLA-A2, A3, B21, DR3 and DQ2 were found in IDDM cases compared to the controls. In contrast, HLA-DR2, DR7 and B53 were represented at a somewhat higher frequency in controls compared to the IDDM patients. Conclusion: These results indicate that HLA-A2, A3, B21, DR3 and DQ2 antigens contribute to susceptibility to IDDM independently and HLA-DR2, DR7 and B53 antigens maybe associated with prevention of IDDM in Arakian patients.

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Introduction: One of the most important skills which should be learned and performed by physicians and nurses is the correct method of intubation. Therefore, more attention should be given to such trainings. The main purpose of the recent study is manufacturing and utilization of a detector device for correct intubation which can be used by inexpert staff who are not members of anesthesia team.
Materials and Methods: In a quasi experimental study a detector device was manufactured and utilized for correct intubation. In this research 400 patients undergone surgery, had been chosen for testing the device. Their ages varied from 5-75 years old and they had no chronic obstructive pulmonary disease (COPD), asthma and heart disease. These patients have been generally anesthetized. In all patients the tracheal tube has been placed in esophagus and then immediately in trachea, using the device. The sensitivity of device was evaluated. During the procedure patients, oxygenation was not disturbed.
Results: All 400 intubations were performed succesfuly using the device. In this study using air flow out of lungs, intubation was done successfuly. So the devices, sensitivity was 100%. By a professional the mean time for intubation using this device was 5 seconds, and it,s price was 1000 Rials.
Conclusion: Regarding the results, it seems the device is useful in emergencies and facilitates intubation. This device is cheap and portable and seems to be more useful than other reported devices in determining correctiveness of intratracheal intubation.

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Introduction: Hepatitis B is a disseminated liver inflammation from HBV, that causes diseases and a large number of deaths. Regarding the fact that some of the vaccinated people are non responder (NR), evaluation of immunity in vaccinated ones and identification of NR especially in high risk group is necessary.
Materials and Methods: In this descriptive study blood samples of all medical students of Borujerd Azad university at the age of 18-25 and vaccinated personnel of Borujerd Shariaty hospital were tested for Anti.HBS-Ab level by ELISA method with Radim kit (cat.KHB31). Results were analyzed according to the number of received vaccines, the duration of vaccination and demographic criteria using descriptive statistics.
Results: About 90% of samples had protective immunity and 10% were NR. 8% of immune group had more than 1000, 17.2 % between 500-1000 and 74.8 % between 10-500 miu/ml of Ab titer. About 75% of immune samples had received two vaccines. In NR group 53% had received three vaccines and 47% had two. 4% of samples were immune with the duration less than one month after vaccination which 85 % of them had two vaccines.
Conclusion: Herd immunity was 90% which is accordant to most studies. In some studies with different results the effective criteria were not differentiated. So regarding these differences, vaccinated people are recommended to evaluate their HBS.Ab level.

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Introduction: Treatment of urinary tract infections(UTIs), as one of the most common nosocomial and community acquired infections, has remained an important medical problem. Differentiation between susceptibility patterns of nosocomial and community acquired pathogens is important epidemiologically and helps the administration of appropriate antimicrobial drugs. The goal of this study was isolation of the most common causative bacteria, in two groups of 13-35 years old women in Shahrekord city within 6 months period(April-September 2004). Also, the resistance patterns of common isolated organisms in these two groups were compared. Materials and Methods: This is an analythical-cross sectional study. 100 urine samples from women aged 13-35 years old hospitalized in different wards of Hajar and Kashani hospitals(group one) with positive urine cultures were obtained performing clean-catch midstream method. Also 100 urine samples from 13-35 years old women with positive urine culture and acute UTI symptoms from Shahrekord private laboratory (group two) were obtained. The most common causative bacteria in the two groups and the antibacterial sensitivity patterns of isolated organisms were evaluated. Data was analysed using T test. Results: Totally, the most common nosocomial UTI pathogens were E.coli, Klebsiella spp., Staphylococcus saprophyticus, Pseudomonas and Enterobacter spp. In group two, E.coli, Klebsiella spp., Enterobacter spp., Proteus, Staphylococcus saprophyticus and Citrobacter spp. were isolated predominantly. The highest bacterial resistance rate belonged to Ampicillin and Co-trimoxazole. Antibiotics useful in treatment of nosocomial UTI were Ceftizoxim, Nitrofurantoin, Nalidixic acid, Cephalothin and Gentamicin respectively. Nitrofurantoin, Nalidixic acid, Ceftazidim, Gentamicin and Cephalothin were the most effective antibiotics in community acquired UTIs. Conclusion: The emergence of pathogens with alarming rates of resistance, highlights the need for a more rationalized and restricted use of antibiotics in order to minimize the spread of resistant bacterial strains.

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Introduction: Cystic hygroma is a disorder in lymphatic vessel formation that involves the adjacent organs and can affect them due to its fast growing nature . The main treatment for cystic hygroma is surgical intervention that can have many complications after surgery. Treatments other than surgical interventions is the use of sclerosing agents. The goal of this study is to analyze the effect of Beliomycin in treating cystic hygroma . Materials and Methods: This quasi experimental study was carried out clinically at st-al Zahra and Kashanie hospitals of Isfahan from 1372 to 1383. A checklist including age, sex, cyst location, cystic hygroma volume before and after Beliomycin injection and/or surgery, was completed for each patient. Data was analyzed by T and paired T-Tests. p<0.05 was considered meaningful. Results:The study was carried out on 72 patients. 24 patients were treated with Beliomycin and 48 patient by surgery. Patients age was below 1 month up to 18 years old . Cystic hygroma was mainly located at neck region(46.8%). The average size of cystic hygroma was 103.9±29.66cm3 before Beliomycin injection and 34.91 16.19cm3 after that (p=0.004). and 43.511±7.81cm3 before surgery and 1.39±1.39 cm3 after that(p=0.006). The rate of recurrence of lymphingoma in the surgery treated group was 25.1% and in the group treated with Beliomycin was 29.2% with no significant difference. Conclusion: Regarding the considerable decrease in cyst volume after Beliomycin injection and it,s low complication compared to surgery, this method can be used as a primary treatment or supplementary to surgery.

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  Introduction: Markazi province was one of the regions with endemic goiter in Iran. Following initiation of iodine deficiency control program in 1989, production, distribution and consumption of iodized salt begun. This survey was conducted in the frame work of national monitoring survey in 2001 to find the prevalence of goiter and urinary iodine level in order to evaluate the iodine status of school age children in Markazi province.

  Materials and Methods: 1200 school children (600 boys and 600 girls), aged 7-10 years, were selected randomly from all regions of Markazi province. The grade of Goiter was determined according to WHO classification and urinary iodine content was estimated using the digestion method in one tenth of the these children. Data was analyzed using T, Chi square and Pearson tests.

  Results: Total Goiter rate was 4.4% (4.4% in girls and 4.4% in boys). Urinary iodine median was 16.7 µg/dl. Urinary iodine was above 10 µg/dl in 81.2% and less than 5 µg/dl in 9.2% of samples. No one had urinary iodine below 2 µg/dl.

  Conclusion: It is concluded that the rate of Goiter in Markazi province has decreased significantly since 1986 and urinary iodine levels in school children are indicative of adequate iodine intake. Therefore Markazi province can be considered as an “iodine deficiency free” zone.

 

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Introduction: Postoperative nausea and vomiting is one of the most common problems in postoperative period. Patients' who are at high risk of PONV, may receive anti-nausea and vomiting drugs. The most common drug is Metoclopramide, but it,s extrapiramidal signs and side effects such as lethargy, dizziness and headache especially in children lead us to perform this study, in order to compare Dexamethasone and Metoclopramide effects in PONV prevention. Materials and Methods: This study was a double-blind randomized controlled clinical trial. 262 patients (2-25 years) in ASA class I,II which were candidates for ENT, eye and laparatomy surgeries, divided into two groups randomly. One group received 0.1 mg/kg Dexamethasone IV and the other group received 0.1mg/kg Metoclopramide IV, 10-15 minuets before operation ending time. During recovery, the frequency of PONV was assessed. Data was analyzed by Pearson test. Results: PONV frequency in the two groups had no significant difference. Also PONV rate in the two groups had no significant difference in male and female. Conclusion: In prevention and treatment of PONV, Dexamethasone effect was same as Metoclopramide. Considering low expense, avalibility and low side effects, Dexamethasone is a proper substitute for Metoclopramide in surgeries with high risk of PONV.

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Introduction: In many studies, immunogenicity of Brucella proteins such as P39 in animals is investigated. In this study, we evaluated antigenicity of recombinant P39 from Brucella abortus in patients with Brucellosis. Materials and Methods: In this experimental study, at first recombinant P39 was produced in Escherichia coli. Sera reactivity of six infected individuals against the recombinant P39 protein was analysed by Western Blot. Results: Data indicated that P39 protein from Brucella abortus was recognized by patients, sera antibodies. Conclusion: Our data showed that recombinant P39 protein can be detected as an antigen by sera in infected human. Therefore, recombinant P39 have same epitopes with natural form of this antigen.

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Introduction: The main goal of treatment and care of chronic patients including those suffering from end stage chronic renal failure is to promote their health and their quality of life (QOL). Various researches have shown that health level, performance status and QOL, especially for hemodialysis patients are often less than expected. So, an attempt to find effective and cost benefit education methods in this area seems to be necessary. This study is done to compare the effects of two educational methods of direct and indirect (multimedia educational package) self-care program on QOL and physical problems of hemodialysis patients. Materials and Methods: This quasi experimental research was carried out on two groups of hemodialysis patients. Sixty three patients were selected from three main dialysis centers in Tehran and allocated randomly into two groups (group one 32 and group two 31 patients). The first group used the direct educational program and the second group used the indirect educational package (multimedia). Patients were assessed before education using QOL questionnaire (short form SF-36), need assessment questionnaire and checklists. After determining educational needs and status of the patients, a self care educational program was designed based on self care model and the principles of patient education and also through counseling with nephrologists and nutritionists. The educational program was implemented directly on group one (direct education). Also it was recorded and indirectly used for the second group as a multimedia educational package once a week within one month during dialysis. After implementation of the self care educational program, both groups were assessed and measured again by same questionnaires and checklists. Data was analysed using student T, Wilcoxon and Mc Nemar tests. Results: Findings showed that most of studied variables including laboratory tests, blood pressure, weight gain between two dialysis, skin itching, edema and some vascular complications are decreased significantly in each group before and after education. QOL was also significantly improved in each group. But there was no significant difference between the two groups. Conclusion: Since, there was no significant difference between the two groups in terms of efficiency of two methods of direct and indirect (multimedia) educational self care programs and also due to the problems and higher costs of the direct educational program comparing to the indirect method, the indirect method is recommended as an effective, cost benefit, simple and patient-friendly method for hemodialysis patients.

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Introduction: A high prevalence of HCV infection among hemodialysis patients has been reported worldwide. Risk factors such as history of blood transfusion, duration of hemodialysis and recently nosocomial transmission of HCV in hemodialysis units have been identified. In this study the prevalence of Hepatitis C virus antibody and risk factors in hemodialysis patients in Markazi province is investigated. Materials and Methods: In this cross-sectional analythical study, blood samples were obtained from all 204 hemodialysis patients. Samples were tested for anti-HCV antibodies by using third generation enzyme immunoassay. The reactive samples on ELISA were confirmed by the third generation RIBA. Risk factors were evaluated by a questionnaire. Data was analysed using Chi square and logistic regression. Results: The prevalence of anti-HCV antibody among hemodialysis patients was 4.9%.Duration of hemodialysis was identified as a major risk factor in transmission of HCV (p=0.004). There was a significant relationship between anti-HCV positivity and previous renal transplantation (p=0.032). Female sex was another risk factor for HCV infection (p=0.030). There was no significant relationship between anti-HCV positivity and history of blood transfusion. Conclusion: Nosocomial transmission of HCV within hemodialysis units seems to be a route of infection in patients on hemodialysis in Markazi province. Application of dialysis precautions recommended by CDC can reduce the prevalence of HCV infection among hemodialysis patients in this province.