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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 : In spite of effective advances in diagnosis and management, ST Elevation Myocardial Infarction (STEMI) is a major health problem in industrialized world and an increasingly important problem in developing countries. Considering the role of age and gender in Myocardial Infarction (MI) and socioeconomic and cultural changes in Iran in recent decades which can affect the epidemiology of the disease, we aimed to determine trend of changes in age and gender of patients with first STEMI in recent decade.

  Methods :�This observational cross-sectional study was based on completing check lists for patients with first STEMI in Rasul-e-Akram Hospital from 1998 to 2007. The Data were analyzed with ANOVA, chi² and Mann-Whitney tests at = 0.05 using SPSS 14.

  Results :�Out of 1829 patients with first STEMI, 76.4% were men and 23.6% women who had mean age of 59.09 ± 12.7 years totally. The mean age of men (56.9 ± 12.2 years) was significantly lower than women (66.1 ± 11.6 years) (p < 0.001) ­.

  Trend of change in mean age for men, women and overall had no specific patterns of change in 10 years. Premature MI occurred in 15% of patients without any particular change during study period. No statistically significant change in proportions of gender and risk factors was seen in a period of 10 years. The most common risk factors were smoking (43.7%) and hypertension (32.8%) respectively. 23 . 7% of patients had hyperlipidemia and 18.8% were diabetics.

  Conclusion: Trend of changes in age and gender of mentioned patients had no significant change over 10 years which can indicate main role of biologic factors. Although this was an observational study unchanged major risk factors in a decade may mark out inadequate primary prevention.

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  Background & Objectives: Severely comminuted distal femur fractures are in association with the high complications and their treatment is so difficult. Supracondylar femur fractures usually occur as a result of low-energy trauma in osteoporotic bone in elderly persons or high-energy trauma in young patients. This study was aimed to assess the results of new treatment plan for comminuted intra-articular distal femur fractures with locking condylar buttress plate. The results of this strategy will help us to find the effective method of treatment for the distal femur fractures.

  Methods: In a prospective cross-sectional study, 47 patients with intra-articular distal femur fractures after two weeks fracture and treating with locking condylar buttress plate were selected. Then, they were examined for infection, range of knee motion and ::union:: at the first and second week and 1, 2 and 3 months after surgery. The data were analyzed by descriptive statistics and the level of significance was set as p<0.05.

  Results: 53.2% of the patients had closed fractures, 6.4% of them had open type I and the rest showed open type IIIA fracture. The overall ::union:: rate was seen in 80.9% of cases and infection was detected in 19/1% and mal::union:: was observed 21.3% of patients. The mean degree for range of motion was 105.74 ±24.47 and the maximum degree of extension was 20.

  Conclusion : Complete fixation for distal femur fracture type C3 was achieved by buttress plate and using this locking condylar plate was association with less complication such as infection, mal::union:: and non-::union::.

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  Background & Objectives: In endemic area, chemically fighting with carrier of kala azar disease is one of the main ways for reducing disease, and ficam is one of the toxins that is appropriate to eliminate mosquitoes and is from health poison among the pesticides. Therefore, by considering the lasting in nature, using ficam can greatly destroy disease-carrying mosquitoes.

  Methods: In this cross - sectional study the rate of effect ficam on different vectors species were examined in Meshkinshahr city. First two infected villages, as cases and controls, and 10 households from each village selected and 1000 m² from the case village was spraying with ficam than 0.3 g /m². Then, using sticky traps set in the distances were attempted to identify species and Fon (per 2 villages).

  Results: In the rate of 524 sand fly predating in this study included 70.5% Phlebotomus Kandelakii, 5% F. Papatasi, 7.5% F. Major, 7.5% F. Balcanicus, 9.5% F. longidoctus. In the case village was spraying and , respectively, 3-15 - 30 - 45-60 -75 and 90 days after spraying at about 79.5% - 69.5% - 83% - 90% - 93% - 100% and 100 % sand fly vanished.

  Conclusion: According to this study can be said that ficam poison with the survival of three months in nature and with average of lethality coverage of appropriate terms of season to prevent from disease Kla-azar and eliminate sand flies and as a poison, appropriate of health before starts up the season of carriers activity. And ficam poison can be used in the whole of region and country.

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  Background & Objectives: The purpose of this study was to investigate the effectiveness of rTMS (repetitive transcranial magnetic stimulation) in reduction the signs and symptoms of depression, such as cognitive, bodily and negativity-worthlessness in recurrent major depression.

  Methods : It was used a quasi-experimental, pretest-posttest design with control group , a sample consisting of 32 patients who had recurrent depression on the basis of DSM-IV,SCID and BDI-II scale & Hamilton scales, were randomly assigned to two groups. The experimental group underwent 20 sessions of rTMS as the independent factor and both groups (control &experimental) had 12 sessions of psychotherapy and drugs treatment. Upon the intervention, both groups were tested with triplex tests, to determine the effect of the independent factor on the dependent factor of rTMS. Data were analyzed using Chi square, T- test, covariance and repeated measures analysis of variance.

  Results : With comprise between pre &post-test, we understand the effect of rTMSin cognitive, bodily and negativity-worthlessness scalesthe difference of two groups was significant, but the decrease of cognitive scale was higher than other two scales. All the tests showed the reduction of signs and symptoms of recurrent depression in participants .

  Conclusion: The rTMS is effective in treatment of triple signs andsymptoms (cognitive, bodily and negativity-worthlessness) in patients with recurrent major depression.

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  Background: Obese patients are at high risk of numerous chronic diseases including diabetes, hypertension, heart disease, dyslipidemia and stroke. Recently researchers focused on complementary medicine along with routine treatments to reduce obesity complications. Therefore we aimed to investigate the effects of omega 3 fatty acids supplementation on serum lipid profiles, C-peptide and fasting blood glucose in obese individuals.

  Methods: In this randomized clinical trial 56 obese volunteers with the mean age of 33.94±8.15 years were assigned into the supplemented (n=30) and placebo (n=26) groups, given two omega 3 fatty acids soft gel (360 mg EPA and 240 DHA) or placebo respectively for 4 weeks. At the onset and the end of the intervention, blood samples were collected after overnight fasting and serum lipid profiles, C-peptide and fasting blood glucose were measured. Data were analyzed with SPSS program and p-value less than 0.05 considered as significant.

  Results: In comparison with placebo group, omega 3 supplementation resulted in a significant decrease in the mean triglyceride (108.37±11.22 mg/dl vs 148.84±59.40 mg/dl). After 4 weeks, the mean C-peptide concentrations increased in both groups but elevation in omega 3 group was more dramatic (p<0.01). However, we didn’t find any significant changes in the mean total cholesterol, LDL-C and HDL-C levels.

  Conclusion: Our finding indicated that 4 weeks Omega 3 supplementation leads to amelioration in some of serum lipid profiles indices and insulin secretion in

  obese individuals. Although, further studies are needed to achieve precise results.

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  Background & Objectives : Visceral leishmaniasis is an important endemic disease in Iran and Meshkin shahr County is the most important foci of visceral leishmaniasis in Iran. The aim of this study is the survey of recent changes in epidemiological patterns of visceral leishmaniasis in Meshkin Shar area during 12 years.

  Methods : This is a descriptive retrospective study. Records of 193 cases with confirmed kala-azar disease were reviewed in the period of 2001-2012. Data collected from files and were analyzed using descriptive statistics and SPSS v.15.

  Results : From 193 patients with confirmed kala-azar disease, 85% were resident in rural and 15% in urban areas. Among of these patients, 43% were female and 57% male. About 66% of patients were under 2 years old, 23% in age group between 2-5 years and 11% above five years. Among four parts of Meshkin Shahr County, in the first five years of the study, the most cases of the disease were from the central part, but in second six years the most cases were from the west part of this county and in latest year (2012) it has been coverted .

  Conclusions : Incidence of kala-azar was decreased during last 12 years. Because of high infection rate in dogs and considering important role of these reservoirs in conserving and distribution of disease, stopped health activities in any parts of area can increase the incidence of disease.

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Background & objectives: Epidemiological and clinical studies have shown a close relationship between asthma and obesity. The present study examined the effect of obesity on the airway response to methacholine and the number of inflammatory cells in the bronchoalveolar fluid of ovalbumin-sensitized male rats.
Methods: Twenty-four male Wistar rats were divided into 4 groups: normal diet (C+ND), OVA‐sensitized with the normal diet (S+ND), high-fat diet (C+HFD) and OVA‐sensitized with high‐fat diet (S+HFD). All animals were fed for 8 weeks with standard diet or high-fat diet, and then were sensitized with ovalbumin or normal saline for another 4 weeks while receiving the designed regimens. At the end of the study, the number of inflammatory cells in bronchoalveolar fluid (BALF) and tracheal responsiveness to methacholine were examined.
Results: In diet-induced obesity groups, weight and obesity indices increased (p<0.05 to p<0.001). The results also showed that tracheal responsiveness to methacholine in S+HFD group compared to S+ND group, was significantly increased (p<0.05). In addition, the number of inflammatory cells in the BAL, in the S+HFD group was higher than other groups (p<0.001).
Conclusion: the results of this study suggest that the response of the airways to methacholine and the number of inflammatory cells are increased in obese-asthmatic male rats.
 

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Background & objectives: Considering the importance of liver toxicity due to drugs and toxins as a major cause of liver damage, this study was conducted to evaluate the effects of the combination of cinnamon and ginger extracts on serum biochemical parameters in carbon tetrachloride (CCl4)- intoxicated rats.
 Methods: In this experimental study, forty-two male Wistar rats were divided into 7 groups (n=6). Three control groups including normal control, combined extract control and damaged control were designated that received distilled water, a mixture of cinnamon and ginger extracts and distilled water respectively for 14 days.
 Other 4 groups were pre-treatment  groups which were treated with cinnamon (50 mg/kg/d), ginger (250 mg/kg/d), cinnamon + ginger (25+125 mg/kg/d) and silymarin (100 mg/kg/d) respectively for 14 days before being damaged by intraperitoneal injection of CCl₄ (1 ml/kg, 1:1 in olive oil). Fifty - two hours after CCl4 injection, blood sampling was performed and biochemical parameters were measured in serum of rats.
Results: The results of this study showed that the injection of CCl₄ significantly increased the ALT and AST enzymes activity ,cholesterol, triglyceride, and LDL levels and decreased the blood albumin and HDL levels in damaged rats compared to the normal control group (p<0.001). However, pre-treatment with the cinnamon and ginger extracts, especially combination of extracts significantly improved these values ​​compared to the CCl₄ damage group (p<0.001).
Conclusion: The results suggest that simultaneous use of cinnamon and ginger extracts has more significant protective effects against CCl₄-induced hepatotoxicity.
 

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Background & objectives: Chronic illnesses are one of the most important causes of mortality. The purpose of this study was to investigate the relationship between perfectionism and stress with life satisfaction in cardiovascular patients.
Methods: The research method is descriptive correlational. The statistical population of this study included patients who came to receive the services in Ardabil in the first half of 1396. The sample consisted of 60 cardiovascular patients who were selected by simple random sampling. Data was collected using questionnaires of perfectionism scale, stress scale and life satisfaction scale. Data were analyzed by descriptive statistics and multiple regression analysis using spss-19 software.
Results: The results showed that there is a significant negative relationship between perfectionism and life satisfaction. Also, there was a significant negative relationship between stress and life Satisfaction (p<0.01). In other words, with increasing stress, life satisfaction decreases. There is a multiplicity relationship between perfectionism and stress with life satisfaction (p<0.01).
Conclusion: The results of this study showed that reducing the perfectionism and stress of individuals helps to increase the satisfaction of people from life and also effective in the process of treatment.
 

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Background & objectives: In the pathogenesis of endometriosis, a variety of genes are involved. The aim of this study was to investigate the GATA2 gene expression changes in endometriosis rat model following a period of aerobic exercise and vitamin B6 intake.
Methods: For this purpose, 25 adult Wistar rats were randomly divided into 5 groups, including: healthy control, patient control, patient+training, patient+vitamin, patient+vitamin+ training. In order to create an endometriosis model, rats were first anesthetized and after opening abdominal muscle, ovarian tissue and part of uterine tissue were removed and were inserted into a sterile container with one cc of PBS and sliced. Tissue fragments were transplanted into the abdominal and ovarian areas. The amount of vitamin intake was 60mg/kg and swimming program lasted 8 weeks, 30 minutes a day, five days a week. One-way ANOVA test and Tukey post hoc test were used for data analysis.
Result: The results showed that a period of swimming exercise program in the patient + training group significantly increased the GATA2 level compared to the patient control group (p≤0.001). Also, the GATA2 gene expression level was significantly increased in the patient + training + vitamin group compared to the patient control group (p=0.002). However, its level in the patient group was significantly lower than that of the healthy control group (p≤0.001).
Conclusion: Regular aerobic exercise combined with intake of vitamin B6 may decrease GATA2 gene expression level in endometrial rat model.
 

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Background & objectives: ABCA1 plays an important role in HDL biosynthesis and cellular cholesterol homeostasis and is effective in preventing the formation of atherosclerotic plaques. This study aimed to investigate the effect of combined and rehabilitation training on ABCA1 gene expression in blood lymphocytes and lipid profile in middle-aged men with coronary bypass graft.
Methods: In this quasi-experimental study, 45 middle-aged men (mean age: 55.58±4.7 years) were selected by convenience sampling method and randomly divided into three groups of combined training (15 people), rehabilitation (n=15), and control (n=15). The combined training group included resistance and aerobic exercises and rehabilitation training group included aerobic exercises for 8 weeks (3 sessions per week). Blood samples were taken from all subjects at weeks 0 and 8 to measure the expression levels of ABCA1, HDL, and LDL genes. Kruskal-Wallis, one-way ANOVA, and Tukey post hoc tests were used for statistical analysis using SPSS software, and significance level was p≤0.05 .
Results: The results showed that eight weeks of combined training and rehabilitation training increased the expression level of the ABCA1 (p=0.001 and p=0.001, respectively) gene and plasma HDL (p=0.001 and p=0.012, respectively) level and decreased plasma LDL (p=0.001 and p=0.01, respectively) level. There was also a significant difference between the three groups in ABCA1 and HDL values in favor of the combined training group. 
Conclusion: It seems that combined training can be more effective than rehabilitation training to further increase ABCA1 gene expression and plasma HDL levels and decrease LDL level in middle-aged men with coronary bypass graft.

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Background & objectives: The aim of this study was to evaluate the effects of preventive administration of ketamine, fentanyl and paracetamol on pain intensity and hemodynamic parameters after deep vitrectomy.
Methods: In this clinical trial, 80 candidates of deep vitrectomy surgery were randomly assigned into 4 groups (1-4) and received 0.5 mg / kg ketamine, 2 μg / kg fentanyl, 10 mg/kg of paracetamol and equivolume of normal saline respectively intravenous infusion during the last 15 minutes of surgery. Pain intensity and hemodynamic parameters were recorded and analyzed.
Results: Pain intensity was significantly higher in placebo group during the first 4 hours after operation (p<0.01), but no significant differences were observed between the study groups at 8 and 24 hours after operation in this regard. There were no significant differences between the three intervention groups in terms of pain intensity during the study. Also there were no significant differences between the 4 study groups regarding to hemodynamic parameters.
Conclusion: The use of each of the three intervention drugs significantly reduced the pain intensity compared to the control group without any hemodynamic derangement.

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Background & objectives: Fenugreek (Trigonella foenum-graecum) is one of the most ancient and well-known medicinal plants, and its useful role has been well - established in treating of many diseases. The purpose of this study was to investigate the effect of Fenugreek on spermatogenesis, total antioxidant capacity and malondialdehyde (MDA) level in male diabetic rats.
Methods: In this experimental study, 24 male Wistar rats weighing approximately 200±20 gram were used. The rats were randomly divided into 4 groups of six. group1: control group, Group2: diabetic, Group3: diabetic+Fenugreek (8gram /kg diet), group4: diabetic+Fenugreek (2gram /kg diet). This treatment continued for 4 weeks. Blood glucose, total antioxidant capacity, malondialdehyde, and sperm profiles were determined.
Results: Blood glucose in diabetic rats which received Fenugreek significantly reduced compared with diabetic animals. Fenugreek also reduced body weight and MDA level of semen (p<0.05).On the other hand, Fenugreek increased the total antioxidant capacity of semen (p<0.05) and normalized sperm profiles (p<0.05).
Conclusion: According to the present results, it can be concluded that consumption of Fenugreek extract probably reduced MDA level, body weight, and normalized sperm profile thus, Fenugreek extract can be used to treat sexual dysfunction in males.
 

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Background & Objective: Hepatitis B virus [HBV] infection is one of the most important public health concerns. The present study was conducted to provide a descriptive analysis of detected HBV infection in Ardabil province.
Methods: In this retrospective longitudinal study, the hepatitis B surveillance database of Ardabil province was examined from 2014 to 2018. The frequency of hepatitis B virus infections was presented based on age, gender, marital status, place of residence, primary symptoms, and reporting sources. Also, the trend of changes in the number of detected cases over time was investigated using time series analysis.
Results: A total of 817 positive cases with a mean age of 43.1 years were reported. Most of them were male [n=503, 61.5]. The Frequency of identified positive cases decreased over time. Most of the infections were asymptomatic [87.5%]. Almost 90.0% of patients with HBV were married and the majority of the identified patients were resided in urban settings [n=598, 73.2%]. Most diagnostic tests were done voluntarily [n=219, 26.8%] or during prenatal care [n=109, 13.3%]. Most cases were identified and reported by the health network [n=292, 35.7%] and blood transfusion organization [n=190, 23.2%].
Conclusion: Decision-makers of the health sector of the province can use this information as a source for evidence-based decision-making in the effective management of the disease.

Corresponding Author:
Eslam moradi-Asl, Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.
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