Journal of Gorgan University of Medical Sciences
Year:2012 | Volume:14 | Issue:3 (43)|Papers Count:28

The Iranian elderly population is rapidly growing. Currently more than 5 million Iranians are over 60 years of age which corresponds to nearly 7.26 percent of the population of the country. It is estimated that more than 10 percent of the population of the country will be elderly in the forthcoming twenty years. Structural and physiological changes which occur in the elderly cardiovascular system include: stiffness of the vasculature, decreased relaxation capacity of the heart during diastole, decreased efficiency of cardiac contraction during exercise, weakened heart muscle response to stimulation by adrenaline, and orthostatic hypotension. In the elderly people we are confronting with increased frequency of cardiovascular diseases especially myocardial infarction, stroke, isolated systolic hypertension, calcific aortic stenosis, orthostatic hypotension, and syncopal attacks due to sick sinus syndrome, complete heart block, atrial fibrillation or other rhythm disorders. Alteration in cardiovascular status in the elderly has undesirable effects on their quality of life and longevity. Myocardial infarction is the most common cause of death in the elderly; however cardiac arrhythmias and valvular heart disease are other important cardiovascular disease in the old people. Diagnosis of these disorders in the elderly requires special consideration since coexistence of structural/functional changes in the old age with cardiovascular disease would alter the classic features of these disorders and result in delay in their appropriate management. Biological aging as evaluated by reduced telomere length has a strong impact on the incidence of cardiovascular disorders especially coronary heart disease and chronic heart failure. This phenomenon could possibly explain interindividual susceptibility to cardiovascular disorders.

Background and Objective: Research have been focused on the applying the chemical inducer for trans-differentiation the adult BMSCs into neural cell. So that, at the first should investigate the toxcity effect of the chemical inducer on the induced cells. Plasticity and easy accessibility of bone marrow mesenchymal stem cells is a unique charactristic for treatment of neural disorderies. This study was desgined to determine the inductive effect of Deprenyl and Dimethyl sulfoxide on proliferation and survival of the mesenchymal stem cells.Materials and Methods: In this experimental study, BMSCs isolated from the adult rat bone marrow and cultured in aMEM containing 10% FBS. Cell identity for surface antigens was performed in third passage by immunocytochemistry and multipotancy capacity of BMSCs was done by BMSC differentiation into adipocytes and osteocytes. The cells were exposed to chemical agents (a: the aMEM medium supplemented with 2% DMSO, b: the aMEM medium supplemented with 10-8M Deprenyl) for 24 houres and then transferred to aMEM containing 10% FBS cell survival and proliferation was evaluated after the 24, 48, 72 and 96 houres by MTT [3-(4-5-Dimethylthiazolyl-2-y1)-2,5-diphenyltetrazolium bromid] test. Data were analyzed using SPSS-16, One-Way ANOVA and Tukey tests.Results: In addition to expression the surface antigens and adipogenic and osteogenic  differentiation by BMSCs, MTT test results showed that proliferation and survival of induced-deprenyl and DMSO cells within 48, 72 and 96 hours after the induction was increased significantly than negative control group.Conclusion: Deprenyl increases survival and cell proliferation compared to Dimethyl Sulfoxide. It can be used as cell inducer.

Background and Objective: Post-traumatic stress disorder (PTSD) impairs spatial learning and memory. Desmopressin acetate ameliorates the cognitive deficits induced by electroconvulsive shock. This study was designed to evaluate the protective effects of Desmopressin acetate on retention of spatial memory deficits induced by post-traumatic stress disorder in rats.Materials and Methods: In this experimental study twenty one male Wistar rats were used. Animals were trained for 5 consecutive days in Morris water maze and then were randomly assigned in three groups (Vehicle + Sham, Saline + PTSD and Desmopressin acetate + PTSD) and tested in a probe 60 sec in 24h after the last acquisition trial. The groups of PTSD+Desmopressin acetate rats and vehicle+sham, saline+PTSD were injected Desmopressin acetate (10 micro gr/kg body weight) and saline (IP), respectively. Injections performed ten minute prior to PTSD and spatial memory was tested ten minutes later. Data were analyzed using SPSS-16, One-Way ANOVA and Tukey tests.Results: The platform location latency of the Desmopressin acetate+PTSD group was significantly shorter (4.24 sec) than the control group (P<0.05) and also, had significantly smaller average proximity values (33.87 cm) compared to the saline+PTSD group (P<0.05). Desmopressin acetate + PTSD spent significantly more time (21.65%) in the target zone (P<0.05).Conclusion: This study indicated that Desmopressin acetate blocks the ability of PTSD to impair spatial memory retention.

Background and Objective: Ischemia-reperfusion invoke cell death in hippocampus. This study was carried out to investigate the effect of transforming growth factor alpha (TGF-alpha) of dentyte jyrus neurons and pyramidal cells of CA1 subfiled of hippocampus following ischemia-reperfusion in rat models.Materials and Methods: This experimental study was done on 40 male Wistar rats weighing 250-300gr. Animals were divided in four groups: control (n=7), sham (n=7), ischemia (n=14) and treatment (n=14). Sham group was just under surgical stress. In ischemia and treatment groups after induction of ischemia-reperfiusion by obstruction of carotid arteries blocked for 30 minutes, reperfusion PBS (phosphate buffer salin) and subsequently TGF-alpha (50 ng) were injected stereotaxicaly in lateral ventricle, respectively. In 12 and 72 days after treatment the brains were fixated by transcardial perfusion and stained by immunohistochemestry and nissle methods. Furthermore, morris water maze was used to evaluate the learning memory. Data were analyzed using SPSS-16 and ANOVA test.Results: Injection of TGF-alpha increased the cell number in hippocampus of treatment group compared to ischemic group. TGF-alpha increased expression of neuron in dentyte jyrus of treatment group in comparison with ischemic group (P<0.05). Also spatial memory improved in treatment group in comparison with ischemia group.Conclusion: TGF-alpha improves ischemia-induced neurodegenration and memory impairment.

Background and Objective: Electromagnetic waved generated by electronic industries and the increasing use of electrical appliances have led to higher rise in chronic exposure to extremely-low-frequency electromagnetic field (ELF-EMF). This study was done to investigate the effects of low electromagnetic field on mice embryos development.Materials and Methods: In this experimental study, eighty female NMRI mice were super ovulated and coupled with male mated over the night. Next morning the female mice with a vaginal plug were identified as pregnant mice. Animals allocated into 2 groups; control group was not exposed to EMF and animals in case group exposed to 50 Hz and amp; 1.2 mT EMF the pregnant mice were scarified by cervical dislocation at 24, 72, 81, 96, 110 and 120 hours. Embryos were subsequently obtained from the mice by flashing the fallopian tubule and uterus horn. Data were analyzed using SPSS-13.5, ANOVA and student’s t-tests.Results: The number of 2, 3-4 cells and 5-8 of embryo cells and blastocyst decreased in case group compared to controls, but these reduction were not significant. The number of morula in cases significantly reduced in comparison with control group (P<0.05). The average number of fragmented blastocyst in experimental groups siginficantly increased compared to control group (P<0.05). The number of inner cell mass and trophoectoderm in experimental group significantly reduced in comparison with controls (P<0.05).Conclusion: The exposure of extremely-low electromagnetic field in pregnancy reduces the number of morula, inner cell mass and trophoectoderm.

Background and Objective: The modern life condition has caused the human to be exposed to electromegnetic fields. Epidemiologic and animal laboratory studies have illustrated the adverse effects of electromegnetic fields on biologic systems. The aim of study was to assess the effects of low density electromegnetic on heart tissue of male rat.Materials and Methods: In this experimental study 30 Wistar rats with weight of 10-150 gram and 5weeks age were used. Rats were allocated randomly in two aqual groups: case and control. Experimenal group rats were exposed to the electromegnetic field 8 hours a day for 2 months (50 HZ, 1 mili Tesla). After 2 months the rats were sacrified, the heart tissues were removed and stained by H&E method.Results: There was not any altherations in cells and tissue of control groups. In experimental group there was a sever disruptions on heart tissue, polymorphysm of cardic myocyte nuclues with same hollow spaced in perinucluar, nuclear cytoplasem and fibrotic tissue. Also, the number and size of cells in case group were reduced. Cagulated necrosis and vacolization of cytoplasm of cardiac myocyte was observed in case group.Conclusion: This study showed that low density of electromegnetic Fields for two months durtion can cause pathological changes in cells and heart tissue of male rats.

Background and Objective: Post pain operative is common and a major complication which lead to numerous dangerous effects in various organs. The purpose of this study was to determine the effect of methocarbamol on postoperative pain following cholecystectomy.Materials and Methods: In a randomized, double-blind clinical trail study 60 ASA I, II patient in two group (n=30 in each group) between 30-50 years old and weigh lower of 100kg undergone general anesthesia for cholecystectomy. Elective surgery was selected in Besat Hospital, Sanandaj, Iran during 2008. Both group did not receive premedication and under similar condition of general anesthesia. Interventional group received 500 mg Methocarbamol intravenus slowly and the control group received 5ml placebo slowly after operation. The pain score were measured by visual anesthesia scale (VAS) on the 1, 3, 6, 12 and 24 hours after operation and if necessitated narcotics (PRN, VAS>4) were prescribed. Data were analyzed using SPSS-16, ANOVA, Chi-Square and student’s t-tests.Results: There were no significant differences between two groups in terms of age, gender. The mean of score pain was lower for interventional group at 6.24 hours after operation (P<0.05). But no significant differences was observed at 1, 3 and 12 hours. The prescribe narcotic in interventional group was lower compared to controls (P<0.05).Conclusion: According to analgesic effects and low prescribe narcotics, it is suggested to use methocarbamol after operative due to analgesic effect.

Background and Objective: Adiponectin is an adipocyte-secreted hormone. Low levels of Adiponectin may indicate the insulin resistance and development of diabetes. The regular exercise therapy induces insulin resistance to be reduced. Glucose uptake increase in muscles, increased adiponectin levels and decreased of HbA1c in diabetic patients. This study was designed to evaluated the effect of down-hill and up-hill running exercises on the adiponectin and serum glucose in type-2 diabetic patients.Materials and Methods: This clinical trial study was conducted on 28 patients (13 male and 15 female), age 40 to 60 years, with type-2 diabetes, in neuromuscular rehabilitation research center, Semnan, Iran during 2009. Participants were assigned randomly in one of the two experimental groups, eccentric or concentric exercise using treadmill. Before and after control and intervention period, glucose, HbA1c and adiponectin serum were measured in both groups. Data were analyzed using SPSS-18, Kolmogorov-Smirnov, Repeated Measures ANOVA, Tukey and independent t tests.Results: Eccentric and concentric exercise significantly decreased glucose, HbA1c and also increased adiponectin levels (P<0.05) in type-2 diabetic patients. However, eccentric exercise also significantly reduced glucose and HbA1c and increased adiponectin levels compared to the concentric exercise (P<0.05).Conclusion: This study showed that eccentric exercise are more effective than concentric exercise to reduce and control the blood glucose level and improve serum adiponectin in type-2 diabetes mellitus patients.

Background and Objective: The first carpometacarpal joint osteoarthritis reduced the ability of upper limb in elderly with subsequent disability in physical activities. This study was carried out to determine the effect of prefabricated and custom-made splints on quality of life in the first carpometacarpal joint osteoarthritis.Materials and Methods: This quasi-experimental study was done on 24 elderly (>60 years of age) patients with the first carpometacarpal joint osteoarthritis and 12 matched healthy subjects in Tehran rehabilitation University during 2010-11. Patients assigned randomly in two groups with 8 weeks treatment period, prefabricated thumb and custom-made splints. Persian version of The Short Form 36 quastioner (SF36) was used to assess the quality of life. Data were analyzed using SPSS-16 and paired t-test.Results: There were significant differences between osteoarthritis patients and healthy subjects in the quality of life according to SF36 score physical health problem (P<0.05), general health (P<0.05), limitations of activities (P<0.05), emotional health problem (P<0.05), social activities (P<0.05), pain (P<0.05), energy and emotions (P<0.05). Using splints significantly improved the quality of life of patients, but there was no significant difference between two splints in improving the quality of life.Conclusion: Prefabricated and custom-made splint improve quality of life in elderly patient with the first carpometacarpal joint osteoarthritis.

Background and Objective: Although acquired immune deficiency syndrome (AIDS) is a vital medical problem but it is more prominant as a personal behavior social cultural phenomenon. Adolescents have been identified as risk population in immune deficiency virus. Health education is only effective method to prevent AIDS. This study was carried out to determine the effect of educational program on knowledge and health belief model structures about acquired immune deficiency syndrome (AIDS) among high school female student in Isfahan, Iran.Materials and Methods: This quasi-experimental study conducted on 72 female students whom divided equaly into case and control groups. The questionnaire included demographic characteristics, knowledge and health belief model. Educational interventions were performed in lecture and group discussion. Data were analyzed using SPSS-18, paired t-test and independent t-test.Results: There were no significant differences in knowledge, perceived severity, benefits and barrier in two groups before intervention. After intervention, there were significant increases in knowledge, perceived severity, perceived benefits and perceived barriers (P<0.05), in the intervention group, but there was not significant increases in perceived susceptibility.Conclusion: Education based on health belief model can improve knowledge, perceived severity, benefits and barriers in female student. More educational sessions are required for improving perceived susceptibility in high school female students.

Background and Objective: Zoonotic Cutaneous Leishmaniasis (ZCL) is a parasitic disease which caused by a protozoan belongs to the genus Leishmania. ZCL is of great public health importance in many countries and also in endemic parts of Iran. Leishmania major is the causative agent, Phlebotomus papatasi as the main vector and Rhombomys opimus is the most important reservoir of the disease. Species identification of Leishmania in a large scale of human samples is necessary to conduct a useful program for controlling the disease outspread. This study was done to identify the Leishmania using microscopic and molecular methods in suspected patients of Cutaneous Leishmaniasis by targeting ITS-rDNA gene, Golestan province, Iran.Materials and Methods: 121 smears collected from suspected patients of ZCL, in Eastern region of Golestan province, Iran during 2009-10, stained and examined under a light microscope. DNA of parasites extracted directly from smears and ITS-rDNA gene amplified. Positive samples digested with BsuRI restriction enzyme, according to RFLP method and subsequently the parasite was identified. After sequencing the ITS-rDNA gene, Molecular software was applied for verification of RFLP results. The achieved results were definitely approved by this procedure.Results: 113 out of 121 and 92 out of 121 samples detected as Leishmania positive using microscopic examination and molecular method respectively. All 92 molecular positive samples digested with BsuRI endonuclease and 90 individuals identified as Leishmania major. In order to final verification, 8 samples of Leishmania major sequenced and confirmed by molecular software analysis. Unfortunately, sequences of two samples which were not Leishmania major were not readable, and consequently, these could not be identified.Conclusion: Comparison of obtained sequences of current study with Gene Bank sequences confirmed L.major in human from Northern Iran. Other species of Leishmania were not identified in this investigation but detection of two other samples, which were not L.major, could indicate the role of other Leishmania species causing infection in human in Eastern region of Golestan province, northern Iran. These findings should be considered to improve the disease control programs, which can be led to increase the rate of public health in Golestan province.

Background and Objective: Human immunodeficiency virus (HIV) pandemic is increasing word-wide. Tuberculosis is the main cause of death and low quality of life in HIV infected patients. The prevalence of Tuberculosis in HIV infected patients varies in different areas according to socioeconomic, cultural and geographical situation. This study was done to asses the pulmonary Tuberculosis risk factors in hospitalized HIV positive patients in Ahvaz, Iran.Materials and Methods: In this data based study all medical files of admitted HIV positive patients in Razi hospital in Ahvaz in south west of Iran were reviewed during 2001-09. Demographic characteristics and HIV Tuberculosis related variables were analyzed using SPSS-16, Fisher’s exact test and Odds Ratio.Results: Out of 123 HIV cases 99 (80.5%) were injecting drug user (IDU), sixty eight (55.3%) had imprisoment history. Eighty one patients (65.8%) had Tuberculosis, in which 46 had co-morbidities such as infective endocarditis or viral hepatitis, 79 cases were IDU, 61 cases had imprisonment history and 24 cases had CD4 count below 200. There was a significant association between Tuberculosis and IDU, imprisonment and CD4 count (P<0.05).Conclusion: This study showed that the rate of Tuberculosis in HIV positive patients is higher than the rate in previous studies performed in Iran. Also exposure to Tuberculosis cases in prison, IDU and low CD4+ T- lymphocyte count are the main risk factors for Tuberculosis acquisition.

Background and Objective: Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders characterized by abdominal pain or discomfort and altered bowel habits. Although IBS etiology is poorly understood, some psychological disturbances and food allergies have been proposed. This study was done to determine the effect of food allergen exculsion on symptoms and quality of life in IBS.Materials and Methods: In this descriptive and anolytical study was done on 100 IBS patients in Tabriz, Iran during 2011. Food allergies of specific origin and effects of non allergic regimens on quality of life, pain severity and disease symptoms were evaluted during one month period. Data were analyzed using SPSS-16, student’s t-test, Chi-Square and Fisher’s exact tests.Results: Patients age were 31.5±7.2 between 15-43 years. Specific antibodies against allergic foods were detectable in 31 (31%) cases. Penaut showed to induce the highest food allergy in 5 (16.1%) patients. The median disease duration was 4.5±2.6 years in allergic patients while 3.5±2.9 in non allergic group with no significant difference. The changes is quality of life was significant in non allergic regimens after one month in allergic group (P<0.05) while disease symptoms such as mucus defecation and flatulence had no significant changes.Conclusion: This study showed that one month non allergic regimens reduce abdominal pain and improve quality of life in IBS patients.

Background and Objective: Internal derangement of knee (IDK) is a common problem following knee trauma. Magnetic resonance imaging (MRI) extensively is used to diagnose the ligamentous and meniscal injuries, but the use of ultrasonography remains controversial. Previous studies showed different results about the usefulness of sonography (IDK). This study was done to determine diagnostic accuracy of ultrasonography in comparison with magnetic resonance imaging in patients with knee trauma.Materials and Methods: This descriptive study was done on internal knee disorders of 73 patients with knee trauma who referred to MRI center of Imam Khomeini hospital in Sari, Iran during 2009-10. Three radiologists independently reported the ultrasonography and MRI of the patients.Results: The study population comprised of 61 (83.6%) men and 12 (16.4%) women, 91.9% of patients were less than 40 years old. The joint pain was the most common complaint (89%). The sensitivity, specificity, positive and negative predictive value of ultrasonography for the lateral meniscus was 100%, 97.14%, 60%, 100%, for the medial meniscus were 61.90%, 94.23% ,81.25%, 85.96%, for the anterior cruciate ligament (ACL) was 65%, 100%, 100%, 70.21% and for the medial collateral ligament (MCL) was 100%, 94.28, 42.86% and 100%.Conclusion: This study showed that the high specificity of ultrasonography as a noninvasive and inexpensive method to exclude the ACL and meniscal lesion. Ultrasonography can reasonably be applied for screening of internal derangement of knee in the absence of MRI, especially in urgent conditions. In clinical setting of highly suspicious of ACL and meniscal tear, MRI is preferred due to low sensitivity of sonography.

Background and Objective: The utrine cervical cancer is the third common cancer among women word-wide. Oral contraceptives (OCs) have characterized as one of the possible risk factors for cervical cancer which are daily used by millions of women. The objective of this study was to determine the relationship between utrine cervical carcinoma and oral contraceptives.Materials and Methods: This case - control study was done on 128 patients with utrine cervical cancer as cases and 128 healthy women as controls in Tehran, Iran during 2008. The cases matched with controls according to age, history of abortion, number of deliveries, and social-economical status. Data were analyzed using SPSS-11, student’s t-test, Chi-Square, Pearson’s correlation and Fisher’s exat tests.Results: Significant correlation was observed between utrine cervical cancer and the history of using and duration of oral contraceptives (P<0.05). Eighty-one (66.3%) and 46 (35.9%) of subjects in case and control groups used oral contraceptives, respectively. The possibility of utrine cervical cancer through oral contraceptives consumption was 3.072 (95%CI: 1.05-2.91) and this rate increased to 5.2 times after consuming the oral contraceptives for longer than 8 years.Conclusion: This study showed that the usage of oral contraceptives increase the possibility of utrine cervical cancer by 3 times.

Background and Objective: Hepatitis B vaccination has been conducted in neonates in the routine vaccination in Iran since 1993. This study was carried out to evaluate the serum hepatitis B antibody level in vaccinated children after 14 years in Kashan, Iran.Materials and Methods: This prospetive cohort study was conducted on 200 fourteen-year-old children which were selected via a simple random sampling method in Kashan, Iran drung 2008-09. This subjects were have been vaccined according to the govermental guildline at 0, 2 and 6 months old. Two ml blood specimens were obtained from children and serum hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc) were determined by ELISA method. Immunity was interpreted as anti-HBs³10 IU/L. Data were analyzed using SPSS-13, Chi-Square and Fisher’s exat tests.Results: 92% girls and 95% boys, totally 187 (93.5%) children had serum anti-HBs³10 IU/L. Anti-HBc was positive in 3 (3%) girls and 5 (5%) boys, totally 8 (4%) which all of them had serum anti-HBS£10 IU/L. No case of positive HBs Ag was detected. Immunity was detected in 11 of 18 (61.1%) children with birth weight<2.5 kg and in 176 of 182 (96.7%) children with birth weight≥2.5 kg (P<0.05).Conclusion: The immunity following the complete series (0, 2, 6 months old) of hepatitis B vaccination remained detectable after 14 years.

Background and Objective: Autism spectrum disorder is a genetic-based cognitive and neurobehavioral disorder characterized by impairment in social interaction, verbal and non-verbal communication and repetitive motor behavior. This study was done to evaluate the verbal fluency and working memory deficit in first-degree relatives of autistic children.Materials and Methods: In this case-control study, 49 first-degree relatives of autistic children from 33 families (32 mothers, 10 fathers, 6 sisters, and 1 brother) supported by Isfahan autism association were selected and compared with 51 first-degree relatives of typical children (23 mothers, 16 fathers, 7 sisters, and 5 brothers) of 27 families during 2010. The assessing tasks were phonemic and semantic verbal fluency tests to assess verbal fluency and forward and backward digiti span tests to assess low load and high load working memory. Data were analyzed using SPSS-19 and independent t-test and paired t-test.Results: Autistic relatives showed significant poor performance in phonemic (11.46±3.3 V.S. 14.08±3.8), semantic verbal fluency (16.83±3.3 V.S. 19.23±3.9), forward digiti span (5.22±0.6 V.S. 5.55±0.9) and backward digiti span (3.65±0.98 V.S. 4.14±0.8) (P<0.05) compared to healthy children of first-degree relatives.Conclusion: This study showed that parents and siblings of autistic children have a lower performance in phonemic and semantic, low and high load verbal fluency, which might be transmitted genetically.

Background and Objective: The prevalence of behavioral disorders in children with mentally ill parents are higher compared with children of healthy parents. This study was carried out to assess the behavioral disorders in children with major depressive mothers.Materials and Methods: This case-control study was done on 50 children (6-11 years) of mothers with major depressive as case group and 50 children of healthy mothers as controls in Bandar Abbas, Iran drung 2009. With psycological interview, DSM-4-R and Beck tests, deprsion in mother were confirmed. The psycological health of control mothers were confirmed using Minnesota multiphasic personality inventory (MMPI) and questionnaire health general (QHG). The behavior disorders of children in two groups were compared using Achenbach child behavior questionnaire. Data were analyzed using SPSS-17, Chi-Square and student’s t tests.Results: Somatic complains, anxiety and depression, social problems, thought problems, externalization, internalization and antisocial behavior scores, were significantly higher in cases compared to controls (P<0.05). No significant differences in isolation and attention behavior were noticed between cases and controls.Conclusion: Behavior disorders in children with depressive mothers are common.

Background and Objective: The child mortality is a index of development and plays an important role in determination of population growth. This study was done to determine the effect of sociol-economical conditions on mortality rate of under 5 years children, Khuzestan- Iran.Materials and Methods: This descriptive study was done on 372 women aged. 20-48 years with at least one child under 5 years whome were admitted to the health centers in urban and rural area of gotvand town in Khuzestan province, Iran during 2004. Individuals questionnaires included variables such as mortality, demographic, economic and social index were completed for each subject. Data were analyzed using SPSS-17, ANOVA, Chi-Square and Pearson’s correlation coefficient tests.Results: Providing maternal health care during pregnancy and up-grading occupational status of parents significantly reduced child mortality rate (P<0.05). Child mortality rate increased in mothers of <18 and >35 years (P<0.05) and parents desire to have male infant (P<0.05).Conclusion: This study showed that up-grading occupational status of parents, maternal health care and maternal age and desire to have male infant play important role on the child mortality rate  in Khuzestan province in south west of Iran.

Background and Objective: Disclosure of cancer is one the main challenges in caring of patients with cancer, since it may have adverse effects on the patients quality of life. This study was done to determine life quality of cancer patient with or without self awareness.Materials and Methods: This case-control study was conducted on 300 cancer patients in Shahid Ghazi-Tabatabaei hospital in Tabriz, Iran during 2009. The cancer patients included 150 subjects aware of their cancer diagnosis as cases and 150 unaware patients as controls.  The patient’s quality of life was assessed Using EORTC QLQ-C30 questionnaire. Data were analyzed using SPSS-17 and student’s t-test.Results: The mean±SD of quality of life among aware and unaware patients were 64.18±18.85 and 65.16±19.02, respectively. There was no significant difference of quality of life between two groups. Life social dimension in unaware patients significantly was more than aware patients (P<0.05).Conclusion: Patients awareness of cancer have no effect on their quality of life.

Background and Objective: Considering the significant incidence of nosocomial infections in hospitalized patients, this study was done to determine the prevalence of Staphylococcus aureus strains isolated from wound infection and drug sensitivity pattern, Tehran-Iran.Materials and Methods: In this descriptive study, Staphylococcus aureus isolated  and identified according to standard procedures from the wound infections of 614 patients referred to Baqiyatallah hospital, Tehran-Iran during 2006-07. The samples were examined and antibiogram was performed by disc diffusion method on Mueller Hinton agar with 12 antibiotics.Results: 100 (16.28%) of wound infection of Staphylococcus aureus was isolated from 614 patients. The infection rate in men was twice compared to women. The highest rate 29 (29%) was observed in people aged 40 to 60 group. Also specimen’s patients with immunosuppressive diseases (28 cases), surgical site infection (16 cases) and normal wounds (13 cases) were considered to be most prevalent isolates. Antibiotic sensitivity testing revealed that 96 (96%) of isolates were sensitive to vancomycin, 95 (95%) and 92 (92%) were resistant to penicillin and cotrimoxazole, respectively. Our result showed that 43% of strains were resistant at 11 antibiotics.Conclusion: This study showed that the prevalence of Staphylococcus aureus was 16.28% of samples, with 43% antibiotic resistance. The highest sensitivity was toward to vancomycin.

Background and Objective: Down syndrome is a genetic disorder due to trisomy of 21 chromosome, which mainly is manifested by moderate to severe mental problems, including physical, sensory and motor symptoms. This study was done to determine the related factors associated with the birth of children with Down syndrome.Materials and Methods: This cross-sectional study was carried out on 913 mothers with children or fetuses of Down syndrome who were referred to genetic counseling clinics in Tehran, Iran during 2011. Diagnosis of Down syndrome confirmed by the chromosomes culture. Maternal age, maternal age at menarche, parents interfamilial marriage, maternal blood group, the number of abortions and children, collected through the questionnaires.Results: Out of 913 affected children and fetuses with Down syndrome, 420 (46%) and 493 (54%) were female and males respectively. 1.17 considered to be The male/female ratio. 32.4% of mothers were in 25-30 years of age and 42% of parants had interfamilial marriages. The abortion in mothers varied from lack of ahortion (96.7%) up to 5 repetitive abortion (0.1%). The number of children in families with affected subject consisted of 1 (15.1%), 4 (16.5%) and 11-13 (1.3%).Conclusion: This study showed that Down syndrome infants are mostly born with the mothers of 25-30 years age.

Both fibrocystic change and phyllodes tumor are classified as fibroepithelial tumors of breast which are composed of epithelial and stromal components. Although as the most common benign breast lump fibrocystic lesions are known by symptom such as pain, nipple discharge, heaviness, usually in women’s third decade of life, mammographic and sonographic features often render them almost indistinguishable from phyllodes tumor. In view of the essential differences in terms of therapeutic planning which exist between these two tumors, their early and precise distinction is crucial to avoid problem such as patients’ anxiety and unwarranted tumors operation. In this article a case of fibrocystic change in a 24 year old woman is reviewed in which clinical signs and symptoms and mammographic changes are indication of phyllodes tumor.