---

 Background & Objectives: Goiter prevalence in school age children is an indicator of the severity of iodine deficiency disorders (IDD_S) in the society and a goiter prevalence ≥5 % in school age children indicates a public health problem. In area of mild to moderate IDD_S, measurement of thyroid volume by ultrasonography through observation is preferrable to population for grading goiter. Considering the importace of this issue, because of being mountainous and lack of this method's application for determining the incidence of goiter this study was desinged.

 Methods: In this descriptive – analytical study, thyroid volumes of 230 boys between 12 to 15 years old were measured by portable ultrasonograph in Tabriz. Also urinary iodine concentrations were determined by method A (Sandell-kolthoff reaction).

 Results: Mean of subjects’ thyroid volume was 8.12 ±2.21 ml and with latest references of Iran and WHO/NHD, goiter prevalence was taken based age 51.7 % and based surface body 81.1 %. Urinary iodine median of tested samples was 15.2µg/dl and iodine deficiency prevalence was 29.1 % . There was no significant correlation between urinary iodine and thyroid volume.

 Conclusion: Large thyroid volume of middle school boys in Tabriz is probably due to iodine intake deficiency in the first years of their life. Also, the role of goitrogenic factors and effect of climate condition on thyroid volume and goiter prevalence of middle school boys in Tabriz shouldn't be ignored. Further studies are recommended for determination of a local reference for thyroid volume Also it is necessary to be sure from consumption of iodine salt and its standardization.

---

  Background & Objective: Preeclampsia is an unknown disease. It was seen in 3.7% of live births and it is the cause of mothers' death in 18%. In addition to complications for mothers, fetal damage have also been seen. Also we sought to consider predictors of neonatal outcome in women with preeclampsia and normal women.

  Methods: It is a prospective and cross-sectional study that was performed on 127 preeclampsia pregnant women and 254 normal pregnancy. Statistical analysis was performed by software SPSS/Win and was used X² test for analysis of the results.

  Results: Prevalence of preterm labor was 54.4% in women with preeclampsia and 25% in normal pregnancy. There was no statistical difference such as parity (P=0.157), age (P=0.256) and type of delivery (P= 0.226). There was a significant difference between two groups in gestational age (P<0.0001), birth weight (P<0.0001), neonatal mortality (P=0.013), neonatal Apgar score (P=0.005) and NICU admission (P<0.0001).

  Conclusion: It is clear that the difference between two groups is mainly because of preterm labor in preeclampsia group. Attention to exact control of illness and avoidance of making rash decision for terminating pregnancy in mild preeclampsia can improve outcomes of Neonates.

---

Background & Objective: one of the most common causes of Epiphora or lacrimation or recurrent infection is Dacryocystitis. The Dacryocystorhinostomy operation, which involves fistulization of the lacrimal sac into the nasal cavity may alleviate the symptoms. Since the routine usage of silicon tube in DCR operation for reducing the replapse has been a controversial issue, This study was done to investigate the rate of success of DCR operation
with silicone tube.
Methods: This study was a cross-sectional descriptive study in which all of the patients (189) who had history of DCR at Sina and Alavi hospitals were asked to continue the treatment after the operation through contact or follow up from home. So the results of their records were analyzed statistically.
Results: 102 out of 189 patients had history of operation who had referred for follow up, in terms of most prevalent symptoms, epiphora and purulent discharge was the highest 55.6% and the second one was epiphora alone 29.1%. The operation prevalence was more in women 74.1%. than in men 25.9% and unilateral involvement 97.3% was more than bilateral one. The highest age prevalence in DCR operation was 30-60 years. The surgery was successful in 82.3%. It was a little more successful in men (85.7%) than in women and the mean age of patients with successful DCR surgery was more than that of patients with unsuccessful DCR surgery.
Conclusion: The results showed that the rate of recovery in unilateral involvement is more than that of bilateral involvement. Also, success after the operation in patients whose primary complain was only purulent discharge was significantly more than those whose primary complain was epiphora and purulent discharge, It also seems that routine application of silicon tuby in DCR surgery has no effect in the increase of recovery and decrease of disease
recurrency which of course more prospective studies are required to prove this.

---

  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.

---

  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.

---

 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.

---

  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.

---

  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.

---

  Backgroud & Objective : Inducing of safe airway and rapid , is very important in the anesthesia of emergency patients and it reduces many complications because of delay in the endotrachal intubation .In this group of patients, administration of succinylcholin is a choice. But, this drug has serious complication, that is sudden increase of serum potassium level , and could cause cardiac arrest .So ,it is suggested, use of non blocker dose of non depolarizant neuromuscular blocker (defasciculation), for reducing this response . So , the aim of this study , was to determine the effect of pretreatment atracurium on serum potassium level associated with administration of succinylcholine .

  Methods: This study was performed clinical trial on 82 elective patients aged between 15 -70 years whit ASAI-II (American society of anesthesiology of physical status class)who where scheduled undergo operate general surgery. Premedication drugs are used to all patients , according to weight. and first blood sample was taken, considered as control group. then pretreatment atracurium injection (50mcg/kg) and after three minutes, was performed induction with thiopental sodium (5mg/kg) and succinylcholine (1.5 mg/kg ), and after 5 minutes , second blood sample was taken, test group . blood samples, were poured in the espicial tube of serum potassium and immediately , serums were separated . Then , potasiom level of serums were measured with micro light . The datas analyzed with statistical program ( spss) and then , were compared .

  Results: According to the obtained results , the mean of serum potassium level after administration of succinylcholine associated with defasciculation atracurium and before the administration of pretreatment atracurium (base level) was not different . It was not seen , a statistically significant difference between two groups, with attention to paired- t-test(p=0.936) and wilcoxon signed ranks test (p=0.594).

  Conclusion: Regarding the results of this study , administration of pretreatment atracurium is not effective in prevention of hyperkalemia induced by succinylcholin with attention base level.

---

  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.

---

  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.

---

  Background and Objective: Intradermal Purified Protein Derivative PPD test is a reliable test assessment of primary mycobacterial infection. In this test the specific antigen is Purified Protein Derivative (PPD). The reaction were assessed by touching, the induration's diameter after 48 &48hours. We compared the induration's size 48 and 72 hour in this study.

  Methods: At this semi experimental study a 5 unit PPD was administered to 120 healthy medical students.

  Results: The measurements made at 72 h were significantly (4.22 mm) (p<0.001) higher than those made at 48h (2.79 mm). The reading taken at 72 h were 1.47mm larger than at 48 h recovery. There were significant differences between induration size of 48 and 72h between male and female.

  Conclusion: This study demonstrates that, in adults, the size of the 5 U Monteux reaction is significantly larger at 72h compared to the reaction at 48h. We suggest to read PPD after 72 hours if the PPD is negative after 48 hours.

---

  Background & Objectives: Despite of high family planning coverage in Ardabil province comparing to other provinces of country, the population growth rate is higher than other provinces in Ardabil that presents incorrect, discontinuous, and interrupted use of intrauterine devices (IUD). This research was carried out to investigate the continuation, and factors affecting to interrupted use of IUD in women referring to health centers of Ardabil city in 2004.

  Methods: The Subjects of this descriptive-analytic and historical cohort study were 301 women. Data were collected by a questionnaire and were analyzed by Kaplan-Meier Survival and Log-Rank tests through SPSS software.

  Results: Duration of continuous use of IUD was more than 18 months among 77.1 % of subjects. Average duration was higher in 20-25 years women (24.5 ± 1 months). The lowest duration of continuous use of IUD was observed among women with age higher then 25 years old (14.3 ± 3.4 months). There was a significant relationship between discontinuous use of IUD and volume of menstrual bleeding (p=0.005). The mean of continuation in the women with a lot of bleeding was 20.5 ± 1 while for the women with low bleeding was 22.4 ± 1.5. Type of referring to IUD control had meaningful correlation (p=0.03) with average duration of using this device. Mean time of continuation in women that referred occasionally was 23.8 ± 0.6. There was significant relation between complication and IUD interruption. The highest interruption time belonged to the women that declared the infection, wound and PID (mean 25.5 months) and the lowest interruption time was observed in the women with bleeding and spotting (mean 18 months).

  Conclusion: Continuation of using IUD in 87.4 % of women was less than 6 months, in 81.4% was from 6 to 12 months, and in 72.1 % was from 12 to18 months. The most common reason of discontinuation was medical factors and IUD caused complication. The most common complication was bleeding.

---

 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.

---

  Background & Objectives : One of the first steps in diagnosis of pleural effusion is distinction between exudative and transudative types. The aim of this study was to assess C – reactive protein (CRP) level as one of the diagnostic marker for differentiation of exudative from transudative pleural effusions.

  Methods : In this descriptive and sectional study, 80 patients with confirmed pleural effusion were assessed. These patients were divided into two groups based on Light´s criteria. Serum and pleural CRP were measured with Latex Agglutination Test.

  Results : Out of 80 patients with pleural effusion 26 were transudative (32.5%) and 54 were exudative (67.5%). In exudative group, 72.2% of cases were CRP positive (1+ to 3+), and in transudative group, only 38.5% of cases were CRP positive (p < 0.05). There was no significant differences between different exudative pleural effusion etiologies (infectious and non infectious, malignant and non malignant and tuberculosis) and the number of CRP positive cases (p > 0.05). The rate of CRP positivity in exudative pleural effusion group was more than transudative group (p < 0.05).

  Conclusion: According to our study it seems that CRP criterion could help in distinction between exudative and transudative types of pleural effusion.

---

  Background & Objectives : Preeclapsmia representing as one of the most important complications of pregnancy, affects up to 8% of all pregnancies nevertheless little has been known about its etiology. It is, however, generally accepted that the pathophysiology of preeclampsia is related to systemic maternal endothelial dysfunction. Homocysteine, a cytotoxic compound, adversely affects the endothelial system. Main objective of this study was to assess plasma levels of homocysteine in women with normal pregnancies and those who suffering from preeclapsmia .

 Methods: A case –control study was designed for 165 preeclamptic patients and 165 normal cases. Controls were matched for gestational age and age of mothers. Blood samples were obtained from patients attending Alavi hospital in Ardabil (after 6-8 hour NPO). Two milliliters blood was collected in tubes containing ice bag stored ethylenediaminetetraacetic acid (EDTA) and homocysteine level was analyzed.

 Results: Mean levels of homocysteine were elevated in the preeclamptic cases compared to control group (7.4±3.3 vs. 4.09±2.3 _mmol/l, P < 0.001) the levels of BMI and Arms sizes have been shown to be different statistically in two groups and other variables revealed no significant differences between the groups.

 Conclusion:�It is concluded that in our study homocysteine Levels, BMI and Arms sizes are signiffantly effected patients with preeclampsia compared with control group and can increase the risk of developing severe side effect to mothers and neonates.

---

  Background & Objectives : Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is common through the world including Iran. Because of its chronic nature and lack of effective treatment, patients are always anxious and stressful and physicians are also exhausted of untreated patients. The cause of IBS is unclear and it has not effective treatment. Therefore, there is a need to find and introduce a proper method of treatment to control symptoms including abdominal pain and defecation changes. This study was aimed to determine the effectiveness of probiotic yogurt on the general relief of symptoms associated with IBS.

  Methods : Subjects were recruited from patients of gastroenterology clinic in Imam Khomeini Hospital, Ardabil. A total of sixty patients fulfilling the Rome II criteria took part in this study. Subjects were randomized into two groups of trial and control. Pre- and post- treatment symptoms were investigated using a questionnaire. Thirty one patients received probiotic and 29 patients normal yogurt for 4 weeks. Bottles of yoghurt were manufactured, and coded by a company. Both participants and researcher were blinded for the bottles' code. The symptoms were followed before and after two and four weeks of treatment and two weeks post- discontinuing of trial, too. Data were analyzed by SPSS (Ver. 17) and differences between groups were compared statistically using of chi-square and t-test.

  Results: A total number of 60 patients were recruited in this study of whom 36 (60%) were female and 24(40%) male. The average age of participants was 34.1±9 which did not differ between two groups. The onset of symptoms did not show any difference between two groups. The trial group had a history of 5.7±5.1 years while this was 6.5±4.9 for the controls. In overall, patients who were given probiotic yogurt had shown a better response in the control of abdominal pain and flatulence than those who were treated with normal yogurt. There was not a significant difference between two groups in the response to treat for other symptoms including epigastric pain, vomiting, frequency of defecation and feces consistency.

  Conclusion: According to our research, adding probiotic yogurt to the patient diet may help ease symptoms of IBS especially, abdominal pain and flatulence. Considering the high prevalence of irritable bowel syndrome and the lack of effective therapies, even a slight reduction in symptoms can have positive public health consequences.

---

 Background & objectives:�Amblyopia as one of the most important social and visual problems is common in the world including Iran. It plays a major role in visual dimness. The aim of this study was to determine prevalence and causes of amblyopia in middle school students in Ardabil city, Iran in 2004.

 Methods: In this descriptive cross-sectional study 4548 middle school students were included. The subjects primarily were screened by optometrists and an ophthalmologist by using of Snelen chart. The doubtful cases were referred to eye clinic for further checking and re-examined by ophthalmologist. The data were collected by questionnaire and the results were analyzed by descriptive and analytical statistics using SPSS software.

  Results: The results cleared that 11.4% of subjects (520) had refractive errors, 2.63% (120) showed the amblyopia and 0.9% (43) experienced strabismus. The most common cause of amblyopia was anisometropia (59% of all cases) and for strabismus was isotropia (69.5% of all cases). These findings showed that there is a significant correlation between type and rate of refractive defects with amblyopia. The highest rate for refractive amblyopia was over 3 Diopter hyperopia (29.5% of refractive amblyopia). Hyperopia revealed to occur in males more than females and vice versa for astigmatism

  Conclusion : It seems that the prevalence of amplyopia in Ardabil is similar to other cities in Iran and other countries. But the refractive amblyopia in Ardabil shows more prevalent than other areas. Its reason may be due to less knowledge to use glass and low socio-economic conditions as well as low quality of treatment.

---

  Background & Objectives: Nowadays, appearance of ESBL producing bacteria is medical problem in the treatment of infections. Uropathogenic Escherichia coli like many other bacteria can produce these types of enzymes. T he assessment of the ESBL production by clinical isolates is not done routinely in laboratories. The aim of this study was to determine the prevalence of ESBL producing E.coli and its antibiotic resistance pattern in Kermanshah.

  Methods: This cross - sectional study was done on 200 Uropathogenic E. coli strains isolated from people in Kermanshah. Sensitivity of isolates to different antibiotics was determined by disk diffusion test and ESBL production was assessed by DDST method.

  Results: The E. coli strains showed high susceptibility to imipenem (100%), amikacin (97%), nitrofurantoin (95.5%), gentamicin (85%), cefepime (75%), ceftazidime (74%), ofloxacin (73.5%), ciprofloxacin, ceftriaxone and aztreonam (71%) and cefotaxime (70%) respectively. The highest resistance was seen to ampicillin (77%), carbenicillin (76%), pipracillin (74%) and SXT (62.5% ). Resistance rate to third generation cephalosporins was 63-75%. Fifty seven isolates (27%) were ESBL producers and 47 isolates (87%) produced all four types of ESBL enzymes.

  Conclusion: There are some similarities and differences in the antibiotic resistance pattern and ESBL production among the isolates in different areas of Iran and other countries. Identification of ESBL producing bacteria and determining its antimicrobial resistance pattern are recommended to effective treatment of infections.