Journal of Gorgan University of Medical Sciences
Year:2013 | Volume:15 | Issue:1 (45)|Papers Count:24

Background and Objective: Electroconvulsive therapy (ECT) is one of the most common methods in treatment of different types of psychological disorder. The effectiveness of this therapy has a direct relation with the duration of convulsion. This study was conducted to assess the effect of lidocaine on duration of seizure and hemodynamic alterations in electroconvulsive therapy.Materials and Methods: This clinical trial study was conducted on 72 ASA-I, II patients with psychotic disorders in Hajar Medical Center in Shahrekord, Iran during 2010. The patients randomly divided into intervention and control group. The interventional group was received 1.5 mg/kg lidocaine and controls were received normal saline. For induction of anesthesia, all patients were received Sodium Thiopental (2mg/kg), Succinylcholine (1mg/kg) and Atropine (0.5mg) Propofol and Succinylcholine during 72 sessions of ECT. Duration of objective convulsion and hemodynamic alterations including blood pressure and heart rate were recorded (before, immediately and 3, 5 minutes after ECT). Data were analyzed using SPSS-11.5 and t-test.Results: Systolic and diastolic blood pressures and heart rate in 3rd minutes in interventional group following electroconvulsive therapy were 143.38 ±16 mmHg, 79.86±6.7 mmHg, 91.9±9.9 mmHg, respectively and in controls were 128.88±13.04 mmHg, 87.63±5.79 mmHg and 102.86±13 mmHg, respectively. These difference were significant (P<0.05). The above-mentioned indices for 5th minutes in intervention and controls were as follow: systolic (113.47±9.97 mmHg, 122.36±13 mmHg), diastolic (73.47±4.27 mmHg, 77.63±6.26 mmHg) heart rate (84.41±4.6 in minute, 93.19±12.53 in minute). These differences in above indices were significant (P<0.05).Conclusion: This study showed that lidocaine administration during electroconvulsive therapy increase the duration of convulsion and reduces heart rate and blood pressure.

Background and Objective: Autism is one the most disturbing neurodevelopmental disorders associated with any kinds of communicative problems and physical objects. This study was done to evaluate the effectiveness of pivotal response treatment on communicative and behavioral disorder of 8-12 years-old autistic boys.Materials and Methods: This clinical trial study was done on 24 boys with autism (aged between 8-12 years) in pediatric rehabilitation clinic in Tehran, Iran, during 2011. Patients randomly were divided into two groups: control and pivotal response treatment (PRT). The interventional group was received 20 session of PRT during the two months, but the control did not receive any intervention. All patients were examined in the field of social communicative, interactive disorder and self-stimulation behavior, using autism diagnostic interview revised. Data were analyzed using SPSS-16 and MANCOVA test.Results: The mean ±SD of social communicative (18.58±0.45), interactive disorder (17.13±0.46), self-stimulations behavior (1.92±0.36) in interventional group were significantly lower than control with following index, 26.33±0.45, 23.11±0.48 and 6.16±0.37, respectively.Conclusion: This study showed that pivotal response treatment can be useful in communicative behavioral disorder of 8-12 years old autistic boys.

Background and Objective: Attention deficit hyperactivity disorder (ADHD) is the most common in psychology and Methylphenidate hydrochloride (MPH) is one of the most frequently prescribed pediatric medicine. This study was done to determine the effect of Methylphenidate hydrochloride on ovarian and pituitary gonadotropin hormone in peripubertal mice.Materials and Methods: This experimental study was done on 40 preipubertal female mice (BALB/c) with three weeks age and approximate 12-15 gram. The mice were allocated randomly in one control and three experimental groups, designated as I, II and III. Animals in group I, II and III were received by gavage Methylphenidate hydrochloride with 2, 5 and 10 mg/kg body weight for six days, respectively. At the end of experiment body weight, serum estrogen, progesterone and pituitary gonadotropins were measured. Morphometric and histopathological evaluation of ovary were examined. Data were analyzed using SPSS-17, ANOVA and Tukey tests.Results: The body weight and ovary dimensions of animals in experimental groups were reduced significantly in comparison with control (P<0.05). Abnormal cells, structural alternations of granules cells and follicular growth abnormality were observed in experimental groups I and III in compare to control group. A significant reduction of estrogen, in group I, progesterone levels in group I and III were observed in comparison with the controls (P<0.05).Conclusion: This study showed that the Methylphenidate hydrochloride administration induces the reduction of body weight, ovary dimensions and hormones.

Background and Objective: The anthracyclin drug doxorubicin (Adriamycin) is one of the most effective antineoplastic agents, and widely used to treat a number of malignancies. However, its use has been restricted due to the dose-dependent cardiotoxicity. The mechanisms of Doxorubicin-induced cardiotoxicity is not entirely clear. This study investigates the effect of Doxorubicin on Bcl2 and Bax genes expression as key molecules that involve in intrinsic pathway of apoptosis in rat heart.Materials and Methods: In this experimental study Doxorubicin administration, male Wistar rats were exposed to intraperitoneal injections (2.5 mg/kg, six times for 2 weeks, n=20). Animals were randomly assigned to the healthy untreated control (n=10) and to the Doxorubicin treatment groups (n=10). Three weeks after completion of treatment myocardial fibrosis, Bcl2 and Bax genes expression were investigated by Masson’s trichrome staining and Real Time- PCR analysis respectively. Statistical analysis was performed using the SPSS-16 and independent samples t-test, Mann-Whitney and Kaplan- Meyer method.Results: Masson’s trichrome staining showed that Doxorubicin increased fibrosis in the cardiac muscle (16.4 ±1) in compare to control group (1±0.79). Real Time- PCR analysis showed that Doxorubicin decreased Bcl2 expression levels (0.1±0.07) and increased Bax expression levels (2.1±0.1) in the myocardium in compare to control group (P<0.01).Conclusion: This study showed that administration of Doxorubicin increase interstitial fibrosis of myocardium and Bax expression levels and decrease Bcl2 expression that are the key genes of mitochondria-dependent apoptotic pathway.

Background and Objective: Post-traumatic stress disorder (PTSD) is an anxiety, which is induced by exposure to life-threatening trauma and produces memory dysfunctions. This study was done to evaluate the effect of  b-estradiol on traumatic memory after post-traumatic stress disorder induced by modified single-prolonged stress model in male rats.Materials and Methods: This experimental study was done on 70 male Wistar rats, weighted 200-250 grams. Initially 30 rats randomly allocated into control, shock and single prolonged stress accompanied shock (SPS&S). In SPS&S group immobilized for 2h, followed immediately with a 20 min forced swim conducted in a cylindrical filled with water. After recuperating for 15 min, animals anesthetized with ether. After 30 min recovery, stressed rats placed in the conditioned fear system (CFS). They received one 1mA, 4 second electric foot shock and remained in the chamber for another 60 second before being returned to their home cages. Shock group: Animals placed in CFS and only received the same shock as previous experiment. Naive group: Animals were removed from their home cages and exposed to chamber without receiving any foot shock. 1, 2 and 3 week later, animals in all groups were re-exposed to the shock chamber for 3 min, in order to examine conditioned fear response. In the second experiment rats were injected with b-estradiol (90  mg/kg), one and two week after training. Date were analyzed using SPSS-16, ANOVA and LSD tests.Results: SPS&S significantly induced freezing response (traumatic memory) compared with controls and shock groups (P<0.05) following three weeks. This response significantly reduced due to repetitive injection of  b-estradiol in rats (P<0.05). After three weeks causes of enhanced freezing response (traumatic memory) compare with both, shock and sham groups (P<0.001). b-estradiol significantly reduced this response in rats (P<0.001).Conclusion:b-estradiol's administration following PTSD induction by modified single-prolonged stress, significantly decreased the freezing response. Therefore, b-estradiol can prevent the formation of traumatic memory.

Background and Objective: Considering the role of the hippocampus in memory, this study was done to evaluate the effect of 3-4,methylenedioxymethamphetamine on CA1 hippocampal neurons in male rats.Materials and Methods: In this experimental study 18 sprague dawley male rats (200-250g) were randomly allocated into three groups as follow: control (intact), control sham and experimental groups. Sham and experimental groups were received normal salin (1 cc) and MDMA10mg/kg IP for 7 days, respectively. Following transcardial perfusion by paraformaldehid 4%, structure and ultrastructure of right CA1 hippocampus were assessed by crysel violet staining and electronic microscope. Data were analyzed using SPSS-16, ANOVA and Tukey tests.Results: There was no significant difference between control (mean=210 ±40.38) and sham groups (mean=199±38.7) in neuron density. Neuron number decreased significantly in experimental group (mean=98±25.4) in compare to control and sham groups (P>0.001). There was no ultrastructural abnormality in control and sham groups. Finally, ultrastructural changes with apoptosis characterized by mitochondrial cristae reduction, distribution of nuclear chromatin and loss of cytoplasmic organelles in MDMA groups.Conclusion: This study shows that MDMA administration can stimulate the cell death with apoptotic pattern in hippocampus.

Background and Objective: Recent studies have shown that diabetes induced cognitive dysfunction and impairs learning and memory. Palmatine is an isoquinoline alkaloid, and has multiple pharmacological effects, including anti-diabetic and antioxidant activity. This study was conducted, to evaluate the effect of Palmatine on learning and spatial memory impairment in STZ-induced diabetic rats.Materials and Methods: This experimental study was conducted on the male Wistar rats (n=32) with approximate weight of 240 ±40 grams. The rats were randomly allocated and were divided into 4 groups (n=8): Control, Palmatine-treated non-diabetic, diabetic and Palmatine-treated diabetic groups. Diabetes was induced by STZ administration at the dose of 55 mg/kg through intraperitoneal route. Palmatine hydrochloride was administered subcutaneous at doses of 10 mg/kg/day 1 week after STZ injection for a period of 6 weeks. Blood samples were taken from the tail vein 1, 3, 5, 7 weeks after STZ injection to measure blood glucose levels. Behavioral tests including spatial recognition and objective recognition were performed at the end of study. Data were analyzed by using Prism-5, one way ANOVA and Tukey tests.Results: In spatial recognition test, the number of entrance in new arm of the Ymaze, in the Palmatine-treated groups significantly increased in compare to diabetic group in both sixth and seventh weeks (P<0.05). Number of rearing in new arm significantly increased in sixth and seventh weeks, compare to the diabetic group (P<0.05). The number of recognition novel objects in the Palmatine-treated diabetic group significantly increased in compare to diabetic group (P<0.05).Conclusion: Palmatine hydrochloride administration for 6 weeks improves cognitive dysfunction in streptozotocin-induced diabetic rats.

Background and Objective: Carbamazepine during pregnancy can induce various malformations. Recent studies have showed an increase in homocysteine level due to Carbamazepine administration. This study was to evaluate the effect of Carbamazepine on homocysteine serum level in pregnant mice and fetal malformations outcome.Materials and Methods: In this experimental study, 40 BALB/c timed-pregnant mice were allocated into 2 experimental and 2 control groups. The experimental groups were received daily intraperitoneal injections of 30 mg/kg (group I) or 60 mg/kg (group II) of Carbamazepine on gestational days 6 to 15. The control groups were received either-normal saline or Tween 20. Dams underwent Cesarean section on GD 18. External examinations were done and all data concerning malformations, weight and crown-rump of fetuses collected. Blood samples were collected from Dams’ hearts prior to performing the Cesarean section. Homocysteine was measured using ELISA method. Data were analyzed using SPSS-18, ANOVA, Chi-Square and Tukey tests.Results: Significant increase in Homocysteine levels of dams’ serum compared to control groups was seen in both experimental groups I and II (10.56 ±1.31 and 11.11±1.64  mmol/L, respectively, P<0.05). The mean weight and crown-rump of the fetuses in both experimental groups were significantly reduced compared with those of the control groups (P,0.05). Various malformations such as limb defects, vertebral defects, facial deformity and severe malformations were observed in fetuses of both experimental groups.Conclusion: Serum elevation of homocysteine in Carbamazepine exposed pregnant mice may be a risk factor for induction of fetal malformations.

Background and Objective: Obesity and saturated fat diet have a negative effect on plasma lipoproteins. The best therapeutic regiment for the treatment of obesity and reduction of serum lipoproteins is a diet containing non-saturated fatty acids accompanied with aerobic exercise. This study was carried to evaluate the effect of 8 weeks aerobic training and peanut consumption on serum Lipoproteins levels in overweight and obese men.Materials and Methods: This semi-experimental study was done on 36 obese males with age of 41.82±3.4yr, BMI: 32.38±2.50 kg/m2 in North of Iran during 2009. Subjects were divided in three equal groups: aerobic interval training, peanut consumption aerobic, interval training and control. Peanut consumption Training group were consumed 50gr peanuts daily. Prior and after training period, serum lipoproteins levels of subjects were evaluated. Data were analyzed using SPSS-16, ANOVA and LSD tests.Results: There was a significant differences between the reduction of total mean serum cholesterol, triglyceride, low density lipoproteins, high density lipoproteins in experiment group II (aerobic interval training and peanut) compare to other groups (P<0.05).Conclusion: Aerobic interval training plus peanut regiment reduce lipoprotein and specifically triglyceride and low-density lipoproteins in overweight and obese men.

Background and Objective: Meralgia paresthetica (MP) is due to lateral femoral cutaneous nerve (LFCN) involvement; if it is left either unattended miss treated it can be followed by significant disabilities. This study was done to compare the neurolysis and nerve resection in treatment refractory of Meralgia paresthetica.Materials and Methods: This descriptive - comparative study was carried out on 14 patients (7 males and 7 females) afflicted with Meralgia paresthetica and resisted to theraputical regiment in Poorsina hospital in Rasht, North of Iran during 2001-08. The patients were selected non-randomly and neurolysis were gone under either neurolysis or nerve resection surgery with 18-month follow-up.Results: All 5 patients with neurolysis operation were found to have the recurrent symptoms. Non of the patient operated with nerve resection demostrated the clinical manifestation of the recurment sympotms, following 18 month follow-up. The success rate of neurolysis and nerve resection were determined to be 3% and 98.8% respectively. Six women and three men are LFCN-resected; a woman and four men treated with neurolysis. The mean age and the disease onset length were 64.6%±9.8 year and 18±11 months, respectively.Conclusion: Nerve resection method is suggested in patients with Meralgia paresthetica resisted to theraputical treatment.

Background and Objective: Limited studies on the relation between the cardiovascular diseases (CVDs) risk factors and dietary glycemic index (GI) and glycemic load (GL) are available. This study was done to determine the association between glycemic index, glycemic load and cardiovascular risk factors in adults.Materials and Methods: This descriptive study was carried out on 2284 subjects (1327 males, 957 females) with 19-84 age in Tehran, Iran during 2005-08. Dietary GI and GL were assessed using a validated semi quantitative food-frequency questionnaire. Blood pressure, Anthropometric, fasting blood of glucose and lipid profiles including total cholesterol, triglyceride, high density lipoprotein (HDL) and low density lipoprotein (LDL) as a CVDs risk factors were measured. The mean intake of nutrient, adjusted for energy production, gender, age, according to GI and GL, using general linear model analysis covariance test was measured. Data were analyzed using SPSS-15, one-way analysis variance, Chi-Square, partial correlation and Linear regression.Results: The mean intakes of glycemic index and glycemic load were 68.3 and 244.8, respectively. Dietary GI and GL was inversely associated with whole grain and positively associated with refined grained, fruits, dairy products and simple sugar. After adjustment for lifestyle and dietary variables, dietary GI was inversely associated with triglyceride and HDL cholesterol concentrations among obese subjects. Dietary GL was inversely associated with fasting and 2-h blood glucose among non-obese subjects after adjustment for confounders.Conclusion: GI in obese men associated with serum increase triglyceride and reduced HDL-C. Glycemic load in a non-obese man is correlated with reducing fasting blood glucose.

Background and Objective: Superficial pigmented lesions are the most common complaint in dermatology. This study was done to assess the therapeutic effect of cryotherapy in facial lentigo and junctional nevus.Materials and Methods: In this descriptive study, 100 cases of flat-pigmented lesions with diameters up to 2 mm and after taking a photograph with USB microscope M2 (Scalar) treated with one freeze thaw cycle with liquid nitrogen through an applicator for 2 second in Imam Reza hospital, Mashhad, Iran during 2004-05. The patients were visited 3 times again through 3 successive months. According to the decrease in color of the lesion, patients were divided into 4 groups: sever pigmentation, no response, partial (>50% color loss) and complete response (<50% color loss). Data were analyzed using SPSS-11.5 and Wilcoxon test.Results: 96% of our patients were female and 45 were male. Mean age was 30±11.7 years. Based on Fitzpatrick criteria fifteen patients had type 2, fifty had type 3 and 35 had type 4 skin color. After the period of 3 months follow up, 6% of the patients completely healded, 58% had partial response, 31%with no response and 5% develop hyperpigmentation. Response in patients with type 2 Fitzpatrick skin color was clinically better than type 3 and 4 but this difference was not significant.Conclusion: Cryotherapy is considered as a simple, cost effective and safe therapeutic regiment in treating of 64% facial pigmental lesions.

Background and Objective: Previous studies suggest a correlation of central venous pressure (CVP) and peripheral venous pressure (PVP) in different surgeries. CVP is one of essential monitoring during coronary arterial bypass graft (CABG). Canulation of peripheral venous catheter and PVP measurement is easier, whit less complication. This study was done to compare the central venous and peripheral venous pressures in the antecubital region in coronary arterial bypass graft surgery.Materials and Methods: This descriptive analytical study was done on 84 patients with American society of anesthesiology III with CABG surgery in Shafa hospital, Kerman, Iran during 2007. The technique of anesthesia was the same in all patients. CVP and PVP were measured every 20 minutes intervals before, on and after cardio-pulmonary pump. Data were analyzed using STAT-10, ANOVA and linear regression tests.Results: A total of 750 simultaneous measurements of CVP and PVP were recorded in all patients. The mean of CVP before of pump was 6.8±0.9 and the mean of PVP was 8.8±1. The mean difference between CVP and PVP was ±2 mmHg and this difference was significant (P<0.05). The mean of CVP on pump was 3.9±1 and the mean on PVP was 7.6±1. The mean difference of these two changeable was ±3.7 mmHg. This difference was significant (P<0.05). The mean of CVP after of pump was 6.5±1 and the mean of PVP was 8.5±1. The mean difference this two changeable was ±2 mmHg and this difference was significant (P<0.05).Conclusion: PVP and CVP are related with each other on cardio-pulmonary pump even in severe hemodynamic condition. PVP and CVP changes are synchronized and PVP is a helpful clinical alternative for estimation of CVP.

Background and Objective: The identification of fungi agents causes allergic rhinitis is crucial for the appropriate diagnosis prophylaxis and treatment of patients suffering from the disease. This study was done to evaluate the prevalence of fungi in patients with allergic rhinitis in Shahrekord, Iran.Materials and Methods: This case-control study was done on 124 patients whom referred to Kashani hospital in Shahrekord, Iran during 2009. 62 patients with allergic rhinitis were selected as case group and 62 patients without allergic rhinitis were considered as controls. Direct smear and culture of nasal secretion were performed to identify the fungi. Also IgE level’s were measured for all participants. Data were analyzed using SPSS-16, Chi-Square and independent t-tests.Results: The fungi from culture medium of nose exeretion were isolated from 15 (24%) cases and 5 persons (8%) in control group. The most common isolated fungi were Aspergillus (8%) and Penicillinum (6.5%). In direct smear the fungi agent were found in 23% and 8% in case and control groups respectively. The IgE titre in 31% of cases with allergic rhinitis was higher than 100 IU/mL, but this titre of IgE only was seen in 4.8% of control group (P<0.05).Conclusion: This study showed that the fungi can be considered as induce of allergic rhinitis.

Background and Objective: The silent brain infarctions are common in first-ever stroke. Some recent studies show the possible role of silent brain infarction in ischemic stroke. The aim of this study was to evaluate the frequency of silent brain infarction in acute first-ever ischemic stroke and its association with stroke risk factors.Materials and Methods: This descriptive - analytical study was carried out on 203 (94 males, 109 females) patients with acute first-ever ischemic stroke in Shafa hospital in Kerman, Iran during 2010. The diagnosis of ischemic stroke was made by physical examination and was confirmed by MRI and CT Scan. A questionnaire containing demographic information and risk factors including hypertension, diabetes, hyperlipidemia, cigarette smoking, ischemic and non-ischemic heart disease for stroke as well as presence of silent stroke was completed for each patient. Data were analyzed using SPSS-16 and logistic regression test.Results: The mean age of patients was 62.56 ±17.35 years. Among our patients history of hypertension, hyperlipidemia, cigarette smoking, diabetes, history of ischemic heart disease, history of other cardiac disease and silent stroke were observed in 66(32.5%), 26(12.8%), 16(7.9%), 40(19.7%), 27(13.3%), 16(7.9%) and 31(15.3%), respectively. The probability of silent stroke among patient with hyperlipidemia, was 3.7 times more than those without hyperlipidemia (95%CI: 1.556-12.780, P<0.05). There was no significant correlation between silent stroke and the above risk factors.Conclusion: Silent stroke was found in 15% of patients with ischemic stroke. Control of hyperlipidemia can have a vital role in the prevention of silent stroke.

Background and Objective: Pollution due to the heavy metals is a problem that may have negative consequences on the hydrosphere. Identification of microorganisms resistant to heavy metals plays an important role in relation to environmental pollution bioremediation. This study was done to assess the antibiotic resistance in isolated bacteria from urban sewage and copper smeltery industrial wastewater.Materials and Methods: This laboratory study was done on the wastewater samples from urban sewage and copper smeltery in Isfahan-Iran, during 2011-12. Heavy metal resistant microorganisms were isolated and enumerated after serial dilution and culturing on PHG agar plates supplemented with 0.5 mM of each heavy metal. The pattern of resistance was assigned by Minimum Inhibitory Concentration (MIC). Antibiotic resistance toward following medicines Ofloxacine, Penicilline, Sulfometoxasole, Lincomycin, Kanamycin, Streptomycin, Clindamycin, Vancomycin, Cefradin and Neomycin were subsequently investigated.Results: The greatest resistance in isolated bacteria has been related to the Ni (MIC: 24 mM) that’s related to the genus of Klebsiella and its minimum MIC is 2mM that’ s of Acinetobacter lwoffi, Providencia stuartii, Branhamella . The minimum degree of resistance is related to Cu. Its Maximum MIC related to this metal in swage is 2mM that’s of Klebsiella pneumoniae and its minimum degree of resistance in copper smeltery effluent is arranged as 1mM related to genus of Pseudomonas alkaligenes. In examining multi metal resistance pattern, the greatest resistance with 8 mM MIC has been related to the Cd, that’s of Ni resistant Moraxella osloensis in Copper smeltery effluent. The highest portion of isolated bacteria were resistant to Pb (P<0.05). The highest resistance of refirary wastewater was to Ni (MIC: 2 mM), which belong to Klebsiella (P<0.05). The lowest belong to Acine to bacter Lwoffi providencia Stuartii, Branhamella (MIC: 2mM) (P<0.05). In urban sewage: the highest resistance belong to copper, which was seen in Klebsiella Pneumoniae (MIC: 2mM). In Antibiogram tests of Klebsiella, Moraxella and Escherichia , it was demonstrated that the metal resistant bacteria were also resistant toward Lincomycin, Kanamycin, Streptomycin, Clindamycin, Vancomycin, Cefradin and Neomycin, as well.Conclusion: Increasing heavy metal resistance in the environment leads to increased antibiotic resistance toward microorganisms.

Background and Objective: The exposures related to the department of radiology can be considered as harmful agent for human. This study was done to assess the partial distribution of the equivalent dose in radiology waiting room in Ardabil, Iran.Materials and Methods: This descriptive analytical study was done in the radiology department and related waiting rooms of 4 teaching hospital and 3 private radiology sonography centers in Ardabil, Northwest of Iran, during 2011. The variables including type of radiography, the number and condition, staying duration in waiting room were considered for dosimetry. Data were analyzed using SPSS-18 and Chi-Square test.Results: The lowest radiation dose belong to one specialist radiology sonography center with 0.2 ±0.002 mS.h-1V, but for each radiography were determined to be 0.00275 ±0.004 mS.h-1V. The highest radiation dose belong to one specialist radiography sonography center with 0.4 ±0.045 mS.h-1V and for each radiography was 0.016 ±0.0006 mS.h-1V. Two teaching hospitals accompanied with three privates centers showed to have radiation dose-rate higher than 0.3 mS.h-1V (P<0.05).Conclusion: This study showed that the increasing radiation-dose rate (higher than 0.3 μS.h-1V) in teaching hospitals and private centers can be related to either the unit life or inadepuate of radiological protective shield.

Background and Objective: Magnesium (Mg) ion has possible role in protecting neurons and glia from ischemic damage through the cerebral blood flow and neuronal action. This study was done to evaluate the correlation of total serum Mg level with clinical outcomes in stroke patients.Materials and Methods: This cross sectional study was done on 316 patients whom diagnosed with stroke in Imam Hossein hospital, Tehran, Iran during 2010-11. Mg levels in all patients were measured. Also, recurrent transient ischemic attack (TIA), recurrent myocardial infarction or stroke, unstable angina and death as clinical outcomes were follow-up for period of 3 and 6 months after admission. Data were analyzed using SPSS-18, Chi-Square, Fisher and Pearson correlation tests.Results: The mean age of patients was 65±15.8 year. Limb weakness (69.9%) and haemoplasia with 63.6% were the most common clinical complaints. Death was the most common finding in 3 month (16.8%) and recurrent stroke was the most common finding in 6 month follow up (2.5%). There was no significant difference between the total serum Mg and the first and second three-months follow up of clinical outcomes.Conclusion: This study can not show a significant correlation between total serum Mg levels and clinical outcomes after 3 and 6 month follow up in stroke patients.

Background and Objective: Triage is the most important and the first stage of patient’s management at the time of arrival to hospital emergency department. Emergency severity index (ESI) is a common triage system worldwide. This study was aimed to evaluate the accuracy of ESI in emergency department of Imam Hossein hospital in Tehran, Iran.Materials and Methods: In this descriptive study the result of patients’ triage based on ESI were gathered for all patients referred to emergency department of Imam Hossein Hospital from January to April 2011. A questioner was filled for each patient by the nurse and a emergency specialist independently. The l index was applied to compare the nurse observation with the specialist clinician. The STATA-11.0 statistical software and roctab table were used to determine the validity, specificity and sensivity of triage. Data were analyzed using Chi-Square and Fisher tests.Results: The calculated l for the degree of agreement of triage between nurse and clinician was 81% (95% CI: 0.79-0.83). The sensivity of triage for step I, II, III, IV and V were 100%, 53.25%, 90.7%, 67.1% and 98% respectively. The specificity of triage for step I, II, III, IV and V were 99.8%, 97.5%, 93.7%, 98.3% and 94% respectively. There was a significant overlapping between the triage step and the patient clinical outcome.Conclusion: This study showed that five steps triage contain a high accuracy and estimation of patient outcomes.