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Background & Objective: Ingrowing toe nail disease is caused by excessive lateral nail growth in to the nail fold. Because of high incidence of this disease and high percentage of recurrence after routine treatments, we decided to compare the matricectomy with phenol %88 with electrocoagulation.
Methods: This research was an clinical trial study that have been done on 30 patients with bilateral ingrowing toe nail disease who referred to the Dermatology clinic in the Ardabil Imam Khomeini Hospital, from October 2005 to September 2006. In each case, phenol %88
matricectomy used on one side of affected zone and lectrocoagulation used on the other side.
The data was collected with questionnaire and the time for follow up patients was six months. Collected data analyzed by SPSS, chi square and fisher exact test.
Results: Average age of patients was 24.56±5.40 years old, ratio of female to male was 3 to 2 and in all patients affected site was the big toe. Most of the patients were in primary level of education (%33.3), 18 (60%) patients had secondary infection, 8 (26.7%) patients had
abscess, 13 (43.3%) patients have granulation tissue and no cases of onychomycosis were detected. Recovery period with phenol was 2-4 weeks and recurrence or side effect were not seen. Regarding the recovery duration these two therapeutic methods had significant
statistical differences only during the second fortnight (p=0.001). But there was no significant statistical difference in recurrence period and side effects.
Conclusion: Matricectomy with phenol %88 had less recovery time than electrocoagulation.

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Background & Objective: Hemorrhage is one of the most common complications of the tonsillectomy that needs accurate intraoperative control. Different techniques are used for its control. The present study was carried out to compare the hemostasis efficiency of electro coagulation with that of suture legation following tonsillectomy operations under identical conditions.
Methods: The prospective study from 2004-2006 was done on 100 patients. Homeostasis was done by suture legations on one side and bipolar diathermy electro coagulation on the other, in the same patients. Then we compared the length of operation, volume of intra-operative hemorrhage, post-operative pain, immediate and late post operative hemorrhage. All of operations were done by the same surgery team and all of data were analyzed in SPSS 14 by paired T-test and Macnemar.
Results: In our series of 100 patients, the mean length of operative time was 8.6 minutes for hemostasis by bipolar electrocoagulation procedure, and 11.3 minutes for suture legation (P< 0.005). Intraoperative blood loss volume by electro coagulation were 9.6cc and by suture legation 12.7 cc (P< 0.005). In 88 patients no difference was in post operative pain but in 7 patients suture legation site had more pain and in 5 patients bipolar caused more pain. With CI 95% there was no significant difference between them.
Conclusion: Electrocoagulation was found to be more effective, easier, and faster than suture legation. Therefore, we recommend this type of hemostasis for children whose length of operation and volume of blood loss is important for them.

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  Background & Objective: Respiratory tract infections causes 4.5 million children death in the world annually that occur mostly in developing countries like Iran. Bacterial and viral pathogens are responsible for this event and Adenovirus is one of the major responsible agents. According to multiple survey, incidence of viral pathogens in different world region is different so local survey is needed to describe regional incidence of different viral pathogens. Rapid test for detection of respiratory pathogens help us to select appropriate treatment and avoidence of antibiotic overusage. So abuse the aim of this study was to evaluate incidence and clinical presentation of Adenovirus infection in children in Tehran with rapid test.

 Methods:�This study is a descriptive-cross sectional analysis. All 3 month to 15 year old children with upper respiratory tract infection that come to OPD of Rasol-e-Acram Hospital in one year(1385) are included.

  Direct smear of patient’s throat was evaluated by rapid chromatography test for adenovirus infection. SPSS software was used to analyse the data.

  Results: 160 children with upper respiratory tract infection with a mean age of 61.5 months were evaluated. 57.5% were boys and 42.5% were girls. 77.4% had fever, 66% had sore throat, 37.4% had cough, 27% pharyngeal exudate, 16.4% had abdominal pain, 15.7% had vomiting, 13.8% had cervical lymphadenopathy, 10% had diarrhea, 5.7% had petechea in palate and 1.9% had conjectivitis. They admitted 24% in spring, 14.1% in summer, 23.1% in fall and 38.5% in winter.

  Adenovirus infection was detected in 10(6.3%) cases, 4(40%) boys and 6(60%) girls with mean age of 83.7(SD=58.5). they were detcted 20% in spring, 30% in summer, 30% in fall and 20% in winter.

  Conclusion: Adenoviruses are responsible in 6.3% of upper respiratory infections in children. They become less prevalent with increasing age. Its prevalence did not obey seasonal pattern. Fever and sore throat are most common clinical signs and cervical lymphadenopathy is more prevalent in adenovirus infection than others.

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  Background & Objective: postpartum depression is a kind of psychiatric disorder that psychosocial factors relate with it . This study was performed in order to determine relationship between postpartum depression and psychosocial effects and Determine the rate of postpartum depression in mothers visiting health-medical centers in city of Rasht .

  Method: In this descriptive-correlational study, 350 women were selected in the Random cluster manner. The instruments for gathering data were two questionnaires including psychosocial effects and Edinbugh test. The reseacher completed these questionnaires through interview.

  Results: The results indicated that 16% of samples suffered from postpartum depression. The results indicated a significant correlation between the satisfaction of life and husband's relatives (p=0.021) the lifes life's unpleasant events (p<0.0001) the psychological disorder history in family (p<0.0001) the post partum depression history in family (p=0.008) the unwanted pregnancy (p=0.041) tendency to abortion (p<0.0001) the satisfaction of mothers about the neonatal gendel (p=0.034) the satisfaction of husband's family about neonatal gentiv (p=0.005) the kind of communication with husband (p<0.0001) The kind of communication with husband's family (p<0.0001) and the postpartum depression .

  Conclusion: Nurses have important roles in secondary prevention and screening women suffering from postpartum depepression, and also in appropriate and quick refering them to psychiatrist. Nurses need to be knowledgeable about high-risk factors and share the information with mothers and their families .

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Background & Objectives: Carcinoid tumor is the most common appendix tumor and its origin in from neuroendocrine cells. 80% of tumors are located in GI tract and the most common site of the tumor is appendix .This neoplasm is found in 0.3-0.5 percent of appendectomized samples. The mean age in diagnosis time is 30 years old and the neoplasm is more common in women. The aim of this study was to investigate the age and sex prevalence of carcinoid tumor in appendectomized patients.
Methods: This descriptive study was done on 5644 specimens in the Fatemi Hospital of Ardabil  for surveying of carcinoid tumor prevalence, on the basis of age & sex, from 2003-2007.
Results: In this study, the prevalence of carcinoid tumor was 0.19%, average involvement mean 33.6 years old (ST= 23.1) & the men diameter of tumor was 0.74 cm (ST= 0.37). The prevalence in women was 3 in 1000 and in men was 1.36 in 1000.All of the tumor located in the tail portion of appendix. The tumor can cause acute appendicitis by duct obstruction but mostly is discovered during pathologic examination accidentally, conclusion pathologic examination of appendix with sagital incision in all appendectomy cases is recommended.

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Background & Objectives: Candida Albicans is a fungus that frequently infects diabetic patients. Because it is very common infection in diabetics, we tried to determine the prevalence of infection and the asymptomatic carriers and show factors like age, sex, duration of diabetes and quality of disease control that  probably  have effect on infection.
Methods: In this study 200 diabetic patients were chosen randomly and blood samples were taken for FBS and HbA1C and then skin smears were performed from body folds (Axillaries groin interdigital folds) and probable lesions. The skin samples were cultured in Chrom-Agar medium. Then the gathered data were analyzed.
Results: Overall, from 200 patients, there were 180 (90%) negative culture and 20 (10%) positive cultures. Candidial infection in men and older patients were relatively higher than others. Candida infection in poor controlled diabetes was considerably higher .Infection in type-1 diabetes was more than type-2 diabetes. There was no correlation between duration of diabetes and prevalence of infection.
Conclusion: Candida infection is more common in diabetic patients with poor control, male and older ones.

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Background & Objectives:�Urinary tract infection (UTI) ranges from asymptomatic bacteriuria to severe renal infection with sepsis. Urinary tract infection can cause many complications as abscess, hypertension, renal failure, renal scar, reflux and so on. Since there is no general agreement on the administration of additional fluid (1.5 times maintenance) on the early treatment of UTI on this study was conducted to see the effect of additional fluid. 

Methods:�206 children with UTI who were admitted in Amir Kabir Hospital of Arak from March 2005 to March 2006, were divided into two groups of 103. One group received the usual amount of maintenance fluid and the other 1.5 times of maintenance. The course of resolution of dysuria, frequency, malodorous urine, abdominal pain and fever were compared in the two groups. Patients' urine culture was performed on the second day, 7-10 days, and 90 days after admission. Patients were matched according to their age and sex. Those who presented with azotemia were excluded from the study.

Results: Receiving additional fluid had a significant effect on the malodorous urine dysuria. However, it had an inverse effect on the treatment of fever and urinary frequency and it made them even last longer. In other areas like abdominal pain and urine culture in 3 stages there was no difference.

Conclusion: It seems that intake of excessive amounts of water has no significant effect on the results of the UTI treatment.

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 Background & Objectives: Cardiovascular disease is the most important cause of death in the world. Statistics shows that mortality and morbidity from cardiovascular disease in Iran is going up, so quality of management and treatment of these patients need to be better. For these reasons, determination of survival rates and factors affecting it is important and is also the aim of this study.

  Methods: This is a survival analytic prospective study, done on 800 patients, admitted in Ardabil Bouali Hospital CCU. All of the patients were followed up one year and a questionnaire about them was obtained. Statistical analysis was done with SPSS. For survival analysis Kaplan Maier, life table, logReng test and Cox regressions model were used.

 Results: Mean age of patients was 60.6±12.4 years. Total number of mortality in one year was 84 persons (10.5%). 582 patients were men and 218 were women. 47.4% were smokers, 33.4% had hypertension, 18.1% had diabetes mellitus, 15.3% had hyperlipidemia and 30% had arrhythmia. Survival rate in the first 10 days, 28 days and one year were 94%, 93% and 90% respectively.

 Conclusion: Factors that affected survival in Cox regress ional model were: diabetes mellitus, age, use of streptokinase, left ventricular ejection fraction, heart rate and heart block. Knowledge from survival rates and relative risks can help health managers in better health service preparation.

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  Background & Objectives: Esophageal carcinoma has more prevalency in northwest of Iran. Relapsing dysphagea after esophagectomy is one of the common delayed complication. It emerges due to technique of surgery. Reflux and or leakage in anastomotic area. The aim of this study is to evaluate the prevalence and etiologies of dysphagea after esophagectomy and postoperative endoscopic dilation results.

  Methods: This is a retrospective discreptive study, during 2000-2005 at Imam Khomeini hospital, all patients who had esophagectomy because of esophageal carcinomas entered this study. Data collected from medical records, Primary tumoral diagnosis, operation endoscopy, dysphagea, histopathological findings, Postoperative complications, especially dysphagia and it’s etiology, and different methods of therapy, reoperation and or endoscopic dilatation were studied.

  Results: Among 324 patients 81 patients had esophagectomy for esophageal carcinomas. In eighteen patients (22.2%), dysphagea reappered after operation. Rate of dysphagea in patients with carcinoma of lower one third area was 5.3 times greater than middle third of the esophagus. Mean time between first hospitalization and second hospitalization due to relapsing dysphagea was 10.03 months. The main cause of relapsing dysphagia in 88.24%, was benign stricture in anastomotic area. 17 patients with endoscopic dilation and one patient with surgical stricturoplasty, were treated.

Conclusion: Relapsing dysphagea after esophagectomy is common in our patients. This represents mostly benign strictures after esophagectomies for esophageal carcinoma. In benign anastomotic strictures, endoscopic dilation is an effective treatment and it is recommended.

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  Background & objective: Different studies have been emphasized the effects of maternal position on labor and delivery these effects isn’t less important than medical and midwifery factors. This study is a quasi- experimental. This study wants to the effects of Maternal elective position during active phase on the process and outcome of Labor and delivery in primigravida women.

  Methods: The of the study were 150 women 75 women in case group (women in the elective Position) and 75 women in whom allowed to cuoie their labor control group in . All women were between 18-30 years, term pregnancy (hist and second s ??), interval of poin in second sreye of labor, the first and minu as scores, mother’s sansfa??? Of delivery experwones, onest of breasr feedy have recorded.

  Results: The results of the study showed that the elective and freedom of position significantly reduced length of active phase (p=0/002), need for oxytocin augumentation (p=0/0058), pain intensity (p=0/026), ceasarean section (p=0/0393) and increased APGAR score in the first minute (p<0/01), early onset of breast feeding (p=0/0015) and Mothers’ satisfaction of delivery experience (p=0/0001). Duration of second stage and fifth minute Apgar were not different in two groups.

Conclusions: This study showed that the Maternal elective position has positive e of resuly of deliveris and the first minuts Apgar score during active phase is good for deliveries and health

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  Background & Objectives: ECT is one of the most common methods in treatment of different types of psychological disorder. The effectiveness of this therapy has direct relation to the duration of convulsion. Knowing the rate of efficacy of anesthetic drugs over convulsion by ECT and preventing of hemodynamic complications are important. This study was conducted to compare effect of Propofol with Sodium Thiopental in the induction of anesthesia during ECT.

  Methods : The subjects of this randomized, controlled and trial study were 16 patents with psychotic disorders. These patients received Sodium Thiopental and Succinylcholine or Propofol and Succinylcholine during 72 sessions of ECT. Duration of subjective and objective convulsion and hemodynamic changes (HR and MAP) as well as side effects of anesthesia and ECT was recorded. The collected data were analyzed by SPSS.

  Results: Duration of subjective and objective convulsion was lower in Propofol taken group than Sodium Thiopental taken patients, but this difference was not statistically significant (p=0.32). The variation of hemodynamic parameter was lower among Propofol taken patients.We observed significant difference between two groups regarding to increase of arterial BP’ mean after taking drugs and immediately after ECT (p=0.04). There was not significant difference from view points of prevalence of respiratory, Hemodynamic complications, nausea, vomiting and restlessness between two groups.

  Conclusion: Duration of convulsion in induction of anesthesia in ECT with Propofol and Sodium Thiopental was not different.

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  Presence of foreign bodies in the anal canal and rectum is usually due to introducing of objects. Various clinical presentation and lack of tendency for giving a definable history are important which may cause delayed and misdiagnosis of disease.

  In this study the case of a 35 years old man with 10 days history of abdominal distention and pain admitted to hospital is reported. The patient underwent laparotomy because of clinical findings in favor of peritonitis. We found that rectal perforation was due to presence of an orange in the anal canal.

  Anal canal foreign bodies cause different and unusual clinical presentation. Therefore good clinical and especially rectal examination is advised for early diagnosis and treatment.

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 Background and objectives: During the last years the effects of pulsative electromagnetic fields have been studied in the human and animals nervous system. The using of these fields in today living has caused worriment in safety of human. Stress causes very problems in behavior and function of biological systems. In this survey the effects of electromagnetic fields on stress behaviors of rats have been studied.

 Methods: In this study we aimed to investigate the effects of electromagnetic fields with 700 milli Gauss currency produced by triangle electrical currents with low (10 Hz) and high (110 kHz) frequencies on stress behaviors in 60 adult, male Wistar rats. The rats were divided to two groups of control and test. The animals were exposed to the field for 80 minutes and in order to evaluate the possible effect of electromagnetic fields the Tail pinch (T.P.) test was conducted. The results were analyzed using statistical tests.

  Results: Analyzing of the results of response time and stress behavior by T-test. In the group exposed electromagnetic fields of triangular low waves (10 Hz) for 80 min the results were meaningful (p < 0.05). The response and stressed behavior with this field is decreased very much. The results of two groups after 80 min under this field that have a difference in frequency showed that effects of frequency in behavior was meaningless.

  Conclusion: The results of this study showed that electromagnetic fields produce anti-stress effect in rats. The radio waves (A.W) have higher effects.

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  Background & Objectives : Scalp defects have various etiologies which included scalp cancers, trauma, burns, congentital vascular lesions (Hemangioma & arteriovenous malformations), acquired & congenital skin defect such as aplasia cutis and infections. These defects need different reconstructive methods. The aime of this study was to determine the etiology of scalp defects and out come of various reconstructive methods.

  Methods : This was a descriptive study and based on the patient’s files during two years from 2004 to 2006. All patients operated for scalp defects were included in the study. Different methods of reconstructive surgery were considered and results analyzed using descriptive statistics.

  Results : The study included 75 patients, (52 males and 23 females) with the mean age of 42 years old. In most cases the scalp defect was in the temporoparietal region and most defects were reconstructed using tissue expander (TE). The most common cause of scalp defects was Basal cell corconoma (primary and recurrence) and the most common primary reconstructive method was skin graft. The second cause of scalp defects was burn scar and in these cases the most common reconstructive method was TE. Operative complications in this study were partial necrosis of the graft or distal flap that was repaired by using the repeated skin graft. In one case there was infection of tissue expander that was extracted.

  Conclusion: The most common cause of scalp defect were Basal Cell Carcinoma and burn respectively and in these cases the skin graft and TE were the most common reconstructive methods respectively .

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  Background & Objectives :�Heart rate deflection point (HRDP) plays an important role in predicting anaerobic threshold and monitoring athletes training schedule. Despite some research, the physiological mechanisms involved in occurrence of the HRDP remains to be fully elucidated. The objective of this study was to survey of the agreement between Heart Rate Deflection Point (HRDP) and the Potassium Turn Point (KTP) in young athlete men.

  Methods :�Thirty young men athlete volunteer (Mean ± SD age= 20 ± 1.21 years height = 176 ± 7.34 Cm and weight = 6.58 ± 5.66 Kg) were selected as subjects. Hofmann protocol was used to cause the HRDP. One week later and after determining the HRDP by using the S.Dmax method, subjects performed Hofmann protocol again and blood samples were taken from left forearm vein in five phases, simultaneously. The amount of potassium was measured directly by the Flamephotometer.

  Results :�According to the results of study, the HRDP and KTP were occurred in average in 78% HRmax and 79% HRmax, in all of the subjects, also there was a highly agreement between HRDP and KTP (158 3.84 vs. 159 3.88 b/min). HRDP & KTP were occurred in third phase, simultaneously.

  Conclusion: Based on these results, exercise induced increase in serum potassium during Hofmann incremental cycle ergo-meter testing protocol can be one of the mechanisms of the occurrence of HRDP.

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  Background & Objectives : Due to rapid population growth, many activities performed to find ways to prevent pregnancy around the world. Vasectomy is one of the most effective contraceptive methods but despite the benefits, it's using incidence is very low. It is important to involve men in order to population control. This study was aimed to describe the experiences of a group of men who had vasectomy and their sexual satisfaction after Vasectomy.

  Methods: A combination of qualitative and quantitative study (Triangulation method) was used on forty men who had been vasectomized in the city of Ardabil before 2006. The method the thematic oral history was used. Questionnaire about sexual satisfaction after vasectomy was prepared and completed by sample subjects (101 people). The results were analyzed by SPSS software.

  Results: The following three descriptive categories were developed from the men's experiences: influencing factors for doing vasectomy outcomes of vasectomy vasectomized men as advisers of the procedure for other men.

  Frequency of intercourses in 65.4%, sexual desire in 64.4%, sexual pleasure in 59.4%, duration of sexual intercourse in 66.3% and sexual ability in 68.3% of subjects did not change after sterilization.

  Conclusion: Family planning programmes must consider the clients sociocultural background. During explanations about vasectomy, the dissemination of the experiences of vasectomised men could improve the confidence and interest of the men to the method and may promote men’s involvement in reproductive health.

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  Background and objectives: Because of diminished inflammatory responses to microbial invasion, the identification and diagnosis of diabetic foot infections remains a complex problem. The aim of this study was to determine the bacterial agents of diabetic foot infection and their antimicrobial susceptibility pattern. Additionally the percent of infections that were lead to amputation was determined.

  Methods: This retrospective study was conducted on a cross sectional basis at two teaching hospitals. Documents belonging to patients with diabetic foot infections in stages III and IV were studied. All demographic information, clinical manifestations, culture results, outcome of infection and other necessary data were recorded in special data sheets. The SPSS 13 statistical software was used for analyzing data. Statistical significance was assayed by Student’s t-test and chi². The differences were considered to be significant at the p<0.05 level.

  Results: Fifty two patients were selected, 36 patients (69.2%) were male. The mean age of patients was 60±12.8 years, and the mean duration of diabetes was 17±10.6 years. Amputation was done in 29 patients, and a significant correlation was found between duration of diabetes and amputation (p=0.04). The most frequently isolated pathogens were Staphylococcus aureus (38.46%) E. coli (15.4%), coagulase negative staphylococci (13.5%), and proteus spp (13.5%). Antimicrobial susceptibility results showed that 55% of Staphylococcus aureus isolates were resistant to methicillin. All the Staphylococcus aureus and coagulase negative Staphylococci isolates were sensitive to vancomycin. 100% and 87.5% of E. coli isolates were resistant to ceftriaxone and ceftazidime respectively. All Pseudomonas aeruginosa isolates were sensitive to ceftazidime.

  Conclusion: More than half of patients with diabetic foot infection were under amputation and there was significant correlation between amputation and duration of diabetes, so prevention of foot ulcer is very important in those patients. The results showed that the most isolates were resistance against common antibiotics and antibiogram is the best way to choose appropriate therapy in these patients.

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  Background & Objectives: Breast cancer is one third of all kinds of cancers and the second reason of death in women. Prevention and screening can decrease affection and death rate. The aim of this study was to determine the breast cancer screening tests performance and affecting factors in women referred to Ardabil’s Health and Medical Centers in 2009 .

  Methods: In this descriptive-analytic study, 300 women referring to Ardabil’s Health and Medical Centers were chosen by multistage sampling. The information was collected through the researcher-made questionnaire including two parts: Knowledge and Attitude questions and a form about demographical characteristics, family, social and economic factors, risk and women-midwifery factors. For analyzing the data, SPSS software version 16, and descriptive and deductive statistic tests were used .

  Results: The percentage of screening tests including self-examination, clinical examination and mammography consequently were 4%, 4.7% and 3.7%. There was significant relationship between breast self-examination and education (p =0.003), knowledge (p =0/002) and attitude (p=0.004). No significant difference was observed between insurance status and history of hormone therapy and breast cancer screening tests.

  Conclusion: In regard to the low rate of breast cancer screening conducted and determining the affecting factors, the appropriate educational programs and interventional research are emphasized .