Background & Objectives: Nosocomial infections occur following admission of patients in the hospitals and usually are accompanied by significant mortalities. This study was conducted to determine the frequency of nosocomial infections and the causatives in Ardabil Bu Ali hospital during 2010.

  Methods: This study was a cross-sectional study which has been done on collection of information through practical examinations, laboratory tests and files of nosocomillay infected patients in Ardabil Bu Ali hospital during 2010. Data were analyzed by SPSS.

  Results: From a total of 3254 patients, 42 (1.3%) had got nosocomial infections. Of these infected patients 47.6% was males and 52.4% was females. Infection was more frequent in patients with ages between 1 month to1 year old (45.2%). Sepsis (33.3%), pneumonia and blood stream infections (23.8%) and urinary tract infection (19%) were the most frequent infections. The mean length of hospital stay was 26.86 days. Klebsiella pneumoniae was the most common pathogen reported (23.8%). Infection was more common in NICU (38.1%).

  Conclusion: In this study, the frequency of nosocomial infection was lower than other studies. Distribution of infection differed with age, ward and length of stay in the hospital.

  Background & Objectives: Cardiovascular events are the most common cause of death in hemodialysis patients. Cardiac biomarkers and especially Cardiac troponin I has been used as a prognostic marker in hemodialysis patients and there is some controversies about its value. For these reasons this study has been done for evaluation of prognostic value of Troponin I and left Ventricular Hypertrophy in mortality of hemodialysis patients.

  Methods:�This is a prospective descriptive-analytic study, has been done from 2006 -2011 All of new cases whom entered to dialysis center in 2006 studied with measurement of base line Cardiac Troponin I and left ventricular mass index .Patients fallowed up 5 years later without any specific intervention and survival rate was calculated crudely and in base of Cardiac Troponin I and left ventricular mass index separately after exclusion of non cardiac deaths.

  Results:�76 patients followed up 5 years and 35 of them died. Mean age of patients was 57.4 ± 15.6 year. Mean Troponin I (cTnI) in dead patients was 0.92±0.68ng/l and in alive patients was 0.78±0.58ng/l (p=0.39). Mean Left Ventricular Mass in dead patients was 274.9±100.8 g/m2 and in alive patients was 249±77.7 g/m2 (p=0.23). A significant linear correlation was not founds between cTnI level and Left Ventricular Mass Age was the most important cofactor of death.

  Conclusion: Significant correlation was not founded between cTnI level and Left Ventricular Mass with cardiac mortality .mortality. This may be due to some other factors such as age, quality of control of hypertension and other coexisted diseases, quality of life and home cares. Age had more important effect on death and this may reflect multiplicity of heath related problems in them.

  Background & Objectives: Recent studies have shown that aquatic actinomycetes can be a source of new biological products such as antibiotics and i n dustrial products. This study was designed to examine the aquatic actinomycetes isolated from mangrove forests in South of Iran and their antibacterial activities against some human pathogens.

  Methods: In this study 115 samples were randomly taken from different places of a mangrove forests in South of Iran. Isolation was based on serial dilution of the samples and plating them on starch casein agar medium. Agar well diffusion and disc diffusion assays were used to examine the antibacterial activity of the isolated purified aquatic actinomycetes.

  Results: The aquatic actinomycetes were isolated from 83 samples (70%). Of them, 66 (80 percent) showed antibacterial activity and 17 (20%) could not inhibit the human pathogenic bacteria. The diameter of the inhibitory zones (ZOI) ranged from 4 to 11 mm and the biggest zone belonged to B acillus cereus (p≤0.05).

  Conclusion: The findings showed that the various and useful aquatic actinomycetes for production of new antibiotic compounds are isolated easily from the mangrove forests in South of Iran. Considering the vast spreading of mangrove forests in South of Iran and the economic and simplicity of isolation of actinomycetes for industrial usage, these source can be an important and new place for research and industry.

  Background & Objectives: Hypertension is one of the most important and common health problems in societies. Hypertension is often asymptomatic and can be simply treated. Many of drugs are available for treatment of hypertension i ncluding d iuretics, beta blockers, blockers of calcium channel, angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, alpha blockers and arterial dilators. This research was performed to evaluate the efficacy of some of these drugs on the hypertension. This may help to choose an appropriate medication for the treatment of stage 2 hypertension.

  Methods: A total of 150 patients with hypertension who were not under antihypertensive treatment and didn’t have contraindications for using hydrochlorothiazide , enalapril and atenolol were randomly allocated into three groups. These groups received atenolol 50 mg daily, hydrochlorothiazide 50 mg daily and enalapril 5 mg twice daily, respectively . After three weeks blood pressure of patients was measured and results were analyzed using SPSS.

  Results: Atenolol reduced systolic blood pressure (26.7±6.7 mm Hg 16.1%), diastolic blood pressure (10.3±1.2 mm Hg 10.4%) and mean arterial blood pressure (16.1±6.4 mm Hg 13.1%). Enalapril reduced systolic blood pressure (30.6±8.8 mm Hg 17.4%), diastolic blood pressure (11.5±4.4 mm Hg 11.4%) and mean arterial blood pressure (17.9±7.0 mm Hg 14.2%). Hydrochlorothiazide reduced systolic blood pressure (25.1±5.8 mm Hg 14.6%), diastolic blood pressure (9.2±2.3 mm Hg 9.3%) and mean arterial blood pressure (14.5±6.4 mm Hg 11.8%).

  Conclusion: Despite recommendations the use of hydrochlorothiazidein the treatment of hypertension, seems lower effect only use of this drug groups in comparison with other groups, and maybe add this category to other drugs and combined treatment is better than monotherapy with these groups .

  Background: Co-inheritance of hemoglobin gene defects is a rare important status that can lead to double heterozygote or homozygote with significant clinical manifestations. Such conditions can be observed in co-inheritance of alpha-thalassemia with beta-thalassemia or hemoglobinopathy. The aim of this study was to evaluate the prevalence of alpha-thalassemia with beta-thalassemia and hemoglobinopathy co-inheritance in a considerable number of Iranian.

  Methods: This descriptive study was performed on patients with abnormal hematological findings in favor of alpha-thalassemia, beta-thalassemia or beta-hemoglobinopathies. Patients with low MCV and MCH levels and high HbA2 (>3.5) and those with low MCV and MCH and normal or low HbA2 were candidate for molecular analysis for beta and alpha thalassemia respectively. Abnormal Hb electrophoresis was diagnostic criteria for molecular analysis of beta-hemoglobinopathies.

  Results: Study revealed that more than half of the patients with alpha-thalassemia affected simultaneously by beta-thalassemia and about thirty percent inherited beta-hemoglobinopathies. Among patients with beta-thalassemia, HbSCd6 (A-T) was the most common mutation and in alpha-thalassemic patients α ^3.7 was the commonest mutation.

  Conclusion: Relatively high prevalence of co-inheritance of alfa-thalassemia with beta-thalassemia and hemoglobinopathies reflect the necessity of genetic consulting and molecular analysis in diagnosis of such conditions.

  Background and Aim: Birth in the 21^st century is characterized by interventions. That interventions increase the risk for mother and baby without improving outcomes. The aim of this study was to compare the effect of physiological birth and routine normal delivery on some of maternal and fetus outcomes.

  Methods: This quasi-experimental study was performed on 160 pregnant women. The participants were allocated in two groups of physiological birth (n=80) and routine normal delivery (n=80). Inclusion criteria were as following: Apgar score between one and five dilatation between three and four cm maternal age between 18-35 years gestational age between 37-40 weeks cephalic presentation and neonatal birth weight of 2500-4000 gr. Physiological birth care included labor begins on its own, freedom of movement throughout labor, continuous labor support, spontaneous pushing, no separation of mother and baby. Routine birth cares include routine interventions in labor or birth. Rate of cesarean, Apgar score and neonatal intensive care unit were evaluated in both groups. Data were analyzed by SPSS 16. The t-test, chi-square and Mann Whitney were the statistical tests of choice.

  Results: Rate of cesarean was significantly different between two groups (p=0.005). First minute Neonatal Apgar score was significantly different (p=0.011), but fifth minute Apgar was similar in both groups (p=0.470). The transmission to neonatal intensive care unit had also significant difference among two groups (p=0.029).

  Conclusion: The present study showed that the physiological birth is safe. It seems that the physiological birth decreases the rate of cesarean and transmission to neonatal intensive care unit, also improves the first minute neonatal Apgar scores.

  Introduction : Cardiac events due to coronary artery disease (CAD) are the most common cause of death in all over the world. Myocardial ischemia and its consequent heart failure are considered as common problems and complications of CAD. The purpose of this study was to assess the anti-ischemic effects of fibrates in patients with CAD.

  Methods : This clinical-trial study was conducted on patients with dyslipidemia and CAD referred to the Baqiyatallah university hospital, Tehran, during 2008-2010. A total of 124 patients randomly divided into two groups: the first group (64 patients) received simvastatin (20-60 mg/day)+fenofibrate (200 mg/day) with lipid-limited diet and exercise and the second group (60 patients) received simvastatin (20-60 mg/day) with diet and exercise for one year and the patients were evaluated at the end of this period.

  Results : The mean age was 54.3±6.5 years and 53.2% of patients were male. Metabolic equation index was changed from 4.32±0.5 to 5.68±0.5 at the first group (P<0.001) and 4.43±0.9 to 4.41±1.1 at the other one (P=0.121) and also time of exercise was changed from 5.21±1.81 to 6.01±1.8 (P<0.001) and 5.43±1.26±5.23±1.2 (P=0.089) respectively. No serious adverse effects were seen.

  Conclusion : Lipid-lowering therapy with simvastatin and fenofibrate reduces myocardial ischemia. Therefore it’s recommended to add fenofibrate to statinsin the treatment of dyslipidemia in patients with high risk of cardiovascular accidents as complementary treatment.

  Background & Objectives: Regarding to high incidence of dysmenorrhea and influence on daily activities and fewer side effects of herbal medicines than chemical drugs, the aim of this study was to compare the effect of mefenamic acid and matricaria chamomilla (MC) on primary dysmenorrhea.

  Methods: This triple-blind randomized clinical trial study was done on 90 female students residents in dormitories of Kashan University of Medical Sciences in 2012. The subjects were categorized into two groups randomly. Mefenamic acid capsules (250 mg, every 8 hours) were given to the first group from 48 hours before menstruation until 24 hours after it. The second group received MC capsules made in Barij Essence Factory of Kashan (250 mg, every 8 hours). Severity of dysmenorrhea was measured by McGill ruler. Finally, the data were analyzed by SPSS. The chi-squire, fisher and paired t-test were used. The p-value of less than 0.05 was considered as statistically significant difference.

  Results: The result of this study indicated that both chamomilla and mefenamic acid can reduce the severity of pain and hemorrhage (p<0.05) but there was no significant difference between two groups (p>0.05).

  Conclusion: This study showed that matricaria chamomilla is effective in decreasing the severity of primary dysmenorrhea and reducing hemorrhage as well as mefenamic acid.

  Eosinophilic gastroenteritis is a rare disease characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal system. The clinical presentation is depending on the involved area and its extension into the layers of the gastrointestinal tract. We repor ted a case of eosinophilic gastroenteritis in the setting of cryptogenic cirrhosis which initially appeared as a tumoral obstruction of the 3^rd portion of duodenum which is relieved by surgical bypass and two years later presented as eosinophilic ascitis. The patient was treated with corticosteroid with full absorption of ascitis.

  Background & Objectives: Venous thromboembolism (VTE) is one of the three causes of mortality made by cardiovascular disease and pulmonary embolism is the most common preventable causes of mortality among hospitalized patients. Considering high prevalence, the importance of etiologic studies of diseases and different previous reports regarding the role of blood groups on occurrence of diseases such as VTE, this study was carried out to determine the blood groups of the hospitalized patients with diagnosis of VTE.

  Methods: This cross-sectional study was carried out on 200 hospitalized patients with the diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) in Imam, Fatemi and Alavi hospitals in Ardebil. The final diagnosis was made by c olour D oppler ultrasound and pulmonary CT angiography and blood groups and risk factors were determined. Results of this study analysed along with the previous epidemiologic reports related with blood groups in Ardebil and Iran population using chi-square and t-test and SPSS software.

  Results: Of 200 patients with VTE, 140 patients were affected with DVT and 60 patients with PE. In this study, 92 patients were males and 108 were females. The mean age of patients was 52 ± 19 years. The most prevalent blood group was type A with a rate of 47.5%. There was no correlation between the diseases namely DVT or PE and blood groups (P=0.55). Frequency of type A ( OR: 2.914) and B ( OR: 1.608) in patients with VTE was more than Ardebil and Iran population but the type O (OR: 0.632) was less than those population. These differences were statistically significant. The frequency of type AB was similar in all groups.

  Conclusion: The Correlation between blood groups and venous thromboembolism, which have been discussed in many studies, have been investigated in Iran and at medical centres of Ardebil University of Medical Science for first time. It seems the type of blood groups (A and B) is effective in frequency of VTE. More studies are needed on the correlation between blood groups and VTE.

  Background & objectives : O bstructive sleep apnea is a preventable and prevalent major health hazard with serious health consequences including excessive daytime sleepiness, cognitive disturbances, depression, cardiovascular diseases and hypertension. Obstructive sleep apnea is a disorder affecting 2 to 4% of the adult population. The continuous positive airway pressur e (CPAP) i s the most efficacious therapy and is often the first option for these patients. The pressure titration during laboratory polysomnography is required for treatment by CPAP.

  Methods: The patients with obstructive sleep apnea requiring continuous positive airway pressure treatment were selected . CPAP titration was done according to American Academy of Sleep Medicine protocol. Comparison among continuous positive airway pressure with polysomnographic parameters was performed and analyzed with Pearson correlation coefficient. For analysis of qualitative parameters, we used chi-square and then checked with SPSS version 18 software.

  Results: From 125 patients with obstructive sleep apnea, there were 112 cases with inclusion criteria. Mean age of participants was 55.07 ± 12, male frequency was 59.2%, apnea hypopnea index was 43.62 and mean continuous positive airway pressure was 12.50 . There was significant relationship among the pressure of continuous positive airway pressure with apnea hypopnea index (P=0.028), arousal index (P=0.011), body mass index (P=0.041) and O₂ desaturation index (P=0.022), although age was not significantly related.

  Conclusion: In accordance to this data, we found out a prediction equation for optimal CPAP in our patients

  Background & objectives : T he main goal of tissue engineering is regeneration and restoration of damaged tissues and organs, besides being used in medicine . Scaffolds are the main segments for tissue engineering, and plasma surface modification is one of the modern methods used for surface modification on polymer scaffolds. The aim of this study was to evaluate the effect of nano-fibers with different densities on fibroblasts' behavior besides the plasma surface modification.

  Methods : Poly Ɛ-Caprolactone nano-fibers (PCL) were developed by an electro-spinning technique at different collecting times. These nano-fibers were then modified by oxygen plasma. Cellular attachment to the nano-fiber and their morphology were evaluated using scanning electron microscope (SEM) and cellular activities were also studied by 3-[4,5-dimethylthiazol- 2-yl]-2,5 diphenyltetrazolium bromide (MTT). Scaffold biocompatibility test was assessed using inverted microscope.

  Results : Scanning electron microscope images of nano-fibers showed that increase in time of spinning has significantly heighten fiber density, on the other hand plasma surface modification of nano-fibers had significant effects on their respective biocompatibilities. The result of cell culture showed that nano-fiber could support the cellular growth and replication by developing 3-dimensional topography.

  Conclusion : Our results showed that increase in time of spinning and using plasma surface modification of nano-fibers by oxygen plasma would result in providing surface with the highest similarity to the extracellular matrix.

  Background & objectives: Heart failure is considered as a major cause of hospitalization. Many studies have shown association between sleep-related breathing disorders and heart failure. It has been shown that the relationship between nocturnal hypoxia and left ventricular dysfunction can cause significant morbidity and mortality in patients with congestive heart failure (CHF ). Accordingly, treatment of sleep related breathing disorders (SRBD) can give rise to improvement in CHF treatment too. This study surveys the prevalence of sleep disorder in stable heart failure patients regardless of ejection fraction.

  Methods : This study was a descriptive-analytical study. One hundred and eight patients with heart failure disease were studied. A questionnaire consisting of two parts (part I consistent of demographic information and part II consistent of sleep disorders) and clinical examination (pulse oximetery and echocardiography) were used for collection of data. The data were analyzed with SPSS statistical software using descriptive and analytical tests including the chi-square, Pearson correlation and ANOVA.

  Results: Fifty six persons (51.9%) of patients were female and 52 persons (48.1%) were male with mean age of 65.42 ± 11 years. In total sleep duration, 95 patients (88%) had nocturnal hypoxemia . There was correlation between arterial oxygen desaturation at night and ejection fraction .

  Conclusion : This study confirmed strong associations between nocturnal hypoxia and left ventricular dysfunction and SRBD should be considered in clinical treatment of systolic heart failure.

  Background &objectives: Echinococcosis, referred to as hydatid disease or hydatidosis, is a parasitic disease caused by larval stage of Echinococcus granulosus. In the life cycle of this parasite, dogs and other carnivores are definitive hosts and herbivores are intermediate hosts. Humansin this cycle may incidentally involve by ingestion of parasite eggs and play as intermediate host. Hydatid disease can involve any organ but liver and lung are the most commonly affected organs and kidney, brain, heart, bone may also be affected to a lesser degrees. Cerebral hydatid cyst occurs in about 2% of all echinococcosis cases. In this paper we report two cases of cerebral echinococcosis in whom diagnoses were made based on MRI findings and confirmed by pathology reports after surgery.

  First Case Report: The first case was a 30 years old man who was admitted after an episode of generalized tonic-clonicseizure. The MRI imaging performedand patient underwent surgery with diagnosis of a right frontal cystic lesion. The patient was improved progressively and there was no seizure attack and recurrence during 18 months follow up period.

  Second Case Report: The second case was a 28 years old woman presented by headache and abnormal behavior. MRI of this patient revealed a large cystic lesion in left frontal lobe and then underwent surgery. No complication was seen during postoperative period. The headache and behavioral disorder were improved completely and there was no sign of recurrence during 18 months follow up period.

  Conclusion: Hydatid cyst should be considered as a differential diagnosis of cystic brain lesions in endemic areas. Although hydatid cyst is a benign lesion but surgical removal of it without rupture is very important for prevention of probable future complications.