Zahedan Journal of Research in Medical Sciences
Year:2014 | Volume:16 | Issue:6|Papers Count:27

Nowadays, hypertension is one of the most important causes of death all over the world because of its adverse effects on cardiovascular system. For this reason its study is very valuable. Vitamin D is one of the important factors that may influence blood pressure. Many studies have shown the modulatory effect of this vitamin on rennin-angiotensin system as well as its inhibitory effect on vascular smooth muscle hypertrophy. According to the fact that vitamin receptors are distributed in almost all organs of human body, we can't consider its role just as factor in calcium homeostasis. Therefore many other important roles could be attributed to it. So vitamin D deficiency could arise many problems. There are many causes for vitamin D deficiency. The most important is insufficient exposure to UV-B. In epidemiological studies the vitamin D deficiency is considered to be associated with high blood pressure, as emphasized in many cross-sectional studies. Concerning the cohort prospective studies, the relationship between vitamin D deficiency and hypertension is reported in some cases. The interventional studies about the association between vitamin D and hypertension are not many and the results are different or contradictory. Controversial results might be due to differences in dose of supplements or duration of supplement therapy. The aim of this systematic review is to assess the researches about the association between vitamin D deficiency and hypertension and discuss the power of them. This can be helpful to lighten the path to prospective investigations.

Background: The aim of this study is to investigate the effect of circadian rhythm on the maximal fat oxidation (MFO) and FATMAX in students without practice.Materials and Methods: The subjects of this study were ten non-athletes male students (N=10), with the body mass index and maximal oxygen consumption below 50%, who were selected randomly. Run test was performed with three-minute stages and increased speed and slope to exhaustion at 6-8 am, 5-7 pm ,and 9.5-11 pm. Post hoc LSD test was used for describing the analytical findings and repeated measures to compare data in three times of morning, afternoon, and night.Results: The results generally showed that average of maximal fat oxidation at night is more than evening and morning) .There is a slight difference between the afternoon and morning (p=0.006), but MFO and FATMAX mean in evening is more than morning and night. There is a slight difference between the morning and night (p=0.002).Conclusion: So it can be concluded that circadian rhythm influences the maximal fat oxidation and fat oxidation is significantly higher in the evening than in the morning and it is good for fats.

Background: Increased vascular stiffness is a marker of atherosclerosis, which is diagnosed in the early stages of diabetes II. Matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) are a family of proteolytic enzymes necessary for structure and function of great vessels. This study examined the effects of 8 weeks of aerobic exercise on MMPR9R and TIMP-1 levels in type II diabetic women.Materials and Methods: This is a quasi-experimental study which included 20 in type II diabetic women with mean age of 53.2±2.5 years, body mass index (BMI) of 28.73±2.27 and fat percentage of 30.6±2.05, who were randomly divided into two groups: aerobic exercise group (8 weeks, 3 sessions per week for 50 minutes) and control group. To examine changes in MMPR9R and TIMP-1, 5 ml of blood was taken from the brachial vein of patients before and 48 hours after completion of exercise period and after 12 hours of fasting at rest. Data analysis was performed using SPSS-16 software with the independent and paired t -tests.Results: A significant decrease was observed in body mass index and body fat percentage in the experimental group (p<0.05). Compared with the control group, the aerobic exercise group showed a significant decrease in MMPR9R (p=0.01) and a significant increase in TIMP-1 levels (p=0.02) after 8 weeks of aerobic exercise.Conclusion: The results showed that aerobic exercise as a stimulus can change the levels of matrix metalloproteinases and their tissue inhibitors in order to prevent cardiovascular diseases in diabetics.

Background: Stroke is the most frequent and highly fatal neurologic disease. Many clinical symptoms and paraclinical methods have been suggested have a prognostic value in stroke, including the shift in white blood cell (WBC) count which has attracted much attention at the moment. The objective of this study is to assess the prognostic value of admission-time WBC count of patients with acute ischemic stroke on their hospital mortality in Rafsanjan.Materials and Methods: This is a descriptive-cross sectional study on 200 patients with acute ischemic stroke, that the diagnosis was confirmed with neuroimaging. WBC count during the first 12 hours of admission was assessed. Subsequently, the patients were divided in 2 groups of normal WBC count and high WBC count and followed until discharge or death. The data were analyzed statistically using Fisher Exact test.Results: In our study, 54% of our patients were men and the others were women.17.5% of patients had abnormal WBC count.27 patients (13.5%) were expired, consisting of 5 patients with increased WBC count and 22 with normal WBC count. No significant relationship was observed between the WBC count and hospital mortality. Also, no significant relationship was observed between the WBC count and hospital mortality in terms of age and gender.Conclusion: The findings of our study show that WBC count doesn’t have any predictive value on hospital mortality in patients with ischemic stroke.

Background: Studies reported conflicting results about the relationship between anthropometric factors, respiratory exchange Ratio, energy expenditure and VO2 max. Therefore the aim of this study was to investigate the relationship between anthropometric factors, respiratory exchange ratio and energy expenditure with VO2 max in sedentary men.Materials and Methods: Thirty one sedentary healthy men (23.67±2.45 years old age, BMI=22.49±1.58 kg/m2) volunteered for participation this study. After the measurement of anthropometric factors, subjects performed an acute endurance exercise on the ergometer for determination of VO2 max. Subjects performed major protocol, one hour cycling on ergometer via 70% VO2 max for the determination of the respiratory exchange ratio and the rate of energy expenditure, 72 hours later.Results: The results of this study showed that there is not any significant relationship between VO2 max and anthropometric factors, respiratory exchange ratio and energy expenditure. Also, regression analysis indicated that all these variables cannot predicate the VO2 max.Conclusion: According to the results of this study anthropometric factors, respiratory exchange ratio and energy expenditure are not strong predictors of VO2 max in sedentary young men.

Background: Ghrelin and agouti-related protein (AgRP) are orexigenic peptides secreted from stomach mucosa and the arcuate nucleus of the hypothalamus, respectively. Both peptides affect feeding behavior and play a role in energy balance, glucose homeostasis, and adiposity. The purpose of the present study was to investigate the effect of two types of exercises, aerobic and single circuit resistance exercise on plasma ghrelin and AgRP levels.Materials and Methods: The current study is semi-experimental. Twenty two athletes young females randomly selected and assigned into two experimental groups and one control group. Blood samples were collected before and after the enforced protocol. Plasma AgRP and ghrelin levels were measured using the enzyme-linked immunosorbent assay (ELISA) method.Results: Results showed a significant increase in plasma AgRP (p=0.001) and ghrelin concentration in control and aerobic (p=0.001) and circulate-resistance (p=0.001) groups.Conclusion: In healthy females a single session of aerobic and circuit-resistance exercise could be associated with the increase of these peptides in response to the negative balance of energy produced by exercising for increasing appetite to compensate energy resources body subjects.

Background: Visual evoked potential is one of the main methods to investigate visual pathway. Some studies in children show that iron deficiency anemia affects on visual evoked potential waves. In this study, we evaluated the effect of iron deficiency and iron deficiency anemia on visual evoked potential in adults.Materials and Methods: This cross sectional study was conducted on 99 non-pregnant women. Patients divided into three groups. Women whose ferritin and hemoglobin levels are less 15 ng/1 and 12 mg/dl placed in iron deficiency aimena group, women whose ferritin level is less than 15 ng/1 and hemoglobin level is more than 12 mg/dl, placed in iron deficiency puorg and women whose ferritin and hemoglobin levels are more than 50 ng/1 and 12 mg/dl, chosen as control group. Visual evoked potential was done from both eyes and the results evaluated by ANOVA test.Results: The average of N75 latency was 65.24±5.06 miliscecond in anemia group, 66.27±7.77 miliscecond in iron deficiency group and 67.19±6.79 miliscecond in control group. The average of P100 latency was 101.60±9.05 miliscecond in anemia group, 102.75±7.91 miliscecond in iron deficiency group and 100.67±7.34 miliscecond in control group. The average of N135 latency was 139.18±31.21 miliscecond in anemia group, 144.81±10.73 miliscecond in iron deficiency group and 141.81±10.73 miliscecond in control group. There is no significant difference between the average of waves’ latency in iron deficiency and anemic groups with control group.Conclusion: Iron deficiency and iron deficiency anemia don’t make any disruptions on visual evoked potential and are not considered as confounding factor of visual evoked potential in adults.

Background: Today, contact lenses have extensive usages. Contact lens places on cornea, so it may induce variation on cornea and these variations can influence the measurement of intraocular pressure (IOP) by Goldman tonometer. The aim of this research was to study the effect of various contact lenses on measurement of intraocular pressure by Goldman tonometer.Materials and Methods: In this study, 80 subjects aged 18-25 were selected randomly among patients of Al-Zahra ophthalmology center. None of them has any eye pathological problems. Before wearing the lens, intraocular pressure was measured, and then patients were divided into two groups of soft and hard contact lenses. Soft and hard contact lenses were placed on the eye for two hours, and the intraocular pressure was measured again.Results: The mean of IOP before wearing contact lenses and two hours later was 15.96 mmHg and 13.93, s respectively. Paired test showed a significant difference between IOP before and after wearing contact lenses (p=0.001).There was no significant differences in mean of intraocular pressure decline before and after placing the contact lens in both soft and hard lenses.Conclusion: According to this study, the intraocular pressure decreases after wearing contact lenses (CL). This decline may be due to variation in properties of cornea after wearing CL that can also affect IOP measurement.

Background: The aim of the current study was to assess the value of simultaneous EKG with EEG to diagnose cardiac disorders in patients with seizure- like attacks and to investigate the extent of misdiagnosis of epilepsy.Materials and Methods: 210 patients presenting with transient loss of consciousness (TLoC) and paroxysmal events suspicious to seizure were studied. All patients had undergone EEG simultaneous with an EKG. Besides reporting the EEG, a cardiologist analyzed the EKG in an attempt to recognize abnormal EKG as a potential cause of TLoC. Moreover, in all patients it was ascertained if any cardiac disorders in patients and their first degree relatives had been diagnosed.Results: Sixteen out of two hundred ten (7.6%) patients had abnormal EKG which was significantly potential cause of symptom of whom 6 patients were found to have bradycardia and 10 patients had dysrhythmias. Moreover, in patients with previous cardiovascular disorder, 30.4% had abnormal EKG where as in patients without cardiac disease only 4.8% had EKG abnormalities. Besides in patients with positive family history for cardiac disease 20.3% had abnormal EKG while in patients without family history of cardiac disease, abnormal EKG was revealed in only 2.05% patients.Conclusion: Simultaneous EKG with EEG is valuable in declining rate of misdiagnosis of epilepsy. Besides, EKG abnormalities in these patients have a significant association with any previous cardiovascular disorders in the patients and in their first degree relatives.

Background: The increase in the amount of heat shock protein and C-reactive protein occurring as a result of stress was done with the aims of returning cell homeostasis, successful restoration of cell injury and protection of cell against more injuries.Materials and Methods: Fifteen climber and 15 non athlete subjects were chosen. A selected aerobic test was done by the subjects using Monark bicycle under two different conditions. Before starting the test, the subjects were exposed to a normal condition with the temperature of 24±2oC for an hour and a blood sample was taken from all the subjects. Then immediately, the subjects took the selected aerobic test to the level of exhaustion and blood sample was taken again. A week later, these subjects were exposed to a heated environment with the temperature of 38±2oC, followed by blood sample taking. Finally, the test was done by the subjects to the level of exhaustion and the last blood sample was taken. Then, the amount of heat shock protein (HSP) and C - reactive protein (CRP) in blood samples was measured.Results: A meaningful difference was observed in the changes of heat shock proteins (p=0.012) and C-reactive protein (p=0.02) between athlete and non athlete subjects. There was no meaningful difference in CRP and HSP in normal and hot condition for non athlete subjects before and after the test. But the result of the study demonstrates that There was a meaningful difference for athletes in both conditions before and after the test (p=0.002).Conclusion: Based on the study, it is claimed that while an athlete is exposed to several stressful conditions (e.g. high temperature and physical exercise), compared to a non athlete, the reaction of his body cells is more significant in order to prevent the injury.

Background: Holly Ramadan is the ninth month of the Islamic calendar in which millions of mature and obligated Muslims fast many hours during a day in all over the world. This study was performed to evaluate some immune factors in fasting athletes during the month.Materials and Methods: This cross sectional study was performed in 90 athletes with physical activity of 2-3 hours per day, age ranged of 16-36 years old, during holly Ramadan. Serum immunoglobulin levels of IgG, IgM, IgA and IgE, as well as serum complement components of C3, C4 and blood count cells with differential evaluation were measured at the beginning and end of holy Ramadan.Results: Mean serum IgA level has significantly increased from 239.2±98.2 mg/dL before Ramadan to 262.8±88.6 mg/dL at the end of this month (p=0.008). Mean serum C4 level was 258.2±150.6 g/L and 330.7±127.6 g/L before and after Ramadan, respectively (p<0.001). However, the percentage of lymphocytes was decreased from 37.81±4.14% before Ramadan to 36.50±5.98% at the end (p=0.005) and neutrophils was decreased from 60.0±4.2% before this month to 56.2±8.3% at the end of the month (p=0.003).Conclusion: Fasting seems to have positive effects on increasing the serum levels of C4, IgA levels, which could have protective effect on the athletes’ immune system against infection during exercise.

Background: Although exercise can increase free radicals by generating oxidative stress, it also can decrease them by increasing the antioxidant enzymes in the body as well. The purpose of this study is to investigate the eccentric activity on some oxidative and anti-oxidative factors pertaining to blood plasma of PE women immediately after the exercise.Materials and Methods: Sixteen female students have been volunteered in this study randomly divided into two groups including eccentric training group and control group. The blood samples were drawn from the subjects one hour before and immediately after the exercise to measure the reduced Glutathione (GSH), Malondialdehyde (MDA) and total anti-oxidant capacity (TAC) levels. The data were analyzed by SPSS-13 software using the one-way analysis of variance, one-way ANOVA test, (to determine the differences between groups) at the confidence level of 90% (p<0.05).Results: The results has shown that the TAC, MDA, GSH levels after the eccentric exercise increased significantly compared to pre-exercise (p=0.001, p=0.001, p=0.033). The GSH and MDA levels also after the eccentric exercise were significantly higher than the pre-exercise compared to control group.Conclusion: It seems that sever eccentric exercise is an important stimulus making significant changes in body’s anti-oxidative system and has the ability to improve the anti-oxidant capacities too.

Background: These minerals have been extensively used in industrial products such as cement-asbestos sheet and pipe, brake shoe, clutch, insulation materials, etc. Occupational and non - occupational exposures to this carcinogenic material have caused to develop several methods to evaluate airborne asbestos fibers.Materials and Methods: In this study, multiple microscopic method of determining the type and concentration of asbestos fibers has been used in an industry. The forty five personal samples on membrane filters (MCE) were collected of different processes of a manufacturing factory of cement-asbestos sheet. The half of each filter was prepared and then fibers counting were accomplished  by  ocular PCM and LCD images methods. Another part of filters was used for identification of asbestos fibers elements and types by scanning electron microscope method.Results: Fibers concentration range were determined 0.009-0.243 fibers/cc by direct counting method (Ocular PCM), while by indirect method (LCD Images), results were 0.00-0.117 fibers/cc and statistical tests showed significant difference (p<0.02). Study of elemental composition of fibers by scanning electron microscope confirmed that, the majority of fibers were chrysotile. Study of elemental composition of fibers by scanning electron microscope confirmed that majority of fibers are chrysotile.Conclusion: Due to limitation of study, use of 1.3 megapixels in indirect method, PCM direct method remains one the best methods of Asbestos fibers counting in Iran.

Background: Endurance training increases capillary density of skeletal muscle, but the molecular mechanism of this process is not yet clear. Therefore, the purpose of this study was to investigate the effect of acute sub maximal endurance exercise on serum levels of vascular endothelial growth factor (VEGF) and matrix metaloproteinases 2 and 9 (MMP-2 and MMP-9) in sedentary men.Materials and Methods: Twelve healthy men (22.37±2.30 years, BMI=23.16±2.61 kg/m2) participated in this study. Subjects exercised for 1h at 70% of VO2 max, 3 days after the VO2 max determination. Antecubital vein blood was collected at rest, immediately and 2h after the exercise. Serum VEGF, MMP-2 and MMP-9 were measured by ELISA methods.Results: Serum levels of VEGF and MMP-2 decreased immediately after the exercise.2 hours after the exercise, serum levels of VEGF remained at a lower level but serum MMP-2 returned to its basal level. Also, serum levels of MMP-9 did not change significantly in response to exercise.Conclusion: Acute sub-maximal endurance exercise decreased the main factors involved in development of capillary density in sedentary men. This might to due to the fact that, sub maximal exercise could not provide the two main stimulating factors of angiogenesis, i.e. Shear stress and hypoxia. It could also be explained by the fact that the mechanism of development of capillary network following regular endurance training is different from that following an acute exercise.

Background: Manganese (Mn) related jobs may cause manganism especially in miners. Side effects include neural and pathological disorders. In spite of liver is the main organ that filters Mn (99%) but few studies has performed about Mn toxicity in liver so no specific biochemical indicator is available (Gunnar). In this study, the relation between blood, urine and saliva Mn level and its hepatotoxic effects is evaluated.Materials and Methods: Blood, urine, saliva of 50 accidently selected miners collected in acid washed tubes for an experience study. Samples were used to evaluation not only biochemical parameters by pars azmoon kits but also Mn concentration by mass spectroscopy.Results: Manganese concentration in all miners in addition to blood AST, ALT, ALP increased significantly (p<0.001) related to controls. Miners with 10-15 years background had higher blood total, direct & indirect billirubin and ALP levels compared to others. Mn concentration in serum declined but in urine and saliva had no changes by working in mine. AST & ALT increased significantly in miners with 300 mg/L serum Mn concentration. Mn concentration in various samples and serum AST & ALT level were higher in native miners than non-native but in both not related to background.Conclusion: Significantly higher levels of billirubin, AST & ALT in miners compared to controls revealed Mn hepatotoxic effects in them. Also significant ALP increasing showed cholestasis in miners that supported by AST, ALT level. Significant billirubin, AST, ALT, ALP in miners with 10-15 years background revealed the importance of this period in miners liver check up. Higher Mn levels in different sources of native miners can be due to more environmental contact. Higher AST, ALT and lower ALP level in native miners indicate more hepatastoxic and less cholestasis and therefore arthrosclerosis and parkinson risk in these workers.

Background: Because of the corrigibility of forward head posture (FHP), the recognition of the relationship between this deformity and scapular rotator muscles may be influential on scapular muscle activities in detection of better way to improve movement disorders. Therefore, the aim of this study was to compare the serratus anterior, upper and lower trapezius muscle contributions during shoulder flexion without weight in women with and without FHP.Materials and Methods: In this case-control study was carried out on 18 women with FHP and 14 healthy subjects who were matched. EMG muscle activities were recorded during shoulder flexion and abduction. The value of each muscle divided on total muscle values to calculate contribution ratio and independent t -test was used to compare contributions between groups.Results: There was a significant decrease in serratus anterior muscle activity ratio (p=0.002) and a significant increase in upper trapezius muscle activity ratio (p=0.001) between subjects with and without FHP. There was not also significant difference in contribution of lower trapezius muscle.Conclusion: Contribution of the serratus anterior muscle in individuals with forward head posture is less than healthy subjects. The contribution of upper trapezius muscle also in individuals with FHP is greater than healthy subjects.

Background: Spinal column abnormalities can highly restrict motor movement in students with dyspraxia. The present study investigated the effect of regular corrective exercises on the spinal column of students with dyspraxia.Materials and Methods: The present study is a quasi-experimental research. For the purposes of the study, spinal column abnormalities of a total of 150 girls and 220 boys were analyzed. The subjects then went through a 12-week period of corrective exercises. The students' spinal column abnormalities were re-examined to determine the effects of the exercise. The study employed SPSS-16 to analyze the data. Also, for the purposes of the study, statistical-descriptive methods, samples t -test and Pearson’s correlation coefficient were used to further analyze the data in detail.Results: The results of the study indicated that students with dyspraxia constituted 6.16 % of the total sample. That is to say, dyspraxic girls and boys made up 5% and 7.3% of the sample, respectively. Moreover, 60% of the boys and 63.3% of the girls suffered from spinal column abnormalities. The results of the experiment indicated that corrective exercises can reduce spinal column abnormalities in school students.Conclusion: The results of the experiment indicated that corrective exercises can reduce spinal column abnormalities in school students.

Background: Immunological, endocrinological, haematological and neurological abnormalities are relatively common in people with Down's syndrome (DS). Zinc (Zn), copper (Cu), selenium (Se) and manganese (Mn) are elements that act in the maintenance of normal function of these systems. The present study aimed to evaluate the concentration of these elements on DS symptoms.Materials and Methods: This case-control study was done from April to October 2011. Serum trace elements including Zn, Cu, Se and Mn were determined by using atomic absorption spectrometry (AAS) in 56 patients with DS and 60 healthy subjects.Results: There was no significant difference in the values of Cu and Se between two groups (p>0.05). While, Zn and Mn levels were found to be significantly decreased in patients with DS compared to the control group (p<0.01 and p<0.001, respectively).Conclusion: Results of this study indicate zinc and manganese deficiency in more than 60% of DS patients. Some of the problems experienced by people with DS may be due to changed level of these trace elements.

Background: Strength of knee extension and squat were compared between anterior cruciate ligament reconstructed (ACLR) patients and healthy subjects.Materials and Methods: Twenty ACLR and twenty control subjects were participated in this non-exprimental study. Isokinetic peak strength of knee extension and squat in involved and uninvolved side of the ACLR patient and control group were measured.Results: Concentric and eccentric knee extension strength of the involved leg was decreased but squat strength showed no difference.Conclusion: In spite of return to sport activity and normal squat strength weakness of knee extensor muscles in the involved side of the ACLR patient was existed.

Background: An investigation of puberty on corrective exercise effectiveness on school girls.Materials and Methods: 64 lumbar lordotic school girls were included (10 and 17 years old) that randomly divided into two groups: experimental (32 persons) and control (32 persons). The experimental groups performed corrective exercise for 8 weeks. Lumbar curved was measured by flexible ruler. Two way ANOVA test was applied on the data.Results: The corrective exercise reduced lumbar curve of prepuberal and pubertal girls (p<0.05) .Conclusion: Corrective exercises had significant effect on increased lumbar lordosis specially after puberty.

Background: Lower limbs nerves are exposed to mechanical injuries in the football players and the purpose of this study is to evaluate the influence of football on the lower leg nerves.Materials and Methods: Nerve conduction studies were done on 35 male college students (20 football players, 15 non active) during 2006 to 2007 in the Shiraz rehabilitation faculty. Standard nerve conduction techniques using to evaluate dominant and non dominant lower limb nerves.Results: The motor latency of deep peroneal and tibial nerves of dominant leg of football players and sensory latency of superficial peroneal, tibial and compound nerve action potential of tibial nerve of both leg in football players were significantly prolonged (p<0.05). Motor and sensory nerve conduction velocity of tibial and common peroneal in football players were significant delayed (p<0.05).Conclusion: It is concluded that football is sport with high contact and it causes sub-clinical neuropathies due to nerve entrapment.

Background: The purpose of this study is to present a geographical map of mortality rate due to diabetes complications in different areas of Yazd during 2001-2010.Materials and Methods: In this ecological study, a sample data of mortality due to diabetic complications in Yazd was gathered. Mortality rate calculation and geographical distribution mapping was performed then using this data.Results: General rate of mortality from diabetic complications is higher in internal and marginal areas than high-income and new-built regions. This pattern is also consistent regardless of patients’ gender.Conclusion: It seems that the observed pattern is due to inactivity in internal areas, as well as unawareness and lack of access to medical facilities in margins.

Background: Postpartum thrombotic thrombocytopenic purpura (TTP) should be considered in thrombocytopenic patients.Case report: The patient was a 28-year-old pregnant woman referred for cesarean section. After CS, hysterectomy was done due to uncontrolled vaginal bleeding. Peripheral blood smear confirmed the TTP diagnosis. Plasmapheresis was initiated and platelets were infused. Six hours after infusion, tonic-colonic seizure, left hemiplegia and bell's palsy appeared. Brain CT Scan revealed intracranial hemorrhage.28 plasmapheresis sessions were performed and finally, she was discharged with good general condition.

a 21 years old man has been complained of bloody diarrhea, liquid stool containing blood, pus, and fecal matter and crampy abdominal pain from four monthes ago. Ulcerative colitis relies upon the patient's history, clinical symptoms, sigmoidoscopic appearance and histology of colonic biopsy specimens. Treatment of patient started with high dose dexamethasone and prednisolone, asacole, suppository, metronidazole. Patient’s condition not improved and patient admitted in hospital. High dose prednisolone, azathioprine, sulfasalazine and folic acid were given.

a common cause of impaired vision and the second leading cause of treatable blindness in some parts of the world are refractive error[1]. In a study conducted by Fotouhi et al. it was found that uncorrected refractive error the most frequent and primary cause of visual impairment in the samples under study[2]. The aim of this study was to determine the prevalence of refractive errors and the exact of visual acuity improvement in these patients by prescribing glasses. In this case study, all referred patients to the low vision clinic from March 2008 to March 2009, were studied. The age of the patients ranged from 7 to 90 years old. In this study, required information included: age, gender, cause of vision impairment, type and amount of refractive error and best correction visual acuity (BCVA) in each eye. This information was obtained from the files of patients and was recorded in the research form. Complete eye examinations were performed for all patients to detect causes of visual impairment. In the first stage objective refraction with the use of autorefractometer and after that subjective refraction performed for all subjects. The BCVA in each eye was measured with Lighthouse distance acuity chart.

stroke is the third reason for deaths around the world [1]. Predisposing risk factors for cerebrovascular disorders are age, history of previous stroke, hypertension, diabetes, heart disease, dyslipidemia, and cigarette smoking, which are well known. A prospective study was conducted across a 30-month period commencing on 23rd September 2009 to evaluate the relationship between Blood BUN, creatinine (Cr), BUN/Cr ratio and mortality in patients with stroke. All patients with Stroke, admitted to the Vali-Asr Hospital (Birjand, Iran), were enrolled. Patient-specific demographic information, serum BUN, Cr, BUN/Cr ratio and outcome data related to each presentation was recorded. Blood BUN, creatinine (Cr), BUN/Cr in patients who died in hospital after admission with stroke and in patients who died through 3 month later after stroke compared with The group of patients who survived stroke.

the effects of noise pollution as a gift of technology progress is known to some extent and the necessity of dealing with it has been increased [1]. In this regard, the nature of sound and its complications should be well recognized to be controlled by a precise program. The present evaluation is paid to the implementation of hearing protection programs in rubber factory for this purpose, sound meter and noise evaluation has been done in the different parts of the factory and then several workers have been chosen by random. Then parts that had extra ordinary noise identified. Two hundred twelve workers with mean age 42 year have been selected randomly from different extra ordinary noisy sectors of the plant. They were examined by otoscopy and pure tone audiometry.