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  Background & Objective: Diabetes is one of diseases in which the main part of treatment depends on the patient's responsibility. Therefore their knowledge of the various aspects of nutrition has great importance. The aim of this study was to evaluate the effect of diabetic diet education on nutritional behaviors. FBS and BMI of patients with type II Diabetes mellitus in Iranian Diabetic Association.

  Methods: 88 type II diabetic patients from Iranian Diabets Association (Karaj Branch) participated in this study. The Patients were randomly divided into two groups as experimental (44) and control group (44). Data were collected with a valid and reliable questionnaire (58questions) and checklist in two stage of before and one month after intervention.

  Results: After the intervention in the experimental group regarding diabetes and nutritional behaviors, there was a significant increase in mean score of knowledge (from 57.50 to 80.18) and a significant decrease in the mean of BMI (from 28.3 to 27.9) and in the mean of fasting blood sugar (from 167.9 to 134.5) (p<0.001). However, there was no significant change in the control group.

  Conclusion: The finding of this study indicated the efficacy of education on FBS and BMI in patients with type II diabetes.

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Background & Objective: Visceral leishmaniasis (kala-azar) is an infectious-parasitic disease occurring sporadically in various parts of Iran. The disease is endemic in Ardabil, East Azarbaijan, Bushehr and Fars provinces. This study was performed with the aim of evaluation and comparison of direct agglutination test (DAT), indirect immunofluorescent antibody (IFAT) and ELISA in sero-diagnosis of visceral leishmaniasis that is following a seroepidemiological survey in Germi district of Ardabil province.
Methods: Cluster sampling has been performed from ≤12 years old and 10% of the adult population in Germi district. Altogether 1155 blood specimens were collected to detect anti- Leishmania antibodies. The samples were tested by direct agglutination test (DAT), indirect immunofluorescent antibody (IFAT) and ELISA methods.
Results: 32 (2.8%) of the collected specimens have anti-Leishmania antibodies with titers ≥1:800 and from total specimens 7 (0.6%) were positive with ≥1:3200 titers. In IFA test 32 (2.8%) have titers ≥1:40 and from total specimens 6 (0.52%) were positive with ≥1:320 titers. In ELISA test 8 specimens were positive and other specimens were negative.
Conclusions: According to the results of this study, IFAT and ELISA are specific and high sensitive tests for sero-diagnosis of visceral leishmaniasis but these methods are expensive and require the complicated tools. Whereas, DAT is a simple method, not expensive and require a simple local laboratory with one or two trained technicians. Therefore DAT could be used for seroepidemiological studies and sero-diagnosis of visceral leishmaniasis in endemic areas instead of IFA and ELISA methods.

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 Background & Objective: As renin-angiotensin system (RAS) activity could affect the severity of oxidative stress and inflammatory markers the effect of enalapril and losartan on these markers in renal transplant recipients (RTRs) with RAS polymorphisms was assessed.

 Methods: After determination of RAS genotypes including angiotensin converting enzyme (ACE I/D), Angiotensinogen (AGT M235T) and angiotensin II type 1 receptor (ATR1 A1166C) by PCR, seventy-six RTRs recruited to four groups randomly: first group (17 patients) and second group (24 patients) were treated with E (E⁺: 10mg/daily) and L (L⁺: 50 mg/daily) alone, respectively. The third group (17 patients as positive control) received E+L (E⁺L⁺: 10mg/daily + 50 mg/daily) and the 4^th group (18 patients as negative control) received no medication (E^-L^-). Hs-CRP and total anti-oxidant (TA) as inflammatory and anti-oxidative markers were measured after 2 months. After 2 weeks as washout period, E group changed to L and vice versa as a cross-over design. They were followed for another 8 weeks and hs-CRP and TA were retested.

 Results: Following up the patients (after 2, 4 months of treatment) in treated groups revealed that hs-CRP and TA levels were significantly decreased and increased (consequently) in E⁺L⁺, L⁺, E⁺ groups (P<0.05). On analyzing the relationship between RAS polymorphisms with baseline hs-CRP and TA levels, CC genotype of ATR1 had lower hs-CRP levels (P=0.04). But none of the RAS polymorphisms could predict the anti-oxidative and anti-inflammatory response rate to the drugs (P>0.05).

 Conclusion: E and/or L reduce hs-CRP and increase TA regardless of the RAS genotypes.

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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: It is now clear that the adult mammalian subventricular zone (SVZ) contains a population of neural stem cells (NSCs) that give rise to neurons and glia. Owing to their rarity, and a paucity of NSC-specific markers, the neurospher assay (NSA) is a common and selective method for isolating and understanding the biology of embryonic and adult neural stem cells. There are different methods for neurosphere growing from different regions of the CNS including Lateral ventricles. The objective of this study is introducing a new and effective strategy for more neurosphere firming from the SVZ of the adult mouse brain lateral ventricle using NSA.

 Methods: Two different methods were used in order to isolate and culture the SVZ of the lateral ventricles using NSA. In the first method (Ritze and Reynolds method) the rostral part of the SVZ of the lateral ventricles was dissected into single cell suspension and cultured using NSA. In the second method (vibratome resecting of the brain) after cutting the brain into 400 µm serial sections using a vibratom, the SVZ was microdissected from all sections of rostral part of lateral ventricle and cultured separately, using NSA. Primary neurospheres were counted seven days after plating. Then the mean numbers of neurospheres generated in two different methods were compared.

 Results: The mean number of neurospheres generated by sectioning method was much higher than the one generated using first method (P<0.0001). The distribution and frequency of neurosphere forming cells (or NSCs) is not the same along the antero-posterior axis of the rostral part of the lateral ventricle. The greatest frequency of neurosphere forming cells was detected in 0.74mm rostral to the bregma.

 Conclusion: Second section method, due to more neurosphere generation, in comparison with the first method is more appropriate and efficient for neurosphere forming from the SVZ of the lateral ventricle.

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  Background & Objective: Migraine is one of the chronic and Common Kinds of headache. Among important treatments which are advised for improvement of acute migraine attack, there are tryp tans and Ergot Alkaloids Because of side effects of Ergot Alkaloids Like nausea, vomiting, lack of appetite, Peripheral vessel contractions and induced headache and its limited consumption and patients age limitation, the patients face some difficulties using Ergot Alkaloid. On the other hand Tryp tans are Consumed as a monotherapeutic regimen but Ergot Alkaloids must be used with metoclopramide in order to prevent nausea and also they should be used in the acute phase of migraine so we decided to Compare the two groups of drugs so that if they have positive effectiveness in favor of Tryp tans, using them would be advised.

 Methods: The range of age for patients was 20- 40 years who suffered from classic and common migraine according to IHS criteria, were randomly placed in two groups. One group (36) was treated in the acute phase of disease by sumatryptan and the other (39) by a combination of 3 dihydroergotamine and naproxen and metoclopramide, and therapeutic effectiveness was studied by three Criteria of intensity, attack and frequency of attack. After the treatment, they were analyzed through chi square.

 Results: In terms of intensity, duration and frequency of the headache after the treatment, there was no significant difference between two groups and the results in both group were the same.

 Conclusion: As there were no significant statistical difference between the effect of two drugs on attack intensity, headache duration and frequency in patients of classic and common migraine, and because of the complications of Ergot Alkaloids like vomiting it should be consumed with metoclopramide and because of vessels contractions which may result in the organs gangrene and induced headache, and its maximum dose is 6 mg per week, sumatryptan is advised as the monotherapeutic.

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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: In addition to the socio-economics costs, Diabetes is a major cause of illness and death at all groups. Diabetes affects over %10 of adults in the world. Despite promising trend in improving many aspects of health Care and treatment in the last decade in our country, little attention has been paid to the subject of registering Diabetes on an international standard. Quality improvement of treatment, identifying high risk groups, controlling, preventing and evaluating of diabetes, would materialize only when the national Diabetes Registry System is established and its data are collected and completed on time. The aim of this study was to suggest Diabetes registry system in Iran, to meet the health and medical needs.

Methods: This Comparative Cross-sectional study was conducted to evaluate the developed national diabetes registry systems in 2003. In this study national diabetes registry system in Britain and USA was evaluated by library resources, Websites and Email communication with internal and external specialist. Suggestions were made on the basis of economic cultural and geographic situations. These axes included aims, structures, data elements, registration, data collection processing, and classification and control of quality of system.

Results: The results show that in order to optimize the diabetes registry system, structure, data elements, information gathering process, main goals, registration criteria, Classification systems and quality control mechanism of the current national diabetes registry system should be reevaluated.

Conclusion: Considering the results and international diabetes institutes recommendation, the decrease in poor registry and increase in quality can be the advantages of model suggestion in comparison with the country's current system.

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 Background & Objectives: Delivery is a process with pain so one of the midwives duties is to decrease the severity of pain during delivery so decrease in labor period has been much of a concern. Atropine and Hyosine are two common drugs in decreasing time of labor and decreasing the need for labor stimulation with oxytosine. The aim of this study was to investigate the effects of hyoscine and atropine in the progress and time of labor.

 Methods:�This study was double blind clinical trial on 200 primiparous women who had labor pain and were admitted in labor in Alavi hospital in 2008. Who were randomly divided into two groups .the case group infused 20 mg Hyoscine with Atropine in the onset of active phase of labor (4cm dilation, Ruptured membrane) and in the control group 2cc, Dextrose water was infused 0.05. Then, progression in dilatation and effacement, time of active labor, time of 2^nd and 3^rd stage of labor, fetal heart rate monitoring, infant APGAR score of the 1^st and 5^th minute were registered. The data were analyzed by SPSS software using descriptive and analytical statistics as chi- square.

 Results: The findings indicated that there was a significant difference in dilatation & effacement between two groups (5/2cm/h, 1/5cm/h) (p<0.05). Duration of active phase of labor was 105 min in case group and 251 min in control group (p<0.05), duration of stage 2 was 17 min in case group and 33 min in the control group (p<0.05). Total time of labor and deliver (121 min in case group, 274 min in control group).incidence of Tachycardia and bradycardia in FHR in 30 min after infusion 25%(15% Tachycardia and 10% bradycardia in case group) 20% (12% Tachycardia and 8% bradycardia in control group) and no difference in two group was seen.

 Conclusion:�According to the finding s of this study Hyoscine and Atropine are effective in the progression of labor and delivery.

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  Background and objectives : Voice problem is the most common problem in singers and the prevention of this problem and clearance of voice is the cause of voice quality improvement in these people. So this study was carried out to" determine the traditional methods for prevention of voice problem in religions singers at Ardabil city".

  Methods: This survey was a descriptive (cross-sectional) study. In this study 43 religious signers were selected. Then singers completed a questionnaire that consisted of data about age, sex, duration of singing, history of Voice problem and the prevention methods that they used. Data were analyzed with SPSS software and descriptive statistics.

  Results: The findings showed all of samples were male. Most of them were 24-44 years old. All of them used their voice in Moharram and 15 persons (34.4%) in Ramadan and 8 cases (18.6%) sang in other months. Clearance of voice was often seen in summer (79%) and Voice problem often was seen in winter (67.4%). 36 singers (83.7%) experienced Voice problem that in most of them (32.6%) its duration is 2 days. Resting and well nutrition were the common methods for prevention of voice problem. Most of singers used corticosteroids and changed singing method to a treble voice.

  Conclusions: The rate of voice problem in religious singers was higher than that of the general population, and it was often seen in special months. Duration of voice problem was low in most of them. Change of singing method and corticosteroid therapy was the common way of its treatment.

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  Background & Objectives: With respect to the importance of diabetes mellitus prevalence and contradictory role of treatment with metformin on vitamin B12 and folic acid serum levels and this study was done in order to determine of Vitamin B12 and folic acid serum level in patients with diabetes mellitus under treatment with metformin. This research was performed in diabetes center of Kashan in 2004.

  Methods: Information about research method, target and conclusions were given to patients. Those who were under treatment with anti acids, and chemotherapy drugs and also those who were alcoholic and had gastrointestinal diseases and hepatic diseases were excluded among all samples of this research, then patients were divided in to 2 groups: The first group were under treatment with metformin, second group were with other drugs for diabetes treatment. All of people were under treatment for at least 6 months folic acid, vitamin B12 serum level of them were checked after 14 hours fasting and the findings were studied with SPSS software and X2 tests, T test fisher exact test.

  Results: there were 145 (84.31%) female and 27 male (15.69%) between 172 patients. Average age of patients was 52.1±12.7 years. Duration of disease was 5.42±9.1 and average Body Mass Index was 27.7±4.7 kg/m2. Folic acid average was 9.2±5.1 (ng/dl) in patients who consumed metformin and was 8.7±4.6 (ng/dl) in patients without consuming of metformin that did not show significant difference (p=0.557). B12 vitamin average was 5.43±342.54 (pg/dl) in patients under treatment with metformin and was 516±32.16 (pg/dl) in patients without consuming metformin in statistical findings between these 2 groups was not significant. (p=0.639). Significant correlation was observed between age of patients whom were studied and serum folic acid level of them. (p=0.07), But did not show significant correlation between age with serum B12 level (p=0.095). There was no significant correlation between age, length of disease, body mass index and level of B12 and folic acid.

  Conclusion: Correlation between reduction serum level of B12 and folic acid with consuming of metformin was not found. Difference between results of this study with other studies is likely because of more use of routine vitamin supplement that is consumed by patients without physician’s recommending, genetic differences or drugs composition.

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  Background & Objectives: Neonatal mortality rate is a main indicator of hygienic development and recognition of the mortality causes is the first step for reduction of the mortality rate and promotion of this indicator. Therefore, in this study, the causes of neonatal mortality have been investigated in Ardabil medical university related hospitals.

  Methods: This study is a retrospective, cross-sectional and descriptive-analytical one that has been done on the bases of admission's units and filling the medical record form for all neonates who have been admitted to Alavi and Imam Khomeini hospitals in Ardabil from September 2006 to September 2007. The questions of forms consisted of infant’s sex, birth weight, gestational age, cause and age of death. The data were analyzed by SPSS software with utilizing T- test and Chi-Squares.

  Results: During this study, there were 1881 admissions of which there were 148 deaths (7.86%). The causes of mortality were hyaline membrane disease (HMD) (52.02%), sepsis (14.86%), pneumonia (9.45%), congenital anomaly (12.83%), asphyxia (7.43%) and meconium aspiration (3.37%). Among the dead neonates, 54.72% were male and others were female. There were 550 LBW neonates and 111 deaths in this group result of our study showed that mortality rate in LBW neonates was 20.18%. There were 578 preterm neonates and 122 deaths in this group prevalence of mortality rate in preterm neonates was 21.10%.

  Conclusion: Prematurity and low birth weight are the most important and fixed cases of infant mortality. The most common causes of mortality were hyaline membrane disease and sepsis. Therefore, the prevention of preterm labor for reduction of prematurity and its related complication recommended which may lead to decreased rate of neonatal mortality.

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  Background & Objectives: Birth weight less than 2500gr (as result of preterm delivery and/or intrauterine growth restriction (IUGR)) is a major cause of both neonatal health. Predominate cause of LBW in developed countries is premature birth, whereas in developing countries is more often IUGR. Different risk factors, including demographic and behavioral during and before pregnancy are effective in LBW incidences which can reduce LBW and neonatal mortality rate by identification and control of these risk factors. The present study has been carried out with purpose of identification and decreasing the LBW rate in Ardabil.

 Methods: In this case – control study all infants delivered in 2006 in hospitals in Ardabil were investigated. Every neonate whose weight was less than 2500gr was taken as a case (n=470) and 482 neonates whose weight was more than 2500gr was taken as a control. Data gathering was done through questionnaires, interviewing the mothers and physical examination. The data were analyzed statistically through SPSS.

 Results: In the present study, the presence of LBW amount is %6.4 in Ardabil hospitals. The results of our study showed that a significant relationship existed between prematurely and gestational age<37wk, mother’s age, mother’s job and maternal weight, premature rupture of membranes (PROM), maternal diseases, multiple births, bleeding during pregnancy, interval between pregnancies less than <2 years, prior history of low birth weight, use of drugs by mother in pregnancy, congenital malformation with LBW. In this study relation between parity, the use of Folic Acid, Fe, cigarette smoking and addiction of mother, living area (village or city), family marriage, health care and mother’s education were not significant with LBW.

  Conclusion: The LBW important risk factors in Ardabil hospitals were prematurity or gestational age <37wk, multiple pregnancies, PROM, mother’s age over 35 years, and mother weight <50kg, maternal diseases.

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  Henoch-Schonlein Purpura (HSP), also known as anaphylactoid purpura is a common vasculitis of small vessels with cutaneous and systemic complications. Henoch-Schonlein Purpura is often associated with an infection, and a wide variety of noninfectious agents have been implicated in its pathogenesis. However, its association with entamoeba histolytica has once been reported. We report the case of a 7-year-old boy with HSP, diagnosed by HSP criteria and observation of numerous cysts and trophozoites of E. histolytica on stool smear. The patient was treated with steroid unsuccessfully but following anti amebic therapy signs and symptoms of disease were disappeared and the patient discharged from the hospital.

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  objective : The research literature extensively indicate that religion often operates as strong protective factor against psychological and psychosomatic disorders. The ways of influence of religious beliefs and rites on psychological and psychosomatic disorders has not explored enough. The�present study aims at studying suicide ideation in patients with depression performing religious rites at different levels.�

  Method: This cross-sectional study were done on 66 patients with depression who referring to Toluo psychiatric and psychological clinic and Shafa psychiatric hospital in Rasht were selected by convenience sampling. Unstructured interview was used for diagnosing depression by psychologist based on DSM-IV-TR criteria and Beck Depression Inventory. The degree of performing religious rites by subjects was determined using a researcher-designed, self- administrated rating scale, and subjects assigned in two group of patients with depression performing religious rites strongly (N=33) and patients with depression performing religious rites weakly (N=33). In addition to Beck Depression Inventory, Beck Hopelessness Scale and Scale of Suicide Ideation were applied for assessing hoplessness and suicide ideation, respectively.

  Results: Statistical analysis by T-test showed no significant (/867) between two groups regarding degree of depression (/847). BW the degree of hopelessness (/034) and suicide ideation (/0005) BW there were significant dirences between two groups from view pe of the heyer of hopelessness and (0.034) suicide ideation (0.0005).

  Conclusion: We conclude that phenomenology of depression in patients strongly performing religious rites differ in terms of degree of suicide ideation and hopelessness with patients weakly performing religious rites.

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 Background and objectives: Long term exposure to high levels of cement dust is one of the most important environmental risk factors in cement industries that adversely affect employee's respiratory system. Provided that achieving sustainable development mainly relies on healthy workers, this study aimed at assessing cement dust concentration and its free SiO₂ content in an Iranian Portland Cement Industry.

 Methods: In a cross - sectional study, airborne dust levels was investigated by collecting 64 personal and 35 environmental samples at both inhalable and respirable dust sizes. Dust concentrations were determined by deploying personal samplers in the breathing zone of workers. SiO₂ fractions were also measured in 4 samples collected from different part of the factory.

 Results: Arithmetic average concentrations of inhalable and respirable dust in personal sampling campaign were 58 and 13 mg m^-3, respectively. Respective values for inhalable and respirable dust in environmental sampling campaign were 154 and 27 mg m^-3. Dust concentrations in 90% of environmental samples and 80% of personal samples exceeded those occupational exposure limit values set for inert dusts i.e. Portland Cement. The average free SiO₂ fraction in analyzed samples was 2.86% varying from 2.33% in "packing and loading" area to 3.67 % in "raw mill" section.

  Conclusion: Free SiO₂ fraction as well as the concentrations of cement dust in this study is much higher than those of occupational exposure limit proposed by Iranian Technical Committee of Occupational Health.

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  Background & Objectives : The early-onset form of GBS (Group B Streptococci) disease typically occurs in the first 24 hours of life, with fulminant sepsis or pneumonia and has associated to high mortality (5-20 %) and morbidity. In prenatal infections GBS is transmitted vertically to the newborn during labor and delivery from the vagina of a typically asymptomatic colonized woman. Preventive strategies can be done with screening program and this study has been done for determination of carriage prevalence and antimicrobial resistance of GBS in pregnant women of Ardabil.

  Methods :�For determination of carriage�prevalence 420 pregnant women selected stratified proportionally from 11 clusters of obstetric clinics of Ardabil. Sampling was done in pregnant women at 35-37 weeks' gestation with a vaginal and rectal swab for culture. Swabs were inoculated into a selective broth medium (Todd-Hewitt broth with colistin, 10mg/L and nalidixic acid 15 mg/L = LIM broth), incubated overnight at 35-37°C, and subcultured onto sheep blood agar. Isolated bacteria identified by standard microbiological tests.

 Results: Out of 420 subjects 62 positive cultures were established (14.8%), 19 of them (4.5%) from anus, 19 of them (4.5%) from vagina and 24 of them (5.8%) from both.

 All of isolates were sensitive to Ampicillin and Vancomycin. There were 1 case of resistance 15 case of semi sensitivity and 46 cases of sensitive versus Erythromycin, these pattern also checked for Clindamycin, and results were respectively 11, 5, 46. All isolated GBS were sensitive to penicillin among them 3 (4.83%) isolates showed reduced susceptibility.

  Conclusion: Because of high prevalence rate we recommend screening of all pregnant women for Group B Streptococcus at 35-37 weeks' gestation with a vaginal and rectal swab. Based on antibiogram drug of choice for treatment is Ampicillin, and in cases of drug hypersensitivity Vancomycin may be choice.