Background & Objectives: One of the most common ways in intubation without muscle relaxant is using propofol and remifentanil. The common practice is injection of remifentanil and then propofol. This occasionally produces severe hemodynamic changes. The aim of this study is to inject propofol followed by remifentanil for evaluating the effect of the order of injection on decreasing these complications.

 Methods: 40 patients with American Society of Anesthesia (ASA) class I-II, who underwent minor elective surgery with airway mallampati class I-II entered the study. Patients were randomized into 2 groups each with 20 patients. The first group received 2.5mg/kg propofol followed by 1.5 g/mg remifentanil while the second group received 1.5 g/mg remifentanil followed by 2.5 mg/kg propofol. Laryngoscopy and hemodynamic changes were compared in two groups.

 Resutls: There was no difference between two groups in laryngoscopy attempts (P=0.145) but the frequency of easy laryngoscopy in the first group (85%) was more than the second group (60%) (P=0.031). Systolic blood pressure changes after laryngoscopy in the first group (20 7.7 mmHg) was less than the second group (28 6.7 mmHg) (P=0.001). There was no statistical significant difference between two groups in diastolic blood pressure and heart rate changes (P=0.88, P=0.86 respectively).

 Conclusion: Administrations of propofol before remifentanil during anesthesia induction produces acceptable hemodynamic changes in patients.

  Background & Objectives: Since 1985 because of increasing incidence of tuberculosis (TB) in HIV background, the outbreaks of TB have been reported in different parts of the world. From 1985 to 1991 the incidence of TB increased by 18% in United States and Europe. In Multi Drug Resistant outbreaks of TB in United States 18 to 35% of heath care workers (HCW) who had exposure to TB patients had PPD Converted to positive test (Seroconversion). That is why the risk of TB incidence in health care workers has been put forward again. This study was designed to determine the rate of Buali hospital HCW exposure to mycobacterium tuberculosis.

 Methods: All 96 HCW of Buali hospital took part in this cross-sectional and analytical study. No PPD test was performed for HCW in this hospital in the beginning of their employment. For this reason 30 officers who had not previously worked in hospital wards and 60 medical students who had not started their clinical course were selected to obtain an estimation of PPD test before starting professional nursing.

  Results: Out of 96 subjects, 72 were female and 24 were male. Rate of positive PPD was 50% in general. Data analysis showed that PPD positivity was in direct relationship with number of working years in hospital. In 60 university students whose mean age was 21.6± 0/2.9 PPD positivity rate was 13.3%. I the third group consisting of 30 office workers (mean age=333±6.5) it was 23.3%.

 Conclusion: This study shows that HCW with 50% of PPD positivity are in exceeding probability of mycobacterium tuberculosis exposure, which is almost twice as much as the other office workers, possibility of exposure.

  Background & Objectives: Postpartum depression is one of the most important problems during post partum. Several new medications have been introduced for treatment, but considering their side effects and also breast feeding women's desire for dietary complements rather than chemical drugs, this research was done to determine comparison of effectiveness of Omega-3 fatty acids with placebo in treatment of mild to moderate postpartum depression.

  Methods: This double-blind randomized placebo controlled trial study was done on 120 women with postpartum depression, who had the required criteria. First by using Edinburgh Postnatal Depression Scale (EPDS) in women who gave birth 2 weeks to 3 months before, postpartum depression approved for determining the severity of depression, Beck Depression Inventory scale (BDI) was used. Women with mild to moderate depression who had a score 46 on the (BDI) and did not have any tendency to use anti-depressant drugs under the supervision of the psychiatrist, enrolled in the study and randomly assigned to receive either 1gr of Omega-3 capsules or placebo for 8 weeks. Severity of depression was measured before treatment and weekly during treatment in both groups. The data analyzed through T-Test, repeated measurements of one way ANOVA and chi square test in SPSS 14/Win.

  Results: There were no significant differences between two groups with respect to demographic characteristics. Results show that Mean Depression Scores before treatment in Omega-3 group (35.4 ± 9.2) decreased after treatment (17.7 ± 7.0), which was significant (p<0.0005). Mean Depression Scores before treatment in placebo group (34.2 ± 3.4) decreased after treatment (33.6 ± 9.3) which wasn't significant (p=0.57). There was a significant difference between reductions of Depression Scores in two groups(P<0.001).

  Conclusion: According to research results, use of Omega-3 1gr/day for 8 weeks improves postpartum depression.