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  Background & Objective: Determining the level of lesion in lumber disc disease might be difficult, especially when there is a transitional vertebrae. MRI is one the methods widely used in presurgery however, presence of sacralization or lumbarization may lead to a incorrect diagnosis. This study aimed at evaluating the agreement degree between the results of MRI and surgery with the post-operative radiographic findings in patients with lumber disc herniation.

 Methods:�Thirty patients with lumber disc herniation were evaluated in a diagnostic value study during a 15-month period of time. Presurgery MRI results, as well as the findings during operation regarding the level of herniated lumbar disc were compared with the radiographic findings, numbering the vertebra below the C2 after surgery. The radiologic assessment of involved segment was considered as the gold standard method. Transitional vertebrae were determined on the basis of radiologic findings.

 Results:�There were thirty patients with lumber disc herniation, 16 males and 14 females, with the mean age of 40.83±12.57 years in the study. There was a high and significant degree of compatibility agreement between the results of MRI and findings during surgery with the radiologic data (kappa=0.719, p<0.001 kappa=0.859, p<0.001). The results of MRI and surgery were incorrect in 4 and 2 cases, respectively. All these cases had a transitional vertebra in lumbosacral segment (totally 6 patients with transitional vertebra) i.e. MRI and surgery were able to detect the right level of herniation in 33.3% and 66.7% of patients with either sacralization or lumbarization, respectively. The sensitivity of MRI and surgery was 87% and 93%, respectively.

 Conclusion:�Our results showed that MRI and surgery can reveal the right level of LDH in majority of patients however, when there is a transitional vertebra, this ability may significantly be decreased.

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Background & objectives: Evaluation of liver and renal function before and after administration of methotrexate (MTX) is recommended in the treatment of molar pregnancy, but the necessity of performing these tests during treatment of ectopic pregnancy (EP) is not clear. The aim of this study was to evaluate the changes of creatinine and AST levels before and after treatment with double (DD) and multiple (MD) doses of MTX in patients with Ep.
Methods: This retrospective cross-sectional study performed on 152 patients with an EP during 2007-2013 in Al-Zahra hospital (Rasht). Seventy six patients received DD and 76 cases were treated with MD of MTX. The success rate, side effects of MTX and changes in creatinine and AST levels were compared between the two groups.
Results: The mean changes in creatinine level was 0.06±0.08 and 0.16±0.13 in DD and MD groups, respectively and the difference between the two groups was statistically significant (p=0.002). The mean changes in AST level was 5.06±2.47 and 9.63±5.5 in DD and MD groups, respectively which was statistically significant (p=0.002). The success rates were 65.8% and 86.8% in DD and MD groups, respectively with statistically significant difference (p=0.002). The side effects rates were 13.2% and 32.9% in DD and MD groups, respectively with statistically significant difference (p=0.004).
Conclusion: It seems that administration of MD of MTX in EP patients leads to an increase in success rate of treatment but also it causes considerable increase in creatinine and AST levels.
 

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Background & objectives: Chlamydia trachomatis is a gram negative bacterium and chlamydia infection, as a curable infection, is one of the most common sexually transmitted diseases (STD). With regard to the essential role of chlamydia in infertility, the study of the prevalence of asymptomatic cases is precious. The aim of this study was to determine of the prevalence of chlamydia trachomatis in endocervical samples in infertile women with PCR method.
Methods: In this cross sectional descriptive-analytical study, a total of 135 women between 20-40 years old with chief complaint of infertility that referred to Alzahra-Rasht hospital and private clinics were randomly selected. The endocervical specimen was prepared using a sterile swab and was transferred to the laboratory in PBS for performing PCR. . The results of PCR and collected data from checklists were statistically analyzed using SPSS16.
Results: Chlamydia trachomatis was detected in 19.3% of infertile women. There were no statistically significant differences between PCR results and the patient's age, type of infertility, obstruction in salpingography, family history and duration of infertility.
Conclusion: The results of this study revealed that chlamydia infection has a high prevalence and in order to reduce the complications of this disease, screening tests can be used as a   part of the country's health programs.
 

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Pulmonary alveolar microlithiasis is a rare autosomal recessive disease characterized by the formation of calcium phosphate deposition in the alveoli. Although the disease most often occurs in children, most patients with the disease are diagnosed in adulthood due to the slow progression of the disease inside the lungs. In childhood, it often causes no symptoms, and changes in the lung parenchyma are usually detected by chance. Symptoms usually appear in the third or fourth decade of life. Diagnosis is made with a combination of positive chest radiography and tissue examination. Genetic testing makes it possible to identify other unidentified patients in the patient's family. In the present study, a patient with pulmonary alveolar microlithiasis was diagnosed using imaging and other disease findings, including clinical manifestations as well as history is taken from the patient.