JOURNAL OF NORTH KHORASAN UNIVERSITY OF MEDICAL SCIENCES
Year:2015 | Volume:7 | Issue:4|Papers Count:23

Background & Objectives: longitudinal studies play an important role in medical research. In these studies, every individual are exposed to the repeated measures over time. Specific statistical methods that consider the correlation are used to analyze for such data. But these methods differ in providing reliable and efficient results that are effective in covariates significantly. Therefore, in this study, in addition to checking factors affecting on recurrence Bipolar I Disorder using Generalized Estimating Equations and Quadratic Inference Function, we compare the efficiency of two methods.Material & Methods: In this longitudinal study, 237 patients with Bipolar I Disorder and history of hospitalization in Zare hospital in Sari were studied. Each of patients was followed in 2007-2011. The applied methods were the Generalized Estimating Equations and Quadratic Inference Function.Results: parameter estimation efficiency by Quadratic Inference Function was more than Generalized Estimating Equations method. Using the Quadratic Inference Function method, the effect of variables- age at onset, first-degree relatives and location were significant, but in the Generalized Estimating Equations method, location variable was not significant.Conclusion: The data used in this study showed that the estimates of the Quadratic Inference Function method is more efficient than Generalized Estimating Equations method.

Background & Objectives: Placenta site trophoblastic tumor is a very rare variant of gestational trophoblastic tumor. It could both occur after normal termination of pregnancy or spontaneous abortion and ectopic or molar pregnancy. There is a wide range of clinical manifestation from a benign condition to an aggressive disease with fatal outcome.Case: We present a case of PSTT and discuss the differential diagnosis in order to further familiarity of physicians in diagnosis and treatment of this disease.Conclusion: It has a varied clinical spectrum and usually present with irregular vaginal bleeding or amenorrhea. Diagnosis is confirmed by dilatation and curettage (D and C) and hysterectomy. Because chemotherapy is not effective, surgery is the cornerstone of treatment. Familiarity of physician with differentiated diagnosis method discussed here.

Background & Objectives: Leptospirosis is a reemerging neglected zoonotic diseases caused by leptospires, belonged to the species of Interrogans which containing over 250 serovars. Rodents can act as a main source of infection for humans and animals. The disease has a global distribution, mainly in humid, tropical and sub-tropical regions. In Iran the disease is being reported in many areas and is endemic in north of the country.Material & Methods: This study was conducted to investigate the existence of Leptospira antibodies in rodent of North Khorasan Province, Iran. For this study, thirty six rodents were trapped alive. The infecting serovars were identified and the antibody titers were measured by standard microscopic agglutination test (MAT), using a panel of 7 strains of live Leptospira species as antigens and a serial dilutions (1.100 to 1.12800) of serum were used for tiration.Results: Antibody of Leptospira detected in spices of Meriones libycus, Rhombomys opimus and Apodemus witherbyi of the the rodents for the first time in Iran. The result of this study showed that 12 samples (33%) had a positive reaction against one or two sarovars. In general, 4 samples had a posistive reaction with serovar Pomona, 3 samples with Grippotyphosa, 3 samples with Australis, 2 samples with Tarassovi and 2 samples with Icterohaemorrhagiae. The results also showed that the most prevalent leptospira serovar was Pomona (14%) and the most common titer was 1.100 (10 samples) and the highest titer was 1.200 (2 samples).Conclusion: This study is the first serological investigation of rodent infection to leptospirosis in this region and it showed that Leptospirosis is prevalent in rodents in North Khorasan Province.

Background & Objectives: Based on WHO report, cutaneous leishmaniasis disease is one of the world health problems, especially in tropical and semitropical countries. One of the efficient way for control and prevention of this disease is the education of the people, So called “Health -Go betweens” can have an efficient role in this basis, so the goal of this research is the survey of knowledge, attitude and practice of “Health-Go betweens” about cutaneous leishmaniasis disease in “Esfarayen country in Iran” in 2013.Material & Methods: This descriptive-analytic study was conducted on 313 girl “Health -Go betweens” of “Esfarayen country” which had selected based on census in 2013. The data were collected by the questionnaire that its reliability and validity had deliberated. The questionnaires were filled out by “Health-workers”. The data were analyzed by the “SPSS16” software and statistical tests “t-independent” and “chisquare”.Results: All of participants in this study were female. Majority of participants %77 were married and 76.82% of them were village settlers. Mean score of “Health-Go betweens” about cutaneous leishmaniasis disease basis on knowledge was 11.99±2.76, attitude was19.8± 51.61 and practice was 14.83±5.47. 86.6% of participants had a good knowledge about cutaneous leishmaniasis meanwhile about attitude and practice by sequence was 5.1% and 32.6%. 53.4% of participants had mentioned that their first premiership for gaining the information about cutaneous leishmaniasis were “Health workers”. Between job with knowledge and attitude showed statistically significant correlation also between settlement place with attitude and practice of participants showed statistically significant correlation (P<0.005).Conclusion: By regarding to the rather appropriate knowledge of “Health-Go betweens” about cutaneous leishmaniasis disease which have gained from “Health-workers” and the importance of this group activities, the educational emprises and more consideration of health-responsible are requisite.

Background & Objectives: The use of gold nanoparticles due to the medical field is expanding for special physical and chemical properties. So in this review we attempted to collect and review previous research into the diagnosis area.Material & Methods: This review is based on studies about gold nanoparticles in more than 100 papers in journals and written books on cancer until now. Accordingly 37 relevant cases were selected and studied. Resource selections were based on relevance to the topic, the research year, not duplicate, comprehensive resource and its contents. Keywords for this search were gold Nanoparticles, AU Nanoparticles, Cancer, Diagnosis, Drug delivery, Imaging, Protein respectively.Results: The conducted studies indicate the current tendency toward use of gold nanoparticles is owing to the selective delivery capability, ease of access and low toxicity, allowing scientists to detect cancer at early stage within fewer time frames.Conclusion: Biofunctionalized gold particles are detectable in target organs and in vivo with microscopes. These improvements have made the nanoparticles detectable and increased their contrast , providing the ability to measure them easily. Because of the high density of electrons in the gold nanoparticles, images are of greater clarity.

Background & Objective: Intelligence is generally defined as an individual talent to perceive world and meet his expectations. Numerous studies have been done on the association between intelligence quotient and socio-economic factors. The aim of this study was to investigate the role of these factors on IQ levels in children.Materials & Methods: The current research was a case-control in which 111 female students aged 9-11 years with low and boundary intelligence quotients as the case group and 111 with high and average intelligence quotients as the control group were randomly chosen from 12 public girly primary schools in Bandar Anzali, Iran. To determine the demographic features, mothers were invited to an interview to complete the socio-economic questionnaire. Wechsler’s revised intelligence test was used to determine each student's intelligence quotient. The acquired data were analyzed in chisquare, 2 student t-test, Univariate and multivariate logistic regression, SPSS (16.0 version), and Stata 11 SE.Results: intelligence quotients had a significant association with job status and educational level of parents, economic level and the number of employed people in the family. But had no significant association with mother and child's weight and height and also, fathers' employment, owning a private house and number of children in family.Conclusion: Based on this study, parents' educational level was the most important socio-economic factor on children's IQ levels. So that, the odds of having children with a low intelligence quotient for parents who have no academic education is respectively 2 and 3.5 times more than parents who have academic education.

Background and Objective: drug abuse is of social concerns in Iran. During past years, Iranians consumption style has been changed. Many of drug abusers are teenagers especially in terms of new drugs such as methamphetamine and crack. The purpose of this study is to examine sensitivity level of behavioral approach system (BAS) and behavioral inhibition system (BIS) as a probable effective factor on tendency toward abusing drugs.Materials and Methods: the present study is a comparative and a cause-effect research. The study sample included 110 men aged 20 to 45 years. This sample consists of drug abusers, irritating drugs abusers, and normal people. The sample members have been selected through convenience sampling method. Data were collected via a BAS/BIS questionnaire which consisted of twenty self-report questionnaire and two subscales, subscales BIS and BAS. The difference between the level of BAS and the BIS were studied in three groups. Data were analyzed with Spss- Version 18 method ANOVA was performed.Results: the findings of this study revealed that BAS of methamphetamine abusers is higher than other groups. Another part of the findings of this study revealed that there is not any significant difference between BAS among methamphetamine and drug abusers. Finally, any significant difference has not observed among three groups of drug abusers, irritating drugs abusers, and normal people in terms of BIS.Conclusions: based on the results of this study it can be said that irritating drug abusers have sensitive BIS than drug users and normal people. This is the main factor that tends abusers toward approach behaviors.

Background and objectives: The chromium compounds could be hazardous to human’s health. The aim of this study was to compare the Performance of Electro-Fenton and Fenton process in the removal of chromium in presence of cyanide as an Intermediate in aqueous.Material & Methods: In this experimental study, a reactor with 1 liter useful volume was used. Four electrodes made of iron were used in EF. Parameters of study including pH, Voltage, initial concentration of chromium, H2O2 and cyanide as an intermediate in EF process and pH, concentration of Fe ions, initial concentration of chromium, H2O2 and cyanide as an intermediate in F process were examined.Results: The results showed that efficiency of EF process in pH=3, Voltag = 20V in 100 mg/lit chromium, was 97%. Also in F process in optimum condition with pH=3, Fe ions = 500mg/lit, H2O2 = 50ml/lit and chromium concentration = 100 mg/L efficiency was 90%. By cyanide addition reactor efficiency was decreased.Conclusion: EF process outperformed Fenton process in removal of chromium compounds.

Background and Objectives: The complications of preterm birth constitute the most common causes of death in infants. The purpose of this study was to identify maternal risk factors contributing to preterm birth. Materials and Methods: This was an analytical research (case-control) which was carried out in 2010 in Shohada Hospital in Quchan. The questionnaires were completed via personal interviews and the collected data were analyzed (CI: 95%) with SPSS v.17 statistical software using descriptive analyze.Result: The results indicated that the most frequent risk factors for preterm birth were multiparity (25%), PROM (8.3%), preeclampsia (8.3%) and renal diseases (6.7%).Conclusions: According to the results of this study, devoting more attempts to promoting the quality and quantity of mothers' information about the risk factors of preterm infant birth and emphasizing the pre- pregnancy and during pregnancy cares can play a significant role in reducing the birth of preterm infants.

Background & objectives: Diazinon (DZN) is an OP insecticide that one of its main mechanisms of toxicity is the inhibition of cholinesterase. The aim of the present study was to investigate the effects of diazinon on cholinesterase activity in adult female rat and protective role of vitamin E that performed following other study on diazinon-induced ovary oxidative stress.Material & Methods: In total 30 adult female wistar rats were divided into 5 groups: control (without any intervention), placebo (received only pure olive oil), experimental 1 (DZN+olive oil, 60 mg/kg), experimental 2 (DZN, 60 mg/kg +Vit E, 200 mg/kg) and experimental 3 (Vit E, 200 mg/kg). After 2 weeks, 3ml blood from the heart was collected with a heparinated syringe. The Serum and erythrocytes cholinesterases inhibition activity was determined.Results: The results revealed that DZN reduces AchE level in erythrocyte significantly in comparison with those of control group (p<0.001). Also DZN reduced PchE level in serum significantly (p<0.05). In addition, Vit E plus DZN increased AchE level in erythrocyte significantly in comparison with those of DZN group (p< 0.001) . A significant increase in PchE level was observed (p<0.05) .Conclusion: The findings of this study indicate DZN decreases AchE and PchE levels in blood while in contrast use of vit E, increase their levels. Therefore, it can be concluded that vit E as antioxidants has a protective effect on AchE activity and reduce the toxicity of DZN in adult female rats.

Background and objectives: Due to the non-biodegradable and persistent nature, heavy metals are accumulated in vital organs in the human body and lead to serious health disorders. The present study was done to determine the intensity of soil contamination by heavy metals, identify the locations with high contamination levels and assessment of health risk for children (1-5 years old) by soil ingestion.Material & Methods: Twenty-four surface soil samples were collected from 12 stations. The concentrations of heavy metals in the soil samples and physicochemical properties were determined. In order to evaluation relationship between heavy metals and soil properties, Pearson correlation was used. Daily exposure to heavy metals by soil ingestion was calculated for children aged 1-5 yearsResults: The average concentrations for Cu, Zn, Pb and Cd were 18.29±40.54, 63.27±148.06, 9.1020±3.638 and 0.2005±0.1856 mg/kg respectively. The results showed that there is statistically significant relationship between Zn-Cu, Cu-Pb, Cu- Cd, Zn-Pb, Pb-Cd, Zn-Cd, Clay-Silt, Pb-pH, Zn-pH, Zn- Electrical conductivity (EC), Cu- EC, Pb- EC and EC -Cd. The results of the risk assessment indicated that average daily intake of Cu, Zn, Pb and Cd via soil ingestion for children aged 1-5 years are 3.11×10-4, 11.3x10-4, 6.98x10-5 and 1.53x10-6 and 1.53×10-6 mg/kg per day respectively.Conclusion: Heavy metals concentration in urban soils of Bojnurd city may be due to traffic emission and industrial activities. Also at present with regard to low daily exposure of metals and compare them with RAIS, they pose no threat to children health.

Background and Objectives: Enlargement of the thyroid gland is called goiter. The aim of this study is to investigate the prevalence of the goiter and thyroid dysfunction in healthy children aged 7-18 years in Bojnurd city. Materials & Methods: This cross-sectional study was carried out on 176, 7-18 years old students in Bojnurd. The demographic and anthropometric data were collected with questionnaires. Physical examination was performed by endocrinologist in order to staging of goiter. Fasting blood sample was obtained to measure the level of thyroid hormones and TSH. The data were analyzed using SPSS software and presented with chi-square, fisher test and logistic regression Results: According to the results 28.4 % of students had goiter including 26.1% grade 1 and 3.2% grade 2. Thyroid function tests revealed 38 students (21.6%) had subclinical hypothyroidism. A meaningful subclinical hypothyroidism was observed in 26% of girls and 18.2 % of boys (p=0.021).Conclusions: Given that to our results the prevalence of the goiter in Bojnurd was moderate more attention to this would be necessary.

Background & objectives: There are well documented cases of transmission of nosocomial infections during anesthesia procedures. A significant factor in preventing nosocomial infections is the effective cleaning of anesthesia equipment. The aim of this study was to determine bacterial contaminate rate and type on laryngoscope blades in operation rooms of Imam Ali hospital in Bojnurd.Materials and Methods: In this descriptive study which was done in 2014, 98 laryngoscope blades were selected in operation rooms randomly. Blind sampling was done with normal saline sterile swap.Results: The results showed that from 98 laryngoscope blades 57 blades were contaminated and most contamination was related to gram- positive bacilli.Conclusion: Our findings indicate that current method for washing and disinfection is not effective and so serious measures should be taken to eliminate the potential risk for infection.

Background & Objectives: Intestinal parasitic infections are the most prevalent infections in humans in developing countries. The most common method of diagnosis of intestinal parasites in health card applicants is using three stool samples for microscopic examination. The aim of the present study was to evaluate the need for routine delivery three stool samples to check for intestinal parasites in health card applicants who refer to Eghbal health center of Urmia city.Material and Methods: In this cross-sectional study samples were collected by way of census from 2774 health card applicant, who refer to Egbal health center during 2014. All samples were examined based on direct stool smear method using normal saline. The results of one turn stool examination were compared with the results of three times stool test using proportion (Z) test.Results: In this study 8322 stool samples were examined. The Positive rate of infection with intestinal parasites after three stool sample examination was 0.8%. Diagnosis of intestinal parasitic infections in different times showed that 90 % of these infections were detected by examining the first specimen submitted.Conclusions: Our findings showed that one turn stool tests, instead of testing three times in asymptomatic health card applicants who refer to urban area for different times to renew their documents, are highly recommended.

Background & Objectives: Despite impressive advances in pediatrics, preterm labor is known as the most common cause of infant mortality in world and identifying its related risk factors could bring about to reduce of preterm birth. Therefore the present study was aimed to determine the prevalence and contributing factors to preterm birth in alive newborns in Bojnurd.Material & Methods: This study was a cross sectional study conducted on 3561 alive newborns in Bentolhoda hospital Bojnurd in 2012. Questionnaire was completed from the records of newborns and mothers and data were analyzed with SPSS18 software and presented with t-tests and chi-square.Results: The incidence of preterm birth was 7.2 %. The mean of mothers’ age was 26.8±6.4 years, 55 percent had a high school education and 54% of the newborns in the study were male. Multifetal (p=0.001), Early rupture of membrane (p=0.002), preeclampsia (p=0.03), breech presentation (p=0.004), use of modern methods for gestation (p=0.01) pregnancy infection (p=0.01) contribute to premature birth. There was not relationship between newborns sex, maternal age, Placental abruption, abortion, addiction, trauma in pregnancy and preterm delivery.Conclusions: Considering that preterm birth is a multifactorial phenomenon, identification of risk factors and consequently the screening and identification of mothers with risk factors for preterm delivery can play a part in drawing mothers ‘attention to consider contributing factor and safe delivery.

Background and Objectives: General anesthesia and surgery are the Cause of various physiological disorders in different organs of patients, giving rise to different complications during recovery of the patient. Emergence from anesthesia and tracheal extubation may be associated with tracheal stimulation, leading to cough and hemodynamic changes. The objective of this study was to evaluate the effect of remifentanil infusion with maintenance dose on symptoms such as cough and hemodynamic changes after general anesthesia.Methods and Materials: In a double-blind clinical trial study, 60 patients underwent discectomy surgery with general anesthesia, were divided into the control group and remifentanil receiving group during emergence from anesthesia. At the end of surgery, remifentanil infusion was discontinued in the control group and in remifentanil receiving group with 0.15mg/kg/min continued until extubation. Blood pressure, heart rate and oxygen saturation were measured.Results: During the emergence, mean blood pressure and heart rate of remifentanil group 5 minutes after extubation, were significantly lower than those of control group. Oxygen saturation in remifentanil group was significantly higher at 5th minutes after extubation in the comparison with the control group. No significant difference was found in the incidence of cough in patients of both groups. Time awakening from anesthesia was significantly longer in the control group.Conclusions: Maintain a low dose of remifentanil infusion during emergence from anesthesia decreased hemodynamic changes without delay of awakening time significantly.

Background & Objective: Endurance activity and "mediator complex subunit 13" significantly influence on structure and tissue of heart. The purpose of this study was to investigate the effects of a long time endurance activity program on "mediator complex subunit 13" gene expression in the left ventricle.Materials and Methods: 14 rats under controlled conditions were housed and after familiarization randomly were assigned into control and Experimental groups, the experimental group performed an endurance activity program (14 weeks) on motorized treadmill, and then 48 hours after the end of the last session were anesthetized and sacrificed. The left ventricle of the heart was removed. Real time RT-PCR method was used to determine the expression levels of "mediator complex subunit 13" gene in the left ventricle. Finally t-test was used to evaluate collected data.Results: The results of this research showed, physical activity not only influences on heart weight indices, but also it enhances "mediator complex subunit 13"gene expression in left ventricle of trained rats.Conclusions: Given to the effects of endurance activity on the size of left ventricle and its indices, it seems part of these effects were related to "mediator complex subunit 13 "gene expression.

Background and Objective: Peripheral nerve injuries are common. Although the nerve autograft still remains the clinical gold standard in bridging nerve injury gaps, but has severed disadvantages. The human umbilical vein (HUV) is appropriate for several vascular reconstructive applications. The aim of this study was to evaluate the final outcome of nerve regeneration across the human umbilical vein channel in comparison with autograft.Material and Method: In this study, 30 adult male rats were used. The rats were divided three groups: sham surgery, umbilical vein and autograft. one cm of the sciatic nerve was removed, and then the gap was repaired by the umbilical vein or nerve autograft. Nerve regeneration was examined at days 28 and 90 after repair by sciatic function index (SFI), electrophysiological assessments, histology and immunohistology staining.Results: On post operation days 60 and 90, the mean of SFI in autograft group was greather than umbilical vein group, but the difference was not significant (P>0.05). On day 90, the mean nerve conduction velocity (NCV) in autograft group was significantly greater than umbilical vein group (P<0.05), but on day 28, the difference was not significant. The mean number of myelinated axons in autograft and umbilical vein groups was not statistically significant (P<0.05).Conclusion: The results of this study indicate that the positive effects of umbilical vein may be useful for treating peripheral nerve injuries.

Background & Objectives: Jaundice is considered as a common clinical condition during. Prevention of severe hyperbilirubinemia is safer and easier than current therapies, like phototherapy or blood exchange. In some animal and human studies, zinc was found effective in reducing jaundice. In this study we evaluated the effect of oral zinc sulfate on serum bilirubin of newborns under 1800 gram.Materials and Methods: This randomized, clinical trial was performed on preterm (<1800 gram) newborns borne within Bentolhoda hospital. Eligible preterm (<1800 gram) newborns aged 24±6 hours, were randomly allocated into two groups: group A (receiving zinc sulfate) and group B (placebo). They were screened by testing serum bilirubin at the end of the third and seventh day of age. Laboratory results and duration of phototherapy were comparison between two groups.Results: Among 66 eligible newborns 32 were placed in group A and 34 in group B. The mean serum bilirubin in group A and B was defined as 7.7±2 and 8.7±2, in the third day (P=0.053) and 6±2 vs 7.6±2 (P=0.012) in the seventh day, respectively and showed significant difference between two groups. Duration of phototherapy was recorded longer among placebo group (108 vs 84 hours).Conclusion: The current study showed that prophylactic administration of 10 mg zinc sulfate in preterm babies may reduce serum bilirubin. Weight loss at the end of first week of life was less among newborns received zinc sulfate. Less phototherapy duration was reported in the zinc group in comparison with the placebo group. No acute adverse effects were reported in the zinc group.

Background & Objectives: The prevalence of diabetes is increasing rapidly. Diabetic patients are deprived of sugar sweetener consumption due to their high blood sugar. Choosing appropriate substitutes in the meal plan of diabetic patients is one of the important therapeutic strategies. The purpose of this study was to evaluate the effect of different types of honey on the levels of glucose, fructosamine and insulin of diabetic rats.Material & Methods: This study was an interventional clinical trial animal study. In this study 64 wistar rats were used, which were divided into 8 groups. The drug of Streptozocin was used to induce diabetes in 4 groups of rats. Three types of Acacia honey, Astragalus honey, and Nodoushan Yazd honey were used in 3 groups of diabetic rats and 3 groups of normal rats. 2 groups also were considered as control groups of diabetic and normal groups.Results: Difference in blood glucose of diabetic and normal rats was not significant in the receiver groups of different types of honey. Fructosamine levels also did not have significant differences in diabetic and normal groups. On the other hand, the honey consumption significantly increased insulin levels in healthy groups.Conclusion: The present study showed that three types of honey don’t have any effect on blood glucose and fructosamine levels of serum of diabetic and normal rats, but they cause an increase in serum insulin levels. Based on the findings of this study, it is recommended that honey is a safe natural sweetener and even can be beneficial.

Background & objectives: Emotional intelligence is a concept based on the emotional and social intelligence which Nowadays, has been growing in interpersonal relationships, in the sphere of educations, the workplaces, and the families. This study was aimed to determine the relationship between emotional intelligence and computer games in students. Materials and Methods: This study was a cross-sectional. The target population included all students of junior high school in Bojnurd, out of which 205 subjects were recruited through a multistage random sampling. For collecting the data in this study, “Shot” questionnaire of emotional intelligence and questionnaire which included variables related to computer games and demographic, was applied. The independent t-test, ANOVA and Pearson correlation test in SPSS20 software were used for analyzing the data.Results: The mean age of the students was 13.05±0.62 years. The subjects were 51.2% males and 48.8 percent female. Results showed a statistically significant relationship between emotional intelligence of students and the kind of game which adolescents more loved to do and the type of game. There was not any significant association between emotional intelligence and other variables.Conclusion: Because of the relationship between emotional intelligence of students and the type of computer games, the twofold effect of such relationship should be considered.

Background & Objectives: Relationship between family functioning and psychological characteristics of the individual is one of the most important discussions of family therapy. Schizophrenia and bipolar I disorder are very common in hospitalized patients. So we decided to investigate and campare the family functioning between these two groups of patients.Material & Methods: In this case control study 50 patients with schizophrenia, 50 patients with bipolar I disorder and control group consists of 50 different professions were evaluated by family assessment device scale (FAD-I). Final results of the three groups were compared by SPSS V21 software.Results: Findings indicate a significant difference between the two groups with the control group. Family dysfunction in patients with schizophrenia in both sexes was more severe than patients with bipolar I disorder. But in terms of age, significant differences between the two groups was found only in patients 20 to 40 years. Conclusion: Based on the results of this study due to more severe impairment of family functioning in patients with schizophrenia, it seems that family therapy as an adjunctive treatment could be helpful.

Seizure resulted from tramadol can cause bilateral joint dislocation. This study is a rare case report that represents fracture and dislocation of right shoulder due to seizure in a 32years old man that had consumed a 300mg single dose of tramadol. He did not have any history of previous seizure or spontaneous dislocation of the shoulder. The right shoulder radiography and MRI demonstrated dislocation of the head of humerus with fracture of its greater tuberosity. Seizure as a side effects of therapeutic dose of tramadol, can occur during sleep, resulting to serious complications.